better    worse    same    no comparison


SubjectID: 10000980, StudyID: 58636672, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with CKD with increased dyspnea and cough x 2 weeks. // R/o pulmonary edema or infiltrate R/o pulmonary edema or infiltrate

IMPRESSION: As compared to ___, the lung volumes have slightly decreased. Signs of mild overinflation and moderate pleural effusions persist. Moderate cardiomegaly. Elongation of the descending aorta. No pneumonia.


SubjectID: 10000980, StudyID: 58206436, Comparison: worse

WET READ: ___ ___ ___ 6:47 AM 1. New mild pulmonary edema with persistent small bilateral pleural effusions   Keywords: new. 2. Severe cardiomegaly is likely accentuated due to low lung volumes and patient positioning. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: Chest radiograph.

INDICATION: ___F with wheezing and dyspnea. Assess for pulmonary edema.

TECHNIQUE: Single portable upright frontal chest radiograph.

COMPARISON: ___ chest radiograph. ___ chest radiograph.

FINDINGS: In comparison to study performed on of ___ there is new mild pulmonary edema with small bilateral pleural effusions   Keywords: new. Lung volumes have decreased with crowding of vasculature. No pneumothorax. Severe cardiomegaly is likely accentuated due to low lung volumes and patient positioning.

IMPRESSION: 1. New mild pulmonary edema with persistent small bilateral pleural effusions. 2. Severe cardiomegaly is likely accentuated due to low lung volumes and patient positioning.


SubjectID: 10011938, StudyID: 55823081, Comparison: worse

WET READ: ___ ___ 3:25 PM Findings consistent with interstitial pulmonary edema. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___F with SOB and hypoxia. Evaluate for congestive heart failure.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph from ___. CT chest from ___.

FINDINGS: There is mild cardiomegaly with increased pulmonary interstitial markings and pulmonary vascular congestion, consistent with interstitial pulmonary edema   Keywords: increase. There are bilateral mid and lower lung areas of streaky atelectasis. There is no focal consolidation, pneumothorax, or pleural effusions.

IMPRESSION: Findings consistent with interstitial pulmonary edema.


SubjectID: 10011938, StudyID: 54202121, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with eosinophilia and CHF // r/o worsening edema or other acute process

COMPARISON: Radiographs from ___

IMPRESSION: Heart size is enlarged but stable. There is unchanged prominence of the pulmonary interstitial markings consistent with mild pulmonary edema   Keywords: unchanged. No focal consolidation or pneumothoraces are seen.


SubjectID: 10011938, StudyID: 51900145, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman hx of CHF, COPD worsening oxygen requirement // Evidence of pneumonia, CHF

COMPARISON: Radiographs from ___

IMPRESSION: Heart size is enlarged but unchanged. There is again seen mild prominence of the pulmonary interstitial markings suggestive of pulmonary edema, stable   Keywords: stable, again. Subsegmental atelectasis at the lung bases is also seen. There is no definite consolidation. No pneumothoraces are seen.


SubjectID: 10013569, StudyID: 56197670, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Acute heart failure, evaluation for Swan-___ catheter placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the Swan___ catheter, introduced over the right internal jugular vein, is unchanged in position. The tip is located too much distally and should be pulled back by approximately 4 cm. The course of the catheter is unremarkable. Unchanged appearance of the heart and the lung parenchyma, without substantial interval changes. No pneumothorax.


SubjectID: 10013569, StudyID: 52553082, Comparison: better

FINAL REPORT

PORTABLE CHEST FROM ___ AT 8:22 CLINICAL

INDICATION: ___ year old with CHF, assess for interval change.

COMPARISON: ___ at 8:53. A portable upright chest film ___ at 8:22 is submitted.

IMPRESSION: 1. A left-sided pacemaker remains in place. A right subclavian PICC line is unchanged. The right internal jugular Swan-Ganz catheter continues to be in the right pulmonary artery with the tip somewhat distal and a pullback of 3-4 cm has been previously conveyed to the house staff on ___ by Dr. ___ ___, but the position remains unchanged. The heart remains stably enlarged. There has been some interval improvement in but there is persistent mild pulmonary edema   Keywords: improve. No pneumothorax is seen. No focal airspace consolidation is seen to suggest pneumonia. There is likely a layering right effusion with patchy streaky right basilar opacities likely reflectiing compressive atelectasis.


SubjectID: 10018081, StudyID: 59614225, Comparison: None

FINAL REPORT

PORTABLE CHEST FILM ___ AT 6:04 A.M. CLINICAL

INDICATION: ___-year-old with bowel ischemia, status post exploratory laparotomy, evaluate for pneumonia. Comparison is made to the patient's prior study dated ___ at 10 p.m. A portable AP upright chest film ___ at 604 is submitted.

IMPRESSION: 1. Nasogastric tube is again seen coursing below the diaphragm with the tip not identified. The heart remains stably enlarged. There is a stable retrocardiac consolidation likely with an associated effusion. In addition, there is more focal patchy opacity developing at the right lung base. Although these findings may represent atelectasis, aspiration and/or bibasilar pneumonia should also be considered. No pneumothorax. No evidence of pulmonary edema.


SubjectID: 10018081, StudyID: 56762822, Comparison: None

WET READ: ___ ___ ___ 10:25 PM As compared to prior chest radiograph from ___, there is increased left retrocardiac opacity which could reflect a combination of pleural effusion, atelectasis and or volume loss. In the appropriate clinical setting, however an early infectious process cannot be excluded. ______________________________________________________________________________

FINAL REPORT

PORTABLE CHEST FILM ___ AT 10 P.M. CLINICAL

INDICATION: ___-year-old with respiratory distress, evaluate left chest for decreased breath sounds. Comparison to prior study dated ___ at 927. A portable AP upright chest film ___ at 10 p.m. is submitted.

IMPRESSION: 1. A nasogastric tube is seen coursing below the diaphragm with the tip not identified. There is increasing retrocardiac consolidation with a probable associated effusion. Although this may represent partial lower lobe atelectasis, aspiration and pneumonia should also be considered. Right lung is grossly clear. Heart remains stably enlarged. No pneumothorax is appreciated. No evidence of pulmonary edema.


SubjectID: 10018081, StudyID: 55281127, Comparison: worse

FINAL REPORT

HISTORY: ___-year-old male with altered mental status and rising white count. Evaluate for pneumonia.

COMPARISON: Chest radiograph status through ___.

FINDINGS: Portable AP chest radiograph demonstrates new bibasilar interstial edema with mildly increased vascular congestion   Keywords: new, increase. No focal consolidation identified. There is opacification of the left hemidiaphragm concerning for atelectasis versus pleural effusion. There is no pneumothorax. The cardiomediastinal contour is unchanged in appearance. An enteric tube is seen descending and an uncomplicated course, its terminal end out of view. Chronic deformed right clavicle redemonstrated.

IMPRESSION: Mild interstial edema and vascular congestion.


SubjectID: 10018081, StudyID: 50772344, Comparison: None

FINAL REPORT

PORTABLE CHEST FILM ___ AT 601 CLINICAL

INDICATION: ___-year-old with leukocytosis, left effusion, question pneumonia. Comparison to prior study of ___ at 604. A portable AP upright chest film ___ at 601 is submitted.

IMPRESSION: 1. Nasogastric tube is again seen coursing below the diaphragm with the tip not identified. The heart is stably enlarged. Persistent retrocardiac consolidation and more patchy opacity at the right base remain and are concerning for atelectasis, aspiration or bibasilar pneumonia. Clinical correlation is advised. There is a layering left effusion. No pulmonary edema. No pneumothorax.


SubjectID: 10018081, StudyID: 58536937, Comparison: None

FINAL REPORT

PORTABLE CHEST FILM, ___ AT 5:06 A.M. CLINICAL

INDICATION: ___-year-old with respiratory failure, assess for interval change. Comparison to prior study of ___ at ___. Portable AP semi-erect chest film, ___ at 5:06AM is submitted.

IMPRESSION: 1. Nasogastric tube is again seen coursing below the diaphragm with the tip not identified. Overall cardiac and mediastinal contours are stable. Interval reduction in lung volumes with appearance of patchy opacity at both bases, right greater than left, most likely representing patchy atelectasis in the setting of low lung volumes. No large effusions. No pneumothorax. No evidence of pulmonary edema.


SubjectID: 10018081, StudyID: 57539618, Comparison: worse

FINAL REPORT

HISTORY: ___-year-old male with ventilatory to dependent respiratory insufficiency. Evaluate for interval change.

COMPARISON: Chest radiograph stated through ___.

FINDINGS: Portable chest radiograph demonstrates an endotracheal tube which terminates 4.5 cm above the level of the carina in appropriateposition. A right internal jugular line terminates in the low SVC. An enteric tube descends in in uncomplicated course, its terminal end outside the field of view. Heart size is mildly enlarged, unchanged. New mild interstitial edema in the right lower lobe   Keywords: new. The left lung appears grossly clear and better aerated. No pneumothorax.

IMPRESSION: New mild right lower lobe interstitial edema   Keywords: new.


SubjectID: 10018081, StudyID: 55735807, Comparison: worse

FINAL REPORT

HISTORY: ___-year-old male with bowel ischemia and volume overload. Evaluate interval change.

COMPARISON: Multiple chest radiographs dated through ___.

FINDINGS: Portable frontal chest radiograph demonstrates an endotracheal tube which terminates 4 cm above the level of the carina in appropriate position. An enteric tube descends in an uncomplicated course to the distal esophagus, its end out of view. A right jugular line ends at the low superior vena cava. Allowing for changes in patient positioning, the lungs appear largely unchanged with mildly increased interstitial edema   Keywords: increase. There is no new focal consolidation. There are likely small bilateral pleural effusions, unchanged. There is no pneumothorax.

IMPRESSION: Mildly increased interstitial pulmonary edema   Keywords: increase.


SubjectID: 10018081, StudyID: 58479559, Comparison: None

WET READ: ___ ___ ___ 6:15 PM dobhoff coils in stomach. left basilar opacification is similar or slightly worse than at 4pm but better than at 9am today.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

PATIENT

HISTORY: ___ years old man with pneumatosis, portal/mesenteric venous catheter, status post exploratory laparotomy with extended right colectomy for ischemic colon and prior anastomosis, now status post abdominal closure, ileostomy with Dobbhoff placement.

COMPARISON: Exam is compared to chest x-ray of the same day at 4:00 p.m.

FINDINGS: AP single view portable chest x-ray shows Dobbhoff tube with tip ending in mid gastric cavity. Left lung base opacity has worsened since prior chest x-ray due to increased pleural effusion and left lower lobe collapse. In the appropriate clinical setting pneumonia should be considered. Right lung is clear without consolidation, nodules or pleural effusion. There is no pneumothorax. Heart size is partially obscured by left pleural effusion but appears within normal limits.

IMPRESSION: Correct positioning of Dobbhoff tube ending in mid gastric cavity. Interval increase of left lung base collapse and pleural effusion, is concerning for pneumonia.


SubjectID: 10018081, StudyID: 57747740, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old male with probable pneumonia. Assess for interval change.

COMPARISON: Chest radiograph from ___ and chest CT from ___ PORTABLE FRONTAL CHEST RADIOGRAPH: There is slight improved aeration of the left lung base as compared to most recent prior radiograph, likely due to decreased atelectasis. However, a moderate consolidation and associated moderate effusion persist and are consistent with the clinical history of pneumonia. There is increased pulmonary vascular congestion, mild, though no overt interstitial edema. There is no pneumothorax. An enteric catheter terminates within the stomach.

IMPRESSION: 1. Unchanged left lower lobe pneumonia, with slightly improved aeration likely due to decreased adjacent atelectasis. 2. Increased mild pulmonary vascular congestion   Keywords: increase.


SubjectID: 10018081, StudyID: 57486705, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is increasing atelectasis at the right lung base. The pleural effusion on the left and the subsequent atelectasis are constant in appearance. Constant size of the cardiac silhouette. Unchanged course of the nasogastric tube.


SubjectID: 10018081, StudyID: 57481090, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: New tachypnea, increasing oxygen requirement, rule out PE.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, no relevant change is noted   Keywords: no relevant change. The lung volumes are low. Atelectasis of the left lower lobe with potential accompanying small left pleural effusion. Unchanged moderate cardiomegaly. No change in appearance of the normal right lung   Keywords: no change. Nasogastric tube is in unchanged position.


SubjectID: 10018081, StudyID: 51961926, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH.

INDICATION: Evaluation of pleural effusions and pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is resolution of the pre-existing right basal atelectasis. Mild pleural effusion on the left, combined to substantial left lower lobe atelectasis. No pneumonia, no overt pulmonary edema. No pneumothorax.


SubjectID: 10018081, StudyID: 58175153, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Sepsis, ischemic bowel disease, intubation, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the monitoring and support devices are unchanged. Moderate-to-severe cardiomegaly remains unchanged, but a pre-existing left pleural effusion has slightly decreased in extent. Also decreased is a pre-existing left perihilar opacity. Overall, the lungs appear better ventilated. Plate-like atelectasis at the right lung bases, associated with a small right pleural effusion. No new parenchymal opacities   Keywords: new. No pneumothorax.


SubjectID: 10018081, StudyID: 55554731, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Arrhythmia. Question central line positioning.

COMPARISONS: Earlier in the same day.

TECHNIQUE: Chest, portable AP upright.

FINDINGS: The patient remains intubated. The endotracheal tube terminates about 5-6 cm above the carina. An orogastric tube courses into the stomach, its distal course not fully imaged. A right internal jugular catheter terminates at the cavoatrial junction. There is a new focal opacity in the left upper lobe with a geometric appearance, probably compatible with atelectasis; a newly forming area of pneumonia is not excluded, however. Dense extensive retrocardiac opacification with air bronchograms and a probable associated pleural effusion persists without clear change. A pleural effusion is not apparent on the right on this study, which may be due to a true decrease or consequence of differences in positioning.

IMPRESSION: New left upper lobe opacity, probably due to atelectasis, but a new focus of infection is not excluded; short-term follow-up radiographs may be helpful to help distinguish if clinical concerns may include the possibility of developing infection. Persistent extensive retrocardiac opacification, most commonly due to atelectasis, with a pleural effusion.


SubjectID: 10018081, StudyID: 53262913, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Ischemic bowel disease, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the monitoring and support devices are unchanged. Unchanged size of the cardiac silhouette. Unchanged bilateral pleural effusions. Unchanged mild-to-moderate fluid overload   Keywords: unchanged.


SubjectID: 10018081, StudyID: 51219318, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post abdominal surgery, evaluation for interval change.

COMPARISON: ___, 5:56 p.m.

FINDINGS: As compared to the previous radiograph, the monitoring and support devices are in correct position, except for the endotracheal tube that has been pulled back. The tube now projects approximately 5 cm above the carina with its tip. The patient is rotated. A pre-existing right parenchymal basal opacity therefore appears slightly more extensive than on the previous image. Blunting of the right costophrenic sinus might be artificial. Moderate cardiomegaly persists. Unchanged left lower lobe atelectasis.


SubjectID: 10018081, StudyID: 50515796, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Endotracheal tube placement, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. On the current image, the tip of the endotracheal tube projects approximately 6 cm above the carina. Unchanged size of the cardiac silhouette. Retrocardiac atelectasis. Minimal right basal atelectasis but no convincing evidence of pneumonia. Mild fluid overload, no overt pulmonary edema.


SubjectID: 10018081, StudyID: 55879987, Comparison: same

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Study of earlier the same date.

FINDINGS: Dobbhoff tube has been replaced, and is malpositioned with coiling in the mid thoracic esophagus and distal tip directed cephalad at the cervicothoracic junction. At the time of this dictation, subsequently obtained chest x-rays document re-positioning. Cardiomediastinal contours are stable, and there is worsening left retrocardiac opacity adjacent to an unchanged left pleural effusion. Patchy atelectasis at the right lung base is new. Otherwise, no relevant short interval change   Keywords: no relevant short interval change.


SubjectID: 10018081, StudyID: 55605617, Comparison: None

FINAL REPORT

PORTABLE SEMI-UPRIGHT CHEST, ___

COMPARISON: ___.

FINDINGS: Persistent left retrocardiac opacity, with increasing volume loss manifested by inferior displacement of the left hilum and apparent displacement of left major fissure, consistent with left lower lobe atelectasis. Coexisting pneumonia is possible in the appropriate clinical setting. Right lung and pleural surfaces are clear.


SubjectID: 10018081, StudyID: 53437264, Comparison: same

FINAL REPORT

PORTABLE CHEST OF ___

COMPARISON: Radiograph of earlier the same date.

FINDINGS: Worsening left retrocardiac opacity, most likely due to atelectasis, although coexisting infectious consolidation is possible in the appropriate clinical setting. Otherwise, similar appearance of the chest compared to the previous radiograph performed several hours earlier   Keywords: similar appearance.


SubjectID: 10018081, StudyID: 52015079, Comparison: same

FINAL REPORT

PORTABLE CHEST ___, ___

COMPARISON: Study of one day earlier.

FINDINGS: Interval repositioning of Dobbhoff tube, now terminating in the stomach. Improving left retrocardiac atelectasis, and near resolution of patchy right basilar atelectasis. Otherwise, no relevant change since the recent study performed about two hours earlier   Keywords: no relevant change.


SubjectID: 10018081, StudyID: 56942504, Comparison: worse

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: History: ___M with oxygen requirement, crackles at bases // ?pulmonary edema, pna

TECHNIQUE: Chest Frontal and Lateral

COMPARISON: ___

FINDINGS: Left-sided PICC is again seen, terminating in the mid SVC. The cardiac silhouette remains moderate to severely enlarged. Bibasilar opacities have increased in there is now a blunting of the costophrenic angles   Keywords: increase. Findings are consistent with small to moderate bilateral pleural effusions with overlying atelectasis, underlying consolidation due to pneumonia is not excluded. There is moderate pulmonary edema. No pneumothorax.

IMPRESSION: Bilateral pleural effusions, pulmonary edema, and marked enlargement of the cardiac silhouette suggest CHF, however underlying consolidation due to pneumonia at the lung bases not excluded in the appropriate clinical setting.


SubjectID: 10018081, StudyID: 55297211, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M CHF, admitted for respiratory distress // compare to prior

COMPARISON: ___.

IMPRESSION: Pulmonary edema has nearly resolved, with associated resolving right pleural effusion   Keywords: resolve. Stable cardiomegaly, and small left pleural effusion with adjacent basilar atelectasis.


SubjectID: 10018081, StudyID: 55937781, Comparison: None

FINAL REPORT

EXAMINATION: Portable Chest Radiograph

INDICATION: ___M s/p end ileostomy takedown now with ulceration of esophagus and duodenum // assess for free air, interval changes

TECHNIQUE: Portable CXR

COMPARISON: Portable CXR ___

FINDINGS: Since the prior CXR, there has been interval placement of a enteric tube that extends to at least the stomach, but the distal tip is beyond the inferior margin of the image. There is a moderate-sized left pleural effusion that appears slightly worse than ___. A small right-sided pleural effusion is also noted. There is pulmonary vascular congestion with mild pulmonary edema. No evidence of pneumothorax. The previously seen pneumoperitoneum has now resolved. Heart appears mildly enlarged, unchanged from prior. No acute osseous abnormalities.

IMPRESSION: 1. Interval resolution of small pneumoperitoneum. 2. Worsening left-sided pleural effusion.


SubjectID: 10018081, StudyID: 52241060, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man s/p ileostomy take down. Crackles on exam, concern for consolidation // pulmonary edema vs. pneumonia

COMPARISON: Chest radiograph from ___.

FINDINGS: AP portable upright view of the chest. Trace pneumoperitoneum is within post surgical limits. The heart is mildly enlarged. The hilar and mediastinal contours are within normal limits. A retrocardiac left basilar opacity likely reflects atelectasis. There is no pneumothorax. Tiny bilateral pleural effusions are present.

IMPRESSION: 1. Left retrocardiac opacity, likely representing atelectasis. Small consolidations in this area cannot be excluded. 2. Trace pneumoperitoneum, within post surgical limits. 3. Trace bilateral pleural effusions.


SubjectID: 10018081, StudyID: 55764579, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with fever to 102.4, POD___ s/p ileostomy takedown, returned with ?ECF // ?acute process

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Left PICC line tip is at the level of mid SVC. Cardiomegaly and mediastinum are unchanged. Right basal opacity has slightly progressed. Left retrocardiac atelectasis is unchanged. Upper zone re- distribution of the vasculature is unchanged


SubjectID: 10018081, StudyID: 53134267, Comparison: None

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: History of ischemic colitis status post right hemicolectomy and ileocolic anastomosis, presenting with feculent material at surgical wound site. Question PICC line placement.

COMPARISONS: ___.

TECHNIQUE: Chest, portable AP semi-upright, single view.

FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged. There is again borderline cardiomegaly. Allowing for rotation as well as scoliosis, the cardiac, mediastinal and hilar contours are probably unchanged. There is similar mild relative elevation of the left hemidiaphragm. There is no definite pleural effusion or pneumothorax. The lungs appear clear. A PICC line terminates in the lower superior vena cava.

IMPRESSION: PICC line terminating in the lower superior vena cava. No evidence of acute disease.


SubjectID: 10023117, StudyID: 59984631, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cardiopulmonary failure // Interval change in intubated patient Interval change in intubated patient

IMPRESSION: Comparison to ___. The patient has been extubated and the nasogastric tube was removed. Moderate cardiomegaly persists. The pacemaker is in stable position. Also stable is the left-sided Swan-Ganz catheter. No pulmonary edema, minimal atelectasis at the right lung basis is stable.


SubjectID: 10023117, StudyID: 55383014, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with non-ischemic cardiomyopathy and EF ___% in cardiogenic shock, intubated // volume status.

TECHNIQUE: Single frontal view of the chest.

COMPARISON: Chest radiograph dated ___.

FINDINGS: Compared chest radiograph from ___, there is little overall change   Keywords: little overall change. Swans-Ganz catheter, ETT and esophageal drainage tubes are unchanged in standard placements. Left cardiac pacing/defibrillator device with transvenous right atrial, right ventricular and coronary sinus/left ventricular leads in unchanged position. Right basilar atelectasis has worsened. Left retrocardiac opacification minimally changed and probably reflects a combination of pleural effusion and atelectasis. There is no pneumothorax. There is no vascular engorgement or pulmonary edema.

IMPRESSION: 1. No evidence of vascular engorgement or cardiac decompensation. 2. Worsening right basal atelectasis. Unchanged left basal atelectasis.


SubjectID: 10023117, StudyID: 54147385, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with sCHF and swan in place // swan placement, ?fluid overload, pneumo, potential consolidation concerning for pneumonia swan placement, ?fluid overload, pneumo, potential consolidation concerning for pneumonia

IMPRESSION: In comparison with the study of ___, the monitoring and support devices are unchanged. Swan-Ganz catheter again extends well into the left pulmonary artery system. Continued enlargement of the cardiac silhouette without appreciable vascular congestion, a discordance that raise the possibility of cardiomyopathy. No acute focal pneumonia.


SubjectID: 10023117, StudyID: 59383121, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post chest tube removal. Evaluation for interval change.

FINDINGS: As compared to the previous image, there is minimally improved ventilation at both the left and right lung base. Plate-like atelectasis at the level of the left hilus. Normal size of the cardiac silhouette. No evidence of pneumothorax.


SubjectID: 10023117, StudyID: 56007252, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Decompensated chronic heart failure, persistent oxygen requirements.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the gastric distention has decreased. There is unchanged evidence of low lung volumes with areas of atelectasis at the lung bases. The ECG cables, pacemaker wires and right PICC line are constant. Unchanged moderate cardiomegaly. No new parenchymal opacities in the ventilated lung zones   Keywords: new. No pneumothorax.


SubjectID: 10023117, StudyID: 54404075, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Decompensated heart failure, leukocytosis. Evaluation for pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Moderate cardiomegaly with moderate pulmonary edema. The areas of increased density at the right lung base are minimally progressive. No new parenchymal opacities   Keywords: new. No pneumothorax.


SubjectID: 10023117, StudyID: 50447167, Comparison: None

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with recent surgery and hypoxia, rule out pneumothorax.

COMPARISON: ___.

FINDINGS: There is no pneumothorax. Left-sided pacemaker has three leads, one in right atrium, one in right ventricle and the last one in the coronary sinus. Left jugular line is at the junction of brachiocephalic vein and superior vena cava. Right-sided PICC line is still looped in the distal subclavian vein and ends in the upper SVC. Bibasilar consolidation which is probably atelectasis is unchanged. Moderate cardiomegaly is stable. The stomach is more dilated than previous exam.

CONCLUSION: 1. There is no pneumothorax. 2. Right-sided PICC line is still looped inside the subclavian vein. 3. Unchanged bibasilar consolidation. This was discussed with the medical team.


SubjectID: 10023117, StudyID: 52880779, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Right subclavian stick for right atrial lead implantation, evaluation for pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has received an additional pacemaker lead. There is no evidence of right pneumothorax and no evidence of right mediastinal widening. At the right lung bases, an area of atelectasis persists in unchanged manner as compared to the previous radiograph. No pleural effusions. Moderate cardiomegaly without evidence of acute pulmonary edema.


SubjectID: 10023117, StudyID: 50130952, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST ___

HISTORY: Right subclavian insertion attempt for right atrial lead.

IMPRESSION: PA and lateral chest compared to ___ through ___: No pneumothorax, pleural effusion or new mediastinal widening. Right middle lobe collapse and extensive extrapleural fat deposition are chronic findings. Moderate cardiomegaly is also longstanding. Lungs are grossly clear and there is no pulmonary edema. Transvenous right atrial and left ventricular pacer and right ventricular pacer defibrillator leads are unchanged since ___ which showed replacement of the previous left ventricular lead and insertion of a new one in the right atrium.


SubjectID: 10055694, StudyID: 59844689, Comparison: same

FINAL REPORT

INDICATION: New shortness of breath with history of congestive heart failure.

COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: The heart size is moderately enlarged, but the cardiac silhouette is obscured due to the presence of a moderate-to-large right pleural effusion with right basilar compressive atelectasis. Mild pulmonary edema appears relatively unchanged compared to prior study. No left-sided pleural effusion is visualized. There is no acute osseous abnormality.

IMPRESSION: Moderate-to-large right pleural effusion, slightly increased from prior, with right basilar atelectasis. Mild pulmonary edema, unchanged   Keywords: unchanged.


SubjectID: 10062617, StudyID: 54889099, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with sick sinus syndrome s/p PM placement, now with fever and prior aspiration events // R/o aspiration pneumonia

COMPARISON: ___, 00:08.

IMPRESSION: As compared to the previous image, no relevant change is seen   Keywords: no relevant change. The pacemaker leads are in constant position. Moderate cardiomegaly persists. No overt pulmonary edema. No pneumonia, no pleural effusions. Moderate elongation of the descending aorta.


SubjectID: 10062617, StudyID: 50247193, Comparison: None

FINAL REPORT

INDICATION: ___ year old male with shortness of breath, new oxygen requirement

TECHNIQUE: Frontal chest radiographs were obtained with the patient in the upright position.

COMPARISON: Chest radiograph from ___, ___ and ___.

FINDINGS: The lungs are clear of focal consolidation or pneumothorax. There is a small left pleural effusion or pleural thickening. The heart continues to be enlarged, and there is a left cardiac pacer device is with leads terminating in appropriate position. The mediastinal contours are normal. Outpouching of the left hemidiaphragm may reflect a hiatal hernia or eventration which can be better assessed with a conventional PA radiograph.

IMPRESSION: No pneumonia or pulmonary edema. Small left pleural effusion or pleural thickening.


SubjectID: 10088198, StudyID: 58224105, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Bilateral effusions, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is a mild increase in extent of the known left pleural effusion and a stable appearance of the right pleural effusion. Increasing atelectasis at both lung bases. Unchanged size of the cardiac silhouette. The position of the central access line is constant.


SubjectID: 10088198, StudyID: 56308459, Comparison: None

FINAL REPORT

HISTORY: Chest tube removal, to assess for pneumothorax.

FINDINGS: In comparison with study of ___, the monitoring and support devices have been removed. Following the chest tube removal, there is no pneumothorax. There is a hazy opacification bilaterally with poor definition of the diaphragms, consistent with layering pleural effusions. No definite vascular congestion. Poor definition of the left hemidiaphragm in the retrocardiac region is consistent with volume loss in the left lower lobe.


SubjectID: 10088198, StudyID: 55536724, Comparison: None

WET READ: ___ ___ ___ 10:43 PM No significant change in the bilateral pleural effusions and basilar opacities, likely atelectasis, though a superimposed pneumonia would be difficult to exclude in the proper clinical setting. No definite pulmonary edema, as the apices remain clear. Unchanged cardiomegaly.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

HISTORY: Patient with desaturation, eval for volume overload.

COMPARISON: Portable chest radiograph performed earlier on the same day on ___.

FINDINGS: Portable single frontal chest x-ray was performed with the patient in upright position. Compared to earlier study, there has been no significant interval change in the moderate bilateral pleural effusions and associated bibasilar atelectasis. Lung volumes are low. The heart remains moderately enlarged. There is no pneumothorax or pulmonary edema. A left subclavian central line has been removed. Median sternotomy wires are intact.

IMPRESSION: No interval change in the appearance of the heart and lungs.


SubjectID: 10088198, StudyID: 57430622, Comparison: None

FINAL REPORT

INDICATION: History of aortic and mitral valve debridement status post tap of right pleural effusion. Please evaluate for interval change.

COMPARISON: Chest radiograph from ___.

TECHNIQUE: Single AP portable exam of the chest.

FINDINGS: There has been significant interval improvement of the large right pleural effusion with residual right basilar atelectasis. There is mild stable left basilar atelectasis. There is no evidence of a pneumothorax. The cardiomediastinal contours are otherwise unremarkable.

IMPRESSION: Interval improvement of the large right pleural effusion, stable small left pleural effusion, no evidence of a pneumothorax.


SubjectID: 10088198, StudyID: 53585599, Comparison: better

FINAL REPORT

INDICATION: History of CABG, please evaluate for effusion.

COMPARISONS: Multiple chest radiographs dated back to ___.

TECHNIQUE: AP and lateral exam of the chest.

FINDINGS: The lung volumes are low. There is prominence of the upper zone vessels, slightly improved compared to the prior exam, compatible with pulmonary vascular congestion. Again seen are moderate-sized layering bilateral pleural effusions, overall unchanged compared to the prior exam with associated compressive atelectasis. Nodular opacities at the right apex are unchanged. Median sternotomy wires are intact.

IMPRESSION: Stable bilateral moderate pleural effusions however with mild interval improvement of the pulmonary vascular congestion   Keywords: improve.


SubjectID: 10095181, StudyID: 59678597, Comparison: 0.0

FINAL REPORT

INDICATION: Pancreatic cancer and hypoxia, here to evaluate for pulmonary edema.

COMPARISON: Chest radiograph dated ___.

TECHNIQUE: Portable semi-erect frontal radiograph of the chest.

FINDINGS: Anterior cervical fixation hardware is redemonstrated. A right Port-A-Cath ends in the right atrium, as before. Pre-existing parenchymal opacities are increased from ___, particularly in the right lung base and possibly in the left lung base   Keywords: increase. There is unchanged background pulmonary interstitial edema   Keywords: unchanged. No large pleural effusion or pneumothorax is appreciated. The cardiomediastinal contours are within normal limits and unchanged.

IMPRESSION: 1. Unchanged pulmonary edema   Keywords: unchanged. 2. Concurrent right basilar pneumonia and possible multifocal infection involving the left lung base.


SubjectID: 10095181, StudyID: 52185486, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Pancreatic cancer, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the vertebral fixation devices in the right-sided Port-A-Cath are in constant position. The pre-existing parenchymal opacities have slightly decreased in extent and severity   Keywords: decrease. Also, a component of minimal interstitial fluid overload is less severe than on the previous image   Keywords: less severe. Unchanged cardiac silhouette. No pleural effusions.


SubjectID: 10095181, StudyID: 51836845, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluation for pneumonia or pleural effusions.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the lung volumes have slightly decreased. The diffuse bilateral parenchymal opacities, right more than left, are unchanged in extent and distribution   Keywords: unchanged. Increasing atelectasis at the left lung base. The size of the cardiac silhouette is constant.


SubjectID: 10095181, StudyID: 51702229, Comparison: worse

FINAL REPORT

INDICATION: Hypoxia, assess for pneumonia.

COMPARISONS: Chest radiograph of ___ and chest CT of ___.

FINDINGS: Frontal and lateral views of the chest demonstrate low lung volumes. Diffuse bilateral opacities have progressed since prior exams   Keywords: progressed. There is small left pleural effusion. Hilar and mediastinal silhouettes are unchanged. Heart size is top normal. Aortic arch calcifications are noted. Right Port-A-Cath tip projects over proximal right atrium. Surgical clips and biliary stent project over right upper abdomen. Cervical fixation hardware is in place.

IMPRESSION: Diffuse bilateral opacities, most likely pulmonary edema, have progressed since prior studies   Keywords: progressed. However, superimposed infection cannot be excluded in the appropriate clinical setting.


SubjectID: 10095181, StudyID: 50494469, Comparison: same

FINAL REPORT

PORTABLE CHEST FILM, ___ AT 5:17

INDICATION: ___-year-old with sepsis, question pneumonia or edema. Comparison is made to the patient's prior study of ___ at 11:46. A portal semi-upright chest film ___ at 5:17 a.m. is submitted.

IMPRESSION: 1. Right subclavian Port-A-Cath continues to have its tip in the distal SVC. There continue to be diffuse bilateral parenchymal and interstitial opacities, which are likely not significantly changed, although there is some improvement in aeration   Keywords: continue, not significantly changed. There is likely a layering left effusion. No pneumothorax. Overall cardiac and mediastinal contours are likely unchanged given differences in positioning. Hardware is seen overlying the lower cervical spine. No pneumothorax.


SubjectID: 10106899, StudyID: 57131579, Comparison: better

FINAL REPORT

INDICATION: ___-year-old female with CAD status post recent NSTEMI, admitted for CHF exacerbation, now requiring assessment for interval change.

COMPARISON: Comparison is made with chest radiograph from ___.

FINDINGS: Pulmonary vasculature is less dilated and there is less pulmonary edema than on prior exam   Keywords: less pulmonary edema. There is a right pleural effusion. There is plate atelectasis in the left mid zone. The right ventricle pacer wire passes in a supero-oblique direction within the heart instead the usual infero-oblique direction. There is no pneumothorax. Heart size cannot be assessed due to bilateral bibasilar opacities. There is a possibility that there an underlying pneumonia hidden by the pleural effusion and pulmonary edema. Recommend followup imaging as the edema clears.

IMPRESSION: Right pleural effusion. Left basilar plate atelectasis. Improving pulmonary edema   Keywords: improving. Recommend followup chest imaging to rule out pneumonia after pulmonary edema has cleared.


SubjectID: 10106899, StudyID: 55149307, Comparison: None

FINAL REPORT

HISTORY: Acute onset of dyspnea. Evaluate for heart failure versus infection.

TECHNIQUE: Single frontal view of the chest.

COMPARISON: None.

FINDINGS: The cardiac silhouette is indistinct. Hazy perihilar opacities and ill-defined pulmonary vascular markings are consistent with pulmonary edema. Blunting of the costophrenic angles and basilar opacities are compatible with moderate-sized pleural effusions and bibasilar atelectasis. Narrowing of the right acromiohumeral interval is consistent with rotator cuff injury. Deformity of the distal right clavicle is compatible with a prior injury at this location. Leads of a right chest wall pacer terminate over the right atrium and ventricle.

IMPRESSION: Pulmonary edema with moderate-sized bilateral pleural effusions and atelectasis.


SubjectID: 10122589, StudyID: 59846275, Comparison: same

FINAL REPORT

INDICATION: ___-year-old male with multifocal pneumonia, assess for interval change.

COMPARISONS: Chest radiographs dating back to ___, most recent from ___. PORTABLE SUPINE CHEST RADIOGRAPH: A right approach PICC terminates at the cavoatrial junction, unchanged. Severe consolidation of the entire right lung appears similar to most recent prior examination and is likely a combination of pneumonia and pleural fluid. Interstitial edema within the left lung remains moderate. A small left pleural effusion is likely. Additional left basilar opacities may reflect additional foci of infection. Apical thickening bilaterally is unchanged. Cardiomediastinal and hilar contours remain mildly enlarged.

IMPRESSION: Ongoing severe right lung consolidation, a combination of pneumonia and edema. Bilateral moderate effusions are likely. No significant change compared to most recent prior   Keywords: no significant change.


SubjectID: 10122589, StudyID: 52495824, Comparison: None

FINAL REPORT

HISTORY: ___-year-old male with pneumonia, assess for interval change.

COMPARISON: Chest radiographs dating back to ___, most recent from ___. PORTABLE SEMI-ERECT FRONTAL CHEST RADIOGRAPH: A right approach PICC terminates in the low SVC. Overall aeration of the lungs is significantly improved compared to most recent prior examination. There is decreased density of the right lung consistent with resolving aspiration. Subtle opacity within the left base may be related to additional areas of aspiration or atelectasis. There is no pneumothorax. Mild enlargement of cardiomediastinal contours is unchanged. A calcified right pleural plaque at the lung base is unchanged.

IMPRESSION: Improved aeration of the lungs, findings compatible with resolving right lower lung aspiration.


SubjectID: 10122589, StudyID: 59058941, Comparison: same

FINAL REPORT

HISTORY: CHF.

FINDINGS: In comparison with the study of ___, the monitoring and support devices remain in place. Again, there are diffuse bilateral pulmonary opacifications, somewhat more prominent on the right   Keywords: again. This could reflect pulmonary edema, though the possibility of superimposed pneumonia would be a strong possibility in the appropriate clinical setting. Coarse reticular changes at the bases are again consistent with fibrotic lung disease. There is pleural plaquing and bilateral pleural effusions.


SubjectID: 10122589, StudyID: 56104045, Comparison: None

FINAL REPORT

HISTORY: Pulmonary edema and pneumonia.

FINDINGS: In comparison with study of ___, the left IJ catheter has been removed. There is continued prominence of the cardiac silhouette with evidence of elevated pulmonary venous pressure. Extensive pleural calcifications again seen, along with bibasilar atelectasis or pneumonia and left effusion.

IMPRESSION: Severe pulmonary edema as seen on the recent CT scan.


SubjectID: 10122589, StudyID: 55266455, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: Chest AP portable single view.

INDICATION: ___-year-old male patient with replaced orogastric tube as previous tube was malfunctioning.

FINDINGS: AP single view of the chest has been obtained with patient in sitting semi-upright position. Analysis is performed in direct comparison with the next preceding similar study obtained 12 hours earlier during the same day. During the interval, the patient has been extubated. Previously described left internal jugular approach central venous line remains in unchanged position. No pneumothorax is seen. No OG or NG tube can be identified below the level of the chest apex. General chest findings are unaltered in comparison with the previous study. Referring physician, ___ ___, was paged at 4:20 p.m.No answer received until 5:15 pm.Apparently the tube placement has failed.


SubjectID: 10122589, StudyID: 54937253, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph of earlier the same date.

FINDINGS: Interval intubation with tip of endotracheal tube terminating 3 cm above the carina. The left lung volumes are increased compared to the prior pre-intubation radiograph, and there is associated improved aeration at the lung bases. Otherwise, widespread pulmonary parenchymal and pleural abnormalities appear similar to the recent radiograph performed a few hours earlier. Note is also made of interval placement of nasogastric tube, terminating within the stomach.


SubjectID: 10122589, StudyID: 52417409, Comparison: worse

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph of one day earlier.

FINDINGS: Interval extubation and removal of nasogastric tube. Widening of vascular pedicle is accompanied by pulmonary vascular congestion and worsening bilateral asymmetrically distributed airspace opacities, involving the right lung to a greater degree than the left   Keywords: worse. These findings may be due to pulmonary edema with or without coexisting pneumonia. Calcified pleural plaques and pleural thickening are present, as well as a homogeneous opacity at the left apex, not fully characterized on this portable radiograph but similar to ___. Coarse reticular opacities at the lung bases suggest the presence of fibrotic lung disease, but are difficult to assess in the setting of superimposed acute abnormalities.


SubjectID: 10122589, StudyID: 53271877, Comparison: same

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___ radiograph.

FINDINGS: Allowing for differences in technique and projection, there has been little change in the appearance of the chest except for slight improved aeration in the left retrocardiac region   Keywords: little change.


SubjectID: 10122589, StudyID: 53075201, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Study of ___.

FINDINGS: Multifocal consolidation in the right lung has progressed in the interval, particularly in the right upper lobe. A dominant rounded opacity in this region has an eccentric lucency suggesting new possibility of cavitation, a finding that could be confirmed or excluded by CT if warranted clinically. Pulmonary vascular congestion and interstitial edema are also noted as well as bilateral areas of pleural thickening, some of which are calcified, suggesting previous asbestos exposure. Asymmetrical biapical thickening, left greater than right, is a longstanding finding based on review of older radiograph of ___.


SubjectID: 10152675, StudyID: 59743592, Comparison: None

WET READ: ___ ___ 1:00 PM Malpositioned nasogastric tube in the pharynx needs to be repositioned. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hyoercalcemia, hypernatremia with new NGT // Ngt placement

COMPARISON: ___

IMPRESSION: A newly placed feeding tube is coiled in the pharynx. The tube does not reach the esophagus. Tube reposition is required.


SubjectID: 10152675, StudyID: 56678828, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with afib on coumadin, MGUS, Gaucher's disease, CAD, and CHF presenting with labored breathing, diffuse rhonchi and hypoxia. Not resposive to deep suctioning. // Evaluate for pneumonia, pulmonary edema, aspiration? Evaluate for pneumonia, pulmonary edema, aspiration?

IMPRESSION: In comparison with the study of ___, the patient is oblique to the left. This may account for the apparent increase in opacification at the left base with poor definition of the hemidiaphragm. Otherwise little change   Keywords: little change.


SubjectID: 10152675, StudyID: 54234805, Comparison: None

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old man with ngt placement // NGT placement

TECHNIQUE: Portable chest radiograph

COMPARISON: Chest x-ray ___ at 10:50.

FINDINGS: Since the prior radiograph performed 2 hours earlier, there has been interval repositioning of the NG tube, which now terminates in the stomach. The right-sided PICC line terminates at the cavoatrial junction. Improving right lung base opacity, and stable appearance of left lung base opacity. There is no pneumothorax. Cardiomediastinal silhouette is mildly enlarged. Atherosclerotic calcifications noted in the aortic arch.

IMPRESSION: Repositioned NG tube now terminates in the stomach.


SubjectID: 10152675, StudyID: 51956328, Comparison: None

FINAL REPORT

EXAMINATION: PORTABLE CHEST RADIOGRAPH

INDICATION: ___-year-old male with acute change in mental status.

TECHNIQUE: Frontal semi-upright chest radiograph

COMPARISON: Chest radiograph from ___.

FINDINGS: Assessment is limited due to positioning. Allowing for this limitation, there patchy pulmonary opacities in the left mid lung and the left base, overlying the region of the apex in this radiograph, with obscuration of the lateral hemidiaphragm. Right basilar streaky opacities may represent chronic fibrosis and associated atelectasis. There is no pneumothorax. Heart size cannot be properly assessed in this exam.

IMPRESSION: Findings compatible with left lower lobe pneumonia.


SubjectID: 10152675, StudyID: 51914560, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: Evaluation for left lower lobe pneumonia

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the image quality is improved. Low lung volumes. Borderline size of the cardiac silhouette. Aortic wall calcifications. No left basal parenchymal opacity, no evidence of pneumonia. No pulmonary edema. No pleural effusions.


SubjectID: 10186442, StudyID: 59891152, Comparison: same

FINAL REPORT

HISTORY: Stroke with elevated white count.

FINDINGS: In comparison with the study of ___, the Dobbhoff tube has been removed. There is again hazy opacification at the bases consistent with layering effusions and compressive atelectasis at the base. Enlargement of the cardiac silhouette with pulmonary vascular congestion persists   Keywords: persists.


SubjectID: 10186442, StudyID: 53681192, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with amyloid cardiomyopathy and diffuse pleural edema s/p large right MCA stroke. // eval pleura edema vs pneumo after diuresis

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, there is a minimal decrease in extent and severity of the bilateral pleural effusions. However, moderate cardiomegaly and mild to moderate pulmonary edema persists   Keywords: persists. No new parenchymal opacities   Keywords: new.


SubjectID: 10186442, StudyID: 56380789, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with recent extubation // ?interval worsening of effusions

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the patient has been extubated. The right PICC line remains in unchanged position. The pigtail catheter on the left has been removed. Mild cardiomegaly. Mild pulmonary edema and bilateral pleural effusions are visualized on today's image.


SubjectID: 10186442, StudyID: 53159896, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with afib and some volume overload // eval for interval change in pulmonary edeam and pleural effusions

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, there is increasing evidence of pulmonary edema with increasing bilateral pleural effusions and appearance of multiple air bronchograms, predominantly in the right perihilar lung zones   Keywords: increasing. The size of the cardiac silhouette is unchanged. Unchanged position of the right PICC line.


SubjectID: 10186442, StudyID: 55286642, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman intubated for hypoxemic respiratory failure // eval for interval change

TECHNIQUE: Portable semi-erect

COMPARISON: Chest films dating back to ___

FINDINGS: ET tube is 3.5 cm above the carinal. NG tube is seen in the stomach and goes out of view. Left chest pigtail catheter is seen terminating in the basal left lung. Right moderate pleural effusion is smaller since prior. Pulmonary vascular congestion is unchanged as compared to prior   Keywords: unchanged. There is moderate cardiomegaly.

IMPRESSION: Smaller moderate right pleural effusion, moderate cardiomegaly which is unchanged, and vascular congestion which is stable   Keywords: unchanged, stable.


SubjectID: 10186442, StudyID: 51406748, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___-year-old female with respiratory failure. Evaluate for worsening edema.

TECHNIQUE: Portable AP radiograph of the chest from ___.

COMPARISON: ___.

FINDINGS: ET and enteric tubes remain in satisfactory position. Moderate to severe pulmonary edema is unchanged   Keywords: unchanged. Moderate bilateral layering pleural effusions appear slightly larger on today's exam. There is no pneumothorax. The heart and mediastinum cannot be accurately assessed due to projection and significant airspace disease. Regional bones and soft tissues are unremarkable.

IMPRESSION: Stable moderate to severe pulmonary edema   Keywords: stable. Slight interval increase in moderate layering bilateral pleural effusions.


SubjectID: 10186442, StudyID: 50490042, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hypoxic respiratory failure // ?interval worsening

COMPARISON: ___

IMPRESSION: As compared to the previous image, the nasogastric tube has been removed. The endotracheal tube, the left pleural pigtail catheter as well as the right PICC line are still visualized, the PICC line has been pulled back by several cm and the tip now projects over the mid to lower SVC. Improvement in the extent of bilateral pleural effusions, with subsequent improvement of pulmonary ventilation. However, mild pulmonary edema and areas of atelectasis, predominantly at the lung bases, are still visualized. Unchanged borderline size of the cardiac silhouette.


SubjectID: 10186442, StudyID: 50275370, Comparison: None

FINAL REPORT

INDICATION: History: ___F with et tube // eval tube placement

TECHNIQUE: AP portable view of the chest

COMPARISON: ___ chest radiograph

FINDINGS: ET tube ends 4.6 cm from the carina. Enteric tube is off the inferior portion of the image. There is left lower lobe collapse. There are small bilateral pleural effusions, with a significant decrease in the size of the left pleural effusion. There is mild pulmonary edema. No pneumothorax.

IMPRESSION: ET tube in appropriate position. Left lower lobe collapse. Mild pulmonary edema. Small bilateral pleural effusions, the left pleural effusion has decreased.


SubjectID: 10191971, StudyID: 59497040, Comparison: worse

FINAL REPORT

HISTORY: Hypoxemia, cough, shortness of breath.

TECHNIQUE: Upright AP and lateral views of the chest.

COMPARISON: ___.

FINDINGS: The heart size is normal. The mediastinal contour is unchanged. Fullness of the hila bilaterally along with widespread perihilar ill-defined opacities and more focal opacification in the right lung base appear slightly progressed in the interval   Keywords: progressed. No pneumothorax is demonstrated. Small right pleural effusion is noted. There is no acute osseous abnormality.

IMPRESSION: Slight worsening of widespread perihilar and right basilar opacities reflective of lymphomatous infiltration with superimposed bronchitis. More focal opacity in the right lung base is concerning for pneumonia. Small right pleural effusion.


SubjectID: 10191971, StudyID: 52938081, Comparison: better

FINAL REPORT

HISTORY: ET position.

FINDINGS: In comparison with the study of ___, the monitoring and support devices are essentially unchanged. The tip of the endotracheal tube lies approximately 5.2 cm above the carina. Cardiac silhouette remains within normal limits. There is some further improvement in the right basilar opacification as well as a slight improvement in the degree of pulmonary vascular congestion   Keywords: improve.


SubjectID: 10191971, StudyID: 58837043, Comparison: None

FINAL REPORT

INDICATION: History of peripheral T-cell lymphoma, possible pneumonia. Interval worsening on chest x-ray.

COMPARISON: Chest radiographs from ___.

FINDINGS: A single portable chest radiograph was provided. There has been improvement in the left and right hilar opacities, likely representing combination of pneumonia and lymphadenopathy. There is left basilar atelectasis. Cardiomediastinal silhouette is unchanged. No pneumothorax or pleural effusions are present.

IMPRESSION: Improvement in right perihilar opacity consistent with improving infection.


SubjectID: 10191971, StudyID: 56265061, Comparison: same

FINAL REPORT

HISTORY: T-cell lymphoma, now with dyspnea, cough, and hoarseness.

TECHNIQUE: Frontal and lateral chest radiographs were obtained.

COMPARISON: Comparison is made to radiographs dated ___.

FINDINGS: Interval removal of a previous left PICC line. A zone of minimally increased density is seen in the ight lower lobe, concerning for a possible consolidation. Bilateral, perihilar lymphadenopathy is noted, unchanged in appearance from prior examination   Keywords: unchanged in appearance. There is no pleural effusion, pneumothorax, or pulmonary edema. The heart size is normal. Mediastinal contours are stable.

IMPRESSION: Right lower lobe consolidation, concerning for early pneumonia. Findings were entered into the radiology dashboard by Dr. ___ at 1:22pm on ___, 5 minutes after discovery.


SubjectID: 10191971, StudyID: 54903696, Comparison: better

FINAL REPORT

HISTORY: Peripheral T-cell lymphoma and COPD with hypoxic respiratory failure and pneumonia.

COMPARISON: Multiple prior chest radiographs, most recently ___.

FINDINGS: Single frontal view of the chest. Endotracheal tube, NG tube, and right IJ central venous catheter are in stable position. Pulmonary congestion has improved since the prior exam with decreased prominence of the pulmonary vascular markings   Keywords: improve, decrease. Masslike consolidation in the right lower lung with central adenopathy is similar to prior. No pneumothorax. Heart size is normal and minimal widening of the vascular pedicle is stable.

IMPRESSION: Interval improvement of pulmonary vascular congestion with stable right lower lung masslike consolidation   Keywords: improve.


SubjectID: 10194132, StudyID: 56569744, Comparison: None

FINAL REPORT

INDICATION: History: ___M with change in meds reports no duiresis // r/o chf

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph from ___.

FINDINGS: Lung volumes are low resulting in crowding of the pulmonary vasculature. No definite consolidation concerning for pneumonia is identified. Small bilateral effusions are new. There is no evidence of pneumothorax.

IMPRESSION: New small bilateral pleural effusions.


SubjectID: 10194132, StudyID: 54186312, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF exacerbation and increasing dyspnea. // Signs of pulmonary edema vs. other pulmonary process

TECHNIQUE: Portable upright chest radiograph

COMPARISON: ___ at 01:50

FINDINGS: Since the prior study there are new interstitial opacities in the mid lung fields bilaterally, right greater than left   Keywords: new. Lung volumes are low, as before. Heart size is moderately enlarged, as before. No large pleural effusion.

IMPRESSION: Increased interstitial opacities bilaterally, right greater than left, representing pulmonary edema   Keywords: increase. Moderate stable cardiomegaly.


SubjectID: 10194776, StudyID: 58707049, Comparison: better

FINAL REPORT

PORTABLE CHEST FILM ___ AT 811 CLINICAL

INDICATION: ___-year-old with question pulmonary edema, question new infiltrates. Comparison is made to the patient's previous study dated ___. A portable AP upright chest film ___ at 811 is submitted.

IMPRESSION: 1. Feeding tube and left-sided dual-lead pacer remain in place. Stable cardiac enlargement. Calcification of the aortic knob and descending aorta consistent with atherosclerosis. Overall, there continues to be a diffuse bilateral interstitial abnormality but when compared to a prior study dating ___ at 8:02, the degree of interstitial abnormality has substantially subsided, and therefore these findings are suggestive of resolving pulmonary and interstitial edema   Keywords: resolving. There is a persistent deformity of the right lower ribcage consistent with previous fractures. No large effusions. No evidence of pneumothorax.


SubjectID: 10194776, StudyID: 55971996, Comparison: same

FINAL REPORT

PORTABLE CHEST FILM ___ AT ___ CLINICAL

INDICATION: ___-year-old with new Dobbhoff tube placement, verify position. Comparison is made to the patient's previous studies dated ___ at 802. Two views of the chest obtained in the semi-erect position are submitted for interpretation.

IMPRESSION: 1. On the initial view, the Dobbhoff feeding tube appears to be coiled just above the gastroesophageal junction. On the second projection, the tube now traverses below the diaphragm with the tip coiled within the stomach. Dual-lead left-sided pacer remains in place. The heart remains stably enlarged. There continues to be a bilateral interstitial and parenchymal process which is not significantly changed and may reflect pulmonary edema, although underlying interstitial lung disease should also be considered   Keywords: not significantly changed. There are likely small layering effusions. No pneumothorax.


SubjectID: 10213338, StudyID: 59947457, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman intubated s/p resuscitation c/f volume ovelroad // interval change

IMPRESSION: In comparison to previous radiograph of 1 day earlier, endotracheal tube now terminates 2 cm above the carinal with the neck in a flexed position. There is otherwise no relevant change in the appearance of the chest since recent study   Keywords: no relevant change.


SubjectID: 10213338, StudyID: 59104846, Comparison: None

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPH

INDICATION: ___ year old woman now intubated s/p exlap // confirm ETT position

TECHNIQUE: AP VIEW OF THE CHEST

COMPARISON: CHEST RADIOGRAPHS FROM ___

FINDINGS: An endotracheal tube terminates just above the carina and should be pulled back 3-4 cm for ideal positioning. A right internal jugular catheter terminates in the mid SVC. An enteric tube descends below the field of view, likely within the stomach. There is a persistent left basal opacity which suggests consolidation or atelectasis, minimally increased from the prior examination. There is minimal right basal atelectasis. There is no large effusion or pneumothorax.

IMPRESSION: Endotracheal tube should be pulled back 3-4 cm for ideal positioning, as it not terminates just above the carina. Dense retrocardiac opacity could reflect atelectasis or consolidation.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on ___ at 1:31 PM, 5 minutes after discovery of the findings.


SubjectID: 10213338, StudyID: 54542962, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with ESRD - extuabted // interval change interval change

IMPRESSION: In comparison with the study of ___, the endotracheal tube has been removed. Continued enlargement of the cardiac silhouette with evidence of elevated pulmonary venous pressure. Retrocardiac opacification again is consistent with substantial volume loss in the left lower lobe, probably associated with some pleural fluid. Other monitoring and support devices are unchanged.


SubjectID: 10213338, StudyID: 52546580, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___ year old woman NGT placement // NGT placement

TECHNIQUE: AP view of the chest

COMPARISON: Multiple prior radiographs from ___

FINDINGS: An endotracheal tube terminates 9 mm above the carina. A right internal jugular catheter terminates in the mid SVC as before. An enteric tube terminates within the stomach. A dense retrocardiac opacity persists which could reflect atelectasis or consolidation.

IMPRESSION: Endotracheal tube terminates 9 mm above the carina. Dense retrocardiac opacity persists.


SubjectID: 10213338, StudyID: 56939249, Comparison: 0.0

FINAL REPORT

HISTORY: ___-year-old female with shortness of breath, fever and cough.

COMPARISON: ___.

FINDINGS: PA and lateral views of the chest. Moderate cardiomegaly is again noted. There has been interval improvement of the right lung base opacity. There has also been decrease in size of the pleural effusion on the right which is now trace. Persistent slightly increased interstitial markings are noted   Keywords: increase. There is no new consolidation.

IMPRESSION: Interval improvement of the right basilar opacity and small effusion. Otherwise, no change   Keywords: no change. There is potentially mild interstitial edema, not significantly changed   Keywords: not significantly changed.


SubjectID: 10213338, StudyID: 53276473, Comparison: same

FINAL REPORT

INDICATION: History of end-stage renal disease who spiked a fever, please evaluate for pneumonia.

COMPARISON: Multiple chest radiographs dating back to at least ___.

TECHNIQUE: Single portable exam of the chest.

FINDINGS: The heart size is moderately enlarged, overall stable compared to the prior exams. There is mild pulmonary vascular congestion with cephalization of the vessels and bilateral hilar fullness, without evidence of definite pulmonary edema. There is a new focal consolidation overlying the right lower lobe compared to the prior exam. There is increased left lung base atelectasis. No large pleural effusions are identified. There is no evidence of a pneumothorax.

IMPRESSION: 1. New focal consolidation overlying the right lower lobe concerning for pneumonia. 2. Stable cardiomegaly with cephalization of the vessels and hilar fullness, without evidence of pulmonary edema   Keywords: stable.


SubjectID: 10213338, StudyID: 56429409, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: (E) ___F SLE, ESRD on HD s/p failed LRRT (___) s/p ACS/DESx2 p/w mesent ischemia s/p R colectomy/open abd, washout, primary anst, closure, s/p rxn leaking anastomosis, end ileostomy with R CVL ? pulled back // assess location of R CVL (? pulled back) assess location of R CVL (? pulled back)

IMPRESSION: Comparison to ___. No relevant change   Keywords: no relevant change. Both monitoring and support devices are in stable position. No pneumothorax or other complications. Minimally increasing retrocardiac atelectasis. Otherwise unchanged radiograph   Keywords: unchanged radiograph.


SubjectID: 10213338, StudyID: 55352955, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with vomiting this morning, and tape connection off tubing on assessment // Assess placement of the feeding tube Assess placement of the feeding tube

IMPRESSION: In comparison with the study of ___, there is continued opacification at the left base silhouetting the hemidiaphragm, consistent with volume loss in the left lower lobe and pleural effusion. No convincing evidence of new consolidation. The view of the abdomen shows the tip of the Dobhoff tube in the distal stomach. Right IJ catheter extends to the mid to lower portion of the SVC.


SubjectID: 10213338, StudyID: 52735997, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with newly placed DHT // DHT placement

IMPRESSION: Radiographs performed for assessment of a Dobhoff tube placement demonstrates tip of tube terminating in the region of the gastroduodenal junction. A comparison the ___ chest radiograph, cardiomegaly and increased pulmonary vascularity persist. Small bilateral pleural effusions are new, accompanied by bibasilar atelectasis.


SubjectID: 10213338, StudyID: 54755986, Comparison: same

WET READ: ___ ___ 9:48 PM No substantial change from prior. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hemoptysis, new fever. History of mitral regurgitation. Evaluate for infection

TECHNIQUE: Portable AP radiograph of the chest from ___.

COMPARISON: ___. And dating back to ___.

FINDINGS: Pulmonary vascular congestion is not significantly changed   Keywords: not significantly changed. Marked cardiomegaly is unchanged. There is no pneumothorax. Mediastinal contours are stable.

IMPRESSION: No significant interval change   Keywords: no significant interval change.


SubjectID: 10213338, StudyID: 51156376, Comparison: None

FINAL REPORT

TECHNIQUE: Portable frontal radiograph of the chest from ___.

INDICATION: ___ year old woman with hemoptysis // Evaluate for infection, hemorrhage. ___ year old woman with hemoptysis. Evaluate for infection, hemorrhage.

COMPARISON: ___. Correlation made to chest CT dated ___.

FINDINGS: Stable enlargement of the cardiac silhouette accompanied by pulmonary vascular congestion superimposed upon chronic upper zone vascular redistribution in this patient with history of mitral regurgitation. Continued improvement and nonspecific left retrocardiac opacity, with no new foci of consolidation to suggest a note new source of infection.


SubjectID: 10213338, StudyID: 51096943, Comparison: None

FINAL REPORT

INDICATION: History: ___F with fever, cough // CXR: eval for pna

TECHNIQUE: Chest PA and lateral

COMPARISON: ___

FINDINGS: The patient is slightly rotated. Allowing for this, the heart is not enlarged. The aorta is calcified, but the cardiomediastinal contours are otherwise within normal limits. Calcified coronary arteries are noted. Rounded density at the right lung base and at the periphery of the left base is thought to represent nipple shadows. Crowding of vessels noted in the right base inferiorly. No increased interstitial markings seen in this area on the ___ radiographs. There is artifact overlying posterior chest on the lateral view. While a focal infiltrate there cannot be excluded, there are no corroborating findings on the AP view. Otherwise, no focal consolidation, pleural effusion or pneumothorax. Chain sutures are noted at the right lung apex for which clinical correlation is requested. Focal vascular calcifications are seen in the left upper arm. Density of the bilateral humeral heads may reflect bone infarcts.

IMPRESSION: Limited assessment of the posterior chest due to overlying artifact. Allowing for this, no pneumonia identified. If clinically indicated, a repeat lateral view could be attempted at no additional charge to the patient. Mild prominence of vessels at the right lung base medially is thought to represent artifact due to rotation. Differential includes atelectasis and bronchiectasis. The appearance is less pronounced than on radiographs from ___ and ___. Chain sutures noted at the right lung apex, compatible with prior surgery. Aortic and coronary artery calcification noted. Vascular calcifications also seen adjacent to the distal humerus. Suspected bilateral humeral head osteonecrosis.

NOTIFICATION: Dilatation persisting a posterior chest due to artifact was emailed to EDQ a nurse's uncovering clinician's at 22:59 on ___.


SubjectID: 10213338, StudyID: 50988974, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with complicated PMHx presents with fever // please assess lateral view for abnormality please assess lateral view for abnormality

IMPRESSION: In comparison with the study of ___, there is little overall change   Keywords: little overall change. Mild hyperexpansion of the lungs again is seen with the cardiac silhouette at the upper limits of normal in size. No vascular congestion or acute focal pneumonia or pleural effusion.


SubjectID: 10216097, StudyID: 58231661, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF exacerbation, hemothorax, pneumo, s/p RHC/LHC, still dyspnic. // please eval evolution of effusion, edema, pneumo please eval evolution of effusion, edema, pneumo

IMPRESSION: In comparison with the study of ___, there is little change   Keywords: little change. Again there is substantial enlargement of the cardiac silhouette with some elevation of pulmonary venous pressure in prominence of the mediastinum. Probable loculated pleural fluid is again seen in the right mid zone.


SubjectID: 10216097, StudyID: 52360092, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with recent VATS for hemothorax now with new hemoptysis. // Is there a new process in the lung?

IMPRESSION: As compared to ___, a small right apical pneumothorax is similar to prior study. Hazy increased opacity with oblique orientation A in the right mid lung probably represents loculated pleural fluid. New patchy right retrocardiac opacity could reflect atelectasis, aspiration, and less likely developing pneumonia. Short-term followup radiographs may be helpful in this regard.


SubjectID: 10216097, StudyID: 51841478, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p VATS decortication, s/p DC of basilar drain. Please perform around noon. // Post pull evaluation

COMPARISON: CHEST X-RAY FROM ___ AT 07:32.

FINDINGS: THE DRAIN PREVIOUSLY SEEN AT THE BASE OF THE LEFT LUNG IS NOT DEFINITIVELY IDENTIFIED. POSSIBLE SMALL RIGHT APICAL PNEUMOTHORAX. SMALL RIGHT EFFUSION AND HAZY OPACITY ALONG THE LOWER RIGHT CHEST IS NOT SIGNIFICANTLY CHANGED. THE PREVIOUSLY SEEN ELLIPSOID DENSITY IN THE RIGHT MIDZONE IS NO LONGER VISUALIZED. MINIMAL PLATELIKE ATELECTASIS OR TRACE FLUID IN THE MINOR FISSURE IS NOW NOTED. OTHERWISE, I DOUBT SIGNIFICANT INTERVAL CHANGE.

IMPRESSION: INTERVAL REMOVAL OF DRAIN. SUSPECT SMALL RIGHT APICAL PNEUMOTHORAX.


SubjectID: 10216097, StudyID: 50944321, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hemothorax s/p chest tube X 3 // please eval for interval change in hemothorax please eval for interval change in hemothorax

IMPRESSION: In comparison with the study of ___, there again is substantial enlargement of the cardiac silhouette with apparent loculated pleural fluid in the right mid zone. Mild elevation of pulmonary venous pressure is again seen. Asymmetric opacification at the right base raises the possibility of atelectasis, aspiration, or even pneumonia. Prominence of interstitial markings is consistent with some elevation of pulmonary venous pressure.


SubjectID: 10216097, StudyID: 58218519, Comparison: None

WET READ: ___ ___ ___ 7:36 AM Significant increase in large right pleural effusion with leftwards shift of mediastinum. No left pleural effusion. No evidence of pulmonary edema. Limited evaluation of the heart due to overlying abnormality. ___ D/w Dr. ___ ___ at 12:50 AM at time of discovery.

WET READ VERSION #1 ___ ___ ___:55 AM Interval increase in large right pleural effusion with leftwards shift of mediastinum. No left pleural effusion. No evidence of pulmonary edema. Limited evaluation of the heart due to overlying abnormality. ___ D/w Dr. ___ ___ at 12:50 AM at time of discovery. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with recent chest tubes. // Is there an acute process in the lungs?

TECHNIQUE: CHEST (PA AND LAT)

COMPARISON: ___

IMPRESSION: There is substantial interval increase in right pleural effusion with the leftward shift of the mediastinum. No substantial left pleural effusion demonstrated. No definitive pulmonary edema is seen. No pneumothorax is present.

NOTIFICATION: ___ D/w Dr. ___ ___ at 12:50 AM at time of discovery.


SubjectID: 10216097, StudyID: 56756725, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with R hemothorax s/p VATS and thoracentesis with 3 chest tubes in place // Eval for interval change

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: 3 right chest tubes are in place. There is questionable minimal apical pneumothorax on the right. There is also fluid within the major fissure. Cardiomediastinal silhouette is unchanged as well as there is no change in bibasal atelectasis.


SubjectID: 10216097, StudyID: 53279592, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with sCHF, R pleural effusion s/p chest tube placement and removal on ___ // Interval change

IMPRESSION: As compared to ___, right pleural catheter has been removed, with slight increase in size of a moderate right pleural effusion but no definite pneumothorax. Persistent enlarged cardiac silhouette accompanied by pulmonary vascular congestion and worsening edema   Keywords: worse.


SubjectID: 10216097, StudyID: 52134581, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with R pleural effusion concern for hemothorax s/p insertion of ___F catheter given supsected hemothorax. // eval R chest tube eval R chest tube

IMPRESSION: In comparison with the earlier study of this date, a right chest catheter is in place and there has been removal of a substantial amount of pleural fluid on the right. Nevertheless, the large effusion persists. No evidence of pneumothorax. The left lung remains clear and there is no evidence of pulmonary vascular congestion.


SubjectID: 10216097, StudyID: 51982352, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hemothorax s/p evacuation // eval post op change eval post op change

IMPRESSION: In comparison with the earlier study of this date, there now are 2 chest tubes in place on the right following drainage of the substantial hemothorax there is increase in size of the cardiac silhouette with indistinctness of pulmonary vessels consistent with some elevated pulmonary venous pressure   Keywords: increase. Left basilar opacification suggests small layering effusion with compressive atelectasis in the left lower lung. .


SubjectID: 10216097, StudyID: 57102728, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p CT DC. Please perform around 1230PM // Evaluation of post pull PTX

COMPARISON: Chest x-ray from ___ at 839

FINDINGS: The right-sided chest tube is been removed. There is a tiny right apical pneumothorax and possible tiny loculated pneumothorax at the base of the right lung. Otherwise, I doubt significant interval change. Minimal blunting of the right costophrenic angle is again noted.

IMPRESSION: As above..


SubjectID: 10216097, StudyID: 56442522, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p VATS decortication with basilar ___ drain. Please perform ___ AM // Routine evaluation for PTX

COMPARISON: Chest x-ray from ___ at 12:25

FINDINGS: Again seen is the drain along the base of the right lung. There is minimal atelectasis. Equivocal trace pneumothorax at the right lung apex. Previously seen lucency at right lung base is no longer visualized. New on today's exam, there is an ellipsoid opacity in the right mid zone. This is partly accounted for by the overlying scapular angle. Doubt pneumonic consolidation. Bibasilar atelectasis is slightly increased. Upper zone redistribution is also slightly more pronounced. No gross left effusion. The cardiomediastinal silhouette is enlarged, but unchanged.

IMPRESSION: 1. Right lung base drain remains in place. Minimal , if any, residual pneumothorax. 2. Upper zone redistribution bibasilar atelectasis slightly increased. No overt CHF. 3. Ovoid opacity right mid lung -- question artifact due to overlying scapula. Attention to this area on followup films is requested.


SubjectID: 10216097, StudyID: 56235879, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pleural effusion s/p drain placement. // Is there interval change?

COMPARISON: ___

FINDINGS: Again seen is a right chest tube, with opacity and pleural fluid/ thickening at the right base. There has been slight improvement compared with 1 day earlier. Otherwise, I doubt significant interval change. No pneumothorax detected.

IMPRESSION: Slight interval improvement in opacities at right base.


SubjectID: 10216097, StudyID: 55079536, Comparison: worse

FINAL REPORT

INDICATION: Hemothorax with multiple chest tubes. Evaluate for change.

TECHNIQUE: Single upright AP view of the chest.

COMPARISON: Multiple chest radiographs, including the most recent from ___.

FINDINGS: Three chest tubes are unchanged in position. No definite pneumothorax is identified. There has been improved aeration at the right base, likely due to improved atelectasis. A small amount of right pleural fluid remains, though has decreased since the prior exam. Subcutaneous air along the right chest wall is likely from the recent chest tube insertions. There is mild left basilar atelectasis and a tiny left pleural effusion. Since the prior exam, vascular congestion has slightly worsened   Keywords: worse. There is no evidence of pneumonia. No left pneumothorax is identified. The mediastinal contours are normal. The cardiac silhouette is significantly enlarged, and unchanged.

IMPRESSION: 1. Improved aeration at the right base, likely due to decreased atelectasis and a slightly decrease in the amount of residual pleural fluid. 2. Slight interval worsening of mild vascular congestion   Keywords: worse. 3. Enlarged cardiac silhouette, which is presumably due to cardiomegaly, though a pericardial effusion cannot be completely excluded.


SubjectID: 10216097, StudyID: 54687008, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with right pleural effusion s/p VATS evacuation and 3x chest tubes. Anterior chest tube now removed. // Eval post chest tube removal. ***Please perform exam at ___ today*** Eval post chest tube removal. ***Please perform exam at ___

IMPRESSION: In comparison with the earlier study of this date, the anterior chest tube has been removed. No evidence of pneumothorax. Increasing opacification at the right base is consistent with effusion and atelectasis, though in the appropriate clinical setting superimposed pneumonia would have to be considered. Substantial enlargement of the cardiac silhouette process.


SubjectID: 10216097, StudyID: 54747485, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with heart failure, mediastinal mass // Please eval PA line position, volume status Please eval PA line position, volume status

IMPRESSION: In comparison with the study of ___, there is little overall change   Keywords: little overall change. The tip of the Swan-___ catheter again extends into the right pulmonary artery beyond the mediastinal border. Loculated pleural effusion within the major fissure on the right is essentially unchanged. Moderate enlargement of the cardiac silhouette is again seen with mild indistinctness of pulmonary vessels suggesting some elevated pulmonary venous pressure   Keywords: again. Blunting of the right costophrenic angle is again noted.


SubjectID: 10216097, StudyID: 54115167, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with heart failure with PA catheter in place // eval PA catheter placement eval PA catheter placement

IMPRESSION: In comparison with the earlier study of this date, the PA catheter is been pulled back to a good position within the mediastinal portion of the right pulmonary artery. Otherwise little change   Keywords: little change.


SubjectID: 10216097, StudyID: 52212875, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF now with tailored therapy // eval PA catheter placement eval PA catheter placement

IMPRESSION: In comparison with the study of ___, there is little overall change   Keywords: little overall change. Continued substantial enlargement of the cardiac silhouette with mild elevation of pulmonary venous pressure and pseudo tumor of pleural fluid in the major fissure on the right. Swan-Ganz catheter remains in good position.


SubjectID: 10216097, StudyID: 54394310, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with sob // ? chf

COMPARISON: None

FINDINGS: PA and lateral views of the chest provided. Opacity involving the right mid through lower lung is concerning for pneumonia with associated small effusion. Left lung appears grossly clear. The heart size cannot be assessed. No pneumothorax. Bony structures are intact.

IMPRESSION: Right mid to lower lung opacity concerning for right middle and lower lobe pneumonia with associated right pleural effusion. Recommend followup to resolution.


SubjectID: 10216097, StudyID: 50082130, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with large right pleural effusion s/p ___fr pigtail placement // ? PTX ? PTX

IMPRESSION: In comparison with the study of ___, there has been placement of a pigtail catheter at the right base with removal of some of pleural fluid. No evidence of pneumothorax. Some residual opacification is consistent with pleural fluid and volume loss in the lower lungs. Cardiac silhouette is prominent and there is some indistinctness of pulmonary vessels suggesting some underlying vascular congestion.


SubjectID: 10220107, StudyID: 59382620, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with shortness of breath // Please evaluate pleural effusion

COMPARISON: Radiographs from ___.

IMPRESSION: There is cardiomegaly which is stable. There is a small to moderate size left pleural effusion which is stable. Atelectasis at the left mid to lower lung field is again seen. Overall, findings are stable. There are no pneumothoraces.


SubjectID: 10220107, StudyID: 51305147, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with chf and B pleural effusions s/p R ___. // ptx

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Left pleural effusion is small to moderate, unchanged. Left basal atelectasis is unchanged. No new consolidations demonstrated. After right thoracocentesis there is no evidence of pneumothorax. And no appreciable right pleural effusion is currently seen


SubjectID: 10220107, StudyID: 54172281, Comparison: None

WET READ: ___ ___ 7:15 PM Status post left chest tube removal with no large pneumothorax; however, a small left apical pneumothorax cannot be excluded. Otherwise, little change compared to prior study from the same day. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post chest tube removal, evaluation for pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the left chest tube has been removed. There is currently no evidence of left pneumothorax. A previously placed mediastinal drain has also been removed. The right central introduction sheath persists. Moderate cardiomegaly without pulmonary edema. Hiatal hernia.


SubjectID: 10220107, StudyID: 51804485, Comparison: None

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with CABG, dropping of hematocrit, evaluation for effusion.

COMPARISON: Multiple chest x-rays from ___ to ___.

FINDINGS: The patient has been extubated. Swan-Ganz has been removed. Remaining right jugular sheath is in lower jugular vein. There is no pneumothorax or pleural effusion. There is no pulmonary edema. Moderate cardiac contour enlargement is stable.

CONCLUSION: 1. The patient just had sternotomy for CABG. 2. There is no pneumothorax or pleural effusion. 3. Moderate cardiomegaly is unchanged.


SubjectID: 10245890, StudyID: 59928668, Comparison: same

FINAL REPORT

HISTORY: CHF exacerbation with subjective fever.

FINDINGS: In comparison with study of ___, there is little interval change   Keywords: little interval change. There is huge enlargement of the cardiac silhouette with minimal if any vascular congestion. This combination suggests cardiomyopathy or pericardial effusion. No acute focal pneumonia. The single-lead pacemaker extends to the apex of the right ventricle.


SubjectID: 10245890, StudyID: 53110670, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man with shortness of breath and bilateral lower extremity edema, question pulmonary edema.

COMPARISONS: Multiple prior radiographs, most recently from ___.

FINDINGS: AP and lateral chest radiograph. No overt edema but mild interstitial edema is difficult to exclude. Severe cardiomegaly is unchanged. There are no pleural effusions or pneumothorax. Left chest wall pacemaker with lead in the right ventricle is unchanged. Bony structures are intact.

IMPRESSION: Stable marked cardiomegaly. No overt pulmonary edema but mild interstitial edema is difficult to exclude.


SubjectID: 10245890, StudyID: 58626162, Comparison: None

FINAL REPORT

INDICATION: ___M with 8 days of fevers, bibasilar crackles on physical examination. // Please evaluate for pneumonia .

COMPARISON: Multiple chest radiographs dating back to ___. Chest CTA ___.

TECHNIQUE Frontal and lateral views of the chest.

FINDINGS: Massive cardiomegaly is unchanged. A single lead pacemaker is seen in the right ventricle. Mediastinal and hilar contours are normal. There is no pulmonary edema. There is no focal consolidation to suggest pneumonia. Calcifications are noted within the aortic arch. There is no pneumothorax or large pleural effusion.

IMPRESSION: Unchanged massive cardiomegaly. No focal consolidation to suggest pneumonia.


SubjectID: 10245890, StudyID: 52493110, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with dCHF COPD A. fib on warfarin, MR and TR, on home O2 at home with SOB, chest tightness and crackles bilaterally ___ up // pulm edema?

COMPARISON: ___ chest radiograph and ___ CT.

IMPRESSION: Massive cardiomegaly is accompanied by pulmonary vascular congestion. Interval resolution of interstitial edema. Lungs are clear except for improving atelectasis in the left lung base. No definite pleural effusion or pneumothorax.


SubjectID: 10245890, StudyID: 57370787, Comparison: same

FINAL REPORT

INDICATION: Shortness of breath and chest pain.

COMPARISONS: ___ and ___.

FINDINGS: AP portable view of the chest demonstrates hyperexpanded lungs. Severe cardiomegaly is redemonstrated. Moderate pulmonary edema persists   Keywords: persists. No pleural effusions or pneumothorax. Aorta appears tortuous. Single AICD device lead projects over right ventricle.

IMPRESSION: Severe cardiomegaly and moderate pulmonary edema, essentially unchanged since ___ exam   Keywords: unchanged.


SubjectID: 10245890, StudyID: 51785820, Comparison: better

WET READ: ___ ___ ___ 7:03 PM Marked cardiomegaly as before with slight mprovement in mild to moderate pumonary edema.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

AP CHEST, 4:04 P.M., ___

HISTORY: ___-year-old man with shortness of breath and chronic CHF exacerbation. Check for pulmonary edema.

IMPRESSION: AP chest compared to ___ at 6:01 a.m.: Previous mild pulmonary edema has improved, although the extent of pulmonary vascular congestion is slightly more pronounced today than it was on ___ indicating that cardiac function could further improve   Keywords: improve. Severe cardiomegaly is longstanding. Pleural effusions are minimal, if any. Transvenous right ventricular pacer lead in standard placement. No pneumothorax.


SubjectID: 10245890, StudyID: 54971648, Comparison: None

FINAL REPORT

INDICATION: Tachybrady syndrome, evaluation for CHF.

COMPARISON: ___ and ___.

FINDINGS: Upright AP radiograph demonstrates severe cardiomegaly, worsened from ___. There is redistribution of pulmonary vascularity to the upper zones but no evidence of overt pulmonary edema. There is no pneumothorax. Atherosclerotic calcifications are noted in the aortic arch. Splaying of the mainstem bronchi likely represents left atrial enlargement.

IMPRESSION: Severe cardiomegaly, worsened from ___.


SubjectID: 10245890, StudyID: 54776161, Comparison: None

FINAL REPORT

STUDY: PA and lateral chest. CLINICAL

HISTORY: ___-year-old man with new single chamber pacemaker. Evaluate lead position.

FINDINGS: Comparison is made to previous study from ___. There is a single-lead left-sided pacemaker with distal lead tip in the right ventricle. There is markedly enlarged cardiomegaly. This is stable. The visualized lung fields are grossly clear; however, they are somewhat hyperexpanded, suggestive of emphysema. There are degenerative changes and mild wedge compression deformities of several thoracic vertebral bodies.


SubjectID: 10246786, StudyID: 57071923, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH.

INDICATION: Hypoxia, large volume thoracocentesis. Questionable pneumothorax. Evaluation.

FINDINGS: As compared to the previous radiograph, there is ongoing increasing opacification of the right lower lung, associated to air bronchograms. The findings are highly suggestive of either pneumonia or aspiration. There is no evidence of pneumothorax. The left hemithorax is unremarkable. Borderline size of the cardiac silhouette without pulmonary edema. At the time of dictation and observation, 9:54 a.m., on ___, the referring physician, ___. ___, was paged for notification and the findings were discussed over the telephone one minute later. The pigtail catheter on the right is in unchanged position. There is no major pleural effusion.


SubjectID: 10246786, StudyID: 55919768, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Large recurrent right effusion, status post pigtail placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has received a small right Pleurx catheter. The extent of the pre-existing right pleural effusion has decreased. Also decreased are the areas of pre-existing atelectasis at the right lung base. However, the moderate amount of right effusion remains. There is no evidence for right pneumothorax. Moderate cardiomegaly of unchanged. No change in appearance of the left lung   Keywords: no change.


SubjectID: 10246786, StudyID: 53823571, Comparison: None

WET READ: ___ ___ ___ 8:25 PM There is little overall change from the prior radiograph in terms of the right lower lobe opacities concerning for pneumonia versus aspiration. There may be developing left lower lobe opacities now as well. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is a minimal decrease in extent and severity of the pre-existing right lower lobe opacities that, however, still remain visible and are concerning for pneumonia or aspiration. Mild atelectasis in the retrocardiac lung regions. Mild fluid overload but no overt pulmonary edema. Unchanged low lung volumes and mild cardiomegaly.


SubjectID: 10246786, StudyID: 51178547, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post drainage.

FINDINGS: As compared to the previous radiograph, the right pigtail catheter in the pleural space is of unchanged position. The pleural effusion has substantially decreased. No pneumothorax. No other relevant change   Keywords: no other relevant change.


SubjectID: 10246786, StudyID: 50180753, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post thoracocentesis.

COMPARISON: ___, 2:44 a.m.

FINDINGS: As compared to the previous radiograph, the right plaural pigtail catheter is in unchanged position. There has been minimal re-accumulation of pleural fluid. Mild atelectasis at the right lung bases. Unchanged appearance of the cardiac silhouette. Unchanged normal appearance of the left lung.


SubjectID: 10246786, StudyID: 56299661, Comparison: None

FINAL REPORT

EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Fever, chills and cough.

COMPARISON: Multiple priors dating back to ___ and most recent from ___.

FINDINGS: There has been significant interval increase in opacity projecting over the right lower hemithorax worrisome for pleural effusion and consolidation. Underlying atelectasis. Additional focus of opacity projecting over the level of the posterior lateral right sixth rib may be concerning for additional site of consolidation. The left lung is grossly clear. There is no left pleural effusion. The right heart border is not well assessed due to the right lower hemithorax opacification. Aortic knob calcification is seen. Evidence of DISH is seen along the spine.

IMPRESSION: Large area of opacity projecting over the right lower hemithorax is worrisome for consolidation and pleural effusion. Additional small focus of opacity superior to this concerning for additional site of infection.


SubjectID: 10246786, StudyID: 56260004, Comparison: None

FINAL REPORT

HISTORY: Status post thoracentesis.

COMPARISON: Chest radiograph ___, ___.

FINDINGS: AP and lateral views the chest were viewed. The cardiomediastinal and hilar contours are stable. There has been decrease in the right pleural effusion following thoracentesis. No pneumothorax is seen. A left PICC line is present in the left brachiocephalic vein, but the tip is not well visualized.


SubjectID: 10246786, StudyID: 52475019, Comparison: None

FINAL REPORT

EXAMINATION: PA and lateral chest

INDICATION: History: ___M with missed dialysis // evel for chf

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph from ___ at ___.

FINDINGS: Moderate cardiomegaly appears slightly increased in size compared to the prior exam from ___ which may reflect cardiomegaly, although pericardial effusion should also be considered. Moderate right-sided pleural effusion, also has increased compared to the prior exam. There has been interval appearance of mild pulmonary edema. There may be a small left pleural effusion. Retrocardiac opacity is likely secondary to atelectasis, although pneumonia cannot be entirely excluded. There is no evidence of pneumothorax. The visualized osseous structures are unremarkable.

IMPRESSION: 1. Mild pulmonary edema. Increasing right pleural effusion.


SubjectID: 10246786, StudyID: 50348492, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with R sided pleural effusion // ? interval change in pleural effusion

COMPARISON: ___.

FINDINGS: Moderate right pleural effusion. It has apparently decreased in size since the recent radiograph, but positional differences in made contribute to this apparent change. Cardiomediastinal contours are normal. Left lung and pleural surfaces are clear


SubjectID: 10251182, StudyID: 59453442, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old male with worsening dyspnea.

COMPARISON: Comparison is made with chest radiograph from ___ and ___.

FINDINGS: The lungs are well expanded. There is interval development of asymmetric mild pulmonary edema, right greater than left   Keywords: development. Alternatively, this could be a symmetric pulmonary edema with a right lower lobe pneumonia, but this is less likely. There is no pneumothorax or pleural effusion. Cardiomediastinal silhouette is unremarkable.

IMPRESSION: Acute asymmetric pulmonary edema, right greater than left, more likely than mild edema and concurrent right pneumonia.


SubjectID: 10251182, StudyID: 54716931, Comparison: better

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with history of gastrostomy, CAD, CABG, CCU pulmonary edema, OG tube position.

COMPARISON: ___.

FINDINGS: NG tube is in adequate position in the stomach. ET tube ends 3.6 cm above the carina. Pulmonary edema has improved and is now minimal   Keywords: improve. Bilateral mild-to-moderate pleural effusion is new with bibasilar atelectasis. Superimposed infection cannot be excluded in appropriate clinical setting.


SubjectID: 10251182, StudyID: 54141224, Comparison: None

FINAL REPORT

HISTORY: ___-year-old man with fever.

COMPARISON: ___.

TECHNIQUE: PA and lateral views of the chest.

FINDINGS: Lung volumes are low. Retro-cardiac opacity likely represents atelectasis, although infectious process can be considered. Cardiomediastinal silhouette is mildly enlarged. Patient is status post median sternotomy. No pleural effusion or pneumothorax is identified.


SubjectID: 10251182, StudyID: 53163573, Comparison: better

FINAL REPORT

INDICATION: ___-year-old male with STEMI and pulmonary edema.

COMPARISON: Comparison is made with chest radiograph from ___ and ___.

FINDINGS: Two frontal images of the chest demonstrate low lung volumes likely due to poor inspiration. Vascular crowding and minimal pulmonary edmea has resolved from previous exam. Left basilar atelectasis has improved. Bilateral pleural effusions are again seen. Cardiomediastinal silhouette is unchanged. There is no pneumothorax. Support and maintenance devices are unchanged.

IMPRESSION: Resolved pulmonary edema   Keywords: resolve. Improving left basilar atelectasis. Bilateral small pleural effusions.


SubjectID: 10251182, StudyID: 53849979, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cord compression // ETT placement

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: THE ENDOTRACHEAL TUBE IS 4 CM ABOVE THE CARINA. LUNG VOLUMES ARE LOW WITH COMPRESSIVE CHANGES AT THE BASES. THERE IS A SMALL LEFT EFFUSION. HEART SIZE IS UPPER LIMITS NORMAL

IMPRESSION: NO significant change   Keywords: no significant change


SubjectID: 10251182, StudyID: 53387478, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p lumbar spine surgery, intubated, new OGT placed // line placement

TECHNIQUE: Portable chest

COMPARISON: ___.

FINDINGS: ET tube is 4.5 cm above the Carina. NG tube tip is in the stomach. Hardware projects over the lumbar spine with associated skin ___. Sternal wires are again visualized. Lung volumes are low and there is volume loss at the bases. There is a more focal area of opacity obscuring the left CP angle that could be volume loss/ infiltrate/effusion

IMPRESSION: Left lower lobe volume loss/ infiltrate/effusion


SubjectID: 10251182, StudyID: 52434441, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with spinal cord compreswsion, NGT in place // evaluate NGT placement

TECHNIQUE: Portable chest

COMPARISON: ___.

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change. The NG tube tip is in the stomach


SubjectID: 10253057, StudyID: 57284535, Comparison: better

FINAL REPORT

INDICATION: Pulmonary edema identified on ___. Evaluation for resolution.

COMPARISON: ___.

FINDINGS: PA and lateral chest radiographs demonstrate marked improvement of pulmonary edema with asymmetric residual opacities in the left perihilar region   Keywords: improve. There are persistent bilateral pleural effusions, moderate on the left and mild on the right as well as associated left lower lobe atelectasis. Median sternotomy wires and CABG clips are noted. The heart size is normal. There is no pneumothorax.

IMPRESSION: Marked improvement in pulmonary edema with residual left perihilar opacities   Keywords: improve.


SubjectID: 10253057, StudyID: 57249850, Comparison: worse

FINAL REPORT

STUDY: PA and lateral chest, ___. CLINICAL

HISTORY: ___-year-old man with end-stage renal disease. Patient admitted for hypoxia and dyspnea.

FINDINGS: Cardiac silhouette is enlarged. There is a left retrocardiac opacity and left-sided pleural effusion, which have increased since the prior study. There are also increased areas of consolidation in the left upper lobe. These may represent asymmetric edema versus developing pneumonia   Keywords: developing. The right lung is relatively clear.


SubjectID: 10253057, StudyID: 56046519, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man with hypoxia.

COMPARISON: ___.

FINDINGS: A single portable AP chest radiograph was obtained. There is a large left and small-to-moderate right pleural effusion. There is diffuse bilateral hilar interstitial opacity. An asymmetric opacity is seen in the central left upper lobe. Median sternotomy wires, mediastinal clips and right lung chain suture are stable.

IMPRESSION: 1. Large left and moderate right effusions and pulmonary vascular congestion suggest moderate-to-severe pulmonary edema. 2. Asymmetric opacity in the central left upper lobe has somewhat of a "butterfly" appearance of pulmonary edema. However, given the unilateral distribution, the presence of an additional consolidation or mass is likely. Repeat radiographs should be taken after diuresis. Cross sectional imaging may be considered at that point if the diagnosis remains in doubt.


SubjectID: 10253057, StudyID: 55142680, Comparison: None

FINAL REPORT

HISTORY: ___-year-old male status post amputation. Evaluate for pulmonary edema.

COMPARISON: Multiple prior radiographs of the chest dated ___ through ___.

FINDINGS: Portable semi-upright radiograph of the chest demonstrates low lung volumes with resulting bronchovascular crowding. There is persistent increased opacification at the left base, likely secondary to pleural effusion with adjacent atelectasis; however, superimposed infection cannot be excluded. There is evidence of mild to moderate pulmonary edema. There is no pneumothorax. There is pneumoperitoneum present with air below the right hemidiaphragm.

IMPRESSION: 1. There is pneumoperitoneum present with air below the right hemidiaphragm. 2. Small left-sided pleural effusion with adjacent atelectasis. 3. Mild-moderate pulmonary edema. COMMENTS: Impression #1 was discussed with Dr. ___ ___ by Dr. ___ ___ telephone at 4:___pm on ___, 1.5 hours after discovery.


SubjectID: 10253057, StudyID: 54981721, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Tachycardia, evaluation for pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the lung volumes have decreased and the size of the cardiac silhouette has increased. There might be mild fluid overload, but no overt pulmonary edema is present. Small newly appeared left pleural effusion with subsequent atelectasis in the retrocardiac lung regions.


SubjectID: 10259898, StudyID: 58549049, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with respiratory failure with CVL pulled back 3 cm // interval change of CVL position

COMPARISON: ___, 08:56

IMPRESSION: As compared to the previous radiograph, the pre-existing pulmonary edema has almost completely resolved   Keywords: resolve. Moderate cardiomegaly persists. The monitoring and support devices are constant. No larger pleural effusions. No pneumonia. No pneumothorax.


SubjectID: 10259898, StudyID: 53879792, Comparison: None

FINAL REPORT

INDICATION: ET tube, evaluate for tube placement.

TECHNIQUE: Portable supine chest radiograph was obtained.

COMPARISON: None available.

FINDINGS: The endotracheal tube terminates 3 cm above the carina. An enteric tube courses out of the field of view of this exam. A left chest AICD device has leads terminating in the right atrium, right ventricle, and coronary sinus. There is moderate pulmonary edema. The heart is moderately enlarged. There is no pneumothorax. Surgical clips are seen in the upper abdomen. Calcifications of the aortic arch and tracheobronchial tree are present.

IMPRESSION: 1. Endotracheal tube terminating 3 cm above the carina in appropriate position. 2. Moderate cardiomegaly and pulmonary edema.


SubjectID: 10259898, StudyID: 51944967, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with resp failure; evaluate for interval change

TECHNIQUE: Portable AP radiograph of the chest from ___.

COMPARISON: ___.

FINDINGS: The endotracheal tube remains at the carina, and should be withdrawn by 2-3 cm for more optimal positioning within the lower trachea. A left pectoral AICD remains in place. Other support devices including a right IJ central venous catheter and nasogastric tube remain in satisfactory position. There is no pneumothorax. The lungs are clear. Moderate cardiomegaly is stable. Metallic right upper quadrant surgical clips denote prior cholecystectomy.

IMPRESSION: Low-lying ET tube should be withdrawn by 2-3 cm for more optimal positioning within the lower trachea. Clear lungs. Stable moderate cardiomegaly.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 10:17 AM, 3 minutes after discovery of the findings.


SubjectID: 10277119, StudyID: 57465846, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman h/o renal transplant immunosuppressed s/p hernia repair // ?pna vs fluid overload

FINDINGS: Heart is upper limits of normal in size accompanied by pulmonary vascular congestion without overt pulmonary edema. Worsening left retrocardiac opacity could reflect atelectasis or developing pneumonia. . Note is also made of a small left pleural effusion.

COMPARISON: ___.


SubjectID: 10277119, StudyID: 53362710, Comparison: None

WET READ: ___ ___ ___:___ AM No evidence of pulmonary edema. A wire projects over the chest, which is likely external to the patient, however this cannot be confirmed in the absence of a lateral exam. Recommend removing external wires from the patient and a repeat examination with a frontal and lateral radiograph, for further evaluation. ___ were d/w Dr. ___ by Dr. ___ by phone at ___:___A on the day of the exam.

WET READ VERSION #1 ___ ___:___ AM No evidence of pulmonary edema. A wire projects over the chest, which is likely external to the patient, however this cannot be confirmed in the absence of a lateral exam. Recommend removing external wires from the patient and a repeat examination with a frontal and lateral radiograph, for further evaluation. ___ were d/w Dr. ___ by Dr. ___ by phone at ___:___A on the day of the exam. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___ year old woman with renal transplant s/p incisional hernia repair // fluid status

COMPARISON: ___

FINDINGS: Cardiomegaly is accompanied by pulmonary vascular congestion, but no overt pulmonary edema. Patchy left retrocardiac opacity is likely atelectasis, but differential diagnosis includes aspiration and early infectious pneumonia. Short-term followup radiographs may be helpful in this regard.


SubjectID: 10277901, StudyID: 59248287, Comparison: same

FINAL REPORT

CLINICAL

HISTORY: CHF, COPD, acutely hypoxic. CHEST:

COMPARISON FILM: ___. There has been no significant change in the appearances since the two prior chest x-rays. Opacifications in both lungs probably due to failure are still present and essentially unchanged.

IMPRESSION: No change   Keywords: no change.


SubjectID: 10277901, StudyID: 58655581, Comparison: same

FINAL REPORT

CLINICAL

HISTORY: CHF and COPD, now with new productive cough. CHEST AP There has been no significant change since the prior chest x-ray of 15 hours previously. Increased opacifications are present in both lungs and bilateral effusions are present. Appearances are consistent with known failure, though additional infective process is not excluded.

IMPRESSION: No significant change   Keywords: no significant change. Failure persists.


SubjectID: 10277901, StudyID: 56002625, Comparison: same

FINAL REPORT

INDICATION: ___-year-old male with hypoxic respiratory failure, now requiring assessment of the re-positioned Dobbhoff tube.

COMPARISON: Comparison is made with chest radiograph from ___ and ___.

FINDINGS: Two frontal images of the chest demonstrate a Dobbhoff tube which has been advanced further into the stomach since previous imaging earlier the same day. There is no pneumothorax or other complication seen. There is no interval change in the pulmonary findings or cardiac findings   Keywords: no interval change.

IMPRESSION: Dobbhoff tube with tip in improved position within the stomach from prior exam. Otherwise unchanged chest radiograph.


SubjectID: 10277901, StudyID: 55312440, Comparison: better

FINAL REPORT

INDICATION: ___-year-old male with hypoxic respiratory failure secondary to CHF exacerbation requiring assessment of Dobbhoff tube placement.

COMPARISON: Comparison is made with chest radiographs from ___.

FINDINGS: Two frontal images of the chest demonstrate a Dobbhoff tube with the tip located within the proximal stomach. The tube should be advanced several centimeters more to put the tip more fully with the stomach. There is mild improvement in the pulmonary perivascular haze noted on previous exam   Keywords: improve. Otherwise, the chest radiograph remains essentially unchanged from previous imaging. There are no pleural effusions. There is no pneumothorax or other complications seen. Cardiomediastinal silhouette is unchanged.

IMPRESSION: Left Dobbhoff tube in place with tip in the proximal stomach, recommend advancing the tube several centimeters to put the tip more fully within the stomach. Otherwise, essentially unchanged chest radiograph.


SubjectID: 10277901, StudyID: 50083821, Comparison: None

FINAL REPORT

HISTORY: Respiratory distress, to assess for pulmonary edema.

FINDINGS: In comparison with the study of ___, there is continued enlargement of the cardiac silhouette with substantial pulmonary edema and bilateral pleural effusions, more prominent on the right. An impression on the lower cervical trachea to the right raises the possibility of a thyroid mass.


SubjectID: 10277901, StudyID: 55915561, Comparison: None

FINAL REPORT

HISTORY: Shortness of breath.

TECHNIQUE: Upright AP view of the chest.

COMPARISON: None.

FINDINGS: The heart size is mild to moderately enlarged. Aortic knob is prominent, suggesting dilatation of the thoracic aorta. Atherosclerotic calcification of the aortic arch is present. Opacification within the retrocardiac region may reflect a combination of a small pleural effusion with adjacent atelectasis. Hazy opacification within the mid lung fields is noted. There is no right-sided pleural effusion pneumothorax. No acute osseous abnormality seen.

IMPRESSION: 1. Left basilar opacification likely reflects a combination of a small pleural effusion and adjacent atelectasis. Infection, however, is not excluded. 2. Hazy opacification within the mid lung fields bilaterally is nonspecific, and could reflect an infectious or inflammatory process. Mild pulmonary edema is considered less likely.


SubjectID: 10277901, StudyID: 55153931, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, pneumonia, evaluation for interval changes.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the pre-existing parenchymal opacities have slightly decreased in extent and severity   Keywords: decrease. However, a minimal right pleural effusion has slightly increased in extent and the presence of small left pleural effusion is likely. Unchanged size of the cardiac silhouette. Unchanged course of the left-sided PICC line.


SubjectID: 10277901, StudyID: 51503041, Comparison: None

FINAL REPORT

HISTORY: Pulmonary edema or pneumonia.

FINDINGS: In comparison with the study of ___, there is increasing bilateral hazy opacification of both lungs in a patient with substantial enlargement of the cardiac silhouette. Although this could all represent pulmonary edema, in the appropriate clinical setting the possibility of supervening pneumonia would have to be considered. Some hazy basilar opacification suggests possible small pleural effusions. There is some displacement of the lower cervical trachea to the left, suspicious for thyroid mass on the right. Of incidental note are several rounded opacifications in the region of the stomach, most likely representing pills. Poor definition of the left hemidiaphragm would be consistent with some substantial volume loss in the left lower lobe.


SubjectID: 10286475, StudyID: 57452571, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with h/o of effusions, RLL pneumonia // interval change in effusion, conslidation

TECHNIQUE: Portable chest

COMPARISON: ___.

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change.


SubjectID: 10286475, StudyID: 53501085, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CML, sepsis and recurrent CHF now s/p Right chest tube and left ___ // ? pneumothorax, improvement in effusions ? pneumothorax, improvement in effusions

IMPRESSION: In comparison with the study ___ ___, the patient has taken a much better inspiration. There is enlargement of the cardiac silhouette with left ventricular prominence, though the pulmonary vascularity is now essentially within normal limits and there is no definite evidence of right pleural effusion. Continued opacification the left base silhouetting the hemidiaphragm, most likely reflecting volume loss left lower lobe pleural fluid.


SubjectID: 10286475, StudyID: 55355476, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ yo male, with h/o CML on hydroxyurea, recent admitted for AMS thought to be ___ medication overdose, presenting with AMS, leukocytosis and hypoxia w/2L O2 requirement. // please assess for interval change - please perform 7AM on ___ please assess for interval change - please perform 7AM on 0

IMPRESSION: In comparison with the study of ___, there are lower lung volumes. Continued enlargement of the cardiac silhouette, probably with mild elevation of pulmonary venous pressure. Hazy opacification in the right hemithorax is again seen, consistent with layering pleural effusion. An area of more confluent opacification is suggested right above the minor fissure, raising the possibility of developing consolidation in the appropriate clinical setting. Poor definition of the left hemidiaphragm again is consistent with pleural fluid and volume loss in the left lower lobe.


SubjectID: 10287348, StudyID: 58427217, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with hepatic encephalopathy. Placed Dobhoff // dobhoff placement (Staged study, will need two films)

TECHNIQUE: 2 subsequent closures of the abdomen and chest

COMPARISON: ___

IMPRESSION: The imaged portions the lungs demonstrate bibasilar atelectasis. The patient is status post median sternotomy. The cardiac size is mildly enlarged. A Dobbhoff tube is seen in appropriate position within the stomach after the second radiograph.


SubjectID: 10287348, StudyID: 54511447, Comparison: None

FINAL REPORT

INDICATION: ___M with confusion, weakness, liver disease // eval pna

TECHNIQUE: PA and lateral views of the chest.

COMPARISON: ___.

FINDINGS: Right apical scarring is again noted. The lungs are otherwise clear without focal consolidation or effusion. The cardiomediastinal silhouette is stable. Mediastinal clips and median sternotomy wires are again noted. No acute osseous abnormalities.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 10306412, StudyID: 55248283, Comparison: None

FINAL REPORT

PORTABLE CHEST ___, ___

COMPARISON: Chest ___ ___ ___.

FINDINGS: Cardiac silhouette is mildly enlarged, and accompanied by widening of the azygos vein and pulmonary vascular congestion. Multifocal areas of patchy and linear opacity are present in the left mid and both lower lung regions, with slight improved aeration at both lung bases. These findings favor a multifocal atelectasis, but co-existing aspiration or pneumonia is possible in the appropriate clinical setting.


SubjectID: 10308375, StudyID: 57023953, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with chest tightness and low saturations. Evaluate for acute process.

COMPARISON: Chest radiographs on ___, ___ and ___.

TECHNIQUE: PA and lateral chest radiograph.

FINDINGS: Ill-defined patchy opacities are seen in the right lung base with an associated small right pleural effusion, which is also confirmed in the lateral view. A dense left-sided retrocardiac opacity abutting the left hemidiaphragm is unchanged since at least ___ compatible with a Bochdalek hernia. A small left pleural effusion is also likely present. There is biapical pleuro-parenchymal scarring, more conspicuous in the left apex. No other focal opacities are identified. Mild cardiomegaly is unchanged from prior. There is no pneumothorax.

IMPRESSION: Right lower lobe pneumonia. Small bilateral pleural effusions.


SubjectID: 10308375, StudyID: 55091382, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female with new-onset CHF. Tachypneic and desatting to ___%. Assess for interval change.

COMPARISON: Chest radiograph ___, ___, ___.

TECHNIQUE: Single portable frontal chest radiograph.

FINDINGS: Interval increase in moderate-sized right pleural effusion, and right lower lobe opacity with new right upper lobe heterogeneous opacity. Unchanged left apical pleural thickening and scarring. No interval change in the dense retrocardiac opacity obscuring the left hemidiaphragm which represents a Bochdalek hernia. No pneumothorax or pulmonary edema. Heart size is partially obscured by the pleural parenchymal process. Mediastinal contour and hila are normal. No bony abnormality.

IMPRESSION: 1. Interval increase in moderate-sized right pleural effusion. 2. Worsening right lower lobe opacity and new right upper lobe opacity are likely due to evolving pneumonia or aspiration. Results were conveyed via telephone to primary team by Dr. ___ on ___ at 3:40 p.m. within 5 minutes of observation of findings.


SubjectID: 10313763, StudyID: 53754596, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Questionable pneumonia, pleural effusions.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is now evidence of bilateral moderate pleural effusions. In addition, an opacity is seen in the middle lobe, better appreciated on the lateral than on the frontal image. This opacity corresponds to pneumonia in the appropriate clinical setting, as suspected in the previous report. Unchanged size of the cardiac silhouette. No additional lung parenchymal findings.


SubjectID: 10313763, StudyID: 53636146, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___ CLINICAL

HISTORY: ___-year-old woman with chest pain, question pneumonia.

FINDINGS: Portable AP upright chest radiograph is obtained. There is airspace consolidation involving the bilateral lower lungs which could represent pneumonia with possible associated pleural effusion. A lateral view would aid in diagnosis. Heart size cannot be fully assessed due to silhouetting by adjacent consolidation. There is faint atherosclerotic calcification along the aortic knob. No pneumothorax. Upper lungs are well aerated. The bony structures appear intact.

IMPRESSION: Lower lung opacities could represent pneumonia with effusion. Would recommend dedicated PA and lateral views to more clearly assess.


SubjectID: 10313763, StudyID: 51527697, Comparison: worse

FINAL REPORT

AP CHEST, 3:29 A.M. ON ___

HISTORY: A ___-year-old woman with pneumonia and recent desaturation and tachycardia.

IMPRESSION: AP chest compared to ___: Pulmonary vascular congestion has worsened to the point of early pulmonary edema, increasing the small right pleural effusion as well as vascular caliber   Keywords: increasing, worse. Heterogeneous opacification at both lung bases could be any combination of asymmetric edema, atelectasis, aspiration, and pneumonia. Left lower lobe atelectasis has worsened. No pneumothorax. The heart is moderately enlarged and the azygos vein is borderline distended.


SubjectID: 10316033, StudyID: 59048456, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with s/p heartware // OG placement - nursing will call

COMPARISON: ___ at 13:29.

IMPRESSION: There has been placement of a nasogastric tube whose tip and side port are below the GE junction. There remains a prior feeding tube which is unchanged. The rest of the lines and tubes are also stable. Heart size is enlarged. There is unchanged pulmonary edema and a left retrocardiac opacity   Keywords: unchanged. There are no pneumothoraces.


SubjectID: 10316033, StudyID: 58536693, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with s/p heartware // eval for effusion

COMPARISON: Radiographs from ___

IMPRESSION: Support lines and tubes are unchanged in position. Heart size is enlarged but stable. There is a persistent left retrocardiac opacity. There remains mild pulmonary edema and airspace opacity within the left upper lobe, stable   Keywords: remains. There is likely a left-sided pleural effusion however this is obscured by the hardware. There are no pneumothoraces.


SubjectID: 10316033, StudyID: 57409239, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with Re-exploration for Bleeding s/p LVAD // eval for ptx, effusion. call cvicu house officer at ___ if there is any concern with findings

COMPARISON: Radiographs from ___

IMPRESSION: Endotracheal tube, Swan-Ganz catheter, left-sided AICD, and left ventricular assist device are unchanged. There has been placement of bilateral chest tubes. There is unchanged cardiomegaly. There has been development of consolidation within the right upper lobe, new since the previous study. Left retrocardiac opacity remains unchanged. There are no pneumothoraces.


SubjectID: 10316033, StudyID: 56838761, Comparison: worse

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old woman with s/p heartware // ?ptx s/p PA line placement Rt IJ

TECHNIQUE: Portable chest

COMPARISON: Portable chest radiograph dated ___ at 07:37

FINDINGS: Since 4 hours prior, there has been interval increase pulmonary edema   Keywords: increase. After confirmation with Dr. ___, an apical predominance of the edema is likely due to the patient's laying in ___ position prior to the radiograph thickening obtained. Severe cardiomegaly is unchanged. There has been interval removal of the left IJ Swan-Ganz catheter and placement of a right IJ Swan-Ganz catheter. A left IJ central venous catheter introducer remains in place. Mediastinal drains are essentially unchanged in position. An ET tube terminates 5 cm above the carina. An enteric tube side port projects over the proximal stomach. Neither costophrenic angle is visualized, but there no large pleural effusions are present.

IMPRESSION: Increased pulmonary edema with an apical predominance caused by a Trendelenburg positioning as described above   Keywords: increase.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 2:14 PM, proximally 20 minutes after discovery of the findings.


SubjectID: 10316033, StudyID: 56392162, Comparison: better

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old woman with LVAD // interval change

TECHNIQUE: Portable chest

COMPARISON: Portable chest radiographs dated ___

FINDINGS: Since 1 day prior, there has been substantial improvement in pulmonary edema, moderate at the right apex and mild elsewhere   Keywords: improve. Severe cardiomegaly is unchanged. The left costophrenic angle is not visualized, but there is no right pleural effusion. No pneumothorax. Substantial retrocardiac atelectasis is unchanged. An ET tube terminates 5.3 cm above the carina. A right-sided IJ Swan-Ganz catheter terminates in the proximal right pulmonary artery. An enteric tube passes into the stomach.

IMPRESSION: Substantially improved pulmonary edema, most pronounced in the right apex   Keywords: improve.


SubjectID: 10316033, StudyID: 56108243, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with s/p VAD/AVR/TVr // eval pulm edema eval pulm edema

COMPARISON: ___

IMPRESSION: Hardware appears to be in unchanged position. There is interval change in the direction of the Swan-Ganz catheter, please correlate with provided readings. There is interval progression of currently moderate pulmonary edema   Keywords: progression. Pacemaker leads are in unchanged position. No appreciable pneumothorax is seen.


SubjectID: 10316033, StudyID: 55059718, Comparison: 1.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with LVAD, intubated, now s/p bronch // eval for post-bronch PTX or other changes

TECHNIQUE: Single frontal view of the chest

COMPARISON: Study performed 2 hours earlier

IMPRESSION: There is no evident pneumothorax. Pulmonary edema has improved   Keywords: improve. Retrocardiac large area of atelectasis is unchanged. Right lower lobe atelectasis has increased. No other interval change from prior study   Keywords: no other interval change.


SubjectID: 10316033, StudyID: 54812204, Comparison: 1.0

FINAL REPORT

INDICATION: ___ year old woman s/p ct removal ? ptx

IMPRESSION: As compared to chest radiograph from the same day, there is no evident pneumothorax. Pulmonary edema has improved   Keywords: improve. Retrocardiac large area of atelectasis is unchanged. No other interval change from prior study   Keywords: no other interval change. Support devices in standard position.


SubjectID: 10316033, StudyID: 54080354, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman s/p Heartware now w low Pa2 // eval for pleural effusions, ETT position

COMPARISON: ___ at 16:39.

IMPRESSION: Tip of the endotracheal tube is 4 cm above the carina. Rest of the support lines and tubes are unchanged in position. There is a persistent left retrocardiac opacity and left-sided pleural effusion, unchanged. There is unchanged mild pulmonary edema   Keywords: unchanged. There are no pneumothoraces.


SubjectID: 10316033, StudyID: 52996004, Comparison: better

WET READ: ___ ___ ___ 10:53 PM Swan-Ganz terminates in the main pulmonary artery, similar to prior exam. Other lines and tubes in unchanged positions. -___ ______________________________________________________________________________

FINAL REPORT

EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 1 EXAM

INDICATION: ___ year old woman s/p VAD placement // eval PA line eval PA line

IMPRESSION: Comparison to ___. Unchanged position of the monitoring and support devices, in particular of the Swan-Ganz catheter. The ventricular assist device is also unchanged. Unchanged low lung volumes. Slightly improving pulmonary edema   Keywords: improving. No larger pleural effusions.


SubjectID: 10316033, StudyID: 52647330, Comparison: same

WET READ: ___ ___ 8:41 AM Feeding tube terminates in the stomach. --___

WET READ VERSION #___ ___ ___ 12:02 AM Feeding tube terminates in the stomach. -___ ______________________________________________________________________________

FINAL REPORT

EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 1 EXAM

INDICATION: ___ year old woman with s/p heartware // eval dobhoff position

TECHNIQUE: Single frontal view of the chest

COMPARISON: Study performed 7 hours earlier

IMPRESSION: Dobhoff tube tip isin the stomach. No other interval change from prior study   Keywords: no other interval change.


SubjectID: 10316033, StudyID: 50089402, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman s/p Heartware // eval for improvement of consolidation s/p bronchPLEASE DO FILM AT 1:30AM. THANKS!

COMPARISON: Radiographs from ___

IMPRESSION: There is no significant interval change   Keywords: no significant interval change. Support lines and tubes are unchanged in position. Cardiac silhouette is enlarged and stable. There remains pulmonary edema and a left retrocardiac opacity   Keywords: remains. There are no pneumothoraces.


SubjectID: 10316033, StudyID: 58038331, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman now s/p PA line exchange // Eval for position of PA line

FINDINGS: As compared to chest radiograph from the same day the Swan-Ganz catheter tip has been advanced and now projects in the region of the right pulmonary artery remains in good position. The IABP is approximately 1.7 Cm from the superior aortic arch. Moderate cardiomegaly and associated small to moderate left pleural effusion is unchanged.

IMPRESSION: Swan-Ganz catheter tip has been advanced and now projects in the region of the right pulmonary artery remains in good position.


SubjectID: 10316033, StudyID: 56490401, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF // pulm edema?

TECHNIQUE: Portable AP chest radiograph.

COMPARISON: Chest radiograph ___

FINDINGS: Supportive a monitoring equipment is unchanged in position compared to the prior study. Even allowing for the projection, the heart appears enlarged. There is prominence of the bilateral hila and pulmonary vasculature consistent with congestive heart failure. No frank pulmonary edema seen. Silhouetting left hemidiaphragm consistent with left lower lobe atelectasis. No pneumothorax or pleural effusion seen.

IMPRESSION: No significant interval change when compared to the prior study   Keywords: no significant interval change.


SubjectID: 10316033, StudyID: 56122988, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with new IABP and Swan placed, with to confirm placement of lines/tubes // PA line placement

COMPARISON: ___

FINDINGS: The right-sided Swan-Ganz catheter is in good position. The intra-aortic balloon pump is approximately 1 cm from the transverse portion of the aortic arch. Single lead defibrillator is in similar position. Moderate cardiomegaly. No interstitial pulmonary edema. The lungs are unchanged in appearance   Keywords: unchanged in appearance. No pneumothorax.

IMPRESSION: The right-sided Swan-___ catheter is in good position. The intra-aortic balloon pump is approximately 1 cm from the of the aortic arch.


SubjectID: 10316033, StudyID: 51318630, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with decompensated CHF // eval for interval change and position of swan

COMPARISON: Radiographs from ___

IMPRESSION: Support lines and tubes are unchanged in position. The tip of the Swan-Ganz catheter is again in the main right pulmonary artery. There is an unchanged left retrocardiac opacity and likely left-sided pleural effusion. There are no pneumothoraces.


SubjectID: 10316033, StudyID: 57289788, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with suggestion on labs that PA catheter has migrated to wedge position // ? interval change in positioning of PA catheter ? interval change in positioning of PA catheter

IMPRESSION: No relevant change as compared to ___   Keywords: no relevant change. The monitoring and support devices are in unchanged position, with the exception of the aortic balloon pump that has been minimally pulled back. The Swan-Ganz catheter has been minimally advanced. The device should be pulled back by approximately 3 cm. Unchanged retrocardiac atelectasis. Unchanged mild pulmonary edema and moderate cardiomegaly   Keywords: unchanged.


SubjectID: 10316033, StudyID: 55999797, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF awaiting VAD // please assess for pulmonary edema please assess for pulmonary edema

IMPRESSION: As compared to the previous image, the intra-aortic balloon pump has been further pulled back. The tip of the pump is now projecting almost 4 cm be low the upper most portion of the aortic arch. Mild pulmonary edema persists   Keywords: persists. Moderate cardiomegaly with retrocardiac atelectasis. No pneumonia.


SubjectID: 10316033, StudyID: 51803497, Comparison: better

FINAL REPORT

INDICATION: ___ year old woman with LVAD // interval change

FINDINGS: As compared to chest radiograph from 1 day prior, the IABP has been removed. The remaining support devices are unchanged. Interval improvement in the pulmonary vascular congestion   Keywords: improve. Moderate cardiomegaly with interval decrease in the pneumopericardium. Retrocardiac opacity is unchanged. No pneumothorax.

IMPRESSION: Slight interval improvement of pulmonary vascular congestion and pneumopericardium   Keywords: improve.


SubjectID: 10316033, StudyID: 51697762, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with PA catheter placement question, concern that it is wedged. // PA catheter placcment PA catheter placcment

IMPRESSION: As compared to the previous image, the Swan-Ganz catheter has been pulled back. The tip of the catheter now projects over the outflow tract of the right ventricle. Minimally improved ventilation at the left lung base. Unchanged mild pulmonary edema and moderate cardiomegaly   Keywords: unchanged. The aortic balloon pump is in unchanged correct position.


SubjectID: 10316033, StudyID: 56982822, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with cardiogenic shock and PA catheter placement // Please assess PA catheter placement Please assess PA catheter placement

IMPRESSION: As compared to the previous image, the position of the Swan-Ganz catheter is unchanged. It is located in the peripheral parts of the right pulmonary artery. The device could be pulled back by approximately 4 cm. Unchanged appearance of the cardiac silhouette. No pneumothorax. No overt pulmonary edema.


SubjectID: 10316033, StudyID: 50978616, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with cardiogenic shock // please eval pulm artery catheter placement please eval pulm artery catheter placement

IMPRESSION: In comparison with the study of ___, the Swan-Ganz catheter has been pulled back so that it now lies within the right pulmonary artery at the outer mediastinal level. Other monitoring and support devices are unchanged. Continued enlargement of the cardiac silhouette without appreciable vascular congestion. Mild increased opacification in the retrocardiac region could reflect some volume loss in the left lower lobe.


SubjectID: 10316033, StudyID: 55498926, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with non-ischemic cardiomyopathy // e/o pulm edema e/o pulm edema

IMPRESSION: In comparison with the study of ___, there is little change   Keywords: little change. Again there is substantial enlargement of the cardiac silhouette consistent with the diagnosis of cardiomyopathy. No appreciable vascular congestion or acute focal pneumonia. The left IJ catheter has been removed. Other monitoring and support devices are stable.


SubjectID: 10316033, StudyID: 50170087, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ F with history of a non-ischemic dilated cardiomyopathy (most recent LVEF ___%, diagnosed DCM ___ years ago), DM (A1c 9% now on insulin), HTN, Hypothyroidism, s/p ICD who presented as a direct admit from cardiology clinic with Dr. ___ ___ worsening dyspnea and evaluation for possible LVAD placement // ?interval change ?interval change

COMPARISON: ___

IMPRESSION: Left internal jugular line tip is at the level of lower SVC. Pacemaker defibrillator leads terminate in the right ventricle. Cardiomegaly is substantial. Pulmonary edema has slightly progressed, moderate, interstitial   Keywords: progressed. No pneumothorax is seen.

RECOMMENDATION(S): Reassessment of the patient after diuresis is recommended for documentation of interval improvement of pulmonary edema.


SubjectID: 10316033, StudyID: 55417421, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with acute decomp heart failure // CVL positioning, e/p pulm process CVL positioning, e/p pulm process

IMPRESSION: As compared to ___, 13:00, the Swan-Ganz catheter has been removed. The left internal jugular vein catheter as well as the left pectoral pacemaker remain in unchanged position. Unchanged moderate cardiomegaly with retrocardiac atelectasis. No pulmonary edema. No pleural effusions.


SubjectID: 10316033, StudyID: 51671394, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with advanced heart failure // interval change interval change

IMPRESSION: As compared to ___, no relevant change is seen   Keywords: no relevant change. The Swan-Ganz catheter and the pacemaker leads are in constant position. Moderate cardiomegaly no overt pulmonary edema. Retrocardiac atelectasis. No pneumonia, no pleural effusions.


SubjectID: 10320599, StudyID: 57967601, Comparison: None

FINAL REPORT

AP CHEST, 6:22 P.M., ___

HISTORY: AVR. Question pneumothorax after chest tube removal.

IMPRESSION: AP chest compared to ___ and earlier on ___: Small left apical pneumothorax is new since 3:08 p.m. Moderate right pleural effusion is unchanged. Postoperative widening of the cardiomediastinal silhouette is also stable. There is no pulmonary edema. Posterior fracture of a right middle rib is healed. ___ was paged; the change in the initial interpretation of no pneumothorax was discussed with the team member, ___, who responded at approximately 7:30am.


SubjectID: 10320599, StudyID: 57030234, Comparison: None

FINAL REPORT

PORTABLE AP CHEST FILM ___ AT 15:08 CLINICAL

INDICATION: Evaluate for pneumothorax with chest tube on waterseal. Comparison is made to the patient's prior study dated ___ at 12:42. Portable AP upright chest film, ___ at 15:08 is submitted.

IMPRESSION: 1. Status post median sternotomy with stable postoperative enlargement of the cardiac silhouette. Overall mediastinal contours are also stable. Interval extubation, removal of the nasogastric tube and removal of the right internal jugular Swan-Ganz catheter. A left basilar chest tube is not well visualized but appears to still be present. Basilar airspace opacity with layering effusions is seen likely representing compressive atelectasis. No evidence of pulmonary edema. No pneumothorax is seen.


SubjectID: 10320599, StudyID: 56816037, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male status post CABG with left apical pneumothorax. Evaluate for pneumothorax or effusion.

EXAMINATION: Single frontal chest radiograph.

COMPARISONS: ___.

FINDINGS: The previously noted small left apical pneumothorax is not appreciated. There are small bilateral left greater than right pleural effusions. There is bibasilar opacification, likely atelectasis. There are no new focal recurring opacities concerning for pneumonia. The cardiomediastinal and hilar contours are stable demonstrating tortuosity of the thoracic aorta with atherosclerotic calcification. The patient is status post median sternotomy and CABG. Multilevel degenerative changes of thoracolumbar spine as manifested by marginal osteophytic formation are stable.

IMPRESSION: No evidence of pneumothorax. Bibasilar atelectasis and small bilateral pleural effusions.


SubjectID: 10320599, StudyID: 57770341, Comparison: None

WET READ: ___ ___ ___ 7:52 AM 1. Interval placement of right-sided chest tube in grossly appropriate location. Hazy opacity in the right mid lung and new surgical chain sutures likely relates to recent right upper lobe wedge resection. 2. Prominence of the mediastinum likely relates to rightward patient rotation and AP technique, not appreciably changed since earlier same day chest radiograph. 3. Low lung volumes. More apparent left basilar and retrocardiac opacity may relate to atelectasis. 4. Right chest wall mild subcutaneous emphysema. C. Hostage

WET READ VERSION #1 ___ ___ ___ 11:52 PM 1. Interval placement of right-sided chest tube in grossly appropriate location. Hazy opacity in the right mid lung and new surgical chain sutures likely relates to recent right upper lobe wedge resection. 2. Prominence of the mediastinum likely relates to rightward patient rotation and AP technique, not appreciably changed since earlier same day chest radiograph. 3. Low lung volumes. More apparent left basilar and retrocardiac opacity may relate to atelectasis. 4. Right chest wall mild subcutaneous emphysema. C. Hostage ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p open RUL wedge // eval for PTX, chest tube placement eval for PTX, chest tube placement

IMPRESSION: In comparison with the earlier study of this date, there has been placement of a right chest tube without definite pneumothorax. Subcutaneous gas is seen along the right lateral chest wall with extension into the neck. Postsurgical changes are seen in the right hemithorax, especially in the mid zone. Opacification at the left base is consistent with volume loss in the lower lobe and probable small effusion. There is again enlargement of the cardiac silhouette with evidence of pulmonary vascular congestion.


SubjectID: 10320599, StudyID: 51734262, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___-year-old man with a history of right upper lobe wedge resection and diastolic heart failure, now status post fluid bolus. Concern for acute on chronic CHF.

TECHNIQUE: Portable AP chest radiograph

COMPARISON: Multiple prior chest radiographs, most recent from ___.

FINDINGS: Median sternotomy wires intact and aligned. Right apical chest tube position unchanged. Small, residual right apical pneumothorax and increased subcutaneous emphysema in the right chest wall and neck that suggests a continuing air leak. Small right pleural effusion and worsening atelectasis at the right base. Improved, small pleural effusion at the left base. Stable, mild cardiomegaly.

IMPRESSION: Small, residual right apical pneumothorax. Increased subcutaneous emphysema suggests continuing air leak. Worsening atelectasis at the right base.


SubjectID: 10320599, StudyID: 51132708, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with preop for vats wedge resection // preop Surg: ___ (R VATS wedge) preop

IMPRESSION: In comparison with the study of ___, there is again enlargement of the cardiac silhouette with elevated pulmonary venous pressure. Nodular opacification is again seen on the right. Overall, little change   Keywords: little change.


SubjectID: 10332328, StudyID: 59680396, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: Multiple priors, most recent dating ___ and prior CT, most recent dating ___. CLINICAL

HISTORY: Shortness of breath, hypoxemia, assess for pneumonia.

FINDINGS: Portable semi-upright AP view of the chest was provided. Underpenetrated technique and low lung volumes limit the evaluation. Allowing for this, there is increase in the bilateral pulmonary opacities which could represent pneumonia, multifocal versus atypical pulmonary edema   Keywords: increase. Please correlate clinically. The heart size cannot be assessed. The mediastinal contour is widened, though this is unchanged. No definite acute bony injury.


SubjectID: 10332328, StudyID: 58967133, Comparison: better

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old male with restrictive lung disease. Patient with acute on chronic hypoxemia. Evaluate for interval changes.

FINDINGS: Comparison is made to prior study from ___. There are low lung volumes and cardiomegaly which is stable. There is mild improvement of the pulmonary interstitial edema since the previous study   Keywords: improve. There remain opacities within the lung bases and likely bilateral pleural effusions. There are no large pneumothoraces seen.


SubjectID: 10336114, StudyID: 58646090, Comparison: None

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Weakness.

COMPARISONS: ___.

TECHNIQUE: Chest, AP upright and lateral.

FINDINGS: The patient is status post coronary artery bypass graft surgery. The heart appears mildly enlarged. The cardiac, mediastinal and hilar contours appear unchanged. There is a moderate left-sided pleural effusion, probably with some degree of loculation along the left lateral hemithorax, as well as patchy parenchymal opacity, most likely compatible with atelectasis. On the right, there is also a pleural effusion, probably free-flowing and small to moderate in size. There is also a small pneumothorax on the right. The distance between the apical visceral pleural edge and the outer chest wall measures about 2.2 cm. A mild interstitial abnormality suggests mild pulmonary edema. Fissures are thickened. The bones are probably demineralized.

IMPRESSION: Pneumothorax on the right. Bilateral pleural effusions. Interstitial abnormality suggesting mild pulmonary edema. Although opacities at the lung bases, greater on the left than right, are probably compatible with atelectasis, underlying infectious process is not entiredly excluded by this examination.


SubjectID: 10336114, StudyID: 51313454, Comparison: None

FINAL REPORT

INDICATION: Severe aortic stenosis and pneumothorax.

COMPARISON: ___.

FINDINGS: Portable frontal radiograph of the chest demonstrates a stable right pneumothorax. A small right pleural effusion and the loculated left pleural effusion has increased in size. Increase in mild enlargement of the cardiac silhouette with mild pulmonary edema.


SubjectID: 10336412, StudyID: 58960299, Comparison: None

FINAL REPORT

HISTORY: Non-small cell lung cancer with increased dyspnea.

COMPARISON: ___

FINDINGS: Again seen is the area of opacity in the right mid to upper lung compatible with postobstructive pneumonia. superimposed on this is an alveolar infiltrate that has progressed slightly on the right. There is some mild pulmonary vascular redistribution.

IMPRESSION: Amount of fluid over load has increased compared to the prior study and there is increased alveolar infiltrate.


SubjectID: 10336412, StudyID: 55188201, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old male with history of non-small cell lung cancer who presents for followup evaluation of a post-obstructive pneumonia.

COMPARISON: Chest radiographs from ___, ___, ___ and CT from ___.

TECHNIQUE: Single AP portable chest radiograph.

FINDINGS: Severe right upper and lower lobe consolidation has worsened in the lower lobe and at least moderate right pleural effusion is larger. Vascular congesion and perihilar edema in the left lung have worsened   Keywords: worse. There is no pneumothorax. Moderate cardiomegaly is stable since at least ___.

IMPRESSION: Interval worsening of severe right pneumonia and moderate right pleural effusion. Increased mild pulmonary edema   Keywords: increase. The findings were discussed with Dr. ___ at 1:40pm by Dr. ___ by telephone on the day of the exam.


SubjectID: 10336412, StudyID: 53860818, Comparison: None

FINAL REPORT

CHEST ON ___

HISTORY: Dyspnea, question interval change.

FINDINGS: Again seen is the right upper lung opacity. There is now increased amount of alveolar infiltrate involving the right upper lung extending to the apex with some areas of increased opacity in the right lower lung as well. The left lung is clear. Findings are compatible with the patient's known right upper lobe mass with post-obstructive pneumonia. It is unclear if the worsened appearance in the right lung is due to lymphangitic tumor spread or infection. However, given the relatively rapid change in appearance, asymmetric pulmonary edema or infection are most likely.


SubjectID: 10336412, StudyID: 58249331, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with shortness of breath.

COMPARISON: Chest radiograph from ___. ONE VIEW OF THE CHEST: The lungs are well expanded and show bilateral interstitial and focal airspace opacities. The cardiomediastinal silhouette and hilar contours are normal. No pleural effusion or pneumothorax is present.

IMPRESSION: Moderate pulmonary edema.


SubjectID: 10336412, StudyID: 56059027, Comparison: 1.0

FINAL REPORT

INDICATION: ___-year-old male with end-stage renal disease status post transplant, hypertension wit recent episode of pulmonary edema. Evaluate for change.

COMPARISON: Chest radiograph from ___ as well as multiple chest radiographs from ___ to ___ and a chest CTA on ___.

TECHNIQUE: PA and lateral chest radiograph.

FINDINGS: The lungs are well inflated. There has been significant interval improvement in the diffuse alveolar opacities previously seen   Keywords: improve. There are no focal consolidations. However, a minimal amount of fluid is still seen in the minor fissure, and there appears to be some right hilar engorgement with upper retraction which appears new compared with ___   Keywords: new. There is no pleural effusion or pneumothorax. Stable mild cardiomegaly.

IMPRESSION: 1. Right hilar fullness with upper retraction is new from ___. Chest CT is recommended for further assessment. 2. Interval improvement of pulmonary edema   Keywords: improve. 3. Stable mild cardiomegaly.


SubjectID: 10336412, StudyID: 52082223, Comparison: None

WET READ: ___ ___ ___ 5:36 PM improved aeration of right lower and left lung with persistent dense opacification of right upper lobe. apex slightly obscured by mandible but no apical pneumothorax evident. stable cardiomediastinal contour. ___

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Lung cancer, right pleural effusion, evaluation.

COMPARISON: ___.

FINDINGS: Since the previous radiograph, the extensive right upper lobe pneumonia is constant in extent and severity. The opacities in the right lower lobe have slightly decreased in extent. There is no evidence of pneumothorax. Moderate cardiomegaly with tortuosity of the thoracic aorta persists. No pleural effusions.


SubjectID: 10338515, StudyID: 59383295, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF, SLE, CKD, chronic steroids presents with URI symptoms, ___ edema, concern for PNA // please assess for interval change, infection

TECHNIQUE: Single frontal view of the chest

COMPARISON: PORTABLE CHEST X-RAY ___

FINDINGS: The right internal jugular central venous catheter terminates in the mid SVC. Low lung volumes, cardiomegaly, and pulmonary vascular congestion remains stable   Keywords: remains, stable. There is no pneumothorax.

IMPRESSION: No evidence of pneumonia however difficult to exclude superimposed pneumonia without lateral view. No interval change in cardiomegaly and vascular congestion   Keywords: no interval change.


SubjectID: 10338515, StudyID: 54316986, Comparison: same

FINAL REPORT

INDICATION: ___-year-old male with right internal jugular central venous line placement. Evaluate line.

TECHNIQUE: Portable AP chest radiograph was obtained.

COMPARISON: Chest radiograph from ___ at 13:01.

FINDINGS: Evaluation is limited by motion. There has been interval placement of a right internal jugular central venous line which terminates in the proximal SVC. Lung volumes continue be low with mild pulmonary edema and cardiomegaly seen   Keywords: continue.

IMPRESSION: Right internal jugular central venous line terminates in the proximal SVC without procedural complications seen. Stable appearance of the chest with low lung volumes, cardiomegaly and pulmonary edema.


SubjectID: 10338515, StudyID: 51080146, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with shortness of breath. Evaluate for infiltrate or edema.

TECHNIQUE: AP chest radiograph was obtained.

COMPARISON: Chest radiograph from ___, ___, ___ and ___.

FINDINGS: Lung volumes are low causing crowding of the central bronchovascular structures. The heart is mildly enlarged, and there is mild pulmonary vascular congestion. There is possible fluid along the right minor fissure, and no focal consolidation or pneumothorax is seen.

IMPRESSION: Low lung volumes. Mild cardiomegaly and pulmonary vascular congestion. Possible small right pleural effusion.


SubjectID: 10345163, StudyID: 59288808, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p CABG // eval for pleural effusions

COMPARISON: None.

FINDINGS: Compared with ___ at 18:23 , I doubt significant change. Again seen are low inspiratory volumes, sternal wires and prominence of the cardiomediastinal silhouette, and left lower lobe collapse and/or consolidation. There is upper zone redistribution, likely accentuated by low inspiratory volumes, without overt CHF. Although small right and left effusions cannot be excluded, no gross effusion is identified. As before, a right IJ central line is again seen, with tip over distal SVC.

IMPRESSION: Doubt significant change compared with ___ at 18:23


SubjectID: 10345163, StudyID: 58169997, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p CABG // eval for pneumo

COMPARISON: ___

FINDINGS: Low inspiratory volumes. No obvious pneumothorax. The right-sided catheter is again seen overlying the distal SVC. The chest tubes and mediastinal tube have been removed. There is prominence of the cardiomediastinal silhouette and of the vascular markings, at least in part accentuated by low lung volumes. The possibility of background CHF cannot be excluded in this setting. The patient has known pre-existing cardiomegaly. Sternotomy wires noted.

IMPRESSION: As above.


SubjectID: 10345163, StudyID: 59107435, Comparison: None

FINAL REPORT

INDICATION: ___ year old man POD 1 AM rounds CABG // Eval for effusion, widened mediastinum. AM POD1

COMPARISON: Comparison is made with prior studies including ___.

IMPRESSION: Since the prior study, the endotracheal tube and nasogastric tubes have been removed. Bilateral chest tubes and mediastinal tube are unchanged. There is no pneumothorax or pneumomediastinum. There is a poor inspiratory effort making evaluation of the cardiac and mediastinal silhouette difficult. There is no CHF or dense consolidation. There is linear atelectasis in both lung bases.


SubjectID: 10349402, StudyID: 58607794, Comparison: None

FINAL REPORT

EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Dementia with altered mental status.

COMPARISON: None.

FINDINGS: Frontal and lateral views of the chest were obtained. Dual-lead right-sided pacemaker is seen with leads extending to the expected positions of the right atrium and right ventricle. Left retrocardiac basilar opacity is seen, which could be due to atelectasis; however, underlying consolidation due to infection or aspiration is not excluded. There is no pleural effusion or pneumothorax. The cardiac silhouette is top normal to mildly enlarged. The aorta is somewhat tortuous.

IMPRESSION: Patchy medial left basilar retrocardiac opacity is nonspecific, could be due to atelectasis, but underlying infection or aspiration not excluded.


SubjectID: 10349402, StudyID: 53553938, Comparison: None

FINAL REPORT

HISTORY: Hypotension elevated lactate. Evaluate for pneumonia.

COMPARISON: ___.

FINDINGS: 2 views of the chest demonstrate a right pacemaker generator with atrial and ventricular leads. Bibasilar opacities are seen which correlate with areas of consolidation on the concurrently obtained CT of the abdomen and pelvis which may represent atelectasis or infection. The cardiac and mediastinal contours are normal. No pleural abnormality is perceived, although a small left pleural effusion was seen on the concurrently obtained CT of the abdomen and pelvis.

IMPRESSION: Bibasilar opacities better seen on the CT of the abdomen and pelvis which may represent atelectasis or consolidation. Small left pleural effusion is better seen on the concurrently obtained abdomen-pelvis CT.


SubjectID: 10352433, StudyID: 58205550, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___M with acute-onset unsteadiness, urinary incontinence today, expressive aphasia, altered mental status; borderline febrile

COMPARISON: Chest radiograph ___

FINDINGS: PA and lateral views of the chest provided. There are prominent bilateral interstitial marking including ___ B-lines, consistent with mild pulmonary edema. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen.

IMPRESSION: Mild pulmonary edema, without pleural effusions.


SubjectID: 10352433, StudyID: 57245074, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with flash pulmonary edema // ?improvement of CXR

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Cardiomediastinal silhouette is unchanged including cardiomegaly but there is interval substantial improvement in pulmonary edema   Keywords: improve. No interval development of pleural effusions demonstrated although small amount of pleural fluid cannot be excluded. No pneumothorax. Right lower lung partial atelectasis is unchanged.


SubjectID: 10352433, StudyID: 54503910, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old male with worsening tachypnea, wheezing, and tachycardia.

COMPARISON: Radiograph dated ___.

FINDINGS: Single portable upright chest radiograph demonstrate save rotated patient. The heart is mildly enlarged. Perihilar bilateral patchy opacities as well as indistinct central vessels are most suggestive of pulmonary edema. There is no large pleural effusion. Mediastinal and hilar contours are stable relative to prior radiograph dated ___. Osseous there is demonstrate chronic appearing multiple left-sided rib deformities.

IMPRESSION: Cardiomegaly with pulmonary edema, progressed since prior study dated ___   Keywords: progressed.


SubjectID: 10354217, StudyID: 56434512, Comparison: same

FINAL REPORT

HISTORY: CHF exacerbation.

FINDINGS: In comparison with study of ___, there is continued evidence of pulmonary vascular congestion, though it appears to be somewhat less than on the previous study   Keywords: continue. Bibasilar opacifications are again consistent with pleural effusion and atelectasis. Central catheter is unchanged.


SubjectID: 10354217, StudyID: 55908130, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female with syncope.

COMPARISON: ___. CT from ___.

FINDINGS: AP and lateral views of the chest. Mild left mid lung opacity is again seen and suggestive of scarring and presence on prior CT. Ther is no large effusion. Cardiac silhouette is enlarged but stable. Aortic valve replacement is again seen. No acute osseous abnormalities detected.

IMPRESSION: No definite acute cardiopulmonary process.


SubjectID: 10364180, StudyID: 58995456, Comparison: same

FINAL REPORT

INDICATION: COPD, pneumonia, atypical layering of pulmonary edema. Now status post diuresis.

COMPARISON: ___.

FINDINGS: AP view of the chest. Patient has been extubated. Moderate cardiomegaly is again seen and the cardiomediastinal and hilar contours are unchanged. The right lower lobe consolidation slightly increased. Mild pulmonary edema is unchanged   Keywords: unchanged.

IMPRESSION: Increasing right lower lobe consolidation. Likely mild pulmonary edema is unchanged   Keywords: unchanged.


SubjectID: 10364180, StudyID: 54648261, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Hypercarbic respiratory failure, evaluation for endotracheal tube position.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The lung volumes are slightly lower, potentially caused by lower ventilatory pressure. The tip of the endotracheal tube is in unchanged position. The tip projects 3 cm above the carina. The nasogastric tube shows unchanged course and position.


SubjectID: 10364180, StudyID: 54580640, Comparison: same

FINAL REPORT

INDICATION: COPD and CHF. Evaluate for change.

COMPARISON: ___ at 3:46 a.m.

FINDINGS: AP view of the chest. Right lower lobe consolidation is unchanged. Mild-to-moderate pulmonary edema is unchanged   Keywords: unchanged   Keywords: unchanged. No large pleural effusion. Cardiomediastinal and hilar contours are stable. No pneumothorax.

IMPRESSION: No significant change in right lower lobe consolidation. Mild-to-moderate pulmonary edema is unchanged.


SubjectID: 10364180, StudyID: 58976644, Comparison: same

FINAL REPORT

PORTABLE CHEST FILM ___ AT 827 CLINICAL

INDICATION: ___-year-old with CHF, COPD, right effusion, assess for interval change. Comparison to prior study of ___ at 242. Portable AP upright chest film ___ at 827 is submitted.

IMPRESSION: 1. Overall cardiac and mediastinal contours are stable. There continues to be a diffuse bilateral predominantly interstitial abnormality in the lungs with more focal vague opacity in the left upper peripheral lung   Keywords: continue. When compared to the most recent prior study, there is no significant interval change, although these findings are more pronounced when compared to studies from ___   Keywords: no significant interval change. Therefore, these findings favor persistent interstitial edema rather than an infectious process   Keywords: persistent. Clinical correlation would be advised. There is a small layering left effusion. There is overall improved aeration at the right base when compared to more remote studies. Heart remains enlarged. Calcification of the aorta consistent with atherosclerosis. No pneumothorax.


SubjectID: 10364180, StudyID: 55260695, Comparison: worse

FINAL REPORT

HISTORY: Shortness of breath after blood transfusion, to assess for pulmonary edema.

FINDINGS: In comparison with study of ___, there is some increase in the bilateral pulmonary opacifications, consistent with worsening pulmonary vascular congestion   Keywords: worse, increase. In the appropriate clinical setting, superimposed pneumonia would be difficult to exclude.


SubjectID: 10364180, StudyID: 58256366, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with intubation // eval ET tube

COMPARISON: Prior exam from approximately 1 hr earlier.

FINDINGS: AP portable supine view of the chest. There has been interval intubation with the tip of the endotracheal tube residing approximately 4 cm above the carina. Mild cardiomegaly and pulmonary interstitial edema persists   Keywords: persists. No large effusions are present.

IMPRESSION: ET tube positioned appropriately. Persistent cardiomegaly and interstitial pulmonary edema   Keywords: persistent.


SubjectID: 10364180, StudyID: 57239268, Comparison: -1.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with COPD exacerbation, now intubated // interval change in pulmonary edema and pleural effusions

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The lung volumes have slightly increased, as a consequence, the bilateral parenchymal opacities, at the right lung bases and in the left upper lobe appear slightly less dense but are still clearly present   Keywords: increase. Moderate cardiomegaly persists. No pleural effusions. Mild pulmonary edema. The course of the endotracheal tube and the nasogastric tube are unchanged.


SubjectID: 10364180, StudyID: 53383509, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with resp distress/hypoxia // r/o infiltrate,failure

COMPARISON: ___. PET-CT scan from ___.

FINDINGS: AP portable upright view of the chest. In this patient with known COPD plans lung cancer, diffuse interstitial opacities are concerning for edema. The known pulmonary nodular opacities are better visualized on the prior PET-CT scan. Small effusions are difficult to exclude. The heart appears mildly enlarged. Aortic atherosclerotic calcifications noted. No acute bony injuries.

IMPRESSION: Mild cardiomegaly with interstitial pulmonary edema and probable small bilateral pleural effusions. Pulmonary nodular opacity seen on prior PET-CT scan poorly visualized on this chest radiograph.


SubjectID: 10364180, StudyID: 58182875, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with COPD, intubated // Evaluate ET Tube placement

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the endotracheal tube and the nasogastric tube are in constant position. The lung volumes are decreasing and there is a new parenchymal opacity at the right lung bases. Overall the opacity could reflect atelectasis, newly appeared pneumonia is another differential diagnostic consideration. Moderate cardiomegaly persists. Mild fluid overload. No larger pleural effusions.


SubjectID: 10364180, StudyID: 54752515, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with COPD, leukocytsois // infiltrate vs atelectasis

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the lung volumes have increased, likely reflecting improved ventilation. The endotracheal tube and the nasogastric tube have been removed. The large parenchymal opacities at the right lung basis and in the left perihilar areas, however, are unchanged. Unchanged appearance of the moderately enlarged cardiac silhouette. No larger pleural effusions. No new parenchymal opacities   Keywords: new.


SubjectID: 10364180, StudyID: 58152775, Comparison: same

FINAL REPORT

INDICATION: COPD, volume overload, and shortness of breath. Evaluate for change.

COMPARISONS: Chest radiograph from ___.

TECHNIQUE: A single upright AP view of the chest was obtained.

FINDINGS: Again, there is moderate pulmonary edema, not significantly changed from the prior exam   Keywords: not significantly changed, again. Right basilar atelectasis is stable. There is no new consolidation. There is no pleural effusion or pneumothorax. The aorta is tortuous and calcified. The heart is moderately enlarged.

IMPRESSION: No significant change in the moderate pulmonary edema   Keywords: no significant change.


SubjectID: 10364180, StudyID: 51539305, Comparison: 0.0

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: COPD, evaluation for pneumonia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is minimally improved pulmonary edema   Keywords: improve. However, the edema is still moderate in severity   Keywords: still. A right basal atelectasis is unchanged. Unchanged size of the cardiac silhouette, with slightly enlarged pulmonary arteries, left more than right, suggesting pulmonary hypertension.


SubjectID: 10364180, StudyID: 55680773, Comparison: worse

FINAL REPORT

HISTORY: ___-year-old female with known diastolic congestive heart failure and COPD. Evaluate for pulmonary edema or focal consolidation.

COMPARISON: Multiple prior chest radiographs most recently dated ___.

FINDINGS: Heart size is only top normal. Nevertheless, worsened moderate pulmonary edema and small pleural effusions are presumably cardiac in origin   Keywords: worse. There is increased density within the right lower lobe, is dependent atelectasis or pneumonia0. No pneumothorax.

IMPRESSION: 1. Worsening pulmonary edema, presumably cardiac   Keywords: worse. Emphysema. 2. Right lower lobe atelectasis or pneumonia. Recommend follow up radiographs to document clearance with treatment of edema.


SubjectID: 10388429, StudyID: 57889015, Comparison: None

FINAL REPORT

EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of shortness of breath at rest, discharged yesterday from ___.

COMPARISON: ___.

FINDINGS: Single frontal view of the chest was obtained. A tube plus catheter is seen projecting over the right hemithorax. There are bilateral pleural effusions with overlying atelectasis, underlying consolidation is difficult to exclude. Cardiac and mediastinal silhouettes are stable.

IMPRESSION: Bilateral pleural effusions with overlying atelectasis. Underlying consolidation not excluded.


SubjectID: 10388429, StudyID: 52731514, Comparison: worse

FINAL REPORT

PORTABLE CHEST

COMPARISON: ___ radiograph.

FINDINGS: Cardiac silhouette is enlarged, and accompanied by mild pulmonary vascular engorgement, new perihilar haziness and more confluent opacities at the bases, accompanied by small effusions   Keywords: new. Findings are likely due to perihilar and basilar edema, but superimposed process such as aspiration at the lung bases is also possible. Followup radiographs may be helpful.


SubjectID: 10391104, StudyID: 58989850, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with severe TR, ?PNA // interval change in effusion

IMPRESSION: As compared to ___ chest radiograph, bilateral pleural effusions have apparently decreased in size with residual moderate right and small to moderate left pleural effusions remaining. Pulmonary vascular congestion is accompanied by decreasing extent of pulmonary edema   Keywords: decreasing. Substantial bibasilar atelectasis and or consolidation persists adjacent to the pleural effusions.


SubjectID: 10391104, StudyID: 52630250, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with h/o ?COPD, CHF with EF ___% hypoxic to 80s // pulmonary pathology

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Biventricular pacer is in place. Large pleural effusion is demonstrated and there is potential worsening of congestive heart failure seen as mild vascular congestion   Keywords: worse.


SubjectID: 10391104, StudyID: 56846827, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with fever, cough dyspnea. // r/o pneumonia

COMPARISON: No previous films on PACs record for comparison.

FINDINGS: There is probable background COPD, with parenchymal scarring. Heart size is at the upper limits of normal, borderline enlarged. There is mild upper zone redistribution. There are increased interstitial markings and peribronchial cuffing   Keywords: increase. There are some more focal areas of increased markings in the left mid and lower zones and right base medially. The significance of this is uncertain, including whether represents an acute or chronic finding. This could represent a combination of parenchymal scarring and CHF or an infectious or inflammatory infiltrate. No frank consolidation or air bronchograms and no effusion is identified.

IMPRESSION: Probable background COPD. Increased interstitial markings in both lungs   Keywords: increase. Please see comment above.


SubjectID: 10391104, StudyID: 51592833, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with cough, concern for PNA // eval for PNA

COMPARISON: Chest x-ray from ___ at 556

FINDINGS: Compared with earlier the same day, I doubt significant interval change. Again seen is cardiomegaly, upper zone redistribution, and increased interstitial markings, including focally more pronounced areas in the left mid and lower zones and in the right cardiophrenic region. As before, it is uncertain whether these represent acute or chronic findings and whether they represent a a single process alone or a process superimposed on some background interstitial changes. The potential differential includes background scarring, interstitial edema, inflammatory infectious processes. The presence of more confluent opacity at the left mid-zone makes it difficult to exclude an acute pneumonic infiltrate.

IMPRESSION: Increased interstitial markings, with focally pronounced areas in left mid zone and both bases, similar to a film obtained earlier the same day   Keywords: increase. The possibility of a focal pneumonic infiltrate cannot be excluded.


SubjectID: 10391104, StudyID: 56712025, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with AVJ ablation and PPM placement now with severe flank/abdominal pain // eval PPM lead placement

TECHNIQUE: AP view of the chest

COMPARISON: Priors most recent on ___

FINDINGS: There has been interval placement of a left-sided pacer and dual leads. The right ventricular lead overlies the left hemidiaphragm on this single view. The heart is moderately enlarged with stable in size from the prior exam. The cardiomediastinal and hilar contours are within normal limits. There is no focal consolidation, effusion or pneumothorax. No evidence of pulmonary edema with minimal pulmonary vascular engorgement.

IMPRESSION: No evidence of pneumothorax. Pacer and leads leads in expected position.


SubjectID: 10391104, StudyID: 53814102, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman s/p AVJ ablation and PPM on ___ // pacemaker lead placement

TECHNIQUE: Chest two views

COMPARISON: ___.

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change.


SubjectID: 10407582, StudyID: 58895720, Comparison: None

FINAL REPORT

AP CHEST, 11:05 A.M., ___

HISTORY: ___-year-old man with pneumothorax after right fiducial seed placements. Chest tube on suction.

IMPRESSION: Three frontal views of the chest, all show the complete resolution of the previous moderate right pneumothorax, now with only a tiny apical component. Pigtail pleural drain unchanged in position in the right lower chest anterolaterally. Both lungs are clear. There is no appreciable pleural effusion, and the cardiomediastinal silhouette is unremarkable.


SubjectID: 10407582, StudyID: 57081381, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male patient with right pneumothorax, status post pigtail removal.

COMPARISON: Prior chest radiograph from ___ at 6:04.

TECHNIQUE: PA and lateral chest radiographs.

FINDINGS: As compared to prior chest radiograph from ___, there has been interval removal of a right-sided pigtail catheter. Miniscule collection of right apical air is identified. There are no pleural effusions. Cardiomediastinal and hilar contours are within normal limits. There is calicifaction of the mitral annulus. Fiducial markers are again noted.

IMPRESSION: Miniscule collection of right apical air.


SubjectID: 10407582, StudyID: 54453540, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male patient with right pneumothorax post fiducial seed placement. Study requested to rule out pneumothorax, now with chest tube on waterseal.

COMPARISON: Prior chest radiograph from ___ at 11:05.

TECHNIQUE: PA and lateral chest radiographs.

FINDINGS: As compared to prior chest radiograph from ___, there has been some increase of a small right apical pneumothorax. A right pleural pigtail catheter remains in unchanged position. Left lung is clear. There are no new focal consolidations. The cardiomediastinal and hilar contours are within normal limits.

IMPRESSION: Interval increase of a small right apical pneumothorax.


SubjectID: 10407582, StudyID: 52749044, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Fiducial marker placement. Evaluation for pneumothorax.

COMPARISON: Pre-interventional CT from ___.

FINDINGS: The patient has developed a right apical pneumothorax. The diameter of the pneumothorax is approximately 1 cm. There is no evidence of tension. Fiducial seeds are seen in the right upper abdomen. Previously present pleural effusions are no longer visible. Normal size of the heart. Normal hilar and mediastinal contours.


SubjectID: 10407582, StudyID: 50299239, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Followup of pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the extent of the pre-existing right pneumothorax has increased. The pneumothorax is at least 3 times wider than previously. In addition, there is very mild depression of the right hemidiaphragm, potentially suggesting beginning tension. No other change   Keywords: no other change. At the time of dictation and observation, Dr. ___ was paged for notification, 4:02 p.m., on ___.


SubjectID: 10407730, StudyID: 57977401, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with CAD, renal failure on HD, CHF, and now significant SOB // assess for pulmonary edema, pleural effusions, or other intrathoracic pathology that might explain severe SOB assess for pulmonary edema, pleural effusions, or other intr

IMPRESSION: In comparison with the study ___ ___, there is substantial increase in the degree of pulmonary edema with continued enlargement of the cardiac silhouette and blunting of the costophrenic angles   Keywords: increase. The central catheter and pacer device remain in place. In the appropriate clinical setting, the opacification at the left mid and lower zones could reflect superimposed pneumonia.


SubjectID: 10407730, StudyID: 53162706, Comparison: better

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: History: ___F with dyspnea and productive cough // ? process

TECHNIQUE: Chest Frontal and Lateral

COMPARISON: ___

FINDINGS: Right-sided large-bore central venous catheter is again seen terminating in the right atrium. Dual lead right-sided pacemaker is stable in position. There is persistent blunting of the bilateral costophrenic angles suggesting trace pleural effusions with overlying atelectasis. Perihilar opacities are consistent with pulmonary edema which appear grossly stable to possibly minimally decreased as compared to the prior study   Keywords: decrease. The cardiac silhouette remains enlarged. The aorta is calcified.

IMPRESSION: Small bilateral pleural effusions again seen. Pulmonary edema which may be slightly improved since the prior study   Keywords: improve. Persistent cardiomegaly.


SubjectID: 10407730, StudyID: 57669115, Comparison: None

FINAL REPORT

STUDY: AP chest; ___. CLINICAL

HISTORY: ___-year-old woman with worsening shortness of breath. Evaluate for acute process.

FINDINGS: Comparison is made to prior study from ___. There is cardiomegaly, which is stable. There is a right-sided dual-lead pacemaker, which is unchanged. There is worsening of the left retrocardiac opacity with likely small bilateral pleural effusions. There are no pneumothoraces.


SubjectID: 10407730, StudyID: 56709687, Comparison: worse

FINAL REPORT

HISTORY: Flash pulmonary edema.

FINDINGS: In comparison with the earlier study of this date, there is continued and probably worsening pulmonary edema, consistent with clinical history   Keywords: worse. The left hemidiaphragm is poorly seen, suggesting some pleural fluid and volume loss on this side. Pacer leads are in satisfactory position in this patient with previous CABG procedure and intact midline sternal wires.


SubjectID: 10407730, StudyID: 54291346, Comparison: better

FINAL REPORT

HISTORY: Flash pulmonary edema, to assess for improvement.

FINDINGS: In comparison with study of ___, there are lower lung volumes, though the degree of pulmonary venous congestion has substantially decreased   Keywords: decrease. Continued enlargement of the cardiac silhouette in a patient with intact midline sternal wires after CABG procedure and a dual-channel pacer device in place.


SubjectID: 10407730, StudyID: 57148256, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with cough // r/o acute process

TECHNIQUE: Upright PA and lateral chest

COMPARISON: Chest radiographs ___, ___, and ___.

FINDINGS: Dual lead right chest wall pacemaker is in stable position. Median sternotomy wires appear intact. Surgical clips project over the mediastinum. Right internal jugular hemodialysis catheter terminates in the right atrium. Mild cardiomegaly is unchanged. The mediastinal and hilar contours are normal. Small bilateral pleural effusions are redistributed with the patient upright and likely not significantly changed since the prior study. There is no evidence of pneumonia. There is no pneumothorax.

IMPRESSION: No evidence of pneumonia. Small bilateral pleural effusions are redistributed but not significantly changed overall.


SubjectID: 10407730, StudyID: 53088898, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CAD, now with SOB // assess for interval change, pulm edema

COMPARISON: ___, 15:12

IMPRESSION: As compared to the previous radiograph, the patient has developed moderate pulmonary edema   Keywords: develop. In addition, there is a left pleural effusion that increases in size. The retrocardiac atelectasis that pre existed is also increased. Unchanged moderate cardiomegaly. The alignment of the sternal wires is constant. Unchanged pacemaker and dialysis catheter. At the time of dictation a pager was placed to the referring physician for

NOTIFICATION:.


SubjectID: 10407730, StudyID: 54681780, Comparison: better

FINAL REPORT

EXAM: Chest, AP upright and lateral views. CLINICAL INFORMATION: Status post non-ST elevation MI and pulmonary edema with persistent productive cough and exertional shortness of breath.

COMPARISON: ___.

FINDINGS: Frontal and lateral views of the chest were obtained. Dual-lead right-sided pacer device is again seen with leads extending to the expected positions of the right atrium and right ventricle. Pulmonary edema persists, although appears somewhat improved since the prior study   Keywords: improve. There are likely small bilateral pleural effusions. Cardiac silhouette is slightly less prominent which may be due to differences in technique and patient position.

IMPRESSION: Moderate interstitial edema, decreased since the prior study   Keywords: decrease. Small bilateral pleural effusions.


SubjectID: 10417160, StudyID: 57398211, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Crackles, oxygen requirement, evaluation for pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, assessment for volume overload.

COMPARISON: ___. As compared to the previous radiograph, the moderate cardiomegaly and the signs of mild fluid overload persist. In addition, there is a zone of increased parenchymal opacity at the left lung base, combined to air bronchograms and minimal blunting of the costophrenic sinus. Findings are highly suggestive of newly occurred pneumonia. At the time of dictation and observation, 9:21 a.m., on ___, the referring physician, ___. ___, covered by Dr. ___, was paged for notification. A telephone conversation occurred one minute later.


SubjectID: 10417160, StudyID: 53970814, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: Chest CT from ___ as well as a chest radiograph from ___. CLINICAL

HISTORY: ___-year-old female with new AFib, shortness of breath, question pulmonary edema or pneumonia.

FINDINGS: AP and lateral views of the chest were obtained with patient positioned upright. In comparison with prior chest radiographs and chest CT, there is improvement in scattered opacities seen on prior exam with near-complete resolution   Keywords: improve. There are coarsened interstitial markings which could represent component of fibrosis. No new consolidation is seen. No effusion or pneumothorax. Patient rotation limits evaluation of the mediastinum. The heart size appears grossly stable and top normal in overall size. The imaged osseous structures appear intact.

IMPRESSION: Interval improvement in previously noted scattered pulmonary opacities   Keywords: improve. There is a probable component of fibrosis likely accounting for interstitial coarsening.


SubjectID: 10432951, StudyID: 59788680, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: COPD, oxygen requirement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is unchanged moderate cardiomegaly with moderate pulmonary edema   Keywords: unchanged. In addition, there is increasing volume loss of the right upper lobe with subsequent opacification of this anatomic region, potentially representing recent or developing pneumonia. The nasogastric tube has been removed. The observation was made at the time of dictation, 11:39 a.m., on ___. At the same time the referring physician, ___. ___, was paged for notification.


SubjectID: 10432951, StudyID: 56640608, Comparison: same

FINAL REPORT

INDICATION: PICC line in proximal SVC has been cleaned and PICC pulled out slightly, please evaluate placement.

COMPARISON: Comparison is made to multiple chest radiographs, most recently dated ___.

FINDINGS: Interval withdrawal of right-sided PICC line with tip terminating in the upper superior vena cava. No pneumothorax identified. Nasogastric tube is seen coursing into stomach and out of view. There is a persistent right hemidiaphragm elevation with increased right lower lung consolidation, likely due to right middle lobe collapse. Unchanged left retrocardiac opacity likely represents combination of atelectasis and effusion, though cannot exclude developing infectious process. Pulmonary edema is unchanged   Keywords: unchanged. Stable bilateral pleural effusions.

IMPRESSION: Interval withdrawal of right PICC line with tip in the upper superior vena cava. Increased right middle lung collapse. Stable bilateral pleural effusions and retrocardiac opacification.


SubjectID: 10432951, StudyID: 54910240, Comparison: same

FINAL REPORT

INDICATION: ___-year-old female with multiple medical problems, now with somnolence and worsening hypoxia after p.o. challenge yesterday, here to evaluate for evidence of aspiration or worsening pleural effusion.

COMPARISON: Chest radiographs, last performed on ___. PORTABLE FRONTAL CHEST RADIOGRAPH: Opacifications at the bilateral bases, right greater than the left, likely represent small bilateral pleural effusions with associated atelectasis, now with worsening right middle lobe atelectasis compared to ___. The right upper lobe opacity seen on the preceding radiograph is no longer present which likely represents resolved right upper lobe atelectasis. Mild pulmonary edema is unchanged. No pneumothorax is present. A right-sided PICC line is unchanged in position with the tip terminating in the upper SVC. The cardiomediastinal silhouette is moderately enlarged but unchanged.

IMPRESSION: 1. Increased bibasilar opacification on the right greater than the left, consistent with small bilateral pleural effusions with associated atelectasis, worse in the right middle lobe. Superimposed pneumonia cannot be excluded in the appropriate clinical setting. 2. Improved aeration at the right upper lobe consistent with resolved atelectasis. 3. Persistent mild pulmonary edema   Keywords: persistent.


SubjectID: 10432951, StudyID: 51410941, Comparison: same

FINAL REPORT

HISTORY: NG tube replacement.

FINDINGS: The NG tube extends to the lower body of the stomach with the side hole beyond the esophagogastric junction. Otherwise, little change   Keywords: little change.


SubjectID: 10432951, StudyID: 59645538, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman with history of severe COPD and restrictive lung disease, obesity and hypoventilation.

FINDINGS: There is a nasogastric tube whose side port and tip are in the esophagus and this needs to either be removed or advanced at least ___-25 cm for more optimal placement. There is a right-sided central venous line whose tip in the proximal SVC. This could be advanced 6-7 cm for more optimal placement. Heart size is enlarged. There is some atelectasis at the lung bases. There is a left retrocardiac opacity. There are bilateral pleural effusions. No pneumothoraces are identified.


SubjectID: 10432951, StudyID: 58859243, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman with delirium, repositioning of nasogastric tube.

FINDINGS: Comparison is made to the prior study performed earlier. The nasogastric tube has been advanced and the tip and side port are below the GE junction. The right-sided central venous catheter has the distal lead tip in the proximal SVC and could be advanced 6-7 cm for more optimal placement. There is unchanged cardiomegaly and a left retrocardiac opacity. There is also atelectasis at both lung bases, right side worse than left. No pneumothoraces are identified.


SubjectID: 10432951, StudyID: 59193599, Comparison: better

FINAL REPORT

INDICATION: Restrictive lung disease and worsening hypoxia. Please evaluate pulmonary edema or hypoxia.

COMPARISON: Comparison is made to multiple chest radiographs, most recently dated ___.

FINDINGS: Single portable chest radiograph demonstrates persistent though minimally improved mild to moderate pulmonary edema with slightly improved aeration of the bilateral upper lungs, left greater than right   Keywords: improve. Bibasilar opacifications noted, likely combination of atelectasis and bilateral pleural effusions, though concurrent infectious process cannot be appreciated. Endotracheal tube ends 2.5 cm above the carina. The nasogastric tube is seen coursing into stomach and out of view.

IMPRESSION: Minimally improved pulmonary edema with stable large bilateral pleural effusions   Keywords: improve. Bibasilar opacifications likely combination of atelectasis and effusion, though concurrent infectious process is a possibility in the appropriate clinical setting.


SubjectID: 10432951, StudyID: 58812506, Comparison: better

WET READ: ___ ___ ___ 9:44 PM ETT ends 3.3 cm above the level of the carina, appropriately positioned. Mild-to-moderate interstital pulmonary edema is decreased. Moderate bilateral pleural effusions persist. ______________________________________________________________________________

FINAL REPORT

AP CHEST, 6:12 P.M. ON ___

HISTORY: Check new ET tube.

IMPRESSION: AP chest compared to ___: New ET tube in standard placement. Nasogastric tube passes below the diaphragm and out of view. Lung volumes have improved, and mild pulmonary edema is more uniformly distributed   Keywords: improve. Small bilateral pleural effusions are presumed. Mild-to-moderate cardiomegaly has improved possibly because of positive pressure ventilator support. No pneumothorax.


SubjectID: 10432951, StudyID: 58494531, Comparison: worse

FINAL REPORT

INDICATION: Restrictive lung disease with rising leukocytosis.

COMPARISON: Radiograph available from ___. FRONTAL CHEST RADIOGRAPH: The heart is mildly enlarged. There is worsening of bilateral pleural effusions as well as central vascular congestion. Moderate pulmonary edema is again seen. There is no large pneumothorax. The apices are obscured by the patient's head.

IMPRESSION: Worsening bilateral pleural effusions with unchanged moderate edema   Keywords: worse. Superimposed consolidation, particularly at the bases, cannot be excluded.


SubjectID: 10432951, StudyID: 56441629, Comparison: better

FINAL REPORT

HISTORY: Mucus plug status post intubation. CHEST, SINGLE AP VIEW. The tip of the ET tube is not well delineated. It appears to overlap the NG tube and may lie approximately 8.3 cm above the carina at the level of the upper clavicle. An NG tube is present -- the tip overlies the fundus. There is prominence of the cardiomediastinal silhouette and left lower lobe collapse and/or consolidation. There is upper zone re-distribution and diffuse vascular blurring. There is increased opacity at the right base which could represent subsegmental or segmental atelectasis, with an elevated right hemidiaphragm. I suspect the presence of a small right effusion as well. There is increased retrocardiac density, with left lower lobe collapse and/or consolidation. No gross left effusion. Prominence of the main pulmonary artery is suggested. The hila also appear prominent.

IMPRESSION: 1. ET tube approximately 8.3 cm above the carina. Please see comment. 2. Cardiomegaly with suspected pulmonary artery enlargement. 3. Findings consistent with CHF. Compared with ___ at 2:40 a.m., the CHF findings are improved   Keywords: improve. 4. Left lower lobe collapse and/or consolidation. 3. Suspected atelectasis at the right base with elevated right hemidiaphragm. This is improved c/w with ___ at 2:40 am, but interval improvement could be also relate to differences in positioning, as the current film was obtained semi-erect.


SubjectID: 10432951, StudyID: 55827326, Comparison: None

FINAL REPORT

INDICATION: NG tube placement.

COMPARISON: Radiograph available from ___. PORTABLE CHEST RADIOGRAPH: Since ___ the patient has been extubated. There is a new nasogastric tube terminating within the stomach. The heart is enlarged. Bilateral pleural effusions and superimposed mild pulmonary edema are stable. There is no pneumothorax. Bibasilar atelectasis is also present.

IMPRESSION: 1. NG tube terminating within the stomach. 2. Unchanged small bilateral pleural effusions, bibasilar atelectasis, and superimposed edema.


SubjectID: 10432951, StudyID: 53855318, Comparison: same

FINAL REPORT

INDICATION: COPD, CHF, presenting with hypoxia.

COMPARISON: Radiograph available from ___. FRONTAL CHEST RADIOGRAPH: The heart is enlarged. The hila are again very enlarged bilaterally. There is superimposed central vascular congestion with moderate pulmonary edema. Bilateral pleural effusions are again seen, worse on the right. There is no pneumothorax. The right lung apex is obscured by an overlying object.

IMPRESSION: Cardiomegaly with superimposed moderate pulmonary edema and a right pleural effusion, unchanged since ___   Keywords: unchanged. Persistant hilar prominence may reflect underlying pulmonary arterial hypertension.


SubjectID: 10432951, StudyID: 57949669, Comparison: None

FINAL REPORT

INDICATION: Severe COPD with respiratory pathology.

COMPARISON: Radiograph available from ___. FRONTAL CHEST RADIOGRAPH: A nasogastric tube terminates within the stomach. Moderate cardiomegaly is unchanged. Moderate bilateral pleural effusions have enlarged since ___. Underlying bibasilar atelectasis appears unchanged. There is no pneumothorax.

IMPRESSION: Worsening moderate bilateral pleural effusions.


SubjectID: 10432951, StudyID: 55283260, Comparison: same

FINAL REPORT

INDICATION: NG tube placement.

COMPARISON: Radiograph available from ___. FRONTAL CHEST RADIOGRAPH: Moderate cardiomegaly, large bilateral pleural effusions, and mild pulmonary edema are unchanged since the 1:59 a.m. study. The mediastinal contour is normal. A nasogastric tube terminates within the stomach. There is no pneumothorax.

IMPRESSION: NG tube terminating within the stomach. Unchanged bilateral pleural effusions and mild interstitial edema   Keywords: unchanged.


SubjectID: 10440642, StudyID: 59734158, Comparison: None

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Shortness of breath; question pneumonia.

COMPARISONS: ___, radiographs from ___ and chest CT from ___.

TECHNIQUE: Chest, PA and lateral.

FINDINGS: There is similar moderate cardiomegaly. The aortic arch is calcified. The mediastinal and hilar contours appear unchanged. There are prominent indistinct central pulmonary vessels as well as a widespread mild interstitial process, which is suggestive of mild pulmonary fibrosis and that was seen previously predominantly in the right hemithorax, but with suspected superimposed vascular congestion. Opacities in the right infrahilar and left retrocardiac regions have improved substantially, but with persistent retrocardiac opacification and small suspected left-sided pleural effusion. Left basilar opacification is probably compatible with chronic atelectasis associated with a substantial hiatal hernia, however, which is hard to directly visualize on this study but which was shown on the prior CT. The bones appeared demineralized. There is exaggerated kyphosis along the mid thoracic spine, as seen previously, and bones are not well delineated. Suboptimally imaged on the lateral view only is the upper part of an abdominal aortic stent.

IMPRESSION: Findings suggesting mild vascular congestion. Substantial improvement in right infrahilar opacity. Persistent retrocardiac opacity, but decreased; although not entirely specific, probably explained by chronic atelectasis associated with a substantial hiatal hernia. Suspected small bilateral pleural effusions.


SubjectID: 10440642, StudyID: 58511476, Comparison: same

FINAL REPORT

INDICATION: Intubation. Evaluation of tube placement.

COMPARISON: ___, 4:07 a.m.

FINDINGS: ET tube terminates 2.1 cm above the carina. NG tube tip is in the stomach and the side hole may be above the diaphragm. There is otherwise no significant interval change   Keywords: no significant interval change.


SubjectID: 10440642, StudyID: 56383128, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Respiratory failure, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the monitoring and support devices are unchanged. However, there is a progression in extent and severity of the bilateral basal parenchymal opacities. These opacities are better characterized on the CT examination from ___ and are likely infectious in origin. Unchanged moderate cardiomegaly. Subtle blunting of the costodiaphragmatic sinuses could be caused by minimal pleural effusions.


SubjectID: 10440642, StudyID: 56122537, Comparison: same

FINAL REPORT

INDICATION: Hypoxia.

COMPARISON: ___ and ___.

FINDINGS: Moderate cardiomegaly is stable. However, a left lower lobe consolidation is worsened compared to ___. Moderate pleural effusion is likely. New interstitial opacities are seen throughout the left upper lobe. Right basilar opacities are chronic and unchanged   Keywords: unchanged. There is no pneumothorax.


SubjectID: 10440642, StudyID: 55577077, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Likely pneumonia, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the monitoring and support devices, in unchanged position. The pre-existing right basal lung opacity is minimally less dense and less extensive. On the left, however, the opacities at the lung base and in the left perihilar areas are unchanged. Also unchanged is the relatively extensive retrocardiac atelectasis as well as the moderate cardiomegaly. No larger pleural effusions can be seen on the chest radiograph. No evidence of pneumothorax.


SubjectID: 10440642, StudyID: 50333748, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female with new right subclavian line placement, question pneumothorax.

COMPARISON: ___ at 6:56 a.m.

FINDINGS: A new right-sided subclavian line terminates within the right atrium. There is no pneumothorax. ET tube terminates 3 cm above the carina. Orogastric tube terminates within the stomach. Remainder of the chest is unchanged with continued left upper lobe patchy opacity, retrocardiac consolidation, small to moderate left pleural effusion, and chronic right basilar changes.


SubjectID: 10455855, StudyID: 55713866, Comparison: None

FINAL REPORT

CHEST, TWO VIEWS: ___

HISTORY: ___-year-old female with fall and right hip pain.

COMPARISON: ___.

FINDINGS: AP and lateral views of the chest. The lungs hyperinflated but clear of focal consolidation or edema. Blunting of the right posterior costophrenic angle is compatible with small effusion and appears somewhat smaller when compared to prior. The cardiac silhouette is enlarged but stable in configuration. Left chest wall dual-lead pacing device again seen with leads in similar position. No acute osseous abnormality is detected.

IMPRESSION: Hyperinflation and persistent small right effusion without acute cardiopulmonary process.


SubjectID: 10455855, StudyID: 55137113, Comparison: None

FINAL REPORT

HISTORY: Preoperative evaluation. Hip fracture.

COMPARISON: Multiple prior chest radiographs, the most recent of ___.

FINDINGS: Portable upright frontal view of the chest. Dual chamber pacer is noted. The aortic knob is calcified. Moderate to severe cardiomegaly is stable. There is no focal consolidation or overt pulmonary edema. Tiny right pleural effusion, if any. No left pleural effusion or pneumothorax.

IMPRESSION: Stable cardiomegaly. No overt pulmonary edema or focal opacity. Tiny right pleural effusion, if any.


SubjectID: 10504635, StudyID: 58363234, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with swan-ganz catheter // evaluate for swan-ganz catheter placement

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Mild cardiomegaly and widened mediastinum are unchanged. Swan-Ganz catheter tip is in the main pulmonary artery. There is no pneumothorax pleural effusion or pulmonary edema.


SubjectID: 10504635, StudyID: 52292686, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with swan // Evaluate position

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Swan-Ganz catheter tip is in the main pulmonary artery. There is no evident pneumothorax or pleural effusion. . The lungs are clear. Cardiomediastinal contours are unchanged.


SubjectID: 10504635, StudyID: 57854196, Comparison: None

FINAL REPORT

INDICATION: ___M with SOB, EF of 20% // Eval for volume overload

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph ___, ___.

FINDINGS: Mildly enlarged cardiac silhouette is again noted. The mediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. The lungs are well-expanded and clear without focal consolidation concerning for pneumonia. Pulmonary vasculature within is within normal limits.

IMPRESSION: Mildly enlarged cardiac silhouette; differential includes mild cardiomegaly or small pericardial effusion. Resolution of small right pleural effusion. No findings concerning for overt volume overload.


SubjectID: 10504635, StudyID: 53382066, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with h/o AML s/p allo-SCT, relapse, most recently received DLI, now w/ multisystem organ failure with decompensated CHF, ___, sig. transamnitis. // progression of heart failure

COMPARISON: Chest radiographs from___

FINDINGS: Heart size is top normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. No focal consolidation, pleural effusion, or pneumothorax. Lines and tubes: IABP tip is more proximal, less than 1cm below the aortic arch. More standard positioning may be achieved by pulling it back at least 1.5 cm. PA catheter tip position is similar to yesterday.

IMPRESSION: 1. Heart size is top-normal. No pulmonary vascular congestion or pleural effusion. 2. IABP tip is less than 1cm below the aortic arch. More standard positioning may be achieved by pulling it back at least 1.5 cm.


SubjectID: 10504635, StudyID: 56942858, Comparison: same

FINAL REPORT

INDICATION: Patient with AML, on induction chemotherapy complicated by pneumonia, now presenting with tachypnea and hypoxia. Evaluate for interval change in pneumonia or signs of congestive heart failure.

COMPARISON: Most recent chest radiograph from ___.

FINDINGS: A bedside AP radiograph of the chest demonstrates marked worsening of the dense airspace consolidation affecting the right upper and middle lobes and the left upper lobe. There is no marked change in the size of the cardiac silhouette or the mediastinum, which does feature persistent vascular engorgement   Keywords: persistent. There is no pneumothorax or pleural effusion, and the pulmonary vascularity is normal. A right-sided PICC terminates in the mid SVC.

IMPRESSION: 1. Worsening multifocal pneumonia. 2. Findings consistent with mild elevation of central venous pressure without signs of decompensated congestive heart failure. NOTE: Findings were communicated to Dr. ___ by Dr. ___ ___ telephone on ___ at 12:10 p.m., immediately after discovery.


SubjectID: 10504635, StudyID: 56797306, Comparison: worse

WET READ: ___ ___ ___ 7:01 PM Increased hazy opacification of the lower lung fields bilaterally, right greater than left, which may be technical or may represent subtle infiltrate. Increased prominence of the mediastinal veins, which may reflect intravascular volume status. Increased prominence of the pulmonary arteries compared to ___, which may be secondary to volume status or pulmonary parenchymal process, but pulmonary emboli should be considered, particularly in the setting of acute desaturation. If clinically indicated, CT could be performed for further evaluation. Discussed with Dr. ___ by phone at 6:58 p.m. on ___ at the time of initial review of the study. ______________________________________________________________________________

FINAL REPORT

PORTABLE CHEST ___ ___

COMPARISON: ___ radiograph.

FINDINGS: Cardiac silhouette is mildly enlarged, and accompanied by new pulmonary vascular congestion and bilateral perihilar haziness as well as increased distention of the azygous vein   Keywords: new, increase. Scattered interstitial opacities are also new   Keywords: new. Constellation of perihilar opacities and peripheral interstitial opacities favors pulmonary edema, but a coexisting opportunistic infection is also possible in this patient with immunosuppression. At the time of this dictation, a CTA has been performed and is dictated separately. Small pleural effusions are noted.


SubjectID: 10504635, StudyID: 50137818, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old man with AML, currently receiving chemotherapy. Patient with bleeding from the line. Evaluate line placement.

FINDINGS: Comparison is made to the prior radiographs from ___. Again seen is a right-sided central venous line with distal lead tip in the mid SVC. It is relatively unchanged when compared to the prior study. No pneumothoraces are seen. There is again seen diffuse perihilar airspace opacity compatible with patient's known multifocal pneumonia. Heart size is within normal limits.


SubjectID: 10504635, StudyID: 55070616, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with h/o AML s/p allo-SCT, relapse, most recently received DLI, now w/ multisystem organ failure with decompensated CHF, ___, sig. transamnitis. // please assess location of PA catheter, intraaortic balloon pump, and for pulmonary edema

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the position of the Swan-Ganz catheter and of the aortic balloon pump are unchanged. The tip of the aortic balloon pump is still at the level of the upper limit of the aortic arch. The device could potentially be pulled back by several mm. No pneumothorax. No pleural effusions. No overt pulmonary edema. Mild cardiomegaly.


SubjectID: 10504635, StudyID: 53176653, Comparison: None

FINAL REPORT

INDICATION: Neutropenic fever, question pneumonia.

COMPARISON: ___.

TECHNIQUE: Single AP portable upright chest.

FINDINGS: Allowing for slight patient rotation, heart size and mediastinal contours are unchanged and within normal limits. There is new slight elevation of the left hemidiaphragm with linear opacity at the left lung base, consistent with atelectasis. No definite evidence of consolidation. No pleural effusion or definite evidence of pneumothorax; a linear density at the right lung apex likely relates to a skin fold. Osseous structures appear within normal limits.

IMPRESSION: New left basilar atelectasis, no definite evidence of consolidation.


SubjectID: 10504635, StudyID: 51970713, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man with neutropenic fever and questionable pneumonia.

COMPARISON: ___.

TECHNIQUE: PA and lateral chest radiographs.

FINDINGS: Heart is normal size and cardiomediastinal contours are unremarkable. Lungs are well expanded and clear. No evidence of focal consolidation to suggest pneumonia. No pleural effusions and no pneumothorax. Left PICC is noted to terminate in the lower SVC.

IMPRESSION: No radiographic evidence of pneumonia.


SubjectID: 10526322, StudyID: 56029595, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman s/p PPM placement // ptx, lead placement

TECHNIQUE: CHEST (PA AND LAT)

COMPARISON: ___

IMPRESSION: Pacemaker leads terminate in the expected location of the right atrium and right ventricle. No evidence of pneumothorax is seen. Heart size and mediastinum are stable. No pleural effusion demonstrated. Replaced tricuspid valve is in unchanged position.


SubjectID: 10526322, StudyID: 53970807, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p PPM placement // PTX, leads

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Lead right-sided pacemaker has been placed with the 2 leads terminating in the expected location of right atrium and right ventricle. There is no pneumothorax. Cardiomegaly is mild, unchanged. Sternotomy wires are stable. Replaced tricuspid valve is in unchanged position. No pleural effusion is seen. No pneumothorax is seen.


SubjectID: 10532326, StudyID: 53897449, Comparison: None

FINAL REPORT

INDICATION: Nausea and vomiting. Presenting with AFib with RVR.

COMPARISON: ___ and concurrent CT abdomen and pelvis of ___.

FINDINGS: PA and lateral chest radiographs demonstrate low lung volumes and distended bowel as described on concurrent CT abdomen/pelvis. There are patchy opacities suggesting minor dependent bibasilar atelectasis. There is persistent cardiomegaly. There is no pneumothorax or pleural effusion. Suggestion of pulmonary venous hypertension is unchanged from prior radiograph.


SubjectID: 10532326, StudyID: 51742525, Comparison: None

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with atrial fibrillation and small-bowel obstruction. NG tube position.

COMPARISON: ___.

FINDINGS: The nasogastric tube is in adequate position and there is a resolution of the gastric distention. There is still mild bibasilar atelectasis. There are no pneumothorax no pleural effusion. The cardiac and mediastinal contour are unchanged.

CONCLUSION: The nasogastric tube is in adequate position and there is resolution of the gastric distention.


SubjectID: 10532853, StudyID: 59565748, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with alc cirrhosis, bilateral PE, empyema with chest tubes // evaluate chest tube, pneumothorax evaluate chest tube, pneumothorax

IMPRESSION: In comparison with the study of ___, there is little change in the areas of localized air- levels consistent with the known empyema   Keywords: little change. Left chest tube at the base of the lung is again seen, with no evidence of pneumothorax. Opacification along the right lateral chest wall is again seen. The left lung is essentially clear. Substantial enlargement of the cardiac silhouette persists, though there is no evidence of pulmonary vascular congestion   Keywords: persists.


SubjectID: 10532853, StudyID: 55156948, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with cirrhosis, bilateral pe, empyema // evaluate chest tubes, empyema, pneumothorax

TECHNIQUE: Chest PA and lateral

FINDINGS: In comparison with the study of ___, there is minimal increase in the areas of pleural air and fluid loculations consistent with the known empyema. Opacification along the right lateral chest wall is again seen. Right chest tube at the base of the lung is again seen. The left lung is essentially clear. Substantial enlargement of the cardiac silhouette persists, though there is no evidence of pulmonary vascular congestion   Keywords: persists.

IMPRESSION: Minimal increase in the right-sided loculated hydro pneumothorax.


SubjectID: 10532853, StudyID: 54730382, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with alcohol cirrhosis, bilateral PE, empyema // evaluate post chest tube removal; please do at 230 pm

TECHNIQUE: Chest PA and lateral

COMPARISON: ___ 8 at 10:00

FINDINGS: There has been interval removal of the right upper chest tube. The right lower chest tube is still in place. There is a the right-sided pneumothorax inferolaterally in the region where the lower portion of the chest tube was previously located. An air-fluid level is seen in this region compatible with a hydro pneumothorax. The heart size continues to be moderately enlarged. There is a small left effusion.

IMPRESSION: Increased right pneumothorax status post removal of the upper chest tube


SubjectID: 10532853, StudyID: 54079393, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with R chest tube s/p VATS // evaluate for CT placement

TECHNIQUE: Chest two views

COMPARISON: ___.

IMPRESSION: The 2 right-sided chest tubes are again visualized. There has been interval improved aeration of the left lung and right upper lobe. There continues to be hazy alveolar infiltrate involving the right lower lung dense consolidation/volume loss in the right lower lobe there small bilateral effusions there is no pneumothorax. The heart continues to be severely enlarged.


SubjectID: 10532853, StudyID: 52999640, Comparison: None

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: ___ year old man with cirrhosis, bilateral PE and exudative effusion // eval pulm effusion, chest tubes; please do in am for ct surg to eval

TECHNIQUE: Chest: Frontal and Lateral

COMPARISON: Prior radiographs on ___

FINDINGS: Compared with prior radiographs on ___, the previously seen right-sided inferior lateral hydropneumothorax is smaller than previous, and again contains an air-fluid level. Again seen is a small left pleural effusion. A right lower chest tube is unchanged in position. There is no new focal consolidation. The cardiac and mediastinal silhouettes are unchanged.

IMPRESSION: Decrease in size in right-sided hydro pneumothorax.


SubjectID: 10532853, StudyID: 52593517, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with Hep C/EtOH cirrhosis s/p VATS evacuation of R hemothorax, now w/ R chest tube removed. // Assess for interval change in R hemithorax post chest tube removal. Assess for interval change in R hemithorax post chest tube removal.

IMPRESSION: Compared to ___, 09:15, the right chest tube has been removed. The extent of the loculated right effusion is unchanged. Unchanged moderate to severe cardiomegaly, without evidence of pulmonary edema.


SubjectID: 10532853, StudyID: 59216710, Comparison: None

WET READ: ___ ___ ___ 7:52 AM Compared with the chest radiograph from earlier on the same date, there is worsening opacification of the right lung field, in keeping with history of worsening hemothorax and bloody pleural fluid from the chest catheter. There has been no change to the position of the right pleural catheter. The trachea is now midline; previously it was deviated slightly to the right due to volume loss. Left upper lung is grossly clear. The above findings were communicated via telephone by Dr. ___ to Dr. ___ at 20:17 on ___, ___ min after discovery.

WET READ VERSION #1 ___ ___ ___ 8:19 PM Compared with the chest radiograph from earlier on the same date, there is worsening opacification of the right lung field, in keeping with history of worsening hemothorax and bloody pleural fluid from the chest catheter. There has been no change to the position of the right pleural catheter. The trachea is now midline; previously it was deviated slightly to the right due to volume loss. Left upper lung is grossly clear. The above findings were communicated via telephone by Dr. ___ to Dr. ___ at 20:17 on ___, ___ min after discovery. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with worsening anemia and chest tube with bloody pleural fluid. // evaluate for worsening effusion, consolidation evaluate for worsening effusion, consolidation

COMPARISON: Comparison to ___ at 09:38

FINDINGS: Portable semi-erect chest radiograph ___ at 19:49 is submitted.

IMPRESSION: Interval increase in size of large layering right pleural collection consistent with hemothorax given history of bloody pleural fluid coming from the chest tube. Right chest tube remains unchanged in position. There is now slight shift to the mediastinal and cardiac structures to the left. There is improved aeration at the left base with interval appearance of patchy opacity in the left mid lung which may reflect an area of atelectasis, although pneumonia cannot be excluded. No pneumothorax. Heart remains enlarged.


SubjectID: 10532853, StudyID: 53292365, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with right empyema and chest tube in place. // Interval change? Interval change?

COMPARISON: Comparisons to ___ at 07:19

FINDINGS: Portable semi-erect chest radiograph ___ at 938 is submitted.

IMPRESSION: A right pleural catheter remains in place and there is a slightly smaller but persistent apical lateral pneumothorax. Overall, there is improving aeration at the right base with decrease in size of the pleural collection. The heart remains markedly enlarged which may reflect cardiomegaly, although a pericardial effusion cannot be excluded. Opacity at the left base most likely reflects partial lower lobe atelectasis, although pneumonia cannot be excluded. No evidence of pulmonary edema.


SubjectID: 10532853, StudyID: 52292676, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with h/o ETOH/HCV cirrhosis presenting with pneumohemothorax on R side, with 2 chest tubes for drainage // interval change

IMPRESSION: Compared to previous radiograph from 1 day earlier, a right chest tube remains in place. The moderate to large loculated right effusion has slightly decreased in size with increase in hydro pneumothorax component laterally. The slight improvement in adjacent opacities in the right mid and lower lung. No other relevant change since recent study   Keywords: no other relevant change.


SubjectID: 10532853, StudyID: 51986541, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hydro/pnuemo/hemothorax with ___F CT in place with very poor drainage. // Interval change? Interval change?

COMPARISON: Comparison to ___ at 19:49

FINDINGS: Portable AP upright chest radiograph ___ 01:14 is submitted.

IMPRESSION: Right chest tube remains unchanged in position. There continues to be near complete opacification of the right hemithorax likely due to a large pleural collection. There continues to be slight leftward shift of the mediastinal structures. A tiny amount of air is seen at the left apex consistent with a small pneumothorax. Streaky opacities in the left lung likely reflect atelectasis. There is possibly a small left effusion as the costophrenic angle appears blunted. The heart remains stably enlarged. No evidence of pulmonary edema.


SubjectID: 10532853, StudyID: 56370428, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with new right sided chest tube

TECHNIQUE: Portable upright AP view of the chest

COMPARISON: ___ 08:20

FINDINGS: There has been interval placement of a new right basilar chest tube with tip projecting along the mid right mediastinal contour. There is a continued moderate size right pleural effusion, perhaps slightly decreased in size compared to the previous study with continued right basilar opacity, potentially atelectasis. No pneumothorax is identified. Left lung remains clear. Heart size is moderately enlarged, and mediastinal and hilar contours are similar.

IMPRESSION: Interval placement of new right basilar chest tube with slightly decreased size of moderate right pleural effusion. Continued right basilar opacity, potentially atelectasis though infection is not excluded. No pneumothorax.


SubjectID: 10532853, StudyID: 55459306, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with etoh and hep c cirrhosis, CHF EF ___%, now with pleural effusion s/p chest tube placement. Please perform at 5AM. // chest tube placement, pleural effusion, infiltrates. PLEASE PERFORM AT 5 AM. chest tube placement, pleural effusion, infiltrates. PLEASE PERFORM AT 5 AM.

IMPRESSION: As compared to the previous image, the right chest tube is in unchanged position. Unchanged small lateral right-sided pneumothorax. The extent of the right basilar atelectasis has minimally increased. Global and relatively massive cardiac enlargement. No pneumothorax. Normal appearance of the left lung.


SubjectID: 10532853, StudyID: 55081250, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___M with r shoulder/back pain, history of CHF and cirrhosis.

COMPARISON: ___.

FINDINGS: PA and lateral views of the chest provided. There is interval increase in right pleural effusion now moderate in size with associated consolidation in the right lower lung likely representing atelectasis though difficult to exclude a superimposed pneumonia. The left lung appears clear. Cardiomegaly is again noted. There is no overt evidence for pulmonary edema. The bony structures are intact.

IMPRESSION: Persistent cardiomegaly with increasing right pleural effusion and right mid and lower lung atelectasis, difficult to exclude a superimposed pneumonia.


SubjectID: 10532853, StudyID: 55468077, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with right chest tube for empyema // Interval change? Interval change?

IMPRESSION: In comparison with the earlier study of this date, the degree of loculated air at the right base has decreased. The overall effusion on the right seen is little change despite the presence of a chest tube. Otherwise, little change in the appearance of the heart and lungs.


SubjectID: 10532853, StudyID: 51409686, Comparison: None

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: ___ year old man with h/o r chest tubes // Evaluate stability of hydro and pneumothorax

TECHNIQUE: Chest: Frontal and Lateral

COMPARISON: Prior radiographs on ___

FINDINGS: Compared with prior radiographs on ___, there is no significant change in the extent of the loculated right hydropneumothorax.The left lung is clear without focal consolidation, effusion or pneumothorax. Cardiomegaly is unchanged.

IMPRESSION: No significant change in right loculated hydropneumothorax.


SubjectID: 10533554, StudyID: 59613716, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chylothorax on the right, chest tube placement. Evaluation for pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has received a right pleural catheter. There is substantial decrease in extent of the pre-existing pleural fluid collection. Small collection persists at the bases of the right hemithorax. Associated atelectasis is also seen. Minimal left pleural effusion is unchanged. Unchanged appearance of the cardiac silhouette.


SubjectID: 10533554, StudyID: 51650480, Comparison: None

FINAL REPORT

EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Dyspnea.

COMPARISON: ___.

FINDINGS: There has been interval development of a significant increase in opacity projecting over the right hemithorax worrisome for worsening loculated/multiloculated pleural effusion with possible areas of underlying consolidation. The right aspect of the cardiac silhouette is not well assessed due to the adjacent opacity at the cardiac silhouette is grossly stable and mildly enlarged. The aorta is calcified and tortuous. Again seen is a left-sided subclavian central venous catheter terminating in the region of the low SVC. Surgical clips are again seen projecting over the posterior lower mediastinum. There may be a trace left pleural effusion. No pneumothorax is seen.

IMPRESSION: Interval significant increase in opacity projecting over the right hemithorax worrisome for worsen loculated/multiloculated pleural effusion with possible areas of consolidation. Possible trace left pleural effusion.


SubjectID: 10533554, StudyID: 58604390, Comparison: None

FINAL REPORT

HISTORY: History of right chylothorax, status post thoracentesis.

TECHNIQUE: Frontal and lateral radiographs were obtained.

COMPARISON: Comparison is made to radiographs dated ___, and ___. Comparison is also made to CT chest dated ___.

FINDINGS: Redemonstrated is a left central port, unchanged in location. As compared to chest radiographs dated ___, there has been partial improvement in the airspace opacities affecting the right lung base and right perihilar region. A stable, small right pleural effusion is noted. There is no new focus of consolidation identified. The left lung is grossly clear, and there is no evidence of pneumothorax. Stable, mild to moderate cardiomegaly is appreciated.

IMPRESSION: Interval improvement in the right perihilar and right lung base airspace opacification.


SubjectID: 10533554, StudyID: 56851318, Comparison: None

FINAL REPORT

PORTABLE CHEST ___ WITH

COMPARISON STUDY OF EARLIER THE SAME DAY

FINDINGS: Following right thoracentesis, a right pleural effusion has substantially decreased in size with only a small residual effusion remaining. There is a probable tiny right apical pneumothorax. Heterogeneous opacities in the right mid and lower lung likely represent reexpansion edema in the setting of recent large volume thoracentesis.


SubjectID: 10533554, StudyID: 51347473, Comparison: None

FINAL REPORT

PORTABLE UPRIGHT CHEST, ___

COMPARISON: ___ radiograph.

FINDINGS: Interval worsening of airspace opacities at the right lung base, now extending to the right perihilar region. Considering recent large volume thoracentesis, this may reflect reexpansion pulmonary edema. Small residual right pleural effusion is present, but there is no evidence of a pneumothorax.


SubjectID: 10533554, StudyID: 50966674, Comparison: None

FINAL REPORT

PATIENT

HISTORY: ___-year-old woman with chylothorax, please do evaluation, compare to chest x-ray for assessment of reaccumulation.

FINDINGS: As compared to prior chest x-ray of ___,, right pleural effusion has increased, now moderate. Left lung is clear. Heart size is mildly enlarged. No pulmonary edema or pneumothorax. The left PICC is unchanged ending in lower SVC.

IMPRESSION: Intervale increase of right pleural effusion, now moderate.


SubjectID: 10533554, StudyID: 57534685, Comparison: None

FINAL REPORT

HISTORY: Evaluation of effusion

TECHNIQUE: PA and lateral views of the chest.

COMPARISON: Multiple chest radiographs the most recent on ___.

FINDINGS: A right pigtail drain is seen at the base of the right lung, unchanged in position. A left central venous catheter is seen terminating in the low SVC and unchanged. There is some opacity at the base of the right lung which likely represents increased atelectasis, however may also represent pneumonia or pulmonary hemorrhage in the appropriate clinical setting. There is possibly a new loculated right pleural effusion. There is a small pleural effusion on the left. The cardiomediastinal silhouette and hilar contours are grossly unchanged. There is no pneumothorax.

IMPRESSION: Opacity at the base of the right lung which likely represents increased atelectasis, however may also represent pneumonia or pulmonary hemorrhage in the appropriate clinical setting.


SubjectID: 10533554, StudyID: 50599835, Comparison: worse

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman status post VATS surgery and thoracic duct ligation.

FINDINGS: Comparison is made to the previous study from ___. There is a right basilar pigtail catheter. No pneumothoraces are seen. There is also a left-sided subclavian catheter with distal lead tip at the cavoatrial junction. Heart size is upper limits of normal. There is again seen consolidation at the right base which may represent developing pneumonia or atelectasis. There are bilateral pleural effusions. There is mild pulmonary edema which has developed since the prior study   Keywords: develop.


SubjectID: 10533554, StudyID: 57073451, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph of two days earlier.

FINDINGS: Right pigtail pleural catheter is in place, with interval decrease in size of right pleural effusion with residual small effusion remaining, and no visible pneumothorax. Cardiomediastinal contours are stable in appearance. Interval improvement in heterogeneous opacities in the right mid and bilateral lower lung regions, as well as decrease in size of a small left pleural effusion.


SubjectID: 10533554, StudyID: 54740343, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___ radiograph.

FINDINGS: A very large right pleural effusion has increased in size from the prior radiograph, and occupies almost the entirety of the right hemithorax with only a small amount of residual aerated right upper lobe at the apex. A small-to-moderate left pleural effusion has only slightly increased in size from the prior radiograph and is associated with adjacent atelectasis at the left lung base.


SubjectID: 10533554, StudyID: 52052678, Comparison: None

FINAL REPORT

PORTABLE CHEST ___

COMPARISON: Radiograph of one day earlier.

FINDINGS: Large right pleural effusion has further increased in size and now occupies the entirety of the right hemithorax, with associated leftward shift of the cardiomediastinal contours. Hemothorax should be considered if the patient has had recent intervention, trauma or has known coagulation disorder. Left lung and pleural surfaces are grossly clear allowing for some crowding of bronchovascular structures related to the leftward cardiomediastinal shift.


SubjectID: 10533554, StudyID: 56759171, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chylothorax, status post VATS, thoracic duct ligation, evaluation for interval change.

COMPARISON: ___.

FINDINGS: The position of the right chest tube is unchanged. On the current image, there is no longer a visualization of a right pneumothorax. No pleural effusion. Overall, decreased lung volumes. Unchanged appearance of the left lung and of the cardiac silhouette.


SubjectID: 10533554, StudyID: 55968851, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluation for post-operative interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the position of the right chest tube is slightly changed. In unchanged manner, there is a millimetric right apical pneumothorax. No evidence of tension, no parenchymal opacities. Unchanged appearance of the heart, unchanged left Port-A-Cath.


SubjectID: 10533554, StudyID: 52578056, Comparison: None

FINAL REPORT

HISTORY: VATS ligation of thoracic duct, to assess for chylothorax.

FINDINGS: In comparison with the study of ___, the right chest tube remains in place. There is probably a small apical pneumothorax. Opacification at the right base in the costophrenic angle is consistent with fluid in the pleural space and some atelectasis. There is opacification at the left base with silhouetting of the hemidiaphragms, consistent with volume loss in the left lower lobe and pleural effusion.


SubjectID: 10533554, StudyID: 56633027, Comparison: better

FINAL REPORT

STUDY: AP chest, ___ at 8:05 a.m.: CLINICAL

HISTORY: Patient with pulmonary edema and CHF exacerbation.

FINDINGS: Comparison is made to previous study performed six hours earlier. There is improvement of pulmonary edema   Keywords: improve. There remains bilateral pleural effusions, right side greater than left. The effusion on the left side is slightly decreased. Left-sided central line is unchanged in position with distal lead tip at the cavoatrial junction.


SubjectID: 10533554, StudyID: 52812105, Comparison: same

FINAL REPORT

STUDY: AP Chest, ___: CLINICAL

HISTORY: ___-year-old woman with worsening dyspnea. Evaluate for pulmonary edema.

FINDINGS: Comparison is made to previous study from ___. There is a left-sided central line with its distal lead tip at the cavoatrial junction. There are unchanged large bilateral pleural effusions. There is again seen pulmonary edema which is moderate   Keywords: again. There is no pneumothoraces. The heart size is enlarged.


SubjectID: 10533554, StudyID: 51424589, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman with CHF exacerbation.

FINDINGS: Comparison is made to study from ___. There is a left-sided central line with its distal lead tip at the cavoatrial junction. There are unchanged large bilateral pleural effusions, right side slightly greater than left. There are no pneumothoraces.


SubjectID: 10533554, StudyID: 53552442, Comparison: worse

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Study of one day earlier.

FINDINGS: Right chest tube in place with slight increase in size of a small right apical pneumothorax. Cardiomediastinal contours are stable allowing for patient rotation. Mild pulmonary vascular congestion is present as well as worsening bibasilar opacities, particularly in the left retrocardiac region and periphery of right lung base   Keywords: worse. Small pleural effusions are again demonstrated.


SubjectID: 10533554, StudyID: 56102921, Comparison: better

FINAL REPORT

PA AND LATERAL CHEST, ___

COMPARISON: Radiographs of ___.

FINDINGS: Right pigtail pleural catheter remains in place, with interval increase in size of a small right apical pneumothorax, with apical visceral pleural line just below the right third posterior rib level. Right pleural effusion has further decreased in size with small residual effusion remaining. Nonspecific right lower lobe opacities, possibly representing reexpansion pulmonary edema, show further interval improvement   Keywords: improve. Left lung remains clear, and there is no evidence of left pleural effusion. Cardiomediastinal contours are stable.

IMPRESSION: Increasing small right apical pneumothorax with pleural catheter in place. Small residual right pleural effusion and improving adjacent right lower lobe opacities, possibly representing reexpansion pulmonary edema in the setting of recent history of large volume thoracentesis   Keywords: improving.


SubjectID: 10533554, StudyID: 53893735, Comparison: None

FINAL REPORT

HISTORY: Chylothorax, assess for interval change.

TECHNIQUE: Frontal and lateral chest radiographs were obtained.

COMPARISON: Comparison is made to radiographs dated ___.

FINDINGS: As compared to the prior examination dated ___, there has been an interval increase in size of the right pleural effusion, now moderate to severe in size. The right upper lung field and left lung are grossly unremarkable without focal consolidation, pneumothorax, or pulmonary edema. There is stable, mild cardiomegaly. Mediastinal contours are normal. The left-sided central venous line remains in an unchanged position, seen terminating in the lower SVC.

IMPRESSION: Interval increase in the right pleural effusion, now occupying roughly half of the right hemi-thorax.


SubjectID: 10533554, StudyID: 50862149, Comparison: None

FINAL REPORT

AP CHEST 7:59 A.M., ___

HISTORY: An ___-year-old woman with a chylothorax after drainage. Please assess for interval change or pleural effusion.

IMPRESSION: AP chest compared to ___: Minimal if any right pleural effusion. Small right apical pneumothorax essentially unchanged. Lungs grossly clear. Heart size normal. Right pleural drain unchanged in position. Left subclavian line ends in the low SVC.


SubjectID: 10533554, StudyID: 50207921, Comparison: same

FINAL REPORT

HISTORY: Chest tube placement for chylothorax.

FINDINGS: In comparison with study of earlier in this date, there has been placement of a left chest tube drainage of a substantial amount of fluid from the right chest. Small effusion and residual atelectasis or reexpansion edema is seen. Otherwise, little change   Keywords: little change.


SubjectID: 10533554, StudyID: 55771288, Comparison: better

FINAL REPORT

INDICATION: ___ y.o. F ___ speaking with multiple medical issues most notable for HTN, CAD, Afib not on anticoagulation, systolic CHF (LVEF ___%), and diffuse large B cell lymphoma on Rituximab presents with cough and dyspnea. Evaluate for interval change.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph from ___

FINDINGS: Lung volumes are low, unchanged from prior. Heterogeneous, asymmetrically distributed opacities remain more severe on the right than the left and show interval improvement, particularly in the left lungCardiomegaly is unchanged.Mediastinal and hilar contours are unremarkable. There is no evidence for pulmonary consolidation, pleural effusion, or pneumothorax.Left subclavian port tip terminates in the upper SVC, unchanged from prior.

IMPRESSION: Improving heterogeneous lung opacities   Keywords: improving. Rapid change suggests pulmonary edema, though underlying pneumonia in the right lung should be considered in the appropriate clinical setting.


SubjectID: 10533554, StudyID: 53969994, Comparison: None

WET READ: ___ ___ ___ 2:13 PM Moderate pulmonary edema with small bilateral pleural effusions and mild cardiomegaly. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: Chest radiograph.

INDICATION: ___F with sob. Assess for pneumonia or congestive heart failure.

TECHNIQUE: Single portable supine frontal chest radiograph.

COMPARISON: Chest radiograph ___, CT chest with contrast ___.

FINDINGS: Moderate diffuse perihilar interstitial and alveolar opacities, right greater than left, with air bronchograms. The lungs are mildly hypoinflated. Small bilateral pleural effusions. No pneumothorax. Mild cardiomegaly is stable. Mediastinal contour is unremarkable. Left subclavian port tip in the upper SVC. Mediastinal clips noted.

IMPRESSION: 1. Moderate diffuse bilateral, right greater than left, opacities could represent severe pulmonary edema however pneumonia cannot be excluded. Clinical correlation recommended. 2. Small bilateral pleural effusions and mild cardiomegaly.

RECOMMENDATION(S): The findings were discussed by Dr. ___ with Dr. ___ on the ___ ___ at 4:09 PM, 5 minutes after discovery of the findings.


SubjectID: 10533554, StudyID: 55720364, Comparison: None

FINAL REPORT

EXAMINATION: Chest

INDICATION: ___ year old woman with pleural effusion // eval

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph PA and lateral ___

FINDINGS: Biapical pleural scarring, stable since the prior radiograph. There is a small to moderate right pleural effusion, not significantly changed from the prior CXR. There are bilateral post-radiation fibrotic changes which are better characterized by the prior CT on ___. Lateral view demonstrates a triangular opacity projecting over the heart, consistent with RML volume loss. Stable cardiomediastinal silhouette. Mild pulmonary vascular congestion. Left subclavian line terminates in the distal SVC. No acute osseous abnormalities.

IMPRESSION: 1. Small to moderate right pleural effusion is not significantly changed. 2. Stable post radiation fibrotic changes with associated volume loss. 3. Mild pulmonary vascular congestion.


SubjectID: 10533554, StudyID: 51096294, Comparison: 0.0

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___F with DLBCL and recurrent right effusion s/p thoracocentesis. Pneumothorax?

TECHNIQUE: Chest PA and lateral

COMPARISON: Multiple prior chest radiographs, most recent performed 4 hr earlier.

FINDINGS: Compared with the radiograph from ___ there is worsening hilar engorgement and pulmonary vascular dilatation consistent with congestive heart failure   Keywords: worse. Right lower lung opacities represent a combination of pleural thickening, post-pleurodesis changes, small effusion and right middle and lower lobe atelectasis. No new focal opacities are seen   Keywords: new. Bilateral post-radiation fibrotic changes are better characterized on prior CT from ___. The cardiac silhouette is stable. A left subclavian line terminates in the distal SVC.

IMPRESSION: 1. Findings of vascular congestion are similar to earlier radiograph   Keywords: similar. No evidence of pneumothorax. 2. Right lower lung opacities represent a combination of pleural thickening, post-pleurodesis changes, small effusion and right middle and lower lobe atelectasis.


SubjectID: 10533554, StudyID: 55711033, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female with shortness of breath.

COMPARISON: ___.

FINDINGS: AP and lateral views of the chest. Low lung volumes are again noted. There has been interval enlargement of the pleural effusion on the right since prior. Small left effusion again noted. Indistinct pulmonary vascular markings seen bilaterally potentially from low lung volumes although interstitial edema is possible. Left subclavian central line is seen unchanged in position. Midthoracic dextroscoliosis is again noted as well as hypertrophic changes in the spine.


SubjectID: 10533554, StudyID: 55249128, Comparison: None

FINAL REPORT

HISTORY: Chylothorax and question of aspiration pneumonia. Evaluation for interval change.

TECHNIQUE: Frontal and lateral views of the chest.

COMPARISON: None

FINDINGS: Again seen is a loculated pleural effusion at the base of the right lung, largely unchanged in appearance. There is an area of consolidation in the right upper lobe which may represent pneumonia or atelectasis. A left subclavian line is seen in the low SVC and unchanged in position. There is no evidence of pneumothorax.

IMPRESSION: Moderate right upper lobe area of consolidation that may represent pneumonia or atelectasis.


SubjectID: 10533554, StudyID: 54134228, Comparison: None

FINAL REPORT

PATIENT

HISTORY: ___-year-old woman with chylothorax. Evaluation for pneumonia, evaluation for pneumothorax after chest tube removal.

COMPARISON: Exam is compared to chest x-ray of ___. F

IMPRESSION: Right subclavian PICC has been pushed down to the origin of the SVC. Left femoral line is unchanged with tip ending in superior cavoatrial junction. Right pleural drain has been removed, there is pneumothorax. Persist mild opacification of the right lung, more dense in the lateral costodiaphragmatic sulcus probably for known chronic pleural effusion. Right base paracardial opacity might be due to atelectasis, but in the appropriate clinical setting, pneumonia should be considered. Follow-up CXR in PA and lateral is reccomended. Left lung is clear. Heart size is normal, mild aortosclerosis. Findings were reported to Dr ___ at 4:56 pm


SubjectID: 10533554, StudyID: 55147664, Comparison: same

FINAL REPORT

HISTORY: Chylothorax with ligation of thoracic duct and talc pleurodesis, to assess for change.

FINDINGS: In comparison with the study of ___, there is little interval change   Keywords: little interval change. Right chest tube remains in place and there is no evidence of pneumothorax.


SubjectID: 10533554, StudyID: 51075355, Comparison: None

FINAL REPORT

CLINICAL

HISTORY: Chylothorax following talc pleurodesis, evaluate for interval change. CHEST Prior chest x-ray ___. The right chest tube is still present. There has been no significant interval change. No right effusion is seen. On the left, no significant change is identified since the prior chest x-ray. A left effusion is still present.

IMPRESSION: No change, no right effusion.


SubjectID: 10533554, StudyID: 51068607, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chylothorax, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the right chest tube remains in place. The left and right central venous access lines are also in place. Although the frontal radiograph shows a minimal decrease in extent of the pleural fluid, lateral radiographs still reveal a small amount of intrafissural and dorsal fluid. Moderate cardiomegaly persists. No intraparenchymal changes. No convincing evidence of pneumothorax.


SubjectID: 10533554, StudyID: 52452295, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chest tube placement. Rule out pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the position of the right-sided chest tube and the left Port-A-Cath are unchanged. There is no evidence of right pneumothorax. The pigtail catheter is in constant position. The appearance of the lung parenchyma is unchanged. No pleural effusion on the right. On the left, a linear atelectasis is seen at the left lung base. Borderline size of the cardiac silhouette. No pulmonary edema.


SubjectID: 10533554, StudyID: 50513270, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: pneumothorax

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is a small pneumothorax at the lung apex. A PICC line catheter is in situ. There is no evidence of tension. No right pleural effusion. The left lung appears unremarkable. Normal size of the cardiac silhouette. No pulmonary edema. Unchanged position of the left Port-A-Cath.


SubjectID: 10533554, StudyID: 52197439, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: Shortness of breath

TECHNIQUE: Portable upright AP view of the chest

COMPARISON: ___ at 15:12

FINDINGS: Left subclavian central venous catheter tip terminates in the mid SVC. The heart size remains moderately enlarged. Numerous clips are seen projecting over the left lower hemi thorax. Mediastinal contour is unchanged. Moderate pulmonary edema persists, perhaps minimally improved in the interval   Keywords: improve. Small right pleural effusion is unchanged. There is no pneumothorax. Patchy opacities in the lung bases likely reflect atelectasis though infection is difficult to exclude.

IMPRESSION: Persistent moderate pulmonary edema, slightly improved in the interval with similar small right pleural effusion   Keywords: improve. Patchy bibasilar opacities likely reflect atelectasis though infection is not completely excluded.


SubjectID: 10533554, StudyID: 52054708, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (APAND LAT)

INDICATION: ___F with fatigue // r/o PNA

COMPARISON: ___.

FINDINGS: AP upright and lateral views of the chest provided. Left subclavian central venous catheter is again seen with its tip located in the mid SVC region. The lung volumes are low with reticulonodular opacities noted diffusely within both lungs which could represent worsening edema versus a superimposed pneumonia   Keywords: worse. Small right pleural effusion persists with loculated fluid along the right major fissure, appearing minimally increased. Cardiomediastinal silhouette appears stable. No pneumothorax.

IMPRESSION: Pulmonary edema possibly with superimposed pneumonia. Small pleural effusion on the right, appears mildly increased. Followup to resolution.


SubjectID: 10538657, StudyID: 59505294, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with severe HF, pulmonary edema, pleural effusions. // ___ year old woman with severe HF, pulmonary edema, pleural effusions.

COMPARISON: Chest x-ray from ___ at 10:40

FINDINGS: Left-sided pacemaker/AICD device is noted with leads terminating in right ventricle and region of the coronary sinus. There is moderately severe cardiomegaly, with sternotomy wires, similar to the prior study. Compared to the prior study, there is new vascular plethora and blurring, consistent with CHF interstitial and possible early alveolar edema   Keywords: new. In addition, there is vascular plethora blurring about both hila. There is a small to moderate right effusion, larger than on the prior study. There is atelectasis at the right base and in the right mid zone and the possibility of a subtle infectious infiltrate at the right base cannot be entirely excluded. On the left, there is upper zone redistribution and mild vascular plethora, without frank consolidation, significant left base atelectasis or gross effusion. The extreme left costophrenic angle is excluded from the film.

IMPRESSION: 1. Increased CHF, compared with ___ 2   Keywords: increase. Increased right pleural effusion with underlying atelectasis. The possibility of an early pneumonic infiltrate at the right base cannot be entirely excluded. 3. Moderately severe cardiomegaly is grossly unchanged. Pacemaker/AICD device again noted.


SubjectID: 10538657, StudyID: 58314953, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___F with dyspnea

TECHNIQUE: Chest PA and lateral

COMPARISON: ___ chest radiograph

FINDINGS: Left-sided pacemaker/ AICD device is noted with leads terminating in the right ventricle and region of the coronary sinus. The patient is status post median sternotomy and CABG. Moderate cardiomegaly is re- demonstrated. The mediastinal and hilar contours are similar with atherosclerotic calcifications noted diffusely within the aorta. Mild pulmonary vascular congestion is present along with a new small right pleural effusion   Keywords: new. Patchy right basilar opacity may reflect atelectasis. No left-sided focal consolidation is present. No pneumothorax is visualized. No acute osseous abnormalities are detected.

IMPRESSION: Mild pulmonary vascular congestion and small right pleural effusion. Patchy right basilar opacity may reflect atelectasis however infection cannot be completely excluded.


SubjectID: 10538657, StudyID: 54600263, Comparison: same

FINAL REPORT

EXAM: Chest single AP upright portable view. CLINICAL INFORMATION: ___-year-old female with history of shortness of breath, question CHF.

COMPARISON: ___.

FINDINGS: Single AP upright portable view of the chest was obtained. The patient is rotated to the right. Given this, the left-sided AICD is without significant change in position. Patient is status post median sternotomy. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are grossly stable given differences in patient position. No overt pulmonary edema is seen.

IMPRESSION: No radiographic evidence of CHF. Patient rotated to the right, but given differences in patient positioning, no significant interval change   Keywords: no significant interval change.


SubjectID: 10538657, StudyID: 53038491, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female with shortness of breath.

COMPARISON: Chest radiographs from ___, and ___. PA AND LATERAL CHEST RADIOGRAPHS: An AICD/pacemaker generator overlies the left chest wall. The leads appear intact and terminate in the expected locations of the right and left ventricles. The lungs are clear. There is no focal consolidation or pneumothorax. There is no vascular congestion or pleural effusions. Mediastinal and hilar contours are within normal limits. Moderate cardiomegaly, with disproportional enlargement of the right heart, is unchanged from prior.

IMPRESSION: 1. Unchanged moderate cardiomegaly. Pacemaker/AICD leads intact and in standard position. 2. No pulmonary edema or consolidation.


SubjectID: 10553084, StudyID: 59274066, Comparison: None

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPH

INDICATION: ___ year old woman with pleural effusion // Eval for interval change of left pleural effusion, pulmonary edema.

TECHNIQUE: Portable AP Chest radiograph.

COMPARISON: Chest radiograph from ___.

FINDINGS: Right-sided pleural effusion is increased in size with fluid extending to the minor fissure. Retrocardiac consolidation is likely a combination of pleural fluid and parenchymal consolidation, which remains unchanged. Pleural drains remain in unchanged position. Evaluation of the cardiac silhouette is limited. No pneumothorax identified. The right hilum continues to be prominent.

IMPRESSION: Interval increase in right-sided pleural effusion with continued prominence of the right hilum.


SubjectID: 10553084, StudyID: 57039060, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with ESRD, Mitral stenosis, MR, here with rapid afib and respiratory distress // eval for pulmonary edema vs. pneumonia eval for pulmonary edema vs. pneumonia

TECHNIQUE: Portable chest radiograph

COMPARISON: None available.

FINDINGS: There is cardiomegaly without vascular congestion raising the possibility of pericardial effusion or a cardiomyopathy. There are bilateral pleural effusions worse on the left. There is a bandlike consolidation extending from a masslike structure at the right hilum to the adjacent pleura.

IMPRESSION: Cardiomegaly without vascular congestion is seen, suggesting either cardiomyopathy or pericardial effusion. An apparent right hilar mass is seen for which a dedicated CT is recommended.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 4:11 PM, a few minutes after discovery of the findings.


SubjectID: 10553084, StudyID: 54441290, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with PMH of rheumatic mitral stenosis, AFib s/p PVI ___, CKD ___ mebranous nephropathy following by transplant surgyer p/w shortness of breath found to be hypoxic, in AF RVR, with likely combination of pulmonary infiltrates and edema. // please assess for plumonary edema/pleural effusion, pericardial effuision please assess for plumonary edema/pleural effusion, pericard

IMPRESSION: In comparison with the earlier study of this date, there is little overall change in the appearance of the heart and lungs. Again there is increased opacification at the left base consistent with volume loss in the lower lobe and pleural effusion. Prominence of the right hilum persists. The curvilinear opacification extending from the hilum to the periphery is again seen, possibly slightly more prominent.


SubjectID: 10553084, StudyID: 52287052, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hypoxia // infection?

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, there is a minimal increase in extent of the pre-existing left pleural effusion. The consolidation at the bases of the right upper lobe is constant. No pulmonary edema. Moderate cardiomegaly persists. No pneumothorax.


SubjectID: 10553084, StudyID: 56249441, Comparison: None

FINAL REPORT

INDICATION: Hypoxia.

COMPARISON: Chest radiograph from ___.

TECHNIQUE: Frontal chest radiograph.

IMPRESSION: A linear opacity extending over the right hemithorax has thickened since the ___ examination, reflecting increased atelectasis. A left retrocardiac opacity is denser, also likely increased atelectasis. There is no pneumothorax. Bilateral pleural effusions are unchanged.


SubjectID: 10553084, StudyID: 55516268, Comparison: None

FINAL REPORT

INDICATION: Acute CHF.

COMPARISON: Chest radiograph from ___.

TECHNIQUE: Frontal and lateral chest radiographs.

IMPRESSION: Linear atelectasis along the right mid lung is minimally changed since the prior radiograph. A moderate left pleural effusion is unchanged. There is no pneumothorax. The cardiac and mediastinal contours are stable.


SubjectID: 10559377, StudyID: 59293099, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: No focal consolidation, pleural effusion or pneumothorax. As before, the left hilus has a somewhat lobulated contour. Consider non urgent chest CT for evaluation of this area when clinically appropriate. ___M with CVL and sepsis // Eval for CVL placement

TECHNIQUE: PORTABLE AP VIEW OF THE CHEST

COMPARISON: None.

FINDINGS: A right-sided central venous catheter via a right internal jugular approach terminates at the superior cavoatrial junction. The cardiomediastinal and hilar contours are within normal limits. The heart is normal in size. The lungs are somewhat low volume. There is no pneumothorax or pleural effusion identified. Subtle opacities seen in the bilateral lung bases could represent atelectasis, aspiration or possible atypical, predominately interstitial infection. There is mild pulmonary vascular congestion.

IMPRESSION: Patchy bibasilar opacities could represent atelectasis, aspiration or infection. pulmonary vascular congestion with mild interstitial edema.


SubjectID: 10559377, StudyID: 56801210, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with respiratory failure // ETT placement

TECHNIQUE: AP view of the chest.

COMPARISON: Chest radiograph on ___

FINDINGS: There has been interval placement of an enteric tube which terminates below the field of view. An endotracheal tube terminates 5.6 cm above the carinal. A right internal jugular catheter terminates at the superior cavoatrial junction. It subtle bibasilar opacities are suggestive of atelectasis however interstitial infection should be considered.

IMPRESSION: Interval placement and enteric tube and endotracheal tube as described above. No other significant change from the prior exam   Keywords: no other significant change.


SubjectID: 10559377, StudyID: 55646614, Comparison: 1.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with septic shock, intubated // interval change

COMPARISON: ___.

IMPRESSION: No relevant change as compared to the previous image   Keywords: no relevant change. The monitoring and support devices are constant. The lung volumes have increased, with the subsequent decrease of the pre described basal opacities   Keywords: decrease. No new opacities   Keywords: new. No pleural effusions. No pulmonary edema.


SubjectID: 10559377, StudyID: 54303984, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with hypoxia. Concern for pneumothorax.

TECHNIQUE: Portable AP chest radiograph.

COMPARISON: ___, ___.

FINDINGS: Compared to the most recent radiograph at 02:21, there is no significant interval change   Keywords: no significant interval change. There is no pneumothorax. Supporting tubes and lines are in stable position. Subtle interstitial opacities are unchanged   Keywords: unchanged. There is no pleural effusion.


SubjectID: 10559377, StudyID: 59102178, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with septic shock, intubated // interval change

IMPRESSION: As compared to ___ chest radiograph, there are no relevant the new changes when consideration is made of differences in patient positioning between the exams.


SubjectID: 10559377, StudyID: 56707379, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hypoxia // ARDS?

COMPARISON: Chest x-ray from ___ at 03:47

FINDINGS: Lines and tubes are similar to the prior film. Compared to the prior film, diffuse bilateral interstitial and alveolar opacities are new or much more pronounced, slightly more pronounced on the right   Keywords: new. The right minor fissure is slightly thickened and slightly retracted. There is increased retrocardiac density, with interval obscuration of the medial left hemidiaphragm. No gross effusions.

IMPRESSION: 1. Increased interstitial and alveolar infiltrates seen diffusely throughout both lungs   Keywords: increase. The most likely differential is CHF. Infection or ARDS might also account for this appearance, but CHF is more likely to develop this rapidly   Keywords: develop. 2. Left lower lobe collapse and/or consolidation


SubjectID: 10559377, StudyID: 58827165, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with resolving shock // PNA?

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: ET tube tip is 6.5 cm above the carinal. Right internal jugular line tip is at the level of mid SVC. Left internal jugular line tip is at the level of superior SVC. NG tube tip is in the stomach. Cardiomediastinal silhouette is stable. Widespread parenchymal consolidations appear to be minimally improved as compared to the previous study.


SubjectID: 10559377, StudyID: 57739232, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with alveolar hemorrhage // Evaluate for interval change

IMPRESSION: As compared to previous radiograph of 1 day earlier, cardiomediastinal contours are stable and support and monitoring devices are similar in position. Widespread asymmetrically distributed airspace opacities have slightly worsened in the lower lungs, and bilateral layering pleural effusions also appear slightly increased although positional differences limit

COMPARISON.


SubjectID: 10559377, StudyID: 52423631, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man intubated with pulmonary hemorrhage, ? infection // interval change

IMPRESSION: As compared to ___ chest radiograph, cardiomediastinal contours are stable and support and monitoring devices are unchanged in position. Widespread asymmetrically distributed airspace opacities have overall slightly improved in the interval, and pleural effusions are not appreciably changed. No visible pneumothorax.


SubjectID: 10559377, StudyID: 51248178, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: Shock, resp failure // ETT position

TECHNIQUE: Portable AP radiograph of the chest

COMPARISON: ___.

FINDINGS: A left IJ central venous catheter terminates in the upper SVC. A right IJ central venous catheter extends to the mid SVC. A nasogastric tube enters the stomach, distal tip not visualized. There is no pneumothorax. Bilateral airspace opacities have improved in the right upper lung field. Mild cardiomegaly despite the projection is stable.

IMPRESSION: Change in distribution but not overall severity of pulmonary edema or hemorrhage.


SubjectID: 10559377, StudyID: 58598663, Comparison: 0.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with DAH, respiratory failure // interval change

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the bilateral parenchymal opacities have minimally decreased in extent and severity   Keywords: decrease. Moderate cardiomegaly persists. No new opacities   Keywords: new. No pleural effusions. The monitoring and support devices are constant.


SubjectID: 10559377, StudyID: 56165243, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M s/p bronch for RUL collapse due to clot // Evaluate for interval change

COMPARISON: Chest radiograph from earlier today.

FINDINGS: AP view of the chest provided. Right upper lobe collapse has resolved. Widespread parenchymal opacities are otherwise unchanged   Keywords: unchanged. Bilateral IJ lines, endotracheal tube, and nasogastric tubes are in appropriate positions.

IMPRESSION: Interval resolution of right upper lobe collapse.


SubjectID: 10559377, StudyID: 55953542, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with decreased sats after decreasing PEEP // eval for PTX, lobar collapse

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the patient has developed collapse of the right upper lobe. No other changes noted   Keywords: no other change. The lung volumes have slightly decreased. Severity and distribution of the pre-existing parenchymal opacities is constant.


SubjectID: 10559377, StudyID: 55877483, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M w/severe sepsis and pulm hemorrhage // evaluate for interval change

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, there is a subtle increase in extent and severity of the pre-existing parenchymal opacities, notably in the right upper lobe. Moderate cardiomegaly persists. No larger pleural effusions. The monitoring and support devices are constant.


SubjectID: 10559377, StudyID: 58158572, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with strep C pneumonia, VAP, now trach'd and PEG'd. // evaluate infiltrates and volume status

IMPRESSION: As compared to ___ chest radiograph, widespread bilateral air space opacities have slightly improved, and a right pleural effusion has apparently decreased in size. . No other relevant changes   Keywords: no other relevant change.


SubjectID: 10559377, StudyID: 50255141, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with complicated prolonged hospital course, now s/p trach with VAP // eval for pulmonary edema vs worsening pna

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the diffuse bilateral massive parenchymal opacities have further increased in extent and severity   Keywords: increase. These increase is notable in the right upper lobe and in the left perihilar region. The tracheostomy tube and the left PICC line are in constant position.


SubjectID: 10559377, StudyID: 57814149, Comparison: better

WET READ: ___ ___ ___ 8:06 AM Tracheostomy tube projects over the midline of the trachea. There has been slight interval decrease in the left pleural effusion, likely related to thoracentesis. No evidence of pneumothorax. Diffuse bilateral pulmonary opacities are essentially unchanged.

WET READ VERSION #1 ___ ___ 6:14 PM Tracheostomy tube projects over the midline of the trachea. There has been slight interval decrease in the left pleural effusion, likely related to thoracentesis. No evidence of pneumothorax. Diffuse bilateral pulmonary opacities are essentially unchanged. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with ___ yo IVDU p/w Strep Group C bacteremia c/b toxic shock -> STEMI/CRT/Alv Hemmorhages/p left thoracentesis 1.2l // s/p ___. ?pneumothorax

TECHNIQUE: Portable AP radiograph of the chest.

COMPARISON: Multiple prior radiographs, most recently ___.

FINDINGS: In comparison to the most recent radiograph, there is no significant interval change in the degree of right lower lobe collapse and moderate right pleural effusion. Extensive bilateral airspace opacities are minimally improved on the left, and again may be due to severe pulmonary edema, hemorrhage or multifocal pneumonia   Keywords: improve. Moderate left pleural effusion with associated partial left lower lobe collapse is also unchanged.

IMPRESSION: Minimal improvement in bilateral airspace opacities which may be due to severe pulmonary edema, hemorrhage, or multifocal pneumonia   Keywords: improve. Stable lower lobe collapse with moderate bilateral pleural effusions.


SubjectID: 10559377, StudyID: 57269866, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hypoxemia, tachypnea, and hypotension. // Evaluate for acute process.

TECHNIQUE: Portable AP radiograph of the chest.

COMPARISON: ___ and dating back to ___.

FINDINGS: Right middle lobe collapse with volume loss is unchanged. A tracheostomy tube is in place. Extensive bilateral airspace opacities are not appreciably changed. Moderate bilateral pleural effusions and left lower lobe collapse are unchanged. There is no pneumothorax.

IMPRESSION: No significant interval change in extensive bilateral airspace opacities which may be due to severe pulmonary edema or multifocal pneumonia   Keywords: no significant interval change.


SubjectID: 10559377, StudyID: 52812886, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with sepsic shock, course c/b STEMI and lung hemorrhage, remains intubated // eval for interval changes

TECHNIQUE: Portable AP radiograph of the chest.

COMPARISON: ___. Correlation made to chest CT dated ___.

FINDINGS: An endotracheal tube terminates at the level of the clavicles. Nasogastric tube enters the stomach, distal tip not visualized. Bilateral IJ central venous catheters terminate in the low SVC. Bilateral airspace opacities are not appreciably changed in extent or distribution. Small layering pleural effusions are also unchanged. The cardiac silhouette is slightly smaller.

IMPRESSION: No appreciable change in bilateral airspace opacities which may be due to pulmonary hemorrhage or edema. Stable small bilateral pleural effusions.


SubjectID: 10559377, StudyID: 52654289, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with prolonged hospital stay s/p trach/peg with worsening respiratory status, increased sputum production and low grade fevers // infiltrates, volume status

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The monitoring and support devices are constant. The very diffuse bilateral parenchymal opacities have not substantially changed but might have minimally decreased in severity at the level of the lung bases. Moderate cardiomegaly and small bilateral pleural effusions persist. Unchanged appearance of the cardiac silhouette.


SubjectID: 10559377, StudyID: 56410750, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with HIV, group C strep bacteremia, VAP with recurring fevers // infiltrates, volume status

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the lung volumes have slightly decreased. Decrease in ventilation of the left and right lung base. The widespread mid and upper zone predominant opacities are unchanged   Keywords: unchanged. Unchanged tracheostomy tube, unchanged left PICC line.


SubjectID: 10559377, StudyID: 54583414, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with HIV, group C strep bacteremia, VAP on last day of abx, now with fever. // evaluate infiltrates, volume status

TECHNIQUE: AP view of the chest

COMPARISON: Multiple prior radiographs most recent on ___

FINDINGS: A tracheostomy and left-sided PICC are stable in position. Widespread alveolar opacities have increased from ___ are less significant in extent compared to ___   Keywords: increase. This likely reflects a combination of increasing edema and persistent multifocal infection   Keywords: increasing. No pleural effusion or pneumothorax is identified. The cardiomediastinal and hilar contours are within normal limits.

IMPRESSION: Widespread alveolar opacities are increased from the most recent prior exam consistent with increasing edema in the setting of persistent multifocal infection   Keywords: increase.


SubjectID: 10559377, StudyID: 54833677, Comparison: worse

FINAL REPORT

INDICATION: ___ year old man with strep c bacteremia s/p prolonged hospital stay, now s/p trach with fevers // eval for pna

COMPARISON: Radiographs from ___

IMPRESSION: The right IJ central line has been removed. The tracheostomy and left-sided central line are unchanged in position. Heart size is within normal limits. There has been worsening of the airspace opacities particularly at the right base and left mid lung field since the previous study   Keywords: worse. Superimposed pulmonary edema would be difficult to exclude; however, the vascular pedicle is not widened, thus this is felt less likely. No pneumothoraces are seen.


SubjectID: 10559377, StudyID: 52089447, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with prolonged hospital course, now s/p trach, concern for VAP // eval for pna

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___ obtained at 07:41

IMPRESSION: There is substantial interval progression of consolidation in particular in right upper lobe but to a certain extent in both lower lobes. PICC line and tracheostomy tube are in place. No pneumothorax is seen. Knee ___ piercing has been removed in the interim. Small amount of pleural effusion is most likely present.


SubjectID: 10559377, StudyID: 54030577, Comparison: worse

FINAL REPORT

INDICATION: Evaluate for interval change in a patient with increasing respiratory distress and tracheostomy.

COMPARISON: Chest radiographs from ___, ___, ___, ___.

FINDINGS: A portable semi supine frontal chest radiograph demonstrates a tracheostomy terminating in the mid thoracic trachea. Bilateral opacities are increased   Keywords: increase. Bilateral pleural effusions are increased, with the increase more significant on the left than right. There is no pneumothorax. The visualized upper abdomen is unremarkable.

IMPRESSION: 1. Increased bilateral opacities, possibly representing increased pulmonary edema   Keywords: increase. Multifocal pneumonia, ARDS, or hemorrhage is also a possibility. 2. Increased bilateral pleural effusions.


SubjectID: 10559377, StudyID: 53801648, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with respiratory failure // f/up pulmonary edema

COMPARISON: ___.

IMPRESSION: No relevant change as compared to the previous image   Keywords: no relevant change. Massive pulmonary edema with massive bilateral pleural effusions and subsequent areas of atelectasis. No new parenchymal opacities are visualized   Keywords: new. Tracheostomy tube is in unchanged position.


SubjectID: 10559377, StudyID: 52012931, Comparison: worse

FINAL REPORT

INDICATION: Evaluate for interval change in a patient with acute on chronic respiratory failure, now with increased respiratory distress.

COMPARISON: Chest radiographs from ___, ___, ___, ___.

FINDINGS: A portable frontal chest radiograph demonstrates a tracheostomy, unchanged in position. The cardiac silhouette is difficult to evaluate secondary to opacity in the bilateral lung bases, but appears increased in size. Bilateral diffuse opacities are increased   Keywords: increase. Bilateral pleural effusions are increased. There is no pneumothorax. The visualized upper abdomen is unremarkable.

IMPRESSION: Increased opacities associated with increased cardiac size and pleural effusions are most consistent with increased edema, although multifocal pneumonia, hemorrhage, and ARDS remain on the differential   Keywords: increase.


SubjectID: 10559377, StudyID: 53419340, Comparison: same

WET READ: ___ ___ ___ 7:58 AM Stable widespread pulmonary opacities and probable bilateral pleural effusions. Tracheostomy tube and left PICC are unchanged.

WET READ VERSION #1 ___ ___ ___ 7:37 PM Stable widespread pulmonary opacities and probable bilateral pleural effusions. Tracheostomy tube and left PICC are unchanged. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with prolonged hospital stay s/p trach/peg with worsening respiratory status, now with acute onset epigastric pain. // r/o free air under diaphragm.

COMPARISON: ___

IMPRESSION: The widespread bilateral diffuse parenchymal opacities are unchanged   Keywords: unchanged. Also unchanged are the areas of pleural thickening. Moderate cardiomegaly with bilateral lower lobe atelectasis persists. Unchanged monitoring and support devices.


SubjectID: 10559377, StudyID: 50377906, Comparison: -1.0

FINAL REPORT

INDICATION: ___ year old man with prolonged hospital stay s/p trach/peg with worsening respiratory status, increased sputum production and low grade fevers // eval for worsening pna, pulmnary edema

TECHNIQUE: APsingle view

COMPARISON: ___

FINDINGS: Again identified are bilateral widespread mid upper and lower zone opacities that remain unchanged   Keywords: unchanged, remain. Tracheostomy tube and left PICC are unchanged in position; multiple EKG leads overlie the chest wall. Bilateral pleural effusions, and cardiomegaly with slight interval worsening compared to the prior radiograph.

IMPRESSION: Overall unchanged widespread lung opacities with interval mild worsening of bilateral pleural effusions and cardiomegaly with possible underlying pulmonary edema   Keywords: worse.


SubjectID: 10559377, StudyID: 50501487, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with sepsic shock, course c/b STEMI and lung hemorrhage requiring intubation to trach placement // evaluate for interval changes

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Cardiac size is top-normal. vascular congestion has improved   Keywords: improve. Lines and tubes are in unchanged standard position. There is no pneumothorax. Small to moderate right and small left effusions associated with adjacent atelectasis are grossly unchanged.


SubjectID: 10569306, StudyID: 59589706, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with worsening mental status, dyspnea // pneumonia?

IMPRESSION: In comparison with the study ___ ___, there is again substantial enlargement of the cardiac silhouette with prominent right pleural effusion and compressive atelectasis at the base. The IJ catheter has been pulled back slightly to about the junction of the SVC and left brachiocephalic vein.


SubjectID: 10569306, StudyID: 57480156, Comparison: worse

FINAL REPORT

INDICATION: Evaluation of patient with dyspnea and history of congestive heart failure.

COMPARISON: Chest radiograph from ___.

FINDINGS: Bilateral increased reticular opacities throughout the lungs consistent with moderate-to-severe pulmonary edema   Keywords: increase. The cardiomediastinal silhouette appears enlarged in comparison to prior study. Additionally, focal opacity is noted overlying the right hemithorax. There are bilateral small pleural effusions. The lungs are without pneumothorax. No acute fractures are identified.

IMPRESSION: 1. Evidence of heart failure with enlarged cardiomediastinal silhouette as well as moderate-to-severe pulmonary edema. 2. Focal opacity in the right lower lobe may be representative of atelectasis, asymmetric pulmonary edema, or pneumonia. 3. Bilateral small pleural effusions.


SubjectID: 10569306, StudyID: 57319203, Comparison: None

FINAL REPORT

CLINICAL

INDICATION: On hemodialysis. Fevers. Evaluation for infection and cardiomegaly.

COMPARISON: Multiple prior chest radiographs, the most recent of ___.

FINDINGS: The lungs are clear without focal opacity, pleural effusion or pneumothorax. The cardiomediastinal silhouette is stable. A calcified density in the right upper quadrant represents a calcified liver cyst which is better characterized on the prior CT abdomen and pelvis.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 10569306, StudyID: 50840402, Comparison: None

FINAL REPORT

CLINICAL

HISTORY: End-stage renal disease, now has persistent fevers and new cough. CHEST, PA AND LATERAL The heart remains enlarged. Some blunting of the right costophrenic angle appears to be present, but this is not confirmed on the lateral film. No evidence of pneumonia is seen.

IMPRESSION: No evidence of active disease. Cardiomegaly consistent with hemodialysis.


SubjectID: 10569306, StudyID: 55919708, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with complex medical history and new intubation. // confirm placement of ET tube

TECHNIQUE: Portable chest x-ray.

COMPARISON: Multiple prior radiographs of the chest dated ___ through ___.

FINDINGS: Portable semi-upright radiograph of the chest demonstrates low lung volumes resultant bronchovascular crowding. As before, there is a large right-sided pleural effusion and a small left-sided pleural effusion with adjacent atelectasis at both bases. The cardiomediastinal and hilar contours are unchanged. The endotracheal tube ends 5.5 cm from the carina. A left-sided internal jugular central venous line ends in the origin of the SVC. The nasogastric tube courses into the stomach with the last side port just below the GE junction. There is no pneumothorax.

IMPRESSION: 1. Endotracheal tube ends 5.5 cm from the carina. 2. Nasogastric tube ends in the stomach with the side port just below the GE junction.


SubjectID: 10569306, StudyID: 50737668, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with critical AS, PCKD s/p failed renal transplant now with worsening mental status and persistent pleural effusion // interval change in pleural effusion

TECHNIQUE: Portable chest x-ray.

COMPARISON: Multiple prior radiographs of the chest dated ___ through ___.

FINDINGS: Portable semi-upright radiograph of the chest demonstrates low lung volumes which results in bronchovascular crowding. There is a large right-sided pleural effusion with adjacent atelectasis. There is a small left-sided pleural effusion with adjacent atelectasis as well. There is no pneumothorax. The cardiomediastinal and hilar contours are unchanged. A left-sided internal jugular central venous line ends at the origin of the SVC. Known calcified hepatic cyst projects over the right upper quadrant.

IMPRESSION: Large right-sided pleural effusion with adjacent atelectasis, and small left-sided pleural effusion with adjacent atelectasis.


SubjectID: 10569306, StudyID: 55494728, Comparison: same

FINAL REPORT

EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Pleuritic right chest pain.

COMPARISON: ___.

FINDINGS: There is a moderate right pleural effusion with overlying atelectasis, increased since the prior study. A small left pleural effusion is also seen, which is grossly stable to possibly slightly increased as compared to the prior study. Prominence of the hila is stable, as compared to ___ and may relate to vascular engorgement. The right aspect of the cardiac border is difficult to assess due to the right-sided opacity. The left aspect of the cardiac and mediastinal silhouette is stable. There is no pneumothorax. Rounded calcified structure again projects over the right upper quadrant.

IMPRESSION: Moderate right and small left pleural effusions, increased on the right and stable to possibly slightly increased on the left. Right base opacity may be due to combination of pleural effusion and atelectasis, but consolidation is not excluded. Prominence of the hila possibly due to vascular congestion is again seen   Keywords: again.


SubjectID: 10569306, StudyID: 53517657, Comparison: None

WET READ: ___ ___ ___ 10:08 PM Improved aeration of right lung base s/p pleurocentesis. No pneumothorax.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman with pleural effusion which is just drained.

FINDINGS: Comparison is made to prior study from ___. There has been improvement of the pleural effusion at the right base since the previous study. The heart size is enlarged but stable. There are no pneumothoraces or focal consolidation. There is some atelectasis at the lung bases. Calcified cystic structure in the right upper abdomen is unchanged and better assessed on the prior CT scan.


SubjectID: 10592564, StudyID: 55909689, Comparison: better

FINAL REPORT

INDICATION: Pulmonary edema, evaluate for change.

COMPARISON: Chest radiograph on ___ at 4:38 a.m.

FINDINGS: AP portable view of the chest. Lung volumes are low. Moderate cardiomegaly is unchanged. Mediastinal and hilar contours are stable. Slight decrease in mild pulmonary edema   Keywords: decrease with less fluid in an accessory fissure in the right lower lobe   Keywords: decrease. No pleural effusions, or pneumothorax.

IMPRESSION: Slight decrease in mild pulmonary edema.


SubjectID: 10592564, StudyID: 52014297, Comparison: None

FINAL REPORT

CHEST PORTABLE Semi UPRIGHT AT 4:39 A.M.

INDICATION: Dyspnea question pulmonary edema, hypertension.

COMPARISON: None available.

FINDINGS: Increased interstitial markings are seen and there is some fluid in the fissure on the right. The heart is rather substantially enlarged for a patient of this age. Although this may represent myocardial enlargement pericardial effusion cannot be excluded. Monitor leads overly the chest.

CONCLUSION: Cardiomegaly. Interstitial edema. Case discussed with Dr. ___ at 08:45.


SubjectID: 10607527, StudyID: 57432223, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female with pulmonary fibrosis and pulmonary hypertension, now presenting with hypoxia.

COMPARISON: Chest radiograph from ___ and chest CT from ___. PORTABLE AP CHEST RADIOGRAPH: Diffuse interstitial opacities correspond with patient's known underlying pulmonary fibrosis. However, compared to the scout image from chest CT from ___, there are overall increased interstitial opacities. Additionally, there is enlargement of the hilar contours and cardiac silhouette. The above collection of findings suggest superimposed moderate pulmonary edema. Probable small bilateral pleural effusions are also present. No pneumothorax is evident.

IMPRESSION: Probable moderate interstitial pulmonary edema superimposed upon background pulmonary fibrosis. The ddx could include fibrosis with superimposed interstital pneumonia, though this is considered less likely.


SubjectID: 10624517, StudyID: 57647260, Comparison: None

FINAL REPORT

HISTORY: Shock with intubation.

FINDINGS: In comparison with the study of ___, the monitoring and support devices remain in place. There is decreased opacification at the right base, consistent with some decrease in pleural effusion. However, some of this could reflect the more erect posture of the patient. Opacification at the left base persists, consistent with substantial volume loss in the left lower lobe and a moderate effusion.


SubjectID: 10624517, StudyID: 57446824, Comparison: worse

WET READ: ___ ___ ___ 7:42 PM Evaluation is limited due to rotation; however, retraction of the right internal jugular catheter by 4.5 cm is recommended. Bilateral effusions, mild on the right and moderate on the left, with adjacent atelectasis are again noted. Retrocardiac and left lower lobe opacity is likely a combination of atelectasis and effusion. However, pneumonia must be excluded in the proper clinical setting. Discussed by Dr. ___ with Dr. ___ ___ telephone at 7:40 pm on ___. ______________________________________________________________________________

FINAL REPORT

HISTORY: Cardiomyopathy, for central line placement.

FINDINGS: In comparison with the earlier study of this date, there is little change in the appearance of the right IJ catheter, which still extends into the right atrium and could be pulled back approximately 4-5 cm. Opacification at the left base is again consistent with substantial volume loss in the left lower lobe and pleural effusion. The possibility of supervening pneumonia would have to be considered. Pulmonary vessels are less well defined, suggesting some increasing pulmonary venous congestion   Keywords: increasing. Continued apical pleural capping on the right, and to a lesser degree, on the left, with no evidence of pneumothorax.


SubjectID: 10624517, StudyID: 55064961, Comparison: None

FINAL REPORT

HISTORY: For ET tube position.

FINDINGS: In comparison with study of ___, the endotracheal tube tip is well positioned approximately 4.1 cm above the carina. Other monitoring and support devices remain in place. Retrocardiac opacification persists, consistent with atelectasis and effusion, though supervening pneumonia would have to be considered in the appropriate clinical setting. Hazy opacification at the right base is consistent with pleural fluid. Indistinctness of pulmonary vessels could reflect some elevated pulmonary venous pressure.


SubjectID: 10624517, StudyID: 54651976, Comparison: None

FINAL REPORT

HISTORY: Intubation.

FINDINGS: In comparison with the earlier study of this date, there is now an endotracheal tube in place with its tip approximately 3.7 cm above the carina. The right IJ catheter again extends to the level of the cavoatrial junction. Little change in the appearance of the heart and lungs. Nasogastric tube has been placed that extends to at least the body of the stomach where it crosses the lower margin of the image.


SubjectID: 10624517, StudyID: 52172761, Comparison: better

FINAL REPORT

AP CHEST, 2:38 A.M., ___

HISTORY: Atrial fibrillation with a rapid ventricular rate.

IMPRESSION: AP chest compared to ___ through ___: Mild pulmonary edema has improved since ___   Keywords: improve. Severe cardiomegaly, marked left lower lobe atelectasis and moderate bilateral pleural effusions are unchanged. No pneumothorax. ET tube and right internal jugular line are in standard placements, nasogastric tube passes below the diaphragm and out of view. No pneumothorax.


SubjectID: 10624517, StudyID: 56880617, Comparison: same

FINAL REPORT

HISTORY: CHF exacerbation.

FINDINGS: In comparison with the earlier study of this date, the monitoring and support devices are essentially unchanged. Extensive opacification at the bases is consistent with bilateral pleural effusions and volume loss in the lower lobes. Pulmonary edema pattern is again seen   Keywords: again.


SubjectID: 10624517, StudyID: 55966911, Comparison: better

FINAL REPORT

PORTABLE UPRIGHT CHEST FILM ___ AT 8:05. CLINICAL

INDICATION: ___-year-old with CHF exacerbation and volume overload, evaluate pulmonary edema and pleural effusions. Comparison to ___ at 17:54. A portable AP upright chest film dated ___ at 8:05 is submitted.

IMPRESSION: 1. Endotracheal tube and right internal jugular central line unchanged in position. Nasogastric tube is seen coursing below the diaphragm with the tip not identify. 2. Persistent layering bilateral pleural effusions. However, there is improving pulmonary edema compared to the prior study   Keywords: improving. Overall stable cardiac and mediastinal contours given differences in patient positioning. No pneumothorax.


SubjectID: 10624517, StudyID: 51827090, Comparison: same

WET READ: ___ ___ 9:32 PM Intestinal catheter traverses below the diaphragm with tip out of view. Otherwise similar exam with pulmonary edema and bilateral pleural effusions. Endotracheal tube and right sided central catheter in similar positions. ______________________________________________________________________________

FINAL REPORT

PORTABLE SEMI-ERECT CHEST FILM ___ AT 17:54 CLINICAL

INDICATION: ___-year-old with volume overload and atrial fibrillation, evaluate nasogastric tube placement. Comparison made to ___ at 13:04. A single portable semi-erect chest film dated ___ 17:54 is submitted.

IMPRESSION: 1. A nasogastric tube is seen coursing below the diaphragm with the tip projecting over the sacrum. Right internal jugular central line has its tip in the distal SVC. Endotracheal tube continues to have its tip 3.5 cm above the carina. 2. Stable bilateral moderate layering pleural effusions with perihilar airspace opacity likely reflecting mild-to-moderate pulmonary edema which is essentially unchanged   Keywords: unchanged. Overall, cardiac and mediastinal contours are likely stable given differences in positioning and technique between studies. 3. Clips in the right upper quadrant likely reflect prior cholecystectomy. Surgical clips are seen overlying the sacrum of uncertain significance. Scattered areas seen in non-dilated loops of bowel.


SubjectID: 10624517, StudyID: 51739847, Comparison: None

FINAL REPORT

INDICATION: Hypoxia, aspiration.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has been extubated and the nasogastric tube has been removed. The right internal jugular vein catheter is unchanged. The lung volumes have overall decreased. In addition, the bilateral pleural effusions have substantially increased, leading to massive bilateral basal areas of atelectasis. The previously enlarged cardiac silhouette is no longer clearly visible. However, much better visible than on the previous examinations, is a right apical lucency, combined to a linear structure between the third and fourth posterior right rib. Together in combination, these findings reflect the presence of a small right apical pneumothorax without evidence of tension. The fact that no bullous disease was seen on the chest CT from ___ makes this diagnosis even more likely. The referring physician, ___. ___ was paged for notification at the time of dictation, 9:01, on ___.


SubjectID: 10630336, StudyID: 58615919, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with resp distress // worsening pulm edema

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the extensive right apical and perihilar opacities are constant in appearance. Also constant is the mild pulmonary edema visualized on the left. Moderate cardiomegaly with elongation of the descending aorta persists.


SubjectID: 10630336, StudyID: 56282207, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (AP AND LAT)

INDICATION: ___M with traumatic foley, GI sx. found to have leukocytosis to ___. Infectious w/u.

COMPARISON: ___ and ___.

FINDINGS: AP upright and lateral views of the chest. Patient has undergone a prior right upper lobectomy with associated volume loss noted in the right upper lung not significantly changed from prior. The heart is stably enlarged. There is no large effusion or pneumothorax. Patient is known to have underlying emphysema with diffuse ground-glass opacity suggesting superimposed mild pulmonary edema. Bony structures are grossly intact. Tiny clips project over the superior mediastinum in the right lung apex. Chronic rib deformity of the right upper rib cage noted.

IMPRESSION: As above.


SubjectID: 10640977, StudyID: 55806735, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman with volume overload.

FINDINGS: Comparison is made to previous study from ___ at 11:38 a.m. There are low lung volumes due to poor inspiratory effort. There is prominence of the pulmonary vascular markings suggestive of pulmonary edema. There is also a right-sided pleural effusion and a developing left retrocardiac opacity. Heart size is upper limits of normal but stable. No pneumothoraces are seen.


SubjectID: 10640977, StudyID: 55746451, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with dyspnea.

COMPARISON: ___.

TECHNIQUE: Single frontal chest radiograph was obtained portably with the patient in an upright position.

FINDINGS: Lung volumes are low. Small right pleural effusion appears slightly increased compared to prior, but may be exaggerated by low lung volumes. There is mild pulmonary vascular congestion. Heart and mediastinal contours are stable.

IMPRESSION: Mild pulmonary vascular congestion and small right pleural effusion, possibly exaggerated by low lung volumes or slightly worse compared to ___. Right base consolidation/infection cannot be excluded. Findings discussed with ___ by ___ by telephone at 12:32 p.m. on ___ at the time of discovery of these findings.


SubjectID: 10640977, StudyID: 53619328, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman with central venous line placed.

FINDINGS: Comparison is made to previous study from ___. There is a right IJ central line with distal lead tip at the cavoatrial junction. Heart size is again seen enlarged. There is prominence of the pulmonary vascular marking suggestive of moderate pulmonary edema. There is a right-sided pleural effusion. There is a wide vascular pedicle. No pneumothoraces are seen.


SubjectID: 10650522, StudyID: 59587671, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with new ETT // Eval ETT, OGT Eval ETT, OGT

IMPRESSION: In comparison with the study of ___, there has been placement of an endotracheal tube with its tip approximately 3.5 cm above the carina. Nasogastric tube extends at least to the mid body of the stomach where it passes the lower margin of the image. There has been the development of diffuse bilateral central opacifications, more prominent on the right, consistent with the bat-wing appearance of severe pulmonary edema   Keywords: development. There is continued enlargement of cardiac silhouette in a patient with evidence of previous CABG procedure and intact midline sternal wires. Bibasilar opacification is consistent with atelectatic change and blunting of costophrenic angles suggests pleural effusions bilaterally.


SubjectID: 10650522, StudyID: 57947765, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with SOB, pneumonia, HF // bilat crackles, SOB

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the pre-existing right and perihilar predominant parenchymal opacities have decreased in extent and severity. No new opacities are visualized   Keywords: new. Moderate cardiomegaly persists. Sternal wires in clips of the CABG are unchanged.


SubjectID: 10650522, StudyID: 55234575, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF having desaturations to high 80s // ? worsening pulm edema vs pneumonia?

COMPARISON: ___, 06:13

IMPRESSION: As compared to the previous radiograph, centralized pulmonary edema has increased in severity   Keywords: increase. Unchanged moderate cardiomegaly. Status post CABG. No larger pleural effusions. No pneumonia.


SubjectID: 10650522, StudyID: 53340086, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with ARDS uncertain etiology // assess for interval progression/improvement in infiltrates

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the bilateral perihilar parenchymal opacities have substantially decreased in extent and severity   Keywords: decrease. However, the opacities are still clearly seen, notably on the right. Unchanged low lung volumes. Unchanged monitoring and support devices. Unchanged retrocardiac atelectasis.


SubjectID: 10650522, StudyID: 58957885, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with new ETT // ?ETT placement

COMPARISON: Chest radiograph from ___.

FINDINGS: AP portable upright view of the chest. A new endotracheal tube terminates at the carina. Again seen are widespread pulmonary opacities bilaterally, unchanged since the ___ examination, reflecting ARDS   Keywords: again, unchanged. Small bilateral pleural effusions are stable. There is no pneumothorax. The patient is post CABG. The heart is mildly enlarged.

IMPRESSION: Endotracheal tube terminating at the carina.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 12:35 PM, 5 minutes after discovery of the findings.


SubjectID: 10650522, StudyID: 57598349, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with improving ARDS still intubated // Interval change?

COMPARISON: None

FINDINGS: AP portable upright view of the chest. An endotracheal tube is no longer visualized. The patient is post CABG. Again seen are bilateral pulmonary opacities which are minimally changed since ___, reflecting known ARDS   Keywords: again. There is no pneumothorax or large pleural effusion. The heart is mildly enlarged.

IMPRESSION: Unchanged appearance of widespread pulmonary opacities, reflecting known ARDS.


SubjectID: 10650522, StudyID: 53266134, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with ARDS s/p re-intubation, // assess for ETT placement after adjustment

COMPARISON: Chest radiograph from ___ at midnight.

FINDINGS: AP portable upright view of the chest. The patient is post CABG. An endotracheal tube has been retracted, now terminating 2.8 cm above the Carina. Central pulmonary vascular congestion and moderate pulmonary edema have improved, in particular at the lung bases   Keywords: improve.

IMPRESSION: Interval retraction of the endotracheal tube, now appropriately positioned, with decreased moderate pulmonary edema and improved aeration, particularly at the lung bases   Keywords: decrease, improve.


SubjectID: 10650522, StudyID: 53787562, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with dyspnea, hypoxia, presyncope // evaluate for flluid overload, pneumonia

COMPARISON: Prior exam dated ___.

FINDINGS: AP portable upright view of the chest. Midline sternotomy wires and mediastinal clips are again noted. There is focal airspace consolidation in the right mid lung concerning for pneumonia. There is associated small right pleural effusion. There is possibly a small left pleural effusion as well. A component of mild pulmonary edema is difficult to exclude in the correct clinical setting. The left lower lobe is poorly assessed given low lung volumes and AP portable technique. No pneumothorax. Cardiomediastinal silhouette is stable. Bony structures are intact.

IMPRESSION: Pneumonia in the right mid lung with small bilateral effusions. Possible mild pulmonary edema.


SubjectID: 10650522, StudyID: 50046711, Comparison: None

FINAL REPORT

PORTABLE CHEST X-RAY OF ___

COMPARISON: ___ radiograph and ___ radiograph.

FINDINGS: Cardiomediastinal contours are stable in appearance. Pulmonary vascular congestion is accompanied by asymmetrical right perihilar airspace opacification, as well as peripheral interstitial opacities. The persistent right perihilar opacity could be due to asymmetrical edema, but infectious pneumonia is also possible in the appropriate clinical setting. Small bilateral pleural effusions are unchanged.


SubjectID: 10667727, StudyID: 59375231, Comparison: same

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old woman with right heart failure and now growing GPCs in blood // ? interval change in pleural effusion

TECHNIQUE: Portable chest radiograph.

COMPARISON: Chest x-ray ___.

FINDINGS: In comparison to the prior CXR performed 2 days earlier, there has been interval improvement in the substantial right pleural effusion. The left lung is essentially clear. There is no pneumothorax. No new areas of focal consolidation. Swan-Ganz catheter terminates in the right pulmonary artery. Left pectoral pacemaker is re-demonstrated, with leads terminating in the right atrium and right ventricle. Cardiomediastinal silhouette is enlarged, not significantly changed from prior.

IMPRESSION: Continued improvement in large right pleural effusion. No other significant changes   Keywords: no other significant change.


SubjectID: 10667727, StudyID: 57828778, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF now s/p swan // eval for swan line position

IMPRESSION: As compared to ___, Swan-Ganz catheter remains in place, terminating in the interlobar portion of the right pulmonary artery. Large right pleural effusion has apparently slightly decreased in size. No other relevant changes   Keywords: no other relevant change.


SubjectID: 10667727, StudyID: 59300854, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman who is intubated // ?interval change in exam ?interval change in exam

COMPARISON: Comparison to ___ at 16:52

FINDINGS: Portable semi-erect chest film ___ at 09:13 is submitted.

IMPRESSION: Endotracheal tube, nasogastric tube, and right internal jugular central line are unchanged in position. There are stable bibasilar opacities with layering effusions, right greater than left ,suggestive of partial lower lobe atelectasis. No pulmonary edema. No pneumothorax. Stable cardiac and mediastinal contours.


SubjectID: 10667727, StudyID: 57357121, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with with effusion recently extubated // progression of pleural effusion/edema progression of pleural effusion/edema

IMPRESSION: In comparison with the study of ___, there is little overall change   Keywords: little overall change. Again there is enlargement of the cardiac silhouette with bilateral pleural effusions and compressive atelectasis at the bases, more prominent on the right, with mild pulmonary edema. Monitoring and support devices are essentially unchanged.


SubjectID: 10667727, StudyID: 56842922, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with recent extubation // ?interval changes

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Right internal jugular line tip is at the level of the right atrium and should be pulled back at least 2.5 cm. NG tube passes below the diaphragm terminating in the stomach. Bilateral pleural effusions and bibasal consolidations are noted as well as mild pulmonary edema.


SubjectID: 10667727, StudyID: 55517979, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F intubated, staph bacteremia, CHF, RV failure, intubated // eval placement of NG tube eval placement of NG tube

COMPARISON: Comparison to ___ at 09:43

FINDINGS: Portable semi-erect chest film ___ at 16:52

IMPRESSION: Right internal jugular central line and endotracheal tube are unchanged in position. Nasogastric tube is seen coursing below the diaphragm with the tip not identified. There are bilateral layering effusions with associated bibasilar airspace disease suggestive of compressive atelectasis. No pneumothorax is seen. No pulmonary edema. Overall cardiac and mediastinal contours are stable.


SubjectID: 10667727, StudyID: 51472478, Comparison: None

FINAL REPORT

INDICATION: NG tube placement.

COMPARISON: Chest radiograph ___.

TECHNIQUE: Frontal chest radiograph.

FINDINGS: An endotracheal tube terminates 3.9 cm above the carina. A right IJ catheter terminates at the upper right atrium. An orogastric/nasogastric tube terminates within the stomach. A small right pleural effusion is unchanged since ___. There is no pneumothorax or focal consolidation. The cardiac and mediastinal contours remain stable.

IMPRESSION: Nasogastric tube terminating within the stomach. Other support lines are unchanged in orientation.


SubjectID: 10667727, StudyID: 59297548, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with chronic pleural effusion, chest tube in place // effusion size, chest tube position

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: NG tube tip is in the stomach. Right central venous line tip is at the level of mid SVC. Cardiomediastinal silhouette including cardiomegaly is unchanged with bilateral pleural effusions which are at least moderate in right pigtail catheter being unchanged in position and no substantial change in minimal right apical pneumothorax seen.


SubjectID: 10667727, StudyID: 59029179, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman who recently slipped restraints and pulled at NGT slightly, s/p re-adjustment of NGT // ?confirm NGT placement

COMPARISON: ___, 08:09

IMPRESSION: As compared to the previous radiograph, there is no change in course of the nasogastric tube. The tip is not included in the image, but the side-hole projects over the middle parts of the stomach. Unchanged moderate cardiomegaly. Unchanged position of the right pleural drain and the right PICC line. No pneumothorax.


SubjectID: 10667727, StudyID: 54111610, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with right sided chest tube, now clamped // interval change interval change

IMPRESSION: In comparison with the study of ___, with the right chest tube clamped, there is no definite evidence of pneumothorax. Otherwise, there is little change, with significant enlargement of the cardiac silhouette and bibasilar effusion and atelectasis, with prominent volume loss in the left lower lobe. Monitoring and support devices are unchanged.


SubjectID: 10667727, StudyID: 52245157, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with chest tube // ?interval changes

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: There has been interval marked worsening of atelectasis in the right lower lobe and right middle lobe. Right chest tube is kinked at the skin entrance. Moderate left effusion has increased. Cardiomegaly and widened mediastinum are unchanged. NG tube tip is out of view below the diaphragm. Right PICC tip is in the upper SVC.


SubjectID: 10667727, StudyID: 51098376, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with hx of sCHF (EF ___%), SSS s/p PPM, HTN, HLD, DM who presents with worsening orthopnea, DOE found to be in decompensated heart failure refractory to her home diuretic regimen, with new evidence of RV failure, with course c/b anuric renal failure with bilateral pleural effusions. Evaluate pleural effusions.

TECHNIQUE: Single portable AP view of the chest.

COMPARISON: Chest radiograph from ___, ___, ___, and ___. CT chest from ___ 3

FINDINGS: Compared with the prior radiograph, the NG tube, right PICC line, and right pleural drain are unchanged in position. Residual small right pleural effusion is unchanged. No left pleural effusion, pneumothorax, or new focal consolidation. Moderate cardiomegaly is stable.

IMPRESSION: Small residual right pleural effusion, with unchanged right pleural drain placement. No left pleural effusion.


SubjectID: 10667727, StudyID: 59252387, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with ETT // ETT positioning ETT positioning

COMPARISON: Comparison to ___ at 07:34

FINDINGS: Portable semi-erect chest film ___ at 07:56 is submitted.

IMPRESSION: Endotracheal tube has its tip approximately 4 cm above the carina. A nasogastric tube is seen coursing below the diaphragm with tip not identified. Right internal jugular central line and right-sided pigtail pleural catheter remain in place. Interval removal of the left-sided pacemaker. The heart remains enlarged, although mediastinal contours are difficult to assess due to patient rotation. There are likely layering effusions, left greater than right. Retrocardiac consolidation most likely reflects partial lower lobe atelectasis, although superimposed infection cannot be excluded. No pneumothorax.


SubjectID: 10667727, StudyID: 55228222, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with RV failure and MRSA bacteremia. Intubated for respiratory distress. // Please eval interval change Please eval interval change

IMPRESSION: In comparison with the study of ___, the monitoring and support devices are essentially unchanged. Small bilateral effusions processed and there is no evidence of pneumothorax. Marked enlargement of the cardiac silhouette is again seen without much elevation in pulmonary venous pressure. This raises the possibility of underlying cardiomyopathy or even pericardial effusion.


SubjectID: 10667727, StudyID: 54693729, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with heart failure, pulmonary effusion, s/p chest tube removal and recurrent respiratory distress. // reaccumulation of pleural effusion? reaccumulation of pleural effusion?

IMPRESSION: In comparison with the study of ___, the monitoring and support devices Check remain in place except for the right chest tube. No substantial pneumothorax. Little change in the heart and lungs with substantial layering effusions especially on the left. Opacification at the right base probably reflects partial collapse of the right lower lobe. In the appropriate clinical setting, superimposed pneumonia would have to be considered.


SubjectID: 10667727, StudyID: 51215859, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with heart failure, respiratory failure, intubated. // interval change in pleural effusion/pulmonary edema interval change in pleural effusion/pulmonary edema

IMPRESSION: In comparison with the study of ___, the monitoring and support devices are essentially unchanged. The AC opacification on the left has decreased, either due to improvement in pleural effusion or merely a manifestation of a more erect posture of the patient. Otherwise little change   Keywords: little change.


SubjectID: 10667727, StudyID: 56709339, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with pleural effusion, chest tube in place. Chest tube position, interval change in effusion.

TECHNIQUE: Single portable AP view of the chest.

COMPARISON: Chest radiograph from ___, ___, ___, and ___. CT chest from ___.

FINDINGS: Compared with the prior radiograph, the NG tube, right PICC line in the upper SVC, and right pleural drain are unchanged in position. There is a moderate right pleural effusion despite the right pleural drain, with persistent right basilar atelectasis. Left lung atelectasis is unchanged without effusion, pneumothorax, or focal consolidation. An enlarged cardiac silhouette is stable.

IMPRESSION: Persistent moderate right pleural effusion despite the pleural drain, with unchanged right basilar atelectasis.


SubjectID: 10667727, StudyID: 58968201, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with hx of sCHF (EF ___%), SSS s/p PPM, HTN, HLD, DM who presents with worsening orthopnea, DOE found to be in decompensated heart failure refractory to her home diuretic regimen, with new evidence of RV failure, with course c/b anuric renal failure with pulmonary edema and worsening of right sided pulmonary effusion // pulmonary effusion

COMPARISON: ___, 08:12

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The nasogastric tube has been removed. The right internal jugular vein catheter continues to be in situ. The extent of the large right pleural effusion is constant. Constant extent of the resulting basilar atelectasis. Constant left retrocardiac atelectasis. No change in appearance of the left lung   Keywords: no change.


SubjectID: 10667727, StudyID: 57190451, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with large right effusion s/p chest tube placement // ? PTX

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, a pigtail catheter was placed into the right pleural space. The right pleural effusion that pre existed is almost completely drained. There is no evidence for the presence of a pneumothorax. Moderate cardiomegaly persists. Right internal jugular vein catheter in situ. Extensive retrocardiac atelectasis is present in almost unchanged manner.


SubjectID: 10667727, StudyID: 53534172, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with respiratory failure now improving with right sided chest tube. Chest tube/ pleural effusion improvement.

TECHNIQUE: Single portable AP view of the chest.

COMPARISON: Chest radiographs from ___ and ___.

FINDINGS: The right IJ central venous catheter has been removed. The right PICC line, right pigtail catheter, and NG tube are unchanged. The cardiac silhouette is quite enlarged, perhaps due to right paracardiac or paramediastinal pleural loculation or pericardial effusion. Left lower lobe atelectasis is unchanged, and there may be a small left pleural effusion.

IMPRESSION: 1. Stable enlargement of the cardiac silhouette may be due to right pericardiac or paramediastinal pleural loculation or pericardial effusion. 2. Interval removal of right IJ central line.


SubjectID: 10667727, StudyID: 50159650, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with chest tube // chest tube placement, interval change in effusion

COMPARISON: ___

IMPRESSION: As compared to the previous image, the size of the cardiac silhouette has moderately decreased. The monitoring and support devices are constant. Also constant is the position of a pigtail catheter in the right pleural space. No recurrent pleural effusion. No pneumothorax. A pre-existing potential minimal pleural effusion on the left has resolved. No new focal parenchymal opacities   Keywords: new. No evidence of pulmonary edema.


SubjectID: 10667727, StudyID: 58805407, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with chst tube // chest tube position, effusion size

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Right pigtail catheter is in place. No interval accumulation of pleural effusion is seen. Minimal apical pneumothorax is unchanged. Cardiomegaly, NG tube tip in the stomach and bibasal consolidations are overall similar to previous examination


SubjectID: 10667727, StudyID: 56890493, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with right sided chest tube for recurrent pleural effusions // interval change

IMPRESSION: As compared to ___ radiograph, right pigtail pleural catheter has slightly changed in position, with a newly appreciated tiny right apical pneumothorax. Moderate right pleural effusion has also apparently slightly increased in size. Persistent enlargement of cardiac silhouette accompanied by pulmonary vascular congestion and mild to moderate edema   Keywords: persistent. Small left pleural effusion is accompanied by a worsening left retrocardiac opacity which may be due to atelectasis and or infectious consolidation.


SubjectID: 10667727, StudyID: 50573853, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with chest tube // chest tube position, effusion size, pneumothorax chest tube position, effusion size, pneumothorax

IMPRESSION: In comparison with the study of ___, the monitoring and support devices are essentially unchanged. An the hazy opacifications in both hemithoraces are less prominent. This could reflect some improving bilateral effusions, especially with the right pigtail catheter in place, although some of it could merely be a manifestation of a more upright position of the patient. Continued enlargement of the cardiac silhouette, probably with mild elevation in pulmonary venous pressure.


SubjectID: 10667727, StudyID: 55009330, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF now s/p swan // Eval for swan line position

COMPARISON: ___

IMPRESSION: The Swan-Ganz catheter, the left internal jugular vein catheter and the pacemaker leads are in correct and unchanged position. The effusion on the right has minimally decreased in extent but still occupies large parts of the right hemi thorax, causing massive atelectasis at the right lung basis. On the left, the heart border and the appearance of the lung parenchyma are unchanged.


SubjectID: 10667727, StudyID: 56895175, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with chronic pulm effusion. Evaluate pulmonary effusion.

TECHNIQUE: Single portable AP view of the chest.

COMPARISON: Chest radiographs from ___, ___, ___, and ___. CT chest from ___.

FINDINGS: The NG tube, right PICC line in the upper SVC, and right pleural drain are unchanged in position. Constant right pleural effusion, despite the right pleural drain. Enlarged cardiac silhouette is stable. No new focal consolidation or pneumothorax.

IMPRESSION: The right pleural effusion is persistent and unchanged, despite the right pleural drain.


SubjectID: 10667727, StudyID: 53009730, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF, pleural effusion, chest tube // eval chest tube eval chest tube

COMPARISON: Comparison to ___ at 08:00

FINDINGS: Portable AP chest film ___ at 13:18 is submitted.

IMPRESSION: Increasing layering effusions with patchy bibasilar opacities likely reflecting compressive lower lobe atelectasis. Pulmonary vascular congestion with no overt pulmonary edema. Right basilar pigtail pleural catheter remains in place as does nasogastric tube coursing below the diaphragm and right subclavian PICC line. No pneumothorax is appreciated. Heart remains enlarged.


SubjectID: 10667727, StudyID: 56444472, Comparison: None

FINAL REPORT

INDICATION: ___F with SOB, DOE // eval for pulm edema

TECHNIQUE: AP and lateral views of the chest.

COMPARISON: None.

FINDINGS: There is an large right-sided pleural effusion. The right lung apex and left lung are essentially clear. Cardiomediastinal silhouette cannot be accurately assessed due to silhouetting on the right. Left chest wall dual lead pacing device is noted with lead tips in the right atrium and right ventricular apex. Degenerative changes are noted in the spine.

IMPRESSION: Large right-sided pleural effusion with underlying atelectasis.


SubjectID: 10667727, StudyID: 52503156, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF // please evaluate for interval change

COMPARISON: ___

IMPRESSION: As compared to the previous image, there is a further increase in extent of the large right pleural effusion. The effusion occupies approximately ___% of the right hemi thorax. No change is seen on the left   Keywords: no change. Unchanged appearance of the left heart border and of the left pectoral pacemaker.


SubjectID: 10667727, StudyID: 54600585, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p NGT placement // pls eval NGT placement. pls eval NGT placement.

IMPRESSION: In comparison with the study of ___, there has been placement of a nasogastric tube extends at least to the lower body of the stomach. Little overall change in the appearance of the heart and lungs.


SubjectID: 10667727, StudyID: 53874681, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF, SOB, AMS // flash pulm edema flash pulm edema

IMPRESSION: In comparison with the study of ___, there is again extensive hazy opacification throughout most of the right hemithorax, consistent with large layering pleural effusion and compressive atelectasis. Less prominent changes are seen on the left. In the appropriate clinical setting, superimposed pneumonia would have to be considered. The right IJ catheter is unchanged. There is now an endotracheal tube in place with its tip approximately 4 cm above the carina. Nasogastric tube extends well into the stomach the for passing below the lower margin of the image.


SubjectID: 10667727, StudyID: 53441911, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with new R IJ swan cathter placed // please eval for proper swan position

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the patient has received a Swan-Ganz catheter via a right internal jugular vein access. The tip is located in the right pulmonary artery, the device should be pulled back by approximately 3 cm. No pneumothorax or other complication. Extensive right pleural effusion is unchanged in extent and severity. Unchanged appearance of the left lung and the left heart border   Keywords: unchanged appearance.


SubjectID: 10667727, StudyID: 51672295, Comparison: None

WET READ: ___ ___ 10:38 AM A large right-sided pleural effusion is minimally increased from the prior examination and partially re distributed. There is some atelectasis of the basal left lung however the left lung appears similar to the prior study. A left-sided internal jugular catheter is seen with its tip in the mid SVC. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST PORT. LINE PLACEMENT; CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF // dialysis cath placement in LIJ Contact name: ___ ___, ___: ___

TECHNIQUE: Portable AP radiograph of the chest from ___.

COMPARISON: Earlier the same day at 08:06.

FINDINGS: The ___ radiograph shows interval placement of a left IJ dialysis catheter which ends in the mid SVC. There is no pneumothorax. A dual lead left-sided pacemaker remains in place. A large right pleural effusion is unchanged. The trachea and mediastinal structures are midline, suggesting there is some component of atelectasis. The left lung is clear. The followup radiograph from ___ shows slight increase in the large right pleural effusion. In addition, the left IJ dialysis catheter has been slightly withdrawn, and now ends at the junction of the upper SVC and brachiocephalic vein.

IMPRESSION: Status post placement of a left IJ dialysis catheter, which initially ends in the mid SVC, but the followup radiograph shows retraction to the junction of the upper SVC and brachiocephalic vein. Slight interval increase in large right pleural effusion with some component of right lung atelectasis. Progressive decreased aeration of the right lung.


SubjectID: 10675468, StudyID: 57855549, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with cough

TECHNIQUE: Portable upright AP view of the chest

COMPARISON: Chest radiograph ___

FINDINGS: Left-sided pacer is again noted with single lead terminating in the region of the right ventricle. Mild enlargement of cardiac silhouette is again noted with dense mitral annular calcifications. Mediastinal and hilar contours are unchanged with atherosclerotic calcifications appearing most pronounced at the aortic knob. No pulmonary edema is present. Increased streaky opacities in the lung bases are noted, potentially worsening atelectasis though infection, particularly in the left lung base is not completely excluded. There is no pneumothorax. Elevation of the right hemidiaphragm is again noted.

IMPRESSION: Streaky opacities in the lung bases may reflect worsening atelectasis though infection in the left lung base is not completely excluded.


SubjectID: 10675468, StudyID: 53775391, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with chest congestion, cough, fevers, leukocytosis // extent of pneumonia extent of pneumonia

IMPRESSION: Comparison to ___. No relevant change as compared to the previous image   Keywords: no relevant change. Severe annular calcification. Borderline size of the cardiac silhouette with at platelike atelectasis at the left lung basis. Unchanged appearance of the right lung   Keywords: unchanged appearance. Unchanged stable correct position of the single lead pacemaker. No interval changes   Keywords: no interval change.


SubjectID: 10675468, StudyID: 53845843, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with SSS status post PPM // eval for pneumothorax and lead placement

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiographs ___ Chest radiograph ___

FINDINGS: A single lead pacemaker is seen with the lead terminating in the right ventricle there is no pneumothorax. Top normal heart size without pleural effusions. No consolidation. Chronic elevation of right diaphragmatic surface, stable since ___. Calcified mitral annulus and atherosclerotic calcifications within the aortic knob are stable since ___. No evidence of pulmonary edema, which is improved from ___   Keywords: improve.

IMPRESSION: Appropriate location of single lead ventricular pacemaker. No pneumothorax.


SubjectID: 10675468, StudyID: 52488564, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with chest pain shortness of breath tachy cardia // eval for pna

COMPARISON: ___.

FINDINGS: AP portable upright view of the chest. Lung volumes are low limiting evaluation. The heart remains moderately enlarged with curvilinear calcification projecting over the heart compatible with mitral annular calcification. There is persistent elevation of the right hemidiaphragm. The lungs appear clear without focal consolidation, large effusion or pneumothorax. No convincing signs of edema or congestion. Atherosclerotic calcifications at the aortic knob again noted. The bony structures appear intact.

IMPRESSION: As above.


SubjectID: 10723086, StudyID: 58504910, Comparison: same

FINAL REPORT

PORTABLE CHEST X-RAY, ___.

COMPARISON: Chest x-ray of one day earlier.

FINDINGS: Cardiac silhouette remains enlarged and is accompanied by pulmonary vascular congestion   Keywords: remains. Apparent area of homogeneous opacity has developed at the right lung base, partially obscuring the right hemidiaphragm. This could represent a right pleural effusion with or without adjacent atelectasis or consolidation. When the patient's condition permits, standard PA and lateral radiographs may be helpful to more fully evaluate this region.


SubjectID: 10723086, StudyID: 59406920, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with difficult breathing // Assess interval change and/or new acute process

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Limited study due to patient body habitus and rotation. Persistent left lower lobe retrocardiac opacity likely due to collapsed left lower lobe. Multiple lung nodules are again demonstrated. Presumed right pleural effusion is probably small and unchanged. Lines and tubes are in unchanged position


SubjectID: 10723086, StudyID: 59370631, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with morbid obesity, OSA, asthma, hypertension, chronic lymphedema, and history of prior ectopic pregnancy with recent hospitalization for LLE cellulitis and pneumonia who presented to the ED for increased dyspnea, hemoptysis, abdominal pain and vaginal bleeding, found to have choriocarcinoma, presumed metastatic to lungs, receiving chemotherapy and renal replacement therapy for acute renal failure who remains intubated ___ metastatic disease to lungs // Please assess for interval change

COMPARISON: ___

IMPRESSION: Technically extremely limited image. Only the right hemi thorax and parts of the left medial hemi thorax are shown. Better visible than on the previous image are multiple rounded opacities of soft tissue density, located in the right lung, and suggesting the presence of metastatic disease. Blunting of the right costophrenic sinus could suggest the presence of a minimal right pleural effusion. The patient is intubated and the visible parts of the support devices are in correct position. The heart is not entirely visible. No evidence of a right pneumothorax.


SubjectID: 10723086, StudyID: 54698338, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with respiratory failure // interval change

COMPARISON: ___.

IMPRESSION: Very limited examination. Moderate cardiomegaly and extensive rounded opacities in the right lung persist. The monitoring and support devices are constant.


SubjectID: 10723086, StudyID: 58994012, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___ radiograph.

FINDINGS: Endotracheal tube remains in standard position, but tip of the nasogastric tube is not confidently visualized beyond the lower esophagus. Stable cardiomegaly accompanied by persistent diffuse airspace opacities affecting the right lung to a greater degree than the left. Many of the opacities have a nodular or mass-like quality, suggesting the possibility of septic emboli or fungal infection in the appropriate clinical setting. The right lung continues to be involved to a greater degree than the left. Probable bilateral pleural effusions appear similar to the prior study.


SubjectID: 10723086, StudyID: 58425386, Comparison: same

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman with hemoptysis. Evaluate interval progression.

FINDINGS: Comparison is made to prior radiographs performed on ___. The endotracheal tube and nasogastric tube are again seen; however, again the tip of the nasogastric tube is not well seen due to technique and the patient's body habitus. There is cardiomegaly. There are again seen diffuse airspace opacities bilaterally, many of which appear nodular   Keywords: again. No pneumothoraces are identified.


SubjectID: 10723086, StudyID: 57994563, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: . // worsening of pulmonary process?

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

FINDINGS: ET tube tip is approximately 6 cm above the carina. There is continuous widening out of the entire right lung as well as of substantial portion of the left mid and lower low. The multifocality of the process is re- demonstrated. Pleural effusion although is present does not represent the major finding.

IMPRESSION: ET tube tip is approximately 6 cm above the carina. There is continuous widening out of the entire right lung as well as of substantial portion of the left mid and lower low. The multifocality of the process is re- demonstrated. Pleural effusion although is present does not represent the major finding.


SubjectID: 10723086, StudyID: 52845972, Comparison: -1.0

FINAL REPORT

STUDY: AP chest, ___.

HISTORY: ___-year-old with choriocarcinoma metastases to the lungs. Evaluate for interval progression.

FINDINGS: Comparison is made to prior study from ___. There is diffuse opacifications of both lung fields, worse within the right lung   Keywords: worse. Numerous nodular densities are seen bilaterally. There is cardiomegaly. The patient is intubated and the endotracheal tube is unchanged. Overall, there has been no significant change   Keywords: no significant change.


SubjectID: 10723086, StudyID: 50855119, Comparison: same

WET READ: ___ ___ ___ 5:41 PM Technically limited study. The position of the new OG tube cannot be determined due to overlying opacities. The study is otherwise unchanged from the prior radiograph from 12 hr ago. ______________________________________________________________________________

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: Patient with new OG tube placement.

FINDINGS: Comparison is made to previous study from ___ at 5:46 a.m. There is an endotracheal tube which is stable. There is an orogastric tube which is not well seen due to the technique. It is seen at least to the level of the mid chest. Heart size is enlarged. There are diffuse airspace opacities and which appear stable but opacified both lung fields   Keywords: stable. There is a small amount of lung aerated in the left upper lobe.


SubjectID: 10723086, StudyID: 52174183, Comparison: better

FINAL REPORT

INDICATION: ___ year old woman with hemoptasis, vented // interval change

TECHNIQUE: Portable AP supine view of the chest

COMPARISON: ___

FINDINGS: Endotracheal tube terminates approximately 6 cm above the carina. Right PICC tip is probably in the mid SVC. Confluent diffuse bilateral opacities have not improved   Keywords: improve. Cardiomegaly is difficult to evaluate.

IMPRESSION: 1. Endotracheal tube terminates 6 cm above the carina and should be advanced by 2 cm. 2. Diffuse bilateral heterogeneous opacities, consistent with multifocal pneumonia.


SubjectID: 10723086, StudyID: 58359266, Comparison: None

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old woman with mechanical ventilation and with metastatic choriocarcinoma. Evaluate for interval change.

FINDINGS: Comparison is made to prior study from ___. Due to the patient's body habitus the study is very limited. There are again seen airspace opacities, more confluent within the right lung. There is mild improved aeration in the left apex; however, this may be partially technical. There is a left retrocardiac opacity. Endotracheal tube and feeding tube are unchanged in position.


SubjectID: 10723086, StudyID: 56774761, Comparison: same

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: A ___-year-old woman with choriocarcinoma and respiratory failure. Extubated and then reintubated.

FINDINGS: Comparison is made to prior study from ___ at 5:18 a.m. There is an endotracheal tube whose tip is at the level of the clavicular heads. There are again seen diffuse airspace opacities bilaterally   Keywords: again. Evaluation for pneumothorax is very limited; however, no large pneumothoraces are seen. There is cardiomegaly and a left retrocardiac opacity. The enteric tube is not well seen due to technique and the patient's body habitus.


SubjectID: 10723086, StudyID: 53980151, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman, metastatic choriocarcinoma and morbid obesity.

FINDINGS: Comparison is made to prior study from ___. There is again seen endotracheal and enteric tube; however, the distal tip of the enteric tube is not well seen due to technique and the patient's very large body habitus. There is unchanged cardiomegaly. There are again seen areas of consolidation throughout both lung fields. There is only a small amount of aerated lung in the left apex and mid lung field.


SubjectID: 10723086, StudyID: 58338130, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with resp failure // assess that trach in is optimal position

TECHNIQUE: Single portable semi upright AP image of the chest.

COMPARISON: Comparison is made with chest radiographs from ___ and ___.

FINDINGS: Tracheostomy tube terminates in the trachea approximately 7 cm above the carina. The tracheostomy is noted to be pointed slightly anteriorly. Right IJ central line terminates in mid SVC. Unchanged right parenchymal opacities consistent with known metastatic disease. Unchanged nodules in the left the lung. Retrocardiac atelectasis unchanged from prior exam. Bilateral pleural effusions are likely present. The cardiomediastinal silhouette is unremarkable.

IMPRESSION: 1. Tracheostomy tube terminates approximately 7 cm above the carinal and is pointed slightly anteriorly. Recommend continued monitoring and repeat radiographs if clinical concern persists or increases. 2. Otherwise stable exam from prior.


SubjectID: 10723086, StudyID: 57992910, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with intubation, b/l mets // interval imaging

COMPARISON: ___

IMPRESSION: No change in appearance of the massive cardiomegaly. The extensive right parenchymal opacities caused by metastatic disease, the lung nodules on the left and the retrocardiac atelectasis. Unchanged monitoring and support devices.


SubjectID: 10723086, StudyID: 58152720, Comparison: None

FINAL REPORT

INDICATION: Fevers.

COMPARISON: Multiple prior chest radiographs dating back through ___, including the most recent study from ___.

FINDINGS: There has been interval removal of a left PICC. A single frontal radiograph of the chest was acquired. Hazy opacification of the mid-to-lower lungs is partially attributable to overlying soft tissues. Retrocardiac dense opacification is not significantly changed compared to the prior study and is likely attributable to atelectasis, although infection or effusion at the left lung base cannot be excluded. There is no right pleural effusion. No pneumothorax is seen. The heart size is somewhat difficult to assess, although appears mildly enlarged, unchanged. The mediastinal contours are normal.

IMPRESSION: Unchanged left retrocardiac opacification, likely secondary to atelectasis, although concomitant infection or effusion at the left lung base is certainly possible.


SubjectID: 10723086, StudyID: 53485784, Comparison: None

FINAL REPORT

HISTORY: Morbid obesity with fevers and retrocardiac density.

FINDINGS: In comparison with study of ___, the left hemidiaphragm is more sharply seen. It is extremely difficult to determine whether the retrocardiac opacification truly represents a finding, or merely a manifestation of extensive scattered radiation related to the size of the patient.


SubjectID: 10723086, StudyID: 50911279, Comparison: None

WET READ: ___ ___ 8:24 AM The status post tracheostomy, with possible more confluent opacities in the left lung, otherwise unchanged.

WET READ VERSION #1 ___ ___ ___ 12:03 AM The status post tracheostomy, with possible more confluent opacities in the left lung, otherwise unchanged. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p trach placement // complications of trach?

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the patient has received a tracheostomy tube. The nasogastric tube was removed. No evidence of complications, notably no pneumothorax. Unchanged appearance of the heart and the cardiac silhouette.


SubjectID: 10723086, StudyID: 53851906, Comparison: None

FINAL REPORT

HISTORY: Dobbhoff placement.

FINDINGS: There has been placement of a Dobbhoff tube that coils in the lower body of the stomach. Extremely limited study due to scattered radiation related to the size of the patient. Tracheostomy tube appears to be in good position and a right IJ catheter extends to the mid to lower portion of the SVC. Bilateral pulmonary opacifications are again seen, more prominent on the right.


SubjectID: 10723086, StudyID: 56573456, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with choriocarcinoma and fever.

TECHNIQUE: Frontal chest radiographs were obtained with the patient in the upright position.

COMPARISON: Chest radiograph from ___, ___ and ___.

FINDINGS: A tracheostomy has been removed. A right central venous line is in stable position. There continues to be a retrocardiac opacity which could represent atelectasis versus consolidation. Multiple previously noted pulmonary nodules are not well seen. The heart size continues to be enlarged.

IMPRESSION: No new focal consolidation. Stable cardiomegaly with left retrocardiac opacity.


SubjectID: 10723086, StudyID: 56014461, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with choriocarcinoma with tachycardia and difficulty breathing

TECHNIQUE: Frontal chest radiographs were obtained with the patient in the upright position.

COMPARISON: Radiographs from ___, ___, ___ and ___.

FINDINGS: Evaluation is somewhat limited due to body habitus. There is a right central venous line, and there continues to be a left retrocardiac opacity. No new consolidation is seen, and the heart continues to be enlarged.

IMPRESSION: Cardiomegaly with left retrocardiac opacity. No new focal consolidation.


SubjectID: 10723086, StudyID: 55942767, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with NGT replaced // NGT placement

COMPARISON: ___

IMPRESSION: In the interval, the nasogastric tube has been changed. The current tube shows a normal course, the tip projects over the gastroesophageal junction. If positioning in the stomach is intended, than the tube needs to be advanced by approximately 10 cm.


SubjectID: 10723086, StudyID: 55497309, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with fevers // eval for signs of infection eval for signs of infection

IMPRESSION: In comparison with the study of ___, there are lower lung volumes. Diffuse opacifications are again seen throughout both lungs   Keywords: again. Much of this represents known nodular metastases from choriocarcinoma. However, the possibility of superimposed pneumonia or pulmonary vascular congestion would be impossible to exclude the in the appropriate clinical setting. Tracheostomy tube remains in place and the enteric tube has been removed. There is substantial enlargement of the cardiac silhouette. The retro cardiac region cannot be assessed on this single study.


SubjectID: 10723086, StudyID: 51063528, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ yo woman with new NGT // eval NGT placement

COMPARISON: ___, 14:48

IMPRESSION: As compared to the previous radiograph, the patient has received a nasogastric tube. The course of the tube is unremarkable, the tip of the tube projects over the gastroesophageal junction, if positioning in the stomach is intended, advancement of the tube by at least 15 cm is required.


SubjectID: 10723086, StudyID: 50338953, Comparison: None

WET READ: ___ ___ 8:22 AM Tip of NG tube unable to be localized.

WET READ VERSION #1 ___ ___ ___ 7:38 PM Tip of NG tube unable to be localized. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with failed speech and swallow now with NGT // NGT placement

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the technique limitations of the image still do not allow reliable identification of the tip of the nasogastric tube. The device projects in part over the stomach. The tracheostomy tube, hemodialysis catheter and right internal jugular vein catheter are in unchanged position.


SubjectID: 10723086, StudyID: 55656872, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman withnew R PICC // R 55cm cephalic DL PPICC, thanks, ___ #___ R 55cm cephalic DL PPICC, thanks, ___ #___

IMPRESSION: In comparison with the earlier study of this date, the right PICC line tip is difficult to see because of the overlying left hemodialysis catheter. Nevertheless, the tip probably is in the lower portion of the SVC.


SubjectID: 10723086, StudyID: 54050905, Comparison: same

FINAL REPORT

EXAMINATION: Portable Chest Radiograph

INDICATION: ___ year old woman with inability to dialyze through temp HD line, please evaluate for positioning of line // ___ year old woman with inability to dialyze through temp HD line, please evaluate for positioning of line and need for adjustment

TECHNIQUE: Portable CXR

COMPARISON: CXR ___

FINDINGS: The left internal jugular approach HD catheter is unchanged in position and terminates in the right atrium. The enteric tube is again noted in the gastroesophageal junction. Unchanged position of the tracheostomy tube. There are no other significant changes   Keywords: no other significant change. No evidence of pneumothorax. Again noted is moderate to severe pulmonary edema   Keywords: again.

IMPRESSION: The left HD catheter is unchanged in position and terminates in the right atrium.


SubjectID: 10723086, StudyID: 55111532, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with h/o choriocarcinoma with SOB and O2 requirement // ? Pneumonia or fluid overload?

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: No interval change from prior study   Keywords: no interval change. Stable cardiomegaly, widened mediastinum, large retrocardiac consolidation, probably small left effusion and mild vascular congestion. Right PICC tip is in the mid to upper SVC . Right lower lobe opacity is a combination of small effusion and atelectasis


SubjectID: 10723086, StudyID: 52387452, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with ARF s/p transfusion // ARF

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Allowing the rotation of the patient, there is no interval change from prior study   Keywords: no interval change. Stable cardiomegaly, retrocardiac opacity, no pneumothorax and standard position of the right IJ catheter and right PICC


SubjectID: 10723086, StudyID: 53905329, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___-year-old female with choriocarcinoma receiving tube feedings. Evaluate for evidence of aspiration.

TECHNIQUE: Portable AP radiograph of the chest from ___.

COMPARISON: ___.

FINDINGS: A tracheostomy tube sits at the level of the clavicles. A right IJ central line terminates in the SVC. Evaluation of the lungs is somewhat limited by low lung volumes and motion artifact. However, bilateral airspace opacities have decreased since the study of 5 days ago   Keywords: decrease. Left lung nodules are again noted. Persistent opacification of the retrocardiac region is likely due to atelectasis. There are likely small layering bilateral pleural effusions. The cardiomediastinal silhouette is magnified by the projection. There is no pneumothorax.

IMPRESSION: Improving airspace opacities which may be due it resolving edema versus aspiration   Keywords: resolving, improving. Right IJ central line remains in satisfactory position.


SubjectID: 10723086, StudyID: 53546396, Comparison: None

WET READ: ___ ___ ___ 9:34 AM A malpositioned enteric tube is present, passing through the left mainstem bronchus and in the left lower lobe. No other significant change since the most recent prior study. The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 6:54 PM, 5 minutes after discovery of the findings. At the time of this report, the tube has been removed.

WET READ VERSION #1 ___ ___ ___ 6:56 PM A malpositioned enteric tube is present, passing through the left mainstem bronchus and in the left lower lobe. No other significant change since the most recent prior study. The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 6:54 PM, 5 minutes after discovery of the findings. At the time of this report, the tube has been removed.

WET READ VERSION #2 ___ ___ ___ 9:29 AM A malpositioned enteric tube is present, passing through the left mainstem bronchus and in the left lower lobe. No other significant change since the most recent prior study. The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 6:54 PM, 5 minutes after discovery of the findings. At the time of this report, the tube has been removed. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with NG tube // NG past carina? NG past carina?

COMPARISON: Comparison a prior study ___

IMPRESSION: The feeding tube has its tip coursing within the airway and terminates in the left lower lobe bronchus. Repositioning was recommended by Dr. ___ as documented in the wet reading. The tracheostomy tube and right internal jugular central line appear unchanged position given the marked differences in positioning between studies. There are multiple bilateral pulmonary nodules consistent with known metastatic disease which makes it challenging to assess for superimposed edema. The heart remains stably enlarged which may reflect cardiomegaly, although a pericardial effusion cannot be excluded. Retrocardiac opacity may reflect partial lower lobe atelectasis ,although infection cannot be entirely excluded. Clinical correlation is advised. No large pneumothorax is appreciated.


SubjectID: 10747985, StudyID: 59186222, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiographs.

INDICATION: ___F with intubated // eval for pna chf

TECHNIQUE: Portable AP view of the chest.

COMPARISON: ___.

FINDINGS: Interval placement of an endotracheal tube which terminates 3.6 cm above the level of the carina. Lung volumes are moderately low. Bibasilar atelectasis is seen without lobar consolidation, pleural effusion, pneumothorax, or frank pulmonary edema. The patient is status post CABG. Severe cardiomegaly is unchanged.

IMPRESSION: ETT in appropriate position. Stable, severe cardiomegaly without superimposed acute cardiopulmonary process.


SubjectID: 10747985, StudyID: 50115632, Comparison: same

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___F with ?sepsis // central line

TECHNIQUE: AP portable view of the chest.

COMPARISON: ___ at 17:46.

FINDINGS: Interval placement of a right-sided internal jugular central venous line with the tip terminating near the cavoatrial junction. A nasogastric tube courses beneath the diaphragm now two-view the radiograph. Endotracheal tube is unchanged in position. Cholecystostomy clips are noted. Lung volumes remain low but without evidence of focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. Severe cardiomegaly is unchanged.

IMPRESSION: Right IJ CVL terminating at the cavoatrial junction. Additional support lines and tubes are properly position. Otherwise no change   Keywords: no change.


SubjectID: 10747985, StudyID: 58529779, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with fatigue, SOB, left sided base rales // please evaluate for pneumonia and CHF please evaluate for pneumonia and CHF

COMPARISON: Prior chest radiographs since ___ most recently ___.

IMPRESSION: Severe cardiomegaly, mediastinal and pulmonary venous engorgement, and mild bilateral pleural scarring are chronic. There is no pulmonary edema or pleural effusion. Lateral view shows substantial hyperinflation, chronic due to emphysema or small airway obstruction.


SubjectID: 10747985, StudyID: 56550579, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___F with fatigue, DOE, lower extremity edema b/l, also with new 10pt Hct drop over last month, please evaluate for pulmonary congestion ___ chf // check for pulmonary edema

COMPARISON: ___. CT abdomen pelvis from ___.

FINDINGS: PA and lateral views of the chest provided. Midline sternotomy wires again noted as well as mediastinal clips. The heart remains moderately enlarged. Flattened CP angle on the left on the lateral projection reflects a small fat containing Bochdalek's hernia. No focal consolidation, large effusion or pneumothorax. No edema or overt congestion. Bony structures appear demineralized though appear grossly intact.

IMPRESSION: Stable cardiomegaly. No pneumonia or overt edema.


SubjectID: 10747985, StudyID: 53532734, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: Chest AP portable single view.

INDICATION: ___-year-old female patient with PICC line placement.

FINDINGS: AP single view of the chest was obtained with patient in upright position. Comparison is made with the next preceding similar study of ___. On the previous examination, a right-sided PICC line was identified and seen to terminate overlying the mid portion of the right atrium. Withdrawal of the line by 4 cm was recommended, but no followup examination obtained. The present examination obtained five days later demonstrates the presence of a right-sided PICC line presumably identical with the previous one. Termination point has changed and is now located 3 cm below the level of the carina which indicates the lower portion of the SVC, but safely above the expected entrance into the right atrium. These findings are unaltered, status post sternotomy and bypass surgery with moderate cardiac enlargement. No pneumothorax identified.


SubjectID: 10747985, StudyID: 51938674, Comparison: same

FINAL REPORT

HISTORY: Shortness of breath.

COMPARISON: ___.

TECHNIQUE: Portable frontal chest radiograph, single view.

FINDINGS: There is little change compared to prior examination with redemonstration of significant cardiomegaly and postoperative mediastinal contour. A central vascular congestion with upper zone redistribution is again noted without frank interstitial edema   Keywords: again. There is redemonstration of a retrocardiac consolidation which obscures the left hemidiaphragm. A right-sided PICC terminates in the low SVC. There is no large effusion or pneumothorax.

IMPRESSION: Retrocardiac consolidation which may be atelectasis or pneumonia. Conventional lateral view may be helpful for further evaluation. Vascular congestion without frank edema.


SubjectID: 10750883, StudyID: 59501399, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post mitral valvuloplasty. Evaluation for Swan-Ganz catheter position.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient was extubated and the nasogastric tube was removed. Swan-Ganz catheter is in unchanged position, with the tip projecting over the inflow tract of the right atrium. No complications. Improved ventilation of both lungs. A small atelectasis in the mid left lung persists. Borderline size of the cardiac silhouette, no overt pulmonary edema.


SubjectID: 10750883, StudyID: 55000633, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post valve replacement, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the Swan-Ganz catheter has been removed. There is unchanged evidence of a left mid lung atelectasis. Moderate cardiomegaly without pulmonary edema. No larger pleural effusions. No pneumonia.


SubjectID: 10750883, StudyID: 50050711, Comparison: worse

FINAL REPORT

HISTORY: Status post aortic valve replacement. Evaluate endotracheal tube placement.

COMPARISON: Chest radiograph from ___.

FINDINGS: A portable frontal chest radiograph demonstrates the endotracheal tube in standard position with the tip 4 cm above the carina, as well as a Swan-Ganz catheter with the tip in the right pulmonary artery and a nasogastric tube which extends at least into the stomach. Lung volumes are extremely low, resulting in vascular crowding. There has been interval development of mild pulmonary edema and engorgement of pulmonary vessels, including the pulmonary arteries   Keywords: development. The cardiomediastinum otherwise has the expected postoperative appearance. There is no focal consolidation, large pleural effusion, or pneumothorax.

IMPRESSION: 1. Endotracheal tube in standard position. 2. Interval development of mild pulmonary edema and pulmonary vascular engorgement   Keywords: development. Otherwise, expected appearance of the cardiomediastinum given postoperative status and low lung volumes. These findings were communicated via telephone by Dr. ___ to Dr. ___ at ___ on ___.


SubjectID: 10750883, StudyID: 52660410, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p TMVR // placement of lines and tubes placement of lines and tubes

IMPRESSION: Comparison to ___. The patient is intubated. The tip of the endotracheal tube projects 4 cm above the carinal. The patient has developed a platelike atelectasis at the left lung bases. Moderate cardiomegaly. No pulmonary edema. No pleural effusions. No pneumothorax.


SubjectID: 10750883, StudyID: 50895316, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with COPD, s/p TMVR and TAVR. // please assess for interval change, pulm edema

IMPRESSION: In comparison to ___, the patient has been extubated. Previously present multifocal atelectasis has substantially improved. No new or worsening lung opacities   Keywords: new, worse.


SubjectID: 10757032, StudyID: 59065969, Comparison: None

FINAL REPORT

EXAM: Chest, single frontal portable view. CLINICAL INFORMATION: ___-year-old male with history of shortness of breath.

COMPARISON: ___.

FINDINGS: Single AP upright portable view of the chest was obtained. Left sided triple-lead AICD is unchanged in position. The lung volumes are slightly decreased. The cardiac and mediastinal silhouettes are stable. Bibasilar opacities likely representing chronic atelectasis/scarring are stable. The right costophrenic angle is not fully included on the image and a small right pleural effusion cannot be excluded. There is trace blunting of the left costophrenic angle and a trace left pleural effusion cannot be excluded. No overt pulmonary edema is seen.


SubjectID: 10757032, StudyID: 58655851, Comparison: None

WET READ: ___ ___ ___ 9:04 PM Small right and moderate left effusions, with bibasal atelectasis. Subtle opacity in the infrahilar left lung, may represent infection. Recommended PA and lateral views for further evaluation. Left chest wall device with leads in optimal position. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Shortness of breath, orthopnea, hemodialysis, evaluation for pneumonia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, a small right and a moderate left pleural effusion persist. Areas of bilateral atelectasis are seen. In the infrahilar left lung, a subtle parenchymal opacity is present, this opacity may reflect infection. Further evaluation with frontal and lateral radiographic projections are recommended. Unchanged appearance of the left pectoral pacemaker and the course of the pacemaker leads.


SubjectID: 10758777, StudyID: 56963061, Comparison: None

FINAL REPORT

CHEST ON ___

HISTORY: Cough and shortness of breath with new crackles. REFERENCE EXAM: ___.

FINDINGS: The heart is mildly enlarged and there is mild pulmonary vascular redistribution and a small left effusion that is new compared to the prior study. There is no focal infiltrate. Compared to the prior exam, the fluid status is slightly worse. Degenerative changes are again seen in both the shoulders.


SubjectID: 10758777, StudyID: 50233726, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with generalized weakness, history of MDS, and low-grade fever two days ago. Evaluate for infectious process.

COMPARISONS: Multiple prior chest radiographs, most recently of ___.

FINDINGS: Frontal and lateral views of the chest were obtained. The heart is of normal size with normal cardiomediastinal contours. The lungs are clear without focal or diffuse abnormality. The pulmonary vasculature is unremarkable. No pleural effusion or pneumothorax is present. Metallic clips overlie the right upper quadrant. Osseous structures are unremarkable.

IMPRESSION: No evidence of acute cardiopulmonary process.


SubjectID: 10760670, StudyID: 56785501, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CP and hypoxia // R/o acute cardiopulm process

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Cardiomediastinal silhouette is unchanged. Right upper lobe consolidation appears to be slightly enlarged as well as right basal consolidation has progressed in the interim. Left basal opacity has progressed as well. No interval development of pulmonary edema is seen   Keywords: development. Further assessment with chest CT for pre size characterization of the reason for progression, specialist or rapid, of the right lung abnormalities is to be suggested


SubjectID: 10760670, StudyID: 50424326, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___F with shortness of breath/cough

TECHNIQUE: Chest PA and lateral

COMPARISON: ___ chest radiograph, ___ CT chest

FINDINGS: Cardiac silhouette size is mildly enlarged. The aorta remains tortuous. Hilar contours are unchanged. Focal consolidative opacity in the right upper lobewith associated elevation of the right minor fissure is relatively unchanged from the most recent prior radiograph, but slightly increased in size compared to the ___ chest CT. Pulmonary vasculature is not engorged. Lungs are hyperinflated suggesting COPD. New patchy opacity within the right lung base could reflect an area of infection. Left lung is clear. There is no pleural effusion or pneumothorax. Osseous structures are diffusely demineralized.

IMPRESSION: 1. New patchy right basilar opacity concerning for pneumonia. 2. Chronic right upper lobe focal area of consolidation, minimally changed from prior radiograph from ___ but slightly increased in size from chest CT from ___, and potentially may reflect a low-grade adenocarcinoma. A dedicated chest CT is recommended for further assessment if clinically indicated.


SubjectID: 10760670, StudyID: 54827584, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old female with chest pain and dyspnea. Rule out infiltrate.

COMPARISONS: Multiple prior chest radiographs, most recently on ___.

FINDINGS: Frontal and lateral views of the chest were obtained. The heart size appears normal. Pulmonary vascular markings are indistinct and prominent in the upper lobes, compatible with mild pulmonary edema. Peripheral wedge shaped right upper lobe opacity is similar to prior. Right hilar and middle lobe patchy consolidative opacities are new. Small bilateral pleural effusions are present. No pneumothorax. No radiopaque foreign body. Osseous structures are unremarkable.

IMPRESSION: Pulmonary edema with small bilateral pleural effusions and new right hilar and middle lobe consolidative opacities, suggestive of pneumonia   Keywords: new. Follow-up radiographs are recommended.


SubjectID: 10760670, StudyID: 53468449, Comparison: better

FINAL REPORT

INDICATION: ___-year-old female with non-productive cough and shortness of breath found to have pneumonia and volume overload, now requiring assessment for interval change.

COMPARISON: Comparison is made with chest radiograph from ___.

FINDINGS: Two frontal images of the chest demonstrate a decrease in the bilateral reticular interstitial markings of the lungs   Keywords: decrease. There has also been interval increase in bilateral pleural effusions. These findings suggest a resolving pulmonary edema   Keywords: resolving. There has also been interval increase in the density of the previously seen right hilar, right lower zone, and right upper zone opacities. Cardiomediastinal silhouette is unchanged.

IMPRESSION: Resolving pulmonary edema   Keywords: resolving. Increasing density of right lung opacities suggest progressing pneumonia.


SubjectID: 10761861, StudyID: 58559277, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with CHF s/p ICD via L axillary vein. // lead position, pneumothorax

FINDINGS: As compared to ___, a single lead ICD remains in place, with tip terminating in the right ventricle. Small amount of subcutaneous emphysema overlies the left axilla, likely related to recent placement of this device. There is no visible pneumothorax. Heart is upper limits of normal in size, aorta is mildly tortuous, and lungs are clear. Mild elevation of left hemidiaphragm is again demonstrated.

IMPRESSION: ICD lead position as described. No evidence of pneumothorax.


SubjectID: 10761861, StudyID: 53507372, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF s/p ICD via L axillary vein. // pneumothorax pneumothorax

IMPRESSION: In comparison with the study of ___ , there has been placement of a defibrillator through the left subclavian approach with the tip in the region of the apex of the right ventricle. Specifically, no evidence of pneumothorax. Low lung volumes accentuate the transverse diameter of the heart. No vascular congestion or acute focal pneumonia.


SubjectID: 10765488, StudyID: 56331030, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with lymphoma and CAD // ? pneumonia

COMPARISON: Radiographs from ___

IMPRESSION: There is a left-sided Port-A-Cath. Heart size is prominent but stable. There has been improvement of the basilar opacities, particularly at the right base. There remains a hazy infiltrate in the right upper lobe.


SubjectID: 10765488, StudyID: 53191964, Comparison: worse

FINAL REPORT

INDICATION: ___ year old man with history of CAD and systolic CHF with shortness of breath and hypoxia. // Eval for pulm edema

COMPARISON: Radiographs from ___

IMPRESSION: There is a right-sided Port-A-Cath with the distal lead tip in the proximal right atrium. There is minimal prominence of the pulmonary interstitial markings suggestive of mild pulmonary edema. There has also been development of bibasilar opacities which may represent aspiration, pneumonia, or asymmetric pulmonary edema   Keywords: development. There are no pneumothoraces.


SubjectID: 10765644, StudyID: 58310989, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old with shortness of breath, please assess acute process.

TECHNIQUE: Frontal and lateral radiographs of the chest were obtained.

COMPARISON: Chest radiograph from ___.

FINDINGS: There is new large right pleural effusion and new mild pulmonary edema. Cardiac silhouette is slightly enlarged. ICD device wires end in the right atrium and right ventricle. A right-sided PICC line ends at the right cavoatrial junction. Chronic compression fractures are stable.

IMPRESSION: New large right pleural effusion and mild edema   Keywords: new.


SubjectID: 10765644, StudyID: 56638404, Comparison: None

WET READ: ___ ___ ___ 9:10 PM Interval reduction of the right pleural effusion, which is now moderate. No pneumothorax. Small left effusion. Cardiomegaly. No edema ______________________________________________________________________________

FINAL REPORT

HISTORY: Right-sided pleural effusion after thoracentesis, to assess for pneumothorax.

FINDINGS: In comparison with the earlier study of this date, there has been substantial decrease in the degree of right pleural effusion, though some fluid in the pleural space remains. Specifically, there is no evidence of pneumothorax. The remainder of the study is unchanged from the previous examination.


SubjectID: 10765644, StudyID: 53707634, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with complicated right pleural effusion status post chest tube placement.

COMPARISON: Comparison is made with chest radiographs from ___.

FINDINGS: Single frontal image of the chest demonstrates interval placement of a right-sided chest tube and reduction of right pleural effusion. There appears to be some gas in the right lower chest, likely represents a pocket of air within a loculated effusion. There is no evidence of pneumothorax or other complications. Cardiac silhouette is unchanged.

IMPRESSION: Improvement in right pleural effusion status post chest tube placement. Otherwise, essentially unchanged chest radiograph from previous imaging.


SubjectID: 10765644, StudyID: 52730962, Comparison: None

FINAL REPORT

HISTORY: CHF, rales, evaluate for pneumonia. CHEST, SINGLE AP PORTABLE VIEW. A left-sided pacemaker is present, with lead tips over right atrium and right ventricle. Multiple leads and lines overlie the chest. There is a small left effusion with some associated left base atelectasis. Possibility of an early pneumonic infiltrate in this location cannot be excluded. There is minimal blunting of the right costophrenic angle and minimal atelectasis at the right base. There are prominent interstitial markings in both lungs, with pleural scarring at the left lung apex.

IMPRESSION: 1. Interstitial markings in both lungs, likely reflecting CHF. 2. Left effusion with left base atelectasis. An early infiltrate in this area cannot be excluded.


SubjectID: 10765644, StudyID: 54409062, Comparison: None

FINAL REPORT

HISTORY: Shortness of breath.

TECHNIQUE: Upright AP and lateral views of the chest.

COMPARISON: ___.

FINDINGS: The left sided dual-chamber pacemaker/AICD device is noted with leads terminating in the right atrium and right ventricle. A right PICC is noted which terminates in the SVC/right atrial junction. The heart remains moderately enlarged but stable. The mediastinal contours are unchanged. There is mild pulmonary vascular congestion. Small bilateral pleural effusions, right greater than left are not significantly changed in the interval. No new areas of consolidation are present, and there is no pneumothorax. Diffuse demineralization the osseous structures is noted with unchanged compression deformities of several mid thoracic vertebral bodies.

IMPRESSION: Mild pulmonary vascular congestion and small bilateral pleural effusions, right greater than left.


SubjectID: 10765644, StudyID: 54126624, Comparison: same

FINAL REPORT

HISTORY: Congestive heart failure with dyspnea.

TECHNIQUE: Upright AP and lateral views of the chest.

COMPARISON: ___.

FINDINGS: Left-sided AICD/pacemaker device is noted with leads terminating in the right atrium and right ventricle, unchanged. Moderate cardiomegaly persists. Right PICC tip terminates within the SVC. Mild interstitial pulmonary edema is noted, not significantly changed from the prior exam, with continued small bilateral pleural effusions, right greater than left   Keywords: not significantly changed. No pneumothorax is identified, and no new areas of focal consolidation are demonstrated. Several compression deformities within the thoracic spine are unchanged.

IMPRESSION: Mild interstitial pulmonary edema and small bilateral pleural effusions, right greater than left, not significantly changed compared to the prior study.


SubjectID: 10765644, StudyID: 50122709, Comparison: None

FINAL REPORT

INDICATION: ___-year-old woman with increasing weakness, to rule out pneumonia.

COMPARISON: Chest radiograph ___ SEMI-UPRIGHT AP AND LATERAL CHEST RADIOGRAPHS: Mild decrease in the small left pleural effusion is seen. The cardiomediastinal and hilar contours are stable, with chronic severe cardiomegaly. No pneumothorax, consolidation or pulmonary edema is detected. Left chest wall AICD device is seen with leads in the expected position of the right atrium and right ventricle. Mild compression of multiple thoracic vertebral bodies, is unchanged since the earlier study of ___.

IMPRESSION: Mild decrease in the small left pleural effusion. Stable chronic cardiomegaly.


SubjectID: 10773491, StudyID: 58772954, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with pulmonary edema, cardiogenic shock, IABP // IABP placement IABP placement

IMPRESSION: In comparison with the earlier study of this date, the IABP has been pulled back to approximately 4 cm below the transverse arch of the aorta and just above the upper aspect of the left mainstem bronchus. For ideal positioning, it it should be advanced about 1.5-2 cm. There is increasing pulmonary edema with continued substantial enlargement of the cardiac silhouette   Keywords: increasing.


SubjectID: 10773491, StudyID: 54418703, Comparison: None

WET READ: ___ ___ ___ 3:43 AM Intra-aortic balloon pump should be advanced by at least 5 cm for more optimal positioning. Swan-Ganz catheter terminates in the right main pulmonary artery. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with MR, CHF s/p cath with PAC and IABP // evaluate position of PA line, IABP evaluate position of PA line, IABP

COMPARISON: Chest radiographs ___:30 and 20:30

IMPRESSION: Tip of the new intra-aortic balloon pump projects below the left main bronchus would need to be advanced 4cm to reposition it in standard placement. An ascending pulmonary flotation catheter loops at the inferior cavoatrial junction but ends in the right descending pulmonary artery. It should not be position more distally. Generalized infiltrative pulmonary abnormality has changed in distribution, but not overall improved. As noted previously it could be pulmonary edema alone or pulmonary edema in combination with widespread metastatic or infectious nodules. Followup advised. No pneumothorax.


SubjectID: 10773491, StudyID: 53394143, Comparison: None

WET READ: ___ ___ ___ 12:00 PM Bilateral diffuse alveolar opacities may be due to a combination of edema, infection, or ARDS. In addition, follow-up after treatment is recommended, noting that underlying pulmonary masses or possible given right axillary surgical clips, suggesting history of malignancy. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with dyspnea. Eval for pneumonia.

TECHNIQUE: Single portable AP view of the chest.

COMPARISON: None available.

FINDINGS: There are bilateral diffuse alveolar opacities obscuring the heart borders. No pneumothorax is identified. Surgical clips overlying the right chest wall/axilla are noted. No pneumothorax is identified.

IMPRESSION: Bilateral diffuse alveolar opacities may be due to a combination of edema, infection, or ARDS. In addition, follow-up after treatment is recommended, noting that underlying pulmonary masses or possible given right axillary surgical clips, suggesting history of malignancy.


SubjectID: 10773491, StudyID: 53769582, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with avr/mvr // r/o ptx, s/p ct d/c

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: The Swan-Ganz catheter is been removed. The IJ Cordis tip is in the SVC. The ET tube and NG tube are unchanged. The bilateral chest tubes have been removed. No pneumothorax is identified. Lung volumes are slightly low but overall there is improved aeration compared to prior. There is still some patchy areas of volume loss/infiltrate in both lower lungs. There tiny bilateral pleural effusions, right greater than left


SubjectID: 10773491, StudyID: 53608917, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with s/p AVR/MVR/CABg // eval infiltrate/ pulmonary edema eval infiltrate/ pulmonary edema

IMPRESSION: In comparison with the study of ___, there again is substantial enlargement of the cardiac silhouette with pulmonary edema that is stable or possibly increasing   Keywords: increasing. Bilateral pleural effusions with compressive atelectasis are again seen. The monitoring and support devices are unchanged.


SubjectID: 10773491, StudyID: 52188249, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with s/p AVR/MVR/CABG // eval pulmonary edema eval pulmonary edema

IMPRESSION: In comparison with the study of ___, there are lower lung volumes. Continued enlargement of the cardiac silhouette with worsening elevation of pulmonary venous pressure. Monitoring and support devices are unchanged. Bibasilar opacification is consistent with pleural effusion and compressive atelectatic changes.


SubjectID: 10773491, StudyID: 51100618, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CABG, MVR, AVR // ? wet

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: The position of the lines and tubes is similar compared to prior. The appearance of the lungs is slightly worsened with bilateral pleural effusions that are small in size the layer posteriorly and hazy alveolar infiltrates bilaterally right greater than left. There is pulmonary vascular redistribution ill definition of the vasculature.

IMPRESSION: Slightly worsened fluid status.


SubjectID: 10773491, StudyID: 50988140, Comparison: better

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___-year-old woman with a history of aortic valve replacement, mitral valve replacement, and CABG, now with increased secretions. Evaluate for pneumonia.

TECHNIQUE: Portable AP chest radiograph

COMPARISON: Multiple prior chest radiographs, most recent from ___.

FINDINGS: Median sternotomy wires intact and aligned. Endotracheal tube terminates 4.6 cm above the carina. NG tube terminates in the stomach, but could be advanced by 5 cm in order for the side ports to be contained within the stomach. Right IJ large-bore introducer catheter terminates in the upper SVC. Stable, moderate cardiomegaly. Improved right pleural effusion. Stable, small left pleural effusion with obscuration of the left heart border that could possibly represent pneumonia, but is most likely consistent with persistent, moderate left lower lobe atelectasis. Acute, mild pulmonary edema improved from ___   Keywords: improve.

IMPRESSION: Likely persistent, moderate left lower lobe atelectasis. Improved acute, mild pulmonary edema   Keywords: improve.


SubjectID: 10790860, StudyID: 59860704, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with PNA // interval change

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: ET tube tip is 4.5 cm above the carinal. Right internal jugular line tip is at the level of lower SVC. Multifocal consolidations are unchanged was overall minimal improvement of the lung opacification potentially reflecting changes in the volume in the vessels.


SubjectID: 10790860, StudyID: 56751465, Comparison: worse

FINAL REPORT

INDICATION: Status post intubation. Evaluate endotracheal tube placement.

COMPARISON: Multiple prior chest radiographs dating back to ___, the most recent on ___.

FINDINGS: A portable supine frontal chest radiograph demonstrates interval placement of an endotracheal tube, with the tip terminating 3.3 cm above the carina. Apparent change in tracheal caliber at the thoracic inlet is seen on multiple prior images. A dual lead left-sided pacer is unchanged in position, with the leads overlying the right atrium and ventricle. A right-sided PICC is retracted compared to prior exam, with the tip now terminating in the mid SVC. Diffuse airspace opacities are redemonstrated, with increased opacity in the right upper lung and a new opacity in the left upper lateral lung   Keywords: increase. This could represent multifocal pneumonia, or an infectious process superimposed on asymmetric pulmonary edema. In the appropriate clinical setting, the differential could include other causes of alveolar opacities. There are again probable bilateral layering pleural effusions. No pneumothorax is identified.

IMPRESSION: 1. Interval placement of an endotracheal tube, with the tip terminating 3.3 cm from the carina. 2. New focal opacity in the left upper lateral lung and the right upper lung, consistent with progression of multifocal pneumonia or an infectious process superimposed on asymmetric pulmonary edema. 3. Retraction of a right-sided PICC, with the tip now terminating in the mid SVC. 4. Probable bilateral layering pleural effusions.


SubjectID: 10790860, StudyID: 54533870, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with ARDS and pneumonia. // Evaluate for interval change.

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Right internal jugular line tip is at the level of mid SVC. Heart size and mediastinum are unchanged. There is interval improvement in widespread parenchymal opacities most likely consistent with location of edema   Keywords: improve. The left upper lobe opacity is unchanged, more focal and nodular. The ET tube tip is 6 cm above the carinal. The right internal jugular line tip is at the level of mid SVC. The right PICC line tip is at the level of mid SVC. No other abnormalities demonstrated


SubjectID: 10790860, StudyID: 50454523, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with PNA, intubated // eval for change in pneumonia or for volume overload eval for change in pneumonia or for volume overload

IMPRESSION: In comparison with the study of ___, the monitoring and support devices are unchanged. The diffuse bilateral pulmonary opacifications are somewhat enhanced, possibly due to the somewhat poor degree of inspiration.


SubjectID: 10790860, StudyID: 59686768, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with resp failure // eval for interval change

COMPARISON: Portable chest radiograph dated ___.

FINDINGS: Since ___, and progressive increased opacification of the left the lung as well as the right middle lung, concerning for pneumonia and less likely pulmonary edema   Keywords: increase. Stable small bilateral low lung volumes. Stable small bilateral pleural effusions. Stable cardiomediastinal silhouette. No pneumothorax. ETT tube in standard placement. Right PICC line is unchanged in position. Dual-lead pacemaker appears intact, also unchanged in position.

IMPRESSION: 1. Interval progression of asymmetric bilateral opacities greater on the left, most concerning for pneumonia. 2. Stable small bilateral pleural effusions.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___, ___ the referring team, on the telephone on ___ at 12:25 PM, 5 minutes after discovery of the findings.


SubjectID: 10790860, StudyID: 55371308, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with respiratory failure on MV worsenign hypoxia; evaluate for interval change.

COMPARISON: Chest radiograph from earlier on the same day, dated ___ at 5:45.

FINDINGS: Marked progression of increased opacification of the left the lung since earlier this morning. Stable opacities in the right middle lung. Stable small bilateral low lung volumes. Stable small bilateral pleural effusions. Stable cardiomediastinal silhouette. No pneumothorax. ETT tube in standard placement. Right PICC line is unchanged in position. Dual-lead pacemaker appears intact, also unchanged in position.

IMPRESSION: Progressive pneumonia since this morning.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ ___ the referring team on the telephone on ___ at 12:31 PM, 2 minutes after discovery of the findings.


SubjectID: 10790860, StudyID: 50868459, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with respiratory failure and shock // interval change

TECHNIQUE: Portable AP radiograph of the chest from ___.

COMPARISON: ___.

FINDINGS: The ET tube ends at the level of the clavicles. A left pectoral pacemaker is in place. A right PICC line ends at the superior cavoatrial junction. Mild pulmonary edema is not appreciably changed. Small bilateral layering pleural effusions are also unchanged. There is no pneumothorax. Cardiomegaly is stable.

IMPRESSION: No significant interval change in mild pulmonary edema and small bilateral pleural effusions   Keywords: no significant interval change.


SubjectID: 10790860, StudyID: 59624118, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with DAH, PNA, intubated // interval change

TECHNIQUE: Portable chest

COMPARISON: ___.

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change.


SubjectID: 10790860, StudyID: 54810278, Comparison: None

FINAL REPORT

PORTABLE CHEST OF ___.

COMPARISON: ___ radiograph.

FINDINGS: Support and monitoring devices are in standard position and cardiomediastinal contours are stable. Bilateral heterogeneous pulmonary opacities have slightly worsened in the interval, with relative sparing of right upper lobe. They continue to be worse in the left lung than the right lung, and are most severe in the left lower lobe. Small-to-moderate left and small right pleural effusions are also demonstrated.


SubjectID: 10790860, StudyID: 53809911, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hypoxic respiratory failure // interval change

TECHNIQUE: Portable AP view of the chest.

COMPARISON: Chest radiograph on ___.

FINDINGS: An endotracheal tube is 4.3 cm above the carinal. A right internal jugular line terminates at the cavoatrial junction. The heart is normal in size. Left-sided common dual lead pacer is unchanged in position. Cardiomediastinal contour is normal, stable. Bibasilar consolidations are minimally improved from prior study and likely represent improving pulmonary edema. No evidence of pneumothorax.

IMPRESSION: Persistent bibasilar opacities, minimally improved from the prior study consistent with improving pulmonary edema   Keywords: improve.


SubjectID: 10790860, StudyID: 51768696, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with DAH // evolving pulmonary process

TECHNIQUE: Portable AP view of the chest.

COMPARISON: Multiple chest radiographs the most recent on ___ and chest CT from ___.

FINDINGS: An endotracheal tube is 4.5 cm above the carina. A right internal jugular catheter terminates in the low SVC and is stable. Left-sided pacer with dual leads is in stable, appropriate position. Diffuse bilateral opacities, predominantly in the lower lobes, are chronic but minimally increased from the prior chest radiograph on ___. There is increased opacity at the left base, which may be due to increased small left pleural effusion and atelectasis. There is no evidence of pneumothorax.

IMPRESSION: Mild pulmonary edema increased   Keywords: increase. Chronic infiltrative pulmonary abnormality attributed to diffuse alveolar hemorrhage .


SubjectID: 10790860, StudyID: 59410275, Comparison: same

FINAL REPORT

HISTORY: ARDS, question pneumonia. CHEST, SINGLE AP PORTABLE VIEW

COMPARISON: Chest x-rays dated ___. Compared with ___, I doubt significant interval change. Again seen are extensive pulmonary opacities, most pronounced at the bases, but also involving the left upper and mid and portions of the right mid zone. The differential diagnosis is extensive and involves CHF with pulmonary edema, infectious infiltrates, and ARDS. Clinical correlation is requested. An ET tube is present, tip approximately 4.1 cm above the carina. An NG tube is present, tip extending beneath the diaphragm, off the film. A left-sided pacemaker is present, with lead tips over right atrium and right ventricle. A left IJ central line is present -- the tip is obscured by the pacemaker leads, but probably lies in the left brachiocephalic vein, near, but proximal to, its junction with the SVC. No pneumothorax is detected.

IMPRESSION: 1. Extensive bilateral pulmonary opacities are essentially unchanged   Keywords: unchanged. Please see comment above. 2. Left IJ catheter unchanged. It is thought to overlie the left brachiocephalic vein.


SubjectID: 10790860, StudyID: 55542575, Comparison: None

FINAL REPORT

HISTORY: Rule out pneumothorax. CHEST, SINGLE AP PORTABLE VIEW.

COMPARISON: Chest x-ray from ___ at 12:18 p.m. There is no definite pneumothorax. No other evidence for pneumothorax is identified. ET tube tip lies approximately 4.1 cm above the carina. NG tube extends beneath the diaphragm off the film. Chest tube at the left lung base is again noted. A left pacemaker with lead tips over right atrium and right ventricle again noted. Possible interval increase in the degree of retrocardiac opacity, with increased obscuration of the left hemidiaphragm -- this may reflect increased collapse and/or consolidation in the left base. Otherwise, I doubt significant interval change.

IMPRESSION: 1. No definite pneumothorax. 2. Interval increase in retrocardiac opacity and obscuration of the left hemidiaphragm suggesting increased left lower lobe collapse and/or consolidation. 3. Otherwise, I doubt significant interval change.


SubjectID: 10790860, StudyID: 55033289, Comparison: same

FINAL REPORT

INDICATION: History of ARDS, intubated. Please evaluate for interval change.

COMPARISONS: Chest radiographs dated back to ___ and chest CT from ___.

TECHNIQUE: Portable semi-erect radiograph of the chest.

FINDINGS: There is an enteric tube which extends below the diaphragm, the tip incompletely evaluated on this exam. ET tube terminates approximately 3.8 cm above the carina. Left-sided pacer leads terminate appropriately in the right atrium and right ventricle. Left internal jugular catheter has an unchanged position and course. Moderate cardiomegaly with extensive bilateral parenchymal opacities at the lung bases is unchanged. Mild-to-moderate left pleural effusion is persistent. There is no evidence of a pneumothorax. Visualized osseous structures are unremarkable.

IMPRESSION: No significant interval change in the extensive bilateral parenchymal opacities at the lung bases, consistent with moderate pulmonary edema   Keywords: no significant interval change.


SubjectID: 10790860, StudyID: 52757227, Comparison: better

FINAL REPORT

PORTABLE CHEST ___ Compared to ___ radiograph.

FINDINGS: Support and monitoring devices are in standard position. Cardiomediastinal contours are stable. Pulmonary vascular congestion is accompanied by an improving asymmetrically distributed combined alveolar and interstitial pattern affecting the left lung to a greater degree than the right, with relative sparing of the right upper lobe   Keywords: improving. More confluent opacity in the left retrocardiac region appears unchanged. Moderate left and small right pleural effusions are similar.


SubjectID: 10790860, StudyID: 58425672, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with dyspnea // eval for volume overload

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: Previously seen midline tracheostomy is no longer seen. There has also been interval removal of a left-sided IJ venous catheter. A right-sided PICC is seen, distal aspect not well appreciated on this study due to overlying opacity, but does appear to course into at least the superior SVC. Dual lead left-sided pacemaker is again seen with leads extending to the expected positions of the right atrium and right ventricle. There is interval increase in bilateral, right greater than left pulmonary opacities, which given history, likely due to slight asymmetric pulmonary edema, however, superimposed infectious process is not excluded   Keywords: increase. There is a small right pleural effusion. The left costophrenic angle is not well seen and there may be a trace left pleural effusion. The cardiac and mediastinal silhouettes are stable.

IMPRESSION: Interval increase in bilateral, right greater than left, pulmonary opacities, which given history, likely due to slight asymmetric pulmonary edema, however, superimposed infectious process is not excluded   Keywords: increase. Small right pleural effusion and possible trace left pleural effusion.


SubjectID: 10790860, StudyID: 54184070, Comparison: -1.0

FINAL REPORT

EXAMINATION: Portable AP chest x-ray.

INDICATION: ___ year old man with hypoxia and concern for PNA vs. pulmonary edema secondary to acute diastolic heart failure // Rule out PNA vs. pulmonary edema

TECHNIQUE: AP projection.

COMPARISON: Portable AP chest x-ray obtained ___.

FINDINGS: There is stable position of left chest pacer device with associated dual leads projecting over the right atrium and right ventricle. There is sepsis stable position of right-sided PICC line with distal tip again not well visualized, projecting over the approximate mid to lower SVC. The cardiomediastinal silhouette is unchanged in appearance. The bilateral hila are not well visualized. There are worsening right greater than left alveolar consolidations, likely signifying worsening asymmetric pulmonary edema ; in particular, the left lung field appears improved with evidence of decreasing pulmonary edema, while the right airspace opacities are worsened in comparison multiple prior radiographs   Keywords: decreasing, improve. Given this appearance and asymmetric nature of progression with continued improvement of the left lung and continued worsening of the right, there is also concern for superimposed multifocal pneumonia. There are probably unchanged small bilateral pleural effusions. There is no pneumothorax.

IMPRESSION: 1. Continued worsening of right alveolar consolidations despite resolving pulmonary edema on left, concerning for right multifocal pneumonia superimposed on resolving pulmonary edema   Keywords: worse. 2. Probably unchanged small bilateral pleural effusions.


SubjectID: 10790860, StudyID: 53946807, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with diastolic heart failure history of pneumonia with shortness of breath and hypoxia // Evaluate for PNA vs. Pulmonary edema Evaluate for PNA vs. Pulmonary edema

IMPRESSION: In comparison with the study of ___, there is little change in the diffuse bilateral pulmonary opacification. Although much of this may merely reflect severe pulmonary edema, in the appropriate clinical setting superimposed pneumonia would have to be considered.


SubjectID: 10790860, StudyID: 56499184, Comparison: same

FINAL REPORT

PORTABLE CHEST ___, ___

COMPARISON: Radiograph of earlier the same date.

FINDINGS: Interval placement of tracheostomy tube, with tip terminating 5.4 cm above the carina. No evidence of pneumothorax or pneumomediastinum. Interval removal of endotracheal tube and nasogastric tube. Otherwise, no relevant short interval change in the appearance of the chest when allowances are made for marked patient rotation   Keywords: no relevant short interval change.


SubjectID: 10790860, StudyID: 55326324, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with tachypnea, shortness of breath

TECHNIQUE: Portable AP upright view of the chest

COMPARISON: ___

FINDINGS: Left-sided pacemaker device is noted with leads terminating in the right atrium and right ventricle, unchanged. Heart size has substantially decreased compared to the previous exam, and is now minimally enlarged with a left ventricular predominance. Diffuse atherosclerotic calcifications are noted within the aorta. The mediastinal and hilar contours are unremarkable. Previously noted pattern of pulmonary edema has completely resolved   Keywords: resolve. There are minimal streaky opacities in the lung bases likely reflective of atelectasis. There may be trace bilateral pleural effusions. No pneumothorax is identified. No acute osseous abnormality is detected

IMPRESSION: Minimal bibasilar streaky atelectasis and possible trace bilateral pleural effusions. Resolution of previously noted pulmonary edema.


SubjectID: 10790860, StudyID: 53794969, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with septic shock with possible free fluid in abdomen // UPRIGHT. rule out free air

COMPARISON: ___, 05:01

IMPRESSION: As compared to the previous radiograph, the monitoring and support devices are in unchanged position. The parenchymal opacity on the right has minimally decreased in extent and severity. The opacity on the left, showing multiple air bronchograms, is not substantially changed. Unchanged low lung volumes with mild cardiomegaly.


SubjectID: 10790860, StudyID: 53523948, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___-year-old man with respiratory failure. Evaluate for interval change.

COMPARISON: Chest radiographs dated ___.

FINDINGS: ETT tube in standard placement. The two- lead cardiac device appears unchanged in position, with one lead in the lower right atrium and the other in the right ventricle. Interval placement of a feeding tube, which traverses the diaphragm and courses into the left upper quadrant. Stable bilateral lower lung volumes. Compared to the prior exam, the right hemithorax is now diffusely opacified. Interval increase in the left lower lung opacity. Small left pleural effusion. The heart is top-normal in size. Stable cardiomediastinal silhouette. No pneumothorax.

IMPRESSION: 1. Progressive bilateral pneumonia since ___ am. 2. Probable worsening underlying congestive heart failure, also since ___ am   Keywords: worse.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___, the referring provider, on the telephone on ___ at 10:06 AM, 1 minutes after discovery of the findings.


SubjectID: 10790860, StudyID: 55209456, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with PnA, resp failure // eval for interval change

IMPRESSION: As compared to ___ radiograph, bilateral airspace opacities have improved, with residual opacities most prominent in the lower lungs, left greater than right   Keywords: improve. Decrease in small right pleural effusion and unchanged small to moderate left pleural effusion.


SubjectID: 10790860, StudyID: 54748480, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with multiple medical problems on mechanical ventillation // Please assess for interval change

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the monitoring and support devices as well as the pacemaker leads are in constant position. The lung volumes have decreased, leading to an increased density of the pre-existing right and left retrocardiac parenchymal opacities. Signs of mild fluid overload continue to be present   Keywords: continue. The right PICC line is also unchanged.


SubjectID: 10790860, StudyID: 51059767, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with septic shock and respiratory failure // interval change

IMPRESSION: As compared to ___, airspace opacities in the right upper and mid lung have substantially improved. Residual bilateral lower lobe airspace opacities persist and could reflect dependent edema with or without coexisting pneumonia. Small bilateral pleural effusions are also demonstrated.


SubjectID: 10790860, StudyID: 51403683, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with ARDS // lung infiltrate

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Unchanged position of the nasogastric tube and the endotracheal tube. Unchanged course of the pacemaker leads. Unchanged position and course of the left internal jugular vein catheter. Moderate cardiomegaly with extensive bilateral parenchymal opacities at the lung bases, combines to retrocardiac atelectasis and a mild to moderate left pleural effusion. No new parenchymal opacities   Keywords: new. No pneumothorax.


SubjectID: 10790860, StudyID: 55022115, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with HF. // Comparison to previous. Comparison to previous.

COMPARISON: Comparison to prior study of ___ at 04:10

IMPRESSION: Dual lead left-sided pacer is unchanged in position. Right subclavian PICC line is also unchanged in position. Stable appearance to the lungs with a diffuse airspace process involving the right lung and left lower lung with relative sparing of the left upper lung. Findings could be consistent with asymmetric pulmonary edema and/or multifocal pneumonia. Clinical correlation is advised. Left mediastinal and cardiac contours are stable. No pneumothorax. Probable layering bilateral effusions, right greater than left.


SubjectID: 10790860, StudyID: 54913324, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Respiratory failure from chronic heart failure, evaluation of pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the parenchymal opacities are unchanged in extent, severity and distribution   Keywords: unchanged. No new parenchymal opacities   Keywords: new. Moderate cardiomegaly persists. No larger pleural effusions. No pneumothorax.


SubjectID: 10790860, StudyID: 52661199, Comparison: same

WET READ: ___ ___ ___ 8:02 PM ET tube in appropriate position. No pneumothorax. No significant interval change from prior examination.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

HISTORY: Pneumonia with intubation.

FINDINGS: In comparison with the earlier study of this date, there has been placement of an endotracheal tube with its tip approximately 3.4 cm above the carina. Otherwise, little change   Keywords: little change.


SubjectID: 10790860, StudyID: 54789664, Comparison: 0.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with mrsa pneumonia now with volume overload, actively diuresing // eval for improvement in volume overload

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Mild interstitial edema has improved   Keywords: improve. Bibasilar opacities are grossly unchanged   Keywords: unchanged. Bilateral effusions are better appreciated in prior CT from ___. Cardiomegaly and mediastinal lymphadenopathy are also better appreciated in prior CT. there is no pneumothorax. Pacer leads are in standard position. Right IJ catheter tip is in the lower SVC


SubjectID: 10790860, StudyID: 50723475, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with PNA // interval change

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Right internal jugular line tip is at the cavoatrial junction. Heart size and mediastinum are unchanged. ET tube tip is 4.2 cm above the carinal. There is slight interval improvement in pulmonary edema but still persistent are bibasal consolidations   Keywords: improve


SubjectID: 10790860, StudyID: 51299219, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man intubated with pneumonia and pulmonary edema. // Evalaute for interval change.

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Mild pulmonary edema has minimally improved   Keywords: improve. Bibasilar consolidations have worsened in the left base due to increasing atelectasis superimposed to a previously present consolidation. Bilateral effusions are unchanged. There is no pneumothorax. ET tube is in standard position. Right IJ catheter tip is in the lower SVC. Left pacer leads are in standard position. Cardiomegaly is stable


SubjectID: 10792610, StudyID: 56440492, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Questionable pneumonia or pulmonary edema. Evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the pre-existing left upper lobe parenchymal opacity has almost completely resolved. However, the cardiac silhouette remains markedly enlarged and signs of vascular distention are seen. In addition, a left retrocardiac parenchymal opacity persists. Overall, the findings suggest persistent mild-to-moderate pulmonary edema with a decreasing right upper lobe pneumonia   Keywords: decreasing. No pleural effusions.


SubjectID: 10792610, StudyID: 55668837, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluation for pulmonary edema and pneumonia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is mild fluid overload but no overt pulmonary edema. Size of the cardiac silhouette is moderately enlarged. Scarring is seen at the bases of the right upper lobe. No pneumonia, no pleural effusions.


SubjectID: 10827966, StudyID: 59711621, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: Chest, PA and lateral.

INDICATION: ___-year-old female patient with cough and productive sputum, rule out process, post-hemodialysis.

FINDINGS: PA and lateral chest views were obtained with patient in upright position. Analysis is performed in direct comparison with the next preceding similar examination of ___. Moderate cardiac enlargement as before. Somewhat widened and elongated thoracic aorta unchanged. The pulmonary vasculature again somewhat congested, but no acute interstitial or alveolar edema is identified, nor is there evidence of pleural effusion in lateral or posterior pleural sinuses. As already identified on the preceding chest examination, there is a sizable triangular density in the mediastinal contours of the left hemithorax blending and obscuring the central half of the left-sided diaphragm. In the left basal periphery, a thin plate additional atelectasis can be seen. No pneumothorax is identified. In comparison with the next preceding examination of yesterday, the findings are stable. Review of the next preceding chest examination of ___ demonstrates beginning changes that herald this atelectasis but still the major portion of the left lower lobe pulmonary parenchyma was aerated. Older chest examinations include that of ___, in which some beginning atelectasis could be seen on the left base but by no means as massive as it exists now.

IMPRESSION: Progressing sizable left lower lobe atelectasis as seen on PA and lateral chest examinations. Cause of this lesion is unclear. If evaluation is required, the next step would be a chest CT. As before, patient has a marked kyphotic curvature on the lateral view and typical endplate sclerosis as a characteristic for chronic renal osteopathy.


SubjectID: 10827966, StudyID: 58660612, Comparison: None

FINAL REPORT

INDICATION: Right upper quadrant pain and cough.

COMPARISON: ___ to ___. CT ___.

FINDINGS: AP and lateral chest radiographs were obtained. The medial left hemidiaphragm is obscured by left lower lobe atelectasis. There is no consolidation, effusion or pneumothorax. Moderate-to-severe cardiomegaly is stable.

IMPRESSION: Left basilar atelectasis.


SubjectID: 10827966, StudyID: 57583249, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with IJ, ESRD on dialysis here for GI bleed. Evaluate line placement, volume.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiographs from ___, ___, ___, ___. CT chest from ___.

FINDINGS: Again seen is a left-sided central catheter with its tip pointing posteriorly in the azygos vein. Otherwise, there is no significant change   Keywords: no significant change. Left lower lobe linear opacity, either atelectasis or scarring, is again seen. Otherwise, the lungs are clear. Top-normal heart size, mediastinum and hilar contours are unchanged. Aortic calcification appear unchanged. Severe thoracic kyphosis and vertebral body endplate changes likely due to renal osteodystrophy appear unchanged.

IMPRESSION: Left-sided central catheter malpositioned in the azygos vein.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the ___ ___ at 11:38 AM, 5 minutes after discovery of the findings.


SubjectID: 10827966, StudyID: 54740065, Comparison: None

FINAL REPORT

INDICATION: History: ___F with line readjustment

TECHNIQUE: Upright AP view of the chest

COMPARISON: Chest radiograph ___ at 14:34

FINDINGS: Left internal jugular central venous catheter tip has been slightly withdrawn with tip projecting over in the region of the upper SVC however curved appearance of the distal aspect of the catheter may suggest that it is approaching the azygos vein. Lung volumes remain low. Heart size remains mildly enlarged. Bibasilar atelectasis is demonstrated. No pneumothorax or pleural effusion is present. Crowding of bronchovascular structures is re- demonstrated without overt pulmonary edema. Assessment of the medial lung apices is obscured by the patient's neck and chin.

IMPRESSION: Tip of left internal jugular central venous catheter projects over the upper SVC however the curved configuration of the distal aspect of the catheter suggests that it may lie within the azygos vein. A lateral view may help confirm positioning of the line.


SubjectID: 10827966, StudyID: 53443421, Comparison: None

WET READ: ___ ___ ___ 9:09 PM A left internal jugular central venous line is present, its tip which projects at the anticipated location of the superior vena cava. Relative to prior examination, PICC catheter tip no longer takes a turn caudally. A lateral would be helpful for definite confirmation out of the azygos. The heart is stable in size. Calcifications involve the aortic arch. Lung volumes are low. Streaky opacities at the bases reflect atelectasis. No pneumothorax or large pleural effusion is identified. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with left IJ CVL that was in azygous now repositioned // please eval line placement please eval line placement

IMPRESSION: Comparison to ___. The previously malpositioned left central venous access line has been repositioned. No complications, notably no pneumothorax. Otherwise unchanged normal radiograph. The pre-existing atelectasis at the left lung bases has resolved.


SubjectID: 10827966, StudyID: 51394046, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with s/p central line placement // eval for line placement

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: There has been been interval placement of a left internal jugular central venous catheter which appears to reach the brachiocephalic/SVC junction and coils back into the left brachiocephalic vein. This was discussed with Dr. ___ at ___:15 on ___, ___ min after discovery. Patient is somewhat rotated. The patient's chin partially obscures the the medial lung apices. There are low lung volumes. Left base atelectasis is noted. There is no definite focal consolidation. No large pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable.

IMPRESSION: Left internal jugular central venous catheter coils in the left brachiocephalic vein. Recommend repositioning so that it terminates in the SVC. No pneumothorax. Left base atelectasis.

NOTIFICATION: Discussed with Dr. ___ at 15:15 on ___, 2 min after discovery.


SubjectID: 10827966, StudyID: 57418708, Comparison: worse

FINAL REPORT

HISTORY: Dyspnea.

COMPARISON: ___.

TECHNIQUE: AP and lateral chest radiograph, two views.

FINDINGS: Moderate-to-severe cardiomegaly is unchanged. Hilar engorgement is indicative of fluid overload along with patchy scattered increased reticulation compatible with moderate pulmonary edema   Keywords: increase. Linear retrocardiac densities are similar to prior exam. There is no pleural effusion or pneumothorax.

IMPRESSION: Moderate pulmonary edema. Infection cannot be excluded given the appropriate clinical circumstance, particularly with slightly more prominent retrocardiac opacity.


SubjectID: 10827966, StudyID: 50958216, Comparison: worse

FINAL REPORT

HISTORY: Female with worsening shortness of breath. Assess for worsening pulmonary edema.

COMPARISON: Chest radiograph ___, ___, ___.

TECHNIQUE: Frontal and lateral chest radiographs.

FINDINGS: Mild interval increase in pulmonary edema   Keywords: increase with stable small left pleural effusion and minimal left lower lobe atelectasis   Keywords: increase. Heart size is mildly increased with mediastinal vein dilatation. No pneumothorax. Left mediastinal contour and hila otherwise normal.

IMPRESSION: 1. Mild interval increase in pulmonary edema. 2. Stable small left pleural effusion and minimal left lower lobe atelectasis. Results were conveyed via telephone to primary team by Dr. ___ on ___ at 11:35 AM after 15 minutes of observation of findings.


SubjectID: 10827966, StudyID: 55520453, Comparison: same

FINAL REPORT

HISTORY: Chest pain and shortness of breath.

COMPARISON: Chest radiograph from ___.

FINDINGS: Again noted is mild pulmonary vascular congestion, similar to that seen previously   Keywords: similar, again. Mild interstitial abnormality is also again noted   Keywords: again. Moderate cardiomegaly remains stable. The lungs are without any new focal opacity. No acute fractures are identified. Spinal changes consistent with renal osteodystrophy are again noted.

IMPRESSION: Mild vascular congestion with mild cardiomegaly again noted   Keywords: again.


SubjectID: 10827966, StudyID: 55199816, Comparison: better

FINAL REPORT

HISTORY: Volume overload status post dialysis.

COMPARISON: ___ and ___. FRONTAL UPRIGHT PORTABLE CHEST: Low lung volumes results in bronchovascular crowding. Pulmonary edema has improved with mild residual pulmonary vascular engorgement. The heart is smaller, now with moderate cardiomegaly. A small left pleural effusion may be present. Atelectasis at the left lung base is worse. Mediastinal silhouette is stable. There is no pneumothorax. Surgical clips project over the left upper lung and right upper quadrant.

IMPRESSION: Improvement in pulmonary edema with moderate cardiomegaly   Keywords: improve.


SubjectID: 10827966, StudyID: 52230468, Comparison: same

FINAL REPORT

HISTORY: Chest pain, end-stage renal disease. Question pneumonia.

COMPARISON: Prior chest radiograph from ___.

TECHNIQUE: AP and lateral chest radiographs.

FINDINGS: There is chronic moderate to severe cardiac enlargement. Pulmonary edema and pulmonary vascular congestion are redemonstrated. There is atelectasis at the left lung base. No focal pulmonary abnormality is identified to suggest pneumonia. There is no pneumothorax or large pleural effusion.

IMPRESSION: Chronic moderate to severe cardiac enlargement, consistent with cardiomegaly and/or pericardial effusion. Stable pulmonary edema and pulmonary vascular congestion   Keywords: stable. No focal pulmonary abnormality to suggest pneumonia.


SubjectID: 10827966, StudyID: 51901033, Comparison: 0.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with ESRD with cough and hypoxia after IVF // ?edema, pna

IMPRESSION: Compared to prior radiograph of 1 day earlier, mild pulmonary vascular congestion and small pleural effusions are new   Keywords: new. Bibasilar atelectasis has worsened. No other relevant changes   Keywords: no other relevant change.


SubjectID: 10827966, StudyID: 51847257, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___F with hypotension, cough, evaluate for infiltrate.

TECHNIQUE: PA and lateral chest radiograph.

COMPARISON: 1. Chest x-ray ___. 2. Chest x-ray ___.

FINDINGS: There are low lung volumes. The cardiomediastinal silhouettes are stable and within normal limits. The bilateral hila are unremarkable. Subtle linear opacities at the lung bases likely represent basilar atelectasis. Otherwise, the lungs are clear without focal consolidation. There is no pulmonary vascular congestion. There is no pneumothorax or pleural effusion. An exaggerated thoracic kyphosis with several mid thoracic vertebral body compression deformities is unchanged in appearance in comparison to prior exams   Keywords: unchanged in appearance.

IMPRESSION: Basilar atelectasis. No focal lung consolidation.


SubjectID: 10842701, StudyID: 53481094, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph of earlier the same date.

FINDINGS: Endotracheal tube remains in standard position. Heart size and pulmonary vascularity are normal. Although previously present opacity at the right lung base has nearly cleared, new poorly defined opacities have developed in the right juxtahilar region and possibly in the adjacent right upper lobe. These findings are nonspecific, but could be due to clinically suspected aspiration. Within the left lung, improved atelectasis is present at the left lung base with a persistent small left pleural effusion.


SubjectID: 10842701, StudyID: 52873152, Comparison: None

FINAL REPORT

HISTORY: ___-year-old woman with new ET tube placement.

COMPARISON: ___.

TECHNIQUE: Single portable view of the chest.

FINDINGS: There is a new endotracheal tube, which terminates approximately 1.2 cm above the carina. An NG tube is seen coursing into the stomach and off the image. Bilateral pleural effusions are now evident. The parenchymal opacity at the level of the left upper lobe has improved since the prior study, perhaps reflecting improved aeration secondary to the intubation. There is interval increased right basilar opacity, possibly relating to pleural effusion. Heart size remains top normal. Crowding of the bronchovascular structures is possibly due to combination of edema as well as low lung volumes. There is no pneumothorax.

IMPRESSION: 1. ET tube approximately 1.2 cm from the carina and can be retracted for better positioning. 2. Improving right upper lobe opacity likely due to improved aeration. 3. Small bilateral pleural effusions. Right base opacity maybe due to pleural effusion and atelectasis.


SubjectID: 10842701, StudyID: 50478436, Comparison: None

FINAL REPORT

INDICATION: Hypoxia, cough and weakness.

COMPARISON: ___.

FINDINGS: PA and lateral chest radiographs. Lung volumes are very low with small bilateral pleural effusions and mild pulmonary vascular engorgement, as well as bibasilar atelectasis. There is no pneumothorax. The cardiac silhouette is enlarged. The aorta tortuous. Severe degenerative changes of the thoracic spine with exaggerated kyphosis are noted.


SubjectID: 10842701, StudyID: 50400120, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: STEMI, onset of hypoxia, evaluation for aspiration or pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is increasing parenchymal opacity with air bronchograms at the level of the right upper lobe. In the appropriate clinical setting, this change could reflect right upper lobe pneumonia or aspiration in this region of the lung. Otherwise, the radiograph is unchanged, without larger pleural effusions, without pulmonary edema and with moderate cardiomegaly   Keywords: unchanged. At the time of dictation and observation, 8:23 a.m., on ___, the referring physician ___. ___, covered by Dr. ___, covered by Dr. ___ was paged for notification and the findings were finally discussed over the telephone.


SubjectID: 10859320, StudyID: 52925357, Comparison: same

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: History: ___F with chest pain on palpation after fall, and increasing respiratory rate // r/o rib fracture, pulmonaryh contusion, hemo/pneumothorax

TECHNIQUE: Chest: Frontal and Lateral

COMPARISON: ___

FINDINGS: There has been no significant interval change   Keywords: no significant interval change.No new focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable, with the cardiac silhouette enlarged and the aorta tortuous. Pulmonary vascular congestion is stable   Keywords: stable. Aortic core valve is re- demonstrated.

IMPRESSION: Stable pulmonary vascular congestion and cardiomegaly   Keywords: stable. No significant interval change   Keywords: no significant interval change.


SubjectID: 10859320, StudyID: 50192934, Comparison: worse

WET READ: ___ ___ ___ 9:32 AM Enlarged heart with increased vascular congestion suggestive of volume overload   Keywords: increase. No pleural effusion, pneumothorax, or opacities to suggest pneumonia. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CXR

INDICATION: ___F here with fall.,Recent history of productive sputum. Hx of CHF and AS s/p TAVR // ?PNA, ?volume overload

TECHNIQUE: Chest AP

COMPARISON: Chest radiograph from ___.

FINDINGS: Post aortic valve repair. The heart appears enlarged, likely stable from previous examination given technical differences. Diffuse increased vascular markings are noted. The cardiac borders and diaphragms are clear. There is no evidence of pleural effusion. No pneumothorax is seen. There is scoliosis of the of the thoracic spine.

IMPRESSION: Enlarged heart with increased vascular congestion suggestive of volume overload. No pleural effusion, pneumothorax, or opacities to suggest pneumonia.


SubjectID: 10866278, StudyID: 54858020, Comparison: worse

FINAL REPORT

INDICATION: Multiple myeloma, query pulmonary congestion, effusion or infection.

COMPARISON: Chest radiograph ___, ___, ___.

FINDINGS: Despite improved inspiration compared to the most recent prior study, increased interstitial markings are indicative of worsening pulmonary edema   Keywords: worse, increase. Small bilateral pleural effusions are not worsened compared to prior. There is no pneumothorax. The cardiomediastinal and hilar contours remain stable. Again seen are multiple rib deformities consistent with old fractures.

IMPRESSION: Worsening pulmonary edema with stable bilateral pleural effusions   Keywords: worse.


SubjectID: 10866278, StudyID: 52092523, Comparison: better

WET READ: ___ ___ 8:21 PM Very slight interval improvement in the mild pulmonary edema. New or increased small bilateral pleural effusions. Stable cardiac silhouette, allowing for changes in positioning, with mild to moderate cardiomegaly.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

INDICATION: Assess for interval change of pulmonary congestion.

COMPARISON: Chest radiographs ___, ___.

FINDINGS: The cardiomediastinal and hilar contours are stable. There are small bilateral pleural effusions with linear atelectasis projecting over the mid and lower lung fields bilaterally. Pulmonary edema is slightly improved   Keywords: improve. There is no pneumothorax. There is no focal consolidation concerning for pneumonia. Multiple rib deformities are again noted.

IMPRESSION: Small bilateral pleural effusions with mild interval improvement of pulmonary edema   Keywords: improve.


SubjectID: 10882916, StudyID: 59309137, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p surgical pinning of right hip, now with fever // infection, other acute change

IMPRESSION: In comparison to ___ chest radiograph, patchy bibasilar opacities are new as well as a poorly defined opacity in the right upper lobe. These findings may be due to multifocal atelectasis, aspiration, or pneumonia.


SubjectID: 10882916, StudyID: 58988106, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___F with right femur/hip fracture //preoperative.

COMPARISON: CT radiograph ___ 07:00. Chest radiograph ___. Chest CT ___ Chest radiograph ___.

FINDINGS: PA and lateral views of the chest provided. There are patchy areas of parenchymal opacity in the right upper lobe which is unchanged from ___. No pleural effusion or pneumothorax. Median sternotomy wires and vascular stent are again visualized. Imaged osseous structures are unremarkable. No free air below the right hemidiaphragm is seen.

IMPRESSION: Right upper lobe parenchymal opacities are grossly unchanged from ___   Keywords: unchanged. No superimposed acute cardiopulmonary process.


SubjectID: 10882916, StudyID: 59194817, Comparison: None

FINAL REPORT

STUDY: PA and lateral chest, ___. CLINICAL

HISTORY: A ___-year-old woman with possible pneumonia. Evaluate for interval change.

FINDINGS: Comparison is made to previous study from ___. The cardiac silhouette and mediastinum is normal. Mediastinal wires are seen. There is again seen hazy areas of consolidation in the right upper lobe and the right base, which is unchanged from prior. The left lung appears well aerated. There has been removal of the nasogastric tube since the prior study. No pleural effusions are seen, and there are no pneumothoraces.


SubjectID: 10882916, StudyID: 51062624, Comparison: None

FINAL REPORT

INDICATION: History of Crohn's with fever. Concerning for pneumonia. Query consolidation.

TECHNIQUE: Single upright portable view of the chest.

COMPARISON: Compared with prior radiographs through ___ to ___.

FINDINGS: The tip of the orogastric tube is at T4 vertebral level. Consider repositioning the orogastric tube. Since ___, right upper and mid lung opacities have worsened whereas right lower lobe opacity is new. The left lung is clear. The heart size, mediastinal and hilar contours are normal. The patient is status post median sternotomy and sternal sutures are intact.

IMPRESSION: Since ___, right upper lobe opacities are worse whereas right lower lobe opacity is new. Possibilities include interval worsening of lung infection or aspiration. Follow up radiograph is recommended after a day to look for interval changes and to differentiate between both.


SubjectID: 10886362, StudyID: 58072789, Comparison: None

WET READ: ___ ___ 8:00 PM esophageal catheter tip and side-port in stomach. interval removal of ETT. no significant change in the lungs. ______________________________________________________________________________

FINAL REPORT

AP CHEST, 6:36 P.M., ___

HISTORY: AVR. Check NG tube.

IMPRESSION: AP chest compared to ___ at 2:29 p.m.: Lateral aspect left lower chest is excluded from the examination. Remaining pleural surfaces show no pneumothorax and minimal if any pleural effusion. Nasogastric tube passes into the stomach and out of the field of view. Swan-Ganz catheter tip is partially obscured by cardiac motion, but is probably in the right pulmonary artery in standard placement. Right pleural, left pleural, midline drains in place. Pulmonary vascular congestion and moderate postoperative widening of the cardiomediastinal silhouette are unchanged. There is more atelectasis in the right lower lobe, left lower lobe atelectasis is mild-to-moderate. There is probably no pulmonary edema.


SubjectID: 10886362, StudyID: 57211901, Comparison: same

FINAL REPORT

HISTORY: Tube removal.

FINDINGS: In comparison with study of ___, the mediastinal and left chest tube has been removed and there is no evidence of pneumothorax. The overall appearance of the heart and lungs is essentially unchanged. Persistent pulmonary vascular congestion with opacification, especially at the left base consistent with effusion and volume loss in the lower lobe   Keywords: persistent. Less prominent changes are seen at the right base.


SubjectID: 10886362, StudyID: 55957472, Comparison: None

FINAL REPORT

AP CHEST, 9:59 AM, ___

HISTORY: AVR. Chest tube removed.

IMPRESSION: AP chest compared to ___ at 9:19 a.m.: No appreciable pneumothorax or right pleural effusion following removal of the right basal pleural drain. Mild pulmonary edema collected in the right lower lung. Left lower lobe atelectasis is moderate-to-severe and small left pleural effusion is stable. Normal post-operative cardiomediastinal silhouette including mild-to-moderate cardiomegaly, improved since pre-operative chest radiograph. Nasogastric tube passes below the diaphragm and out of view. Transvenous right atrial and right ventricular pacer leads are unchanged in their longstanding positions, including a more medial location than generally seen for the tip of the right atrial lead. Swan-Ganz or other pulmonary arterial line ends in the right pulmonary artery. No pneumothorax.


SubjectID: 10886362, StudyID: 54962274, Comparison: same

FINAL REPORT

CHEST ON ___

HISTORY: AVR, AFib, tamponade effusion. REFERENCE EXAM: ___ at 10:30.

FINDINGS: Compared to the film from earlier the same day, there is no significant interval change   Keywords: no significant interval change.


SubjectID: 10886362, StudyID: 53460154, Comparison: worse

FINAL REPORT

AP CHEST, 10:32 A.M., ___

HISTORY: CABG. Right chest tube removed.

IMPRESSION: AP chest compared to ___ at 9:59 a.m.: Mild pulmonary edema worsened slightly since earlier in the day   Keywords: worse. No pneumothorax. Small left pleural effusion and moderate left basal atelectasis are unchanged. Pulmonary artery catheter ends in the right pulmonary artery. Transvenous right atrial and right ventricular pacer leads are unchanged in longstanding locations including the more medial than usual positioning of the tip of the right atrial lead. Mild-to-moderate cardiomegaly comparable to the preoperative appearance.


SubjectID: 10886362, StudyID: 51423353, Comparison: same

WET READ: ___ ___ ___ 10:02 PM ET tube now 7.0 cm above the carina. Continued central vascular congestion and mild edema. ______________________________________________________________________________

FINAL REPORT

CHEST

HISTORY: Reintubation.

FINDINGS: The ET tube is now 7 cm above the carina. There continues to be pulmonary vascular redistribution and areas of alveolar infiltrate consistent with fluid overload   Keywords: continue. Swan-Ganz catheter tip is in the pulmonary outflow tract. Cardiac pacemaker is unchanged. The left IJ line tip is in the SVC.


SubjectID: 10886362, StudyID: 50301215, Comparison: None

FINAL REPORT

HISTORY: Status post AVR.

FINDINGS: The endotracheal tube is too high, at the thoracic inlet. This finding was called to the CCU nurse, ___ at 5:00 p.m. at the time of dictating this report by Dr. ___. Otherwise, the appearance of the lungs is unchanged. Pacemaker and left IJ line are unchanged.


SubjectID: 10886362, StudyID: 56034024, Comparison: worse

FINAL REPORT

CHEST ON ___

HISTORY: Evaluate swan ganz line placement, lost waveform.

FINDINGS: On the prior study, there was a femoral Swan-Ganz catheter that is no longer visualized. It is off the film. It has likely been pulled back. Left IJ line tip is in the SVC. Cardiac pacer with wires is again visualized. ET tube is unchanged. Bilateral pleural effusions have increased in size compared to the prior study. The heart size is moderately enlarged and is larger than on the prior exam. There is pulmonary vascular redistribution with perihilar haze. The overall impression is that of worsening CHF   Keywords: worse.


SubjectID: 10887781, StudyID: 56311739, Comparison: better

FINAL REPORT

INDICATION: Respiratory distress requiring BiPAP.

COMPARISON: Chest radiograph ___. CT chest ___. Chest radiograph ___.

FINDINGS: New rounded consolidations in the upper and middle right lobes are likely pneumonia. The hazy opacification of the right and left lung bases is improving pulmonary edema   Keywords: improving. A small right pleural effusion is unchanged. No definite pleural effusion is present on the left. There is no pneumothorax. Stable cardiomegaly is unchanged. Sternal wires are intact.

IMPRESSION: 1. New right upper and middle lobe pneumonia. 2. Improved mild pulmonary edema   Keywords: improve.


SubjectID: 10887781, StudyID: 55750562, Comparison: 1.0

FINAL REPORT

AP CHEST, 7:33 A.M., ___

HISTORY: Pneumonia and heart failure. Question change in pleural effusions and pulmonary edema.

IMPRESSION: AP chest compared to ___ and ___ at 5:56 a.m.: Lung volumes have improved since over the past hour, and although there is still pulmonary vascular engorgement, edema is improving as well   Keywords: still. There is only a relatively small volume of decreasing right pleural effusion. Extensive right lung consolidation is less prominent, which could be due to genuine improvement in widespread bronchopneumonia or in radiographic improvement due to decreasing edema   Keywords: decreasing. Distortion of the proximal left humerus could be an artifact of positioning or an old fracture deformity.


SubjectID: 10887781, StudyID: 55089732, Comparison: None

FINAL REPORT

INDICATION: Dyspnea.

COMPARISON: ___. PORTABLE UPRIGHT AP VIEW OF THE CHEST: The patient is status post median sternotomy and CABG. The heart size is moderately enlarged. The aorta is tortuous and diffusely calcified. There is moderate alveolar pulmonary edema with bilateral perihilar opacities demonstrated, and small bilateral pleural effusions, right greater than left. No pneumothorax is identified. There is an old left mid clavicular fracture.

IMPRESSION: Moderate pulmonary edema with small bilateral pleural effusions, right greater than left.


SubjectID: 10896351, StudyID: 59646755, Comparison: worse

FINAL REPORT

INDICATION: ___ year old man intubated w/ CHF // OG tube placement

COMPARISON: The comparison is made with prior studies including ___ at 04:26..

IMPRESSION: There are findings suggesting mild CHF which is new as compared to the earlier study   Keywords: new. Nasogastric tube tip is beyond the GE junction and off the edge of the film. The pacemaker, Swan-Ganz catheter are unchanged. Endotracheal tube tip is 8 cm above the carina. There is no pneumothorax.


SubjectID: 10896351, StudyID: 59050289, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF sepsis, has new OGT please check for placement thanks // pt with new OG tube please check for placement. pt with new OG tube please check for placement.

IMPRESSION: In comparison with the earlier study of this date, the nasogastric tube extends well into the stomach. Otherwise, no change in the monitoring and support devices and appearance of the heart and lungs.


SubjectID: 10896351, StudyID: 58096231, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cardiogenic shock intubated and sedated. // evaluate for pulmonary edema evaluate for pulmonary edema

IMPRESSION: In comparison with the study of ___, there is little change in the appearance of the monitoring and support devices. Continued substantial enlargement of the cardiac silhouette with minimal if any vascular congestion, a discordance that suggests the possibility of cardiomyopathy or pericardial effusion. Continued opacification at the left base is consistent with pleural fluid and mild volume loss in the left lower lobe. The IABP tip lies approximately 6 mm below the transverse arch of the aorta. This could be withdrawn about 1.5 cm for more optimal positioning.


SubjectID: 10896351, StudyID: 56068897, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with staph bacteremia and VT now with chest pain and shortness of breath // Please evaluate for any new pulmonary process

COMPARISON: Comparison is made with prior studies including ___.

IMPRESSION: There is cardiomegaly and upper zone redistribution with blurring of vascular detail suggesting CHF. There is patchy atelectasis in the right lung base. The left lung base is difficult to visualize due to the cardiomegaly and patient rotation to the left. There is no pneumothorax. The pacemaker and right central line are unchanged.


SubjectID: 10896351, StudyID: 55980157, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with pulmonary edema, VTach, sepsis // Please assess for interval change

COMPARISON: The comparison is made with prior studies including ___ at 04:38.

IMPRESSION: The right central line is unchanged. There is no evidence of CHF. There is no pneumothorax or dense consolidation. There is stable cardiomegaly. The left pacer is unchanged in position.


SubjectID: 10896351, StudyID: 53577621, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with MRSA bacteremia, persistent VT // Intubated, volume status on Lasix gtt. ET tube advanced 5 cm from prior. Evaluate ET position

IMPRESSION: In comparison to ___ chest radiograph, an intra-aortic balloon pump is in place, with tip terminating within 1 cm of the superior aspect of the aortic knob. Since the time of this dictation, a subsequently reported chest radiograph documents repositioning of this device. Exam is otherwise remarkable for worsening pulmonary edema, and increased left retrocardiac opacification, with no other relevant changes   Keywords: worse, increase.


SubjectID: 10896351, StudyID: 50906903, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with volume overload, vtach // interval change?

COMPARISON: The comparison is made with prior studies including ___.

IMPRESSION: The cardiac silhouette is unchanged. There is no CHF, pneumothorax. There is persistent linear atelectasis in the right lung base and the right perihilar region.


SubjectID: 10896351, StudyID: 50469947, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man intubated and sedated // ET tube advanced. Evaluate placement ET tube advanced. Evaluate placement

IMPRESSION: Intra-aortic balloon pump continues to be relatively high, 1.3 cm below the roof of the aortic arch and might be pulled back approximately 2 cm. Biventricular pacer is are in expected positions. Cardiomegaly is severe. Swan-Ganz catheter tip is at the level of the right main pulmonary artery. Mild interstitial pulmonary edema is present but improved since the prior study   Keywords: improve. Left pleural effusion is small. ET tube tip is 5.2 cm above the carinal. NG tube passes below the diaphragm most likely terminating in the stomach.


SubjectID: 10896351, StudyID: 56730548, Comparison: worse

WET READ: ___ ___ ___ 3:50 AM A Swan-Ganz catheter is in appropriate position in the proximal right pulmonary artery. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with VT storm, EF ___%, MRSA bacteremia s/p TAVR s/p ICD ___ complete heart block // fluid status, swan position fluid status, swan position

IMPRESSION: Compared to chest radiographs ___ through ___ at 05:45. Mild pulmonary edema has worsened, restricted to the right long   Keywords: worse. Left lung is grossly clear. Small left pleural effusion is probably larger. Moderate cardiomegaly is stable, improved since ___. No pneumothorax. Tip of the intra-aortic balloon pump is nearly at the apex of the aortic knob, approximately 4 cm above the usual location closer to the upper margin of the left main bronchus. ET tube in standard position. Esophageal drainage tube passes below the diaphragm and out of view. Swan-Ganz catheter is been withdrawn to the intra pericardial right pulmonary artery. Transvenous right atrial biventricular pacer defibrillator leads are unchanged in standard locations.


SubjectID: 10896351, StudyID: 56002368, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluation for lead position.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The external pacemaker pad has been removed. The pacemaker lead continues to be positioned in the left ventricle. No evidence of complications, notably no pneumothorax. Unchanged moderate cardiomegaly without pulmonary edema   Keywords: unchanged.


SubjectID: 10896351, StudyID: 53657451, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with endocarditis and decompensated HF with balloon pump in place // Interval change in intubated patient Interval change in intubated patient

IMPRESSION: Comparison to ___. The aortic balloon pump has been advanced. The tip is now approximately 8 mm from the most apical part of the aortic arch. The other monitoring and support devices are also in correct position. Moderate cardiomegaly persists. Minimal left pleural effusion. No pulmonary edema. No pneumonia.


SubjectID: 10896351, StudyID: 56514316, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with VT and CHF and MRSA bacteremia // Evaluation of volume status

IMPRESSION: Allowing for differences in technique, there has not been a relevant change in the appearance of the chest since recent study of 2 days earlier.


SubjectID: 10896351, StudyID: 54358913, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with Afib, sCHF, and asthma presenting with fever, SOB // Suspicious for pulmonary edema vs. infectious process, please have done around 2PM (after diuresis) Suspicious for pulmonary edema vs. pneumonia

IMPRESSION: In comparison with the study of ___, there is continued enlargement of the cardiac silhouette. The degree of pulmonary vascular congestion has decreased   Keywords: decrease. Dual-channel pacer device remains in place.


SubjectID: 10896351, StudyID: 54273862, Comparison: worse

FINAL REPORT

The: Portable AP view of the chest.

INDICATION: History: ___M with wheezing, edema?

COMPARISON: Chest radiograph ___, ___, chest CTA of ___.

FINDINGS: There is severe cardiomegaly. The mediastinal and hilar contours are stable. There is no pneumothorax or large pleural fusion. The lungs are well-expanded. There is mild vascular congestion. Slight increased vascular markings at the right base likely represents asymmetric pulmonary edema. The patient is status post CABG. Left axillary pacemaker is noted with leads in stable positions.

IMPRESSION: Mild increased vascular congestion, slightly more prominent the right base   Keywords: increase. The most ready explanation for this finding is asymmetric pulmonary edema.


SubjectID: 10902272, StudyID: 55534678, Comparison: None

FINAL REPORT

EXAM: Chest single frontal view.

HISTORY: CoreValve placement.

COMPARISON: ___.

FINDINGS: Single AP upright portable view of the chest was obtained. The patient's chin overlies the medial lung apices. A right-sided pacer is again seen to terminate in the region of the right ventricle. CoreValve is not as well seen as compared to the prior study due to technique, however, is in grossly stable position. The cardiac silhouette is stably enlarged. The aorta is calcified and tortuous. No focal consolidation. Persistent minimal blunting of the costophrenic angles. No evidence of pneumothorax is seen.


SubjectID: 10902272, StudyID: 54243872, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST X-RAY

INDICATION: Patient with CoreValve, temporary pacemaker IJ line.

COMPARISON: ___ to ___.

FINDINGS: Right-sided temporary pacemaker ends in the right atrium. There is no pneumothorax. There is minimal blunting of the right costodiaphragmatic angle. Moderate cardiomegaly is unchanged in this patient with a new aortic CoreValve.

CONCLUSION: Right-sided temporary pacemaker ends in the right atrium. There is no pneumothorax.


SubjectID: 10908761, StudyID: 57569366, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post CABG, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the lung volumes have increased, likely reflecting improved ventilation. Status post CABG. Borderline size of the cardiac silhouette without pulmonary edema. Unchanged position of the right internal jugular vein catheter. The presence of a minimal left pleural effusion cannot be excluded. No focal parenchymal opacity suggesting pneumonia.


SubjectID: 10908761, StudyID: 52700188, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: CABG, dropping hematocrit.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Borderline size of the cardiac silhouette. Low lung volumes. Presence of bilateral areas of atelectasis. Minimal fluid overload may also be present, as reflected by mild increase in diameter of the pulmonary vasculature. No newly appeared focal parenchymal opacity suggesting pneumonia.


SubjectID: 10908761, StudyID: 56228353, Comparison: better

FINAL REPORT

PA AND LATERAL CHEST, ___

HISTORY: Shortness of breath. Volume overload.

IMPRESSION: PA and lateral chest compared to ___ and ___: Mild pulmonary edema has improved   Keywords: improve. Residual heterogeneous opacification in the axillary region of the right upper lobe could be due to pneumonia, particularly aspiration. Careful followup advised. Heart size is normal. Pleural effusions are small, if any. Chest radiographs on ___ suggest pre-existing interstitial lung disease which is undoubtedly contributing to some of the pulmonary abnormality currently. Of note, the patient had distended esophagus on that examination raising possibility of scleroderma or CREST syndrome.


SubjectID: 10908761, StudyID: 50407539, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old male with cough.

COMPARISON: ___ and ___. PA AND LATERAL CHEST: The lung volumes are low, which likely exacerbate the worsened appearance of diffuse interstitial abnormality in comparison to prior studies. However, the worsened appearance could also in part reflect progression of known pulmonary fibrosis (per OMR notes, demonstrated on prior Atrius CT), or superimposed interstitial edema or widespread atypical infectious process. There is no associated effusion or pneumothorax. Hilar and cardiomediastinal contours are unchanged. Mild thoracic degenerative change.

IMPRESSION: Worsened diffuse interstitial abnormality compared to prior studies, which could reflect progression of chronic interstitial lung disease versus superimposed interstitial edema or atypical infectious process   Keywords: worse.


SubjectID: 10917306, StudyID: 59984565, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with recent onset of cough. Noted to have rales at lower lung fields bilat. // CHF?

FINDINGS: Cardiac silhouette is upper limits of normal in size accompanied by pulmonary vascular congestion, new bronchial wall thickening and scattered interstitial opacities with lower lung predominance   Keywords: new. Minimal patchy opacities are also seen in both lung bases. No pleural effusion. Bones are diffusely demineralized, and a compression deformity is observed in the upper lumbar spine, present since ___ lateral chest radiograph. Healed lateral right rib fractures are also noted.

IMPRESSION: Findings may be explained by congestive heart failure with interstitial edema, but differential diagnosis includes an atypical pneumonia. If the diagnosis is in doubt clinically, short-term followup radiographs after diuresis may be helpful.


SubjectID: 10917306, StudyID: 53177034, Comparison: None

FINAL REPORT

EXAMINATION: PA and lateral views of the chest

INDICATION: History: ___F with worsening sob // ? pna

TECHNIQUE: Upright PA and lateral chest

COMPARISON: Chest radiographs ___ through ___.

FINDINGS: The lungs are normally expanded. Perihilar and interstitial opacities are compatible with pulmonary edema. There are small bilateral pleural effusions. Heart size has increased since the prior study now with mild cardiomegaly. There is no pneumothorax.

IMPRESSION: 1. Mild pulmonary and interstitial edema. Mild cardiomegaly. Recommend repeat radiographs following diuresis to ensure no underlying pneumonia. 2. Small bilateral pleural effusions.


SubjectID: 10917306, StudyID: 58605600, Comparison: same

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: History: ___F with fever and cough // ? pna

TECHNIQUE: Chest: Frontal and Lateral

COMPARISON: ___

FINDINGS: Patchy right base opacity is worrisome for pneumonia. Minimal vascular congestion persists   Keywords: persists. No pleural effusion or pneumothorax is seen. Cardiac mediastinal silhouettes are stable. The patient is status post median sternotomy.

IMPRESSION: Patchy right basilar opacity with possible involvement of the right middle lobe as well, worrisome for pneumonia.


SubjectID: 10917306, StudyID: 50102471, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with chf exacerbation // ?new pneumonia

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Heart size and mediastinum are stable. There is interval development of more conspicuous upper zone re- distribution of the vasculature as well as perihilar opacities concerning for interval progression of interstitial pulmonary edema   Keywords: progression. No pleural effusion or pneumothorax is seen.


SubjectID: 10917546, StudyID: 54436588, Comparison: None

FINAL REPORT

INDICATION: History: ___F with abdominal pain, nausea, vomiting, diarrhea for 1 day

TECHNIQUE: Upright AP and lateral views of the chest

COMPARISON: ___

FINDINGS: The cardiac silhouette size is normal. Coronary artery calcifications are re- demonstrated. The aorta remains tortuous with atherosclerotic calcifications again noted at the arch. Hilar contours are unremarkable. The pulmonary vasculature is normal. Lung volumes are low with no focal consolidation demonstrated. No pleural effusion or pneumothorax is seen. Mild degenerative changes are noted in the thoracic spine.

IMPRESSION: No acute cardiopulmonary abnormality.


SubjectID: 10917546, StudyID: 50665685, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with dCHF with Urosepsis s/p IVF and crackles on exam // eval for pulm pathology, evidence of edema or infection

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Relatively low lung volumes with borderline size of the cardiac silhouette. Mild elongation of the descending aorta. Minimal atelectasis at the left lung bases, projecting over the left costophrenic sinus. No larger pleural effusions. No pneumonia.


SubjectID: 10918768, StudyID: 57386742, Comparison: None

FINAL ADDENDUM ADDENDUM The original report for this exam was placed under the incorrect clip number. Does not correspond to this patient. The following report is the correct one. Endotracheal tube terminates 4.8 cm above the carina. Left apical pneumothorax measures 1.5 cm. Left pigtail pleural catheter is positioned with side holes within the pleural space. Extensive subcutaneous emphysema extends along the left lateral chest wall. A fiducial marker in the left upper lobe is new with ill-defined surrounding opacity consistent with post ablative changes. Lung volumes are low. Heart size is stable. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with pneumothorax s/p bx and RFA. Now s/p chest tube // evaluate for resolution of pneumothorax

TECHNIQUE: Single frontal view of the chest

COMPARISON: None

FINDINGS: Cardiac size is normal. The lungs are clear. There is no pneumothorax or pleural effusion.

IMPRESSION: No acute cardiopulmonary abnormality


SubjectID: 10918768, StudyID: 50484273, Comparison: worse

FINAL REPORT

INDICATION: ___ year old woman with h/o COPD on home O2, afib, HFpEF, and recent dx concerning LUL lung nodule s/p biopsy and RFA c/b pneumothorax // eval pneumothorax

EXAMINATION: CHEST (PORTABLE AP)

TECHNIQUE: Portable Chest radiograph, single AP view

COMPARISON: Chest radiograph ___

FINDINGS: Small left apical pneumothorax is stable. Pigtail catheter is in unchanged position in the left chest cavity. Bilateral pleural effusions and lung base atelectasis are increased compared to ___. Pulmonary vessels are engorged and interstitial edema is also slightly increased   Keywords: increase. Cardiomediastinal silhouette is unchanged. Subcutaneous emphysema in the left chest wall is unchanged. Small radiodensity is in the left upper lung, likely related to ablation.

IMPRESSION: 1. Moderate bilateral pleural effusions and basal atelectasis and mild pulmonary edema are increased from ___   Keywords: increase. 2. Stable small left apical pneumothorax. Pigtail catheter is in unchanged position in the left chest cavity laterally.


SubjectID: 10918768, StudyID: 52945874, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with PTX after RFA, stable size with chest tube. please perform upright, today at 15:00 (3PM). // is PTX stable is PTX stable

IMPRESSION: In comparison with the earlier study of this date, there is little change in the small left apical pneumothorax and extensive subcutaneous gas along the left lateral chest wall. Pigtail pleural drainage catheter remains in place. Blunting of the right costophrenic angle is again seen. Small left pleural effusion persists.


SubjectID: 10933538, StudyID: 55355885, Comparison: None

FINAL REPORT

STUDY: PA and lateral chest, ___. CLINICAL

HISTORY: ___-year-old woman with dyspnea and congestive heart failure.

FINDINGS: Comparison is made to the prior study from ___. The heart size is upper limits of normal, but stable. There is atelectasis at the lung bases. There are no signs for overt pulmonary edema or focal consolidation. No pneumothoraces are identified.


SubjectID: 10933538, StudyID: 51785035, Comparison: None

FINAL REPORT

HISTORY: ___ year old woman with hx CHF, n/v and R sided crackles

COMPARISON: ___.

FINDINGS: PA and lateral views of the chest were provided. The heart remains mildly enlarged. There is stable scarring at the left lung base. No focal consolidation, effusion, or pneumothorax is seen. The mediastinal contour is stable. Bony structures are intact. Partially imaged hardware is seen in the mid cervical spine.

IMPRESSION: No acute findings.


SubjectID: 10943603, StudyID: 54991938, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: None. CLINICAL

HISTORY: Acute dyspnea.

FINDINGS: Portable supine AP chest radiograph is obtained. Endotracheal tube is seen with its tip located approximately 5 cm above the carina. NG tube courses into the left upper abdomen. Diffuse bilateral ground-glass opacities, which are most compatible with pulmonary edema. A right pleural effusion is noted, moderate in volume. There may be a tiny left pleural effusion. No pneumothorax is seen. Heart size difficult to evaluate though is at least top normal. Widening of the mediastinum is likely due to supine portable technique. The imaged osseous structures are intact.

IMPRESSION: Endotracheal and nasogastric tubes appropriately positioned. Pulmonary edema with moderate right and tiny left pleural effusion. Top normal heart size.


SubjectID: 10943603, StudyID: 54390252, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Spiking fevers. Evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The monitoring and support devices are in unchanged position. Low lung volumes, moderate-to-severe bilateral pleural effusions and unchanged mild-to-moderate pulmonary edema   Keywords: unchanged. Bilateral areas of atelectasis at both lung bases, right more than left. No newly appeared parenchymal opacities   Keywords: new. No pneumothorax.


SubjectID: 10943603, StudyID: 54287521, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Intubated with fluid overload, suspected chronic heart failure.

COMPARISON: ___, 2:42 p.m.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Massive decrease in lung volumes with moderate-to-severe bilateral pleural effusions as well as moderate pulmonary edema. Moderate-to-severe cardiomegaly. Extensive areas of atelectasis at both lung bases. The monitoring and support devices are unchanged.


SubjectID: 10943603, StudyID: 52056748, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

TECHNIQUE: Single supine portable view was compared with prior chest radiographs from ___ to ___. Chest CT from ___ was also concurrently reviewed.

FINDINGS: Tip of the endotracheal tube terminates approximately 5.5 cm above the carina. OGT is seen to course below the diaphragm into the stomach; however, the distal end is beyond the field of view. Internal jugular line ends at right mid atrium. Bilateral, veil-like opacities, right side more than left, reflecting moderate right and mild left pleural effusions are unchanged since ___. AN ill-defined and more discrete opacity in the right mid lung corresponds to the opacity in the lateral segment of the right middle lobe, demomsrated on chest CT from ___, is most likely atelectasis. However, requires attention on followup radiograph to rule out an evolving pneumonia. Presumed small left Pleural effusion and increased retrocardiac opacity suggesting left lower lung atelectasis is similar. Moderate-to-large heart and hilar contours are unchanged in appearance.


SubjectID: 10944871, StudyID: 58631389, Comparison: 1.0

FINAL REPORT

INDICATION: ___ year old woman with CHF exacerbation and possible PNA. // Is there an underlying infectious process?

TECHNIQUE: Chest PA and lateral

COMPARISON: ___

FINDINGS: The lung volumes are low. There is interval improvement in bilateral diffuse interstitial opacities   Keywords: improve. Persistent bibasilar opacities noted   Keywords: persistent. Metallic stent projects over the lower mediastinum. Stable cardiomegaly. No pleural effusion or pneumothorax noted. Bony thorax is stable.

IMPRESSION: Interval improvement in bilateral diffuse interstitial and bibasilar opacities, likely improving pulmonary edema   Keywords: improve. No pleural effusions. The rest of the findings are stable.


SubjectID: 10944871, StudyID: 54386435, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with SOB, hypoxia // eval edema, PNA

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: Bilateral perihilar alveolar opacities are worrisome for pulmonary edema, underlying infectious process difficult to exclude. Obscuration of the left hemidiaphragm may be due to a small pleural effusion. Cardiac and mediastinal silhouettes are stable. Aorta core valve is noted.

IMPRESSION: Moderate pulmonary edema. Recommend repeat after treatment to exclude underlying infection.


SubjectID: 10944871, StudyID: 58105164, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p TAVR with temp wire placement // evaluate evaluate

IMPRESSION: In comparison with the earlier study of this day, there is again diffuse bilateral pulmonary opacification, consistent with significant pulmonary edema   Keywords: again. There has been placement of a right IJ temporary pacer, which extends to the region of the apex of the right ventricle.


SubjectID: 10944871, StudyID: 54286355, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with severe AS, s/p TAVR.

COMPARISON: Chest radiographs from ___

FINDINGS: AP view of the chest provided. Compared to prior study, there is significant improvement in bilateral pulmonary vascular congestion   Keywords: improve. There is no new focal consolidation. Left lower lobe atelectasis is noted. There is small left pleural effusion. Endotracheal tube, enteric tube, and right ventricular pacer lead is unchanged in position. CoreValve is again seen.

IMPRESSION: Significant improvement in bilateral pulmonary edema   Keywords: improve.


SubjectID: 10944871, StudyID: 54160853, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with recent TAVR and pulmonary edema // assess for interval improvement

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The monitoring and support devices, including the right external pacemaker, are constant. Constant position of the aortic valve replacement. Mild cardiomegaly but no evidence of pulmonary edema. No larger pleural effusions. No pneumonia.


SubjectID: 10944871, StudyID: 54155301, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with severe AS, now hypoxic and dyspneic // eval for pulmonary edema eval for pulmonary edema

IMPRESSION: In comparison with the study of ___, there has been a dramatic increase in diffuse bilateral opacifications, consistent with significant pulmonary edema   Keywords: increase. Continued enlargement of the cardiac silhouette. There has been placement of an endotracheal tube with its tip approximately 6.8 cm above the carina. Dilated bowel is seen in the left upper quadrant. It is unclear whether this represents the gas-filled stomach, for which a nasogastric tube could prove helpful.


SubjectID: 10944871, StudyID: 55380404, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with recent tavr // assess for interval change

IMPRESSION: As compared ___ radiograph, the patient has been extubated. Cardiomegaly and pulmonary vascular congestion are accompanied by worsened pulmonary edema as well as a more confluent opacity in left retrocardiac region   Keywords: worse. The latter probably represents a combination of pleural effusion and atelectasis but this superimposed secondary process such as aspiration or developing pneumonia are also possible an short-term followup radiographs may be helpful in this regard.


SubjectID: 10947173, StudyID: 56257210, Comparison: None

FINAL REPORT

HISTORY: ___-year-old man status post STEMI, now with episodes of shortness of breath. Evaluate for pulmonary edema.

COMPARISON: Radiographs of the chest dated ___ and ___.

FINDINGS: Portable semi-upright radiograph of the chest demonstrates low lung volumes with resulting bronchovascular crowding. There is atalectasis at the right lung base. There is mild vascular congestion without frank pulmonary edema. The heart is mildly enlarged. The thoracic area is somewhat tortuous. No pneumothorax or significant pleural effusion.

IMPRESSION: Right basalar atelecatasis and mild vascular congestion.


SubjectID: 10968253, StudyID: 53011022, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with worsening hypoxemia in the setting of probable aspiration, who presents for evaluation.

COMPARISONS: Chest radiographs from ___ and ___.

TECHNIQUE: PA and lateral radiographs of the chest.

FINDINGS: There is a left-sided PICC extending to the level of the mid SVC. There has been interval improvement of the right medial lung base opacity. No new focal consolidations are seen. There are no pleural effusions or pneumothorax. The heart is mildly enlarged. The mediastinal contour is stable with atherosclerotic calcifications at the aortic knob. Again seen are the midline sternotomy wires and mediastinal clips as well as the prosthetic cardiac valve.

IMPRESSION: No new focal consolidations identified to explain patient's worsening hypoxemia.


SubjectID: 10968253, StudyID: 51776446, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: ___. CLINICAL

HISTORY: Lethargy, assess for acute intrathoracic process.

FINDINGS: AP and lateral views of the chest provided. Midline sternotomy wires and mediastinal clips as well as a prosthetic cardiac valve again noted. There is a PICC line in the left arm extending to the level of the lower SVC. Lung volumes are low with increased opacity at the right medial lung base which could represent pneumonia. This is a finding which is new from prior exam. Otherwise, lungs appear clear. The heart is mildly enlarged. Mediastinal contour is stable with atherosclerotic calcifications at the aortic knob. Bony structures are intact. No free air below the right hemidiaphragm.

IMPRESSION: New opacity at the right medial lung base which is concerning for pneumonia. Mild cardiomegaly redemonstrated. PICC line in appropriate position.


SubjectID: 10975446, StudyID: 58917552, Comparison: same

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___ chest x-ray.

FINDINGS: Cardiac silhouette remains enlarged and is accompanied by persistent pulmonary vascular congestion and interstitial edema   Keywords: remains, persistent. Patchy bibasilar atelectasis also appears similar compared to the prior study.


SubjectID: 10975446, StudyID: 50572011, Comparison: None

FINAL REPORT

PORTABLE CHEST ___

COMPARISON: Radiograph ___.

FINDINGS: Cardiac silhouette is mildly enlarged, and accompanied by pulmonary vascular congestion and mild interstitial edema. Patchy opacities persist at the bases, and likely reflect atelectasis. Followup radiographs may be helpful to exclude pneumonia in the appropriate clinical setting.


SubjectID: 10975446, StudyID: 56820999, Comparison: None

FINAL REPORT

INDICATION: ___-year-old with hypoxia.

TECHNIQUE: Single frontal radiograph of the chest was obtained.

COMPARISON: Chest radiograph from ___.

FINDINGS: There are lower lung volumes with secondary mild widening of cardiomediastinal silhouette. There is no pleural effusion, pneumothorax or focal lung consolidation. There are bibasilar opacities which are better seen on the subsequent CT abd, may represent aspiration or atelectasis.


SubjectID: 10975446, StudyID: 56390608, Comparison: None

FINAL REPORT

CHEST ON ___

HISTORY: Intubated for respiratory distress.

FINDINGS: Again seen is low position of the ET tube, 1.4 cm above the carina. The appearance of the lungs is unchanged. Right IJ line tip at cavoatrial junction is unchanged.


SubjectID: 10975446, StudyID: 55747813, Comparison: None

FINAL REPORT

CHEST ON ___

HISTORY: Hypoxia. REFERENCE EXAM: ___ at ___.

FINDINGS: The ET tube is still slightly low, 1.7 cm above the carina. Right IJ line tip is at the cavoatrial junction. There are bilateral pleural effusions, vascular plethora, patchy areas of alveolar edema. The overall impression is that of CHF and underlying infectious infiltrate cannot be excluded. Compared to the prior study, the fluid status is slightly worse.


SubjectID: 10975446, StudyID: 53843466, Comparison: None

FINAL REPORT

CHEST ON ___

HISTORY: ET tube position.

FINDINGS: The ET tube is low, 1.5 cm above the carina. There are increased lung markings bilaterally in this patient with known bilateral basilar atelectasis/infiltrate/aspiration. An IJ line tip is at the cavoatrial junction.


SubjectID: 10975446, StudyID: 55185117, Comparison: worse

FINAL REPORT

AP CHEST, 3:18 A.M., ___

HISTORY: ___-year-old intubated patient, rule out cardiopulmonary process.

IMPRESSION: AP chest compared to ___: Moderately severe pulmonary edema is worsening, accompanied by increasing small-to-moderate bilateral pleural effusions and progressive moderate-to-severe cardiomegaly   Keywords: increasing, worse. Right jugular line ends in the upper right atrium. ET tube is in standard placement. No pneumothorax. Thoracic aorta is heavily calcified and at least tortuous if not dilated, but probably not acutely changed.


SubjectID: 10975446, StudyID: 56122911, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Respiratory failure, pulmonary changes.

COMPARISON: ___, 2:25.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The extensive bilateral parenchymal opacities, bilateral pleural effusions, cardiomegaly, and basal atelectasis are unchanged. No new opacities   Keywords: new. Unchanged monitoring and support devices.


SubjectID: 10975446, StudyID: 55911959, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH.

INDICATION: Aspiration pneumonia, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no major change. The monitoring and support devices are in unchanged position. Small bilateral pleural effusions with evidence of relatively extensive bilateral probably atelectatic consolidations. Mild-to-moderate fluid overload. No newly appeared focal parenchymal opacities   Keywords: new. Extensive calcifications and tortuosity of the thoracic aorta.


SubjectID: 10975446, StudyID: 53835190, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Respiratory failure.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is unchanged evidence of bilateral parenchymal opacities, constant on the right and minimally improving on the left   Keywords: improving. Unchanged cardiomegaly and small bilateral pleural effusions. Subsequent areas of basal atelectasis. Unchanged position of the endotracheal tube and right-sided central venous access line.


SubjectID: 10975446, StudyID: 53829371, Comparison: None

FINAL REPORT

AP CHEST, 7:34 A.M., ___

HISTORY: ___-year-old man with CHF, question pulmonary edema.

IMPRESSION: AP chest compared to ___: Pulmonary vascular congestion, hilar enlargement and moderate cardiomegaly are longstanding. There is no pulmonary edema. Pleural effusions are small if any. Thoracic aorta is heavily calcified, tortuous and generally large, but there is no evidence of focal aneurysm or interval change. No pneumothorax.


SubjectID: 10975446, StudyID: 51473674, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Question worsening congestive heart failure.

COMPARISONS: ___.

TECHNIQUE: Chest, AP upright portable.

FINDINGS: There is mild cardiomegaly. The aorta is tortuous and calcified. The mediastinal and hilar contours appear unchanged. There is a similar mild interstitial abnormality with prominence of central pulmonary vascularity, suggesting mild vascular congestion   Keywords: similar. In addition, patchy streaky opacities in the right mid and lower lung suggest a background of minor scarring or atelectasis. Although evaluation is limited, there is no definite pleural effusion. No pneumothorax is demonstrated, although it is noted that the left lung apex is obscured by a flexed chin.

IMPRESSION: Essentially stable findings suggesting mild pulmonary vascular congestion   Keywords: stable.


SubjectID: 10976602, StudyID: 58573817, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, increasing shortness of breath.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Mild elevation of the hemidiaphragms. Borderline size of the cardiac silhouette, currently there is no evidence of pulmonary edema. Retrocardiac atelectasis. Unchanged course and position of the pacemaker leads.


SubjectID: 10976602, StudyID: 53885627, Comparison: None

FINAL REPORT

PORTABLE CHEST ___, ___

COMPARISON: ___ ___ ___.

FINDINGS: As compared to the recent radiograph, there has been a slight worsening of bibasilar atelectasis. Small pleural effusions are similar to the prior ___, and there are no new areas of abnormality evident.


SubjectID: 10976602, StudyID: 53362954, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with persistent hypotension, pleural effusions // Evolution of pleural effusions, pulmonary edema

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, there is now mild pulmonary edema. The extent of the bilateral pleural effusions is unchanged. Moderate to severe cardiomegaly with bilateral areas of atelectasis.

NOTIFICATION: At the time of dictation and observation, 09:08, on the ___, the referring physician ___. ___ was paged for notification.


SubjectID: 10976602, StudyID: 52127136, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF, pacemaker, hypotension // r/o pulm edema

TECHNIQUE: Portable chest

COMPARISON: ___.

FINDINGS: Again seen is severe cardiomegaly and a dual lead pacemaker the mediastinal contour coarse are similar. There small bilateral pleural effusions that are increased compared to prior there is mild pulmonary vascular redistribution

IMPRESSION: Small bilateral pleural effusions, increased compared to prior


SubjectID: 10984032, StudyID: 54964860, Comparison: same

WET READ: ___ ___ ___ 9:53 PM Persistent pulmonary edema. Left basilar opacification persists with likely pleural effusion and atelectasis, but underlying consolidation cannot be excluded. There is either leftward mediastinal shift or patient rotation; repeat true frontal radiograph is recommended. Discussed with Dr. ___ by phone at 9:52 p.m. on ___.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ is a medically complex ___year-old woman with a history of breast cancer, s/p partial mastectomy and chemotherapy (last cycle ___), severe MR, and recent onset HFpEF presumably due to MR. ___ has also had recent PNA and C. dif infections. She was readmitted to ___ in decompensated HF and is being transferred for HF optimization and consideration of surgical candidacy for MVR. // r/o acute process, assess pulm edema, r/o infection // infection, change in pulm edema?

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the bilateral parenchymal opacities are unchanged   Keywords: unchanged. Unchanged appearance of the cardiac silhouette. Minimal blunting of the left costophrenic sinus, potentially reflecting a small left pleural effusion. No new opacities   Keywords: new. No pneumothorax. The right pectoral Port-A-Cath is constant in position.


SubjectID: 10984032, StudyID: 51650625, Comparison: same

FINAL REPORT

INDICATION: . ___ is a medically complex ___year-old woman with a history of breast cancer, s/p partial mastectomy and chemotherapy (last cycle ___), severe MR, and recent onset HFpEF presumably due to MR. ___ has also had recent PNA and C. dif infections. She was readmitted to ___ in decompensated HF and is being transferred for HF optimization and consideration of surgical candidacy for MVR. // r/o acute process, assess pulm edema, r/o infection

TECHNIQUE: Chest PA and lateral

COMPARISON: ___

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change. There continues to be increase in interstitial markings, pulmonary vascular redistribution, and left effusion. The right-sided catheter tip is in the mid SVC. There is no pneumothorax. Degenerative changes are again seen in the right humeral head.

IMPRESSION: No chain


SubjectID: 10984032, StudyID: 50603608, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___-year-old woman with a history of breast cancer, s/p partial mastectomy and chemotherapy (last cycle ___), severe MR, and recent onset HFpEF presumably due to MR. ___ has also had recent PNA and C. dif infections. She was readmitted to ___ in decompensated HF and is being transferred for HF optimization and consideration of surgical candidacy for MVR. // r/o acute process, assess pulm edema, r/o infection // please re-assess tracheal deviation?

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the pre-existing parenchymal opacities on the right are minimally progressive, notably at the right lung apex. On the left, the lung parenchyma has increased in transparency, likely reflecting improved ventilation. Moderate cardiomegaly and retrocardiac atelectasis persist. Unchanged position of the right Port-A-Cath.


SubjectID: 10993119, StudyID: 50319700, Comparison: None

FINAL REPORT

PORTABLE CHEST ___

COMPARISON: Radiograph of one day earlier.

FINDINGS: Tip of the intra-aortic balloon pump terminates 3 cm below the superior aspect of the aortic knob. Heart is upper limits of normal in size. Pulmonary vascular congestion is accompanied by mild-to-moderate edema. Worsening left retrocardiac atelectasis. Slight increase in small bilateral pleural effusions but no visible pneumothorax.


SubjectID: 10993119, StudyID: 51619132, Comparison: better

FINAL REPORT

INDICATION: 3 vessel disease now with intra-aortic balloon pump and pulmonary edema. Evaluate for intra-aortic balloon pump placement and pulmonary edema.

COMPARISON: ___.

FINDINGS: Portable supine frontal radiograph of the chest the demonstrates the intra-aortic balloon pump terminating 1.3 cm below the superior aspect of the aortic knob. Top-normal heart size is stable. There is interval improvement in pulmonary edema, now mild   Keywords: improve. Pleural effusions are small if present. Slight improvement in retrocardiac atelectasis.


SubjectID: 10998537, StudyID: 59198364, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph ___.

FINDINGS: Heart is upper limits of normal in size. Pulmonary vascular congestion is accompanied by mild interstitial edema. Note is also made of a patchy area of increased opacity in the right infrahilar region. This could be due to focal atelectasis, aspiration or an early focus of pneumonia. Short-term followup radiograph may be helpful in this regard. Bullous emphysema is present at the right apex, but there is no evidence of a pneumothorax.


SubjectID: 10998537, StudyID: 55817564, Comparison: None

WET READ: ___ ___ ___ 8:33 PM No significant change compared to the prior study ___. Bibasilar atelectasis. No evidence of volume overload. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Shortness of breath, abdominal pain, evaluation for fluid overload.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the known healed right rib fractures are of unchanged appearance. The previously described contour abnormality along the fifth left rib is not visible on today's image. A dedicated rib series might be helpful if further evaluation is warranted. There is no evidence of a left pneumothorax. No pulmonary edema. Borderline size of the cardiac silhouette and tortuosity of the thoracic aorta. No pneumonia, no pleural effusions.


SubjectID: 10998537, StudyID: 57996402, Comparison: None

FINAL REPORT

HISTORY: Productive cough and shortness of breath, question infiltrate or other abnormal findings.

TECHNIQUE: AP and lateral view of the chest.

COMPARISON: Chest radiograph on ___.

FINDINGS: There is slightly low lung volumes. Heart size is top normal. There are aortic calcifications. There are no pleural effusions or pneumothorax. There is probable mild pulmonary vascular congestion. There is a retrocardiac opacity that may represent pneumonia or atelectasis.

IMPRESSION: Mild pulmonary vascular congestion. Retrocardiac opacity is likely atelectasis however cannot rule out infection. Recommend clinical correlation.


SubjectID: 10998537, StudyID: 56022612, Comparison: None

FINAL REPORT

HISTORY: New IJ placement.

TECHNIQUE: Portable AP view of the chest.

COMPARISON: Chest radiograph from ___ at 12:00.

FINDINGS: The right IJ catheter ends in the mid SVC. There are aortic calcifications. The retrocardiac opacity is again seen and may represent pneumonia or atelectasis. No pleural effusion or pneumothorax.

IMPRESSION: Right IJ catheter ends in the mid SVC. Otherwise unchanged.


SubjectID: 10998537, StudyID: 56651463, Comparison: None

FINAL REPORT

PORTABLE CHEST: ___

HISTORY: ___-year-old female with shortness of breath, missed dialysis.

FINDINGS: Single portable view of the chest is compared to previous exam from ___. Lungs are clear of confluent consolidation. There is mild indistinctness of the pulmonary vasculature which could be in part technical. Bibasilar opacities likely due to atelectasis. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable.

IMPRESSION: Mild pulmonary vascular congestion.


SubjectID: 10998537, StudyID: 53854800, Comparison: same

FINAL REPORT

PORTABLE CHEST: ___.

HISTORY: ___-year-old female with line placement.

FINDINGS: Single portable view of the chest is compared to previous exam from earlier the same day. New right IJ line is seen with catheter tip at the RA-SVC junction. There is no visualized pneumothorax. Otherwise, there has been no significant change   Keywords: no significant change.

IMPRESSION: New right IJ line with tip at the RA-SVC junction. No pneumothorax.


SubjectID: 10998537, StudyID: 56648971, Comparison: None

FINAL REPORT

CLINICAL

HISTORY: ___-year-old woman with cough. Interval change after dialysis.

COMPARISON: ___.

FINDINGS: Lungs are again clear. Cardiomediastinal silhouette and hilar contours are unremarkable. Patchy opacity previously noted in the right lower lung base is likely just atelectasis.


SubjectID: 10998537, StudyID: 51671173, Comparison: None

FINAL REPORT

INDICATION: Chest discomfort, productive cough.

COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: The heart size is normal. The aorta is calcified. The mediastinal and hilar contours are normal. There is no pulmonary edema. On the lateral view, a patchy opacity is noted posteriorly within the right lower lobe, which could represent atelectasis but developing infection is not excluded. No pleural effusion or pneumothorax is identified. There are mild degenerative changes in the thoracic spine.

IMPRESSION: Subtle patchy opacity within the right lower lobe, which could reflect atelectasis though developing infection is not excluded.


SubjectID: 10998537, StudyID: 54266470, Comparison: better

FINAL REPORT

PA AND LATERAL CHEST, ___

COMPARISON: ___.

FINDINGS: Central venous catheter remains in place terminating in the mid superior vena cava. Heart is upper limits of normal in size. Previously noted pulmonary vascular congestion as well as subtle interstitial edema has resolved in the interval   Keywords: resolve. No areas of consolidation are identified within the lungs, and there are no pleural effusions. Bones are diffusely demineralized, and the aorta is tortuous and calcified.

IMPRESSION: No evidence of pneumonia or pulmonary edema.


SubjectID: 11010572, StudyID: 59898794, Comparison: None

FINAL REPORT

CHEST

HISTORY: Cough and hypotension. REFERENCE EXAM: ___.

FINDINGS: Lung volumes are slightly low and there is increased opacity in the left mid lung. It is unclear how much of this is volume loss versus infiltrate. The remainder of the lungs are clear. Heart is upper limits normal in size.


SubjectID: 11010572, StudyID: 57904894, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man with cirrhosis, here with hyponatremia and asterixis. Evaluate for pulmonary process.

COMPARISONS: Chest radiograph of ___.

FINDINGS: Single frontal portable view of the chest was obtained. The heart is of top normal size with normal cardiomediastinal contours. The pulmonary vasculature is slightly prominent, compatible with mild pulmonary congestion. The lungs are otherwise clear without focal consolidation, pleural effusion, or pneumothorax. Osseous structures appear unremarkable. A metallic stent overlies the right upper quadrant.

IMPRESSION: Mild pulmonary congestion. TIPS stent projecting over the right upper quadrant.


SubjectID: 11010572, StudyID: 58293079, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Dyspnea.

COMPARISONS: Prior radiographs from ___ and outside radiographs and CT from earlier on the same day.

TECHNIQUE: Chest, portable AP upright.

FINDINGS: The lung volumes are low. Hazy opacification of the lung bases suggests pleural effusions of substantial size, more conspicuous and probably larger on the left than right side. Fullness of each hilum with indistinct contours is suggestive of perihilar congestion, although mild and unchanged. There is no pneumothorax.

IMPRESSION: Findings suggestive of substantial pleural effusions and mild congestion.


SubjectID: 11020740, StudyID: 55722743, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Pulmonary edema, ETT repositioning.

COMPARISON: ___, 2:52.

FINDINGS: As compared to the previous radiograph, there has been a minimal pulling back of the endotracheal tube. The tube however, still projects 2.3 cm above the carina, the tube could be pulled back another 0.5-1 cm. The other monitoring and support devices are in correct position. The orogastric tube has a normal course, the tube is coiled in the stomach. No evidence of complications, notably no pneumothorax. Unchanged appearance of the lung parenchyma and the cardiac silhouette.


SubjectID: 11020740, StudyID: 52429008, Comparison: None

FINAL REPORT

INDICATION: Evaluation of patient with new intubation.

COMPARISON: None available. Endotracheal tube is approximately 6 mm from the carina. Right internal jugular catheter is visualized with the tip obscured by multiple overlying wires. Lung volumes are low bilaterally and exaggerate pulmonary vascular markings. There is prominence of bilateral hila but no focal consolidation, effusion, or pneumothorax. There is mild-to-moderate cardiomegaly. Pacemaker is visualized in place and there may be a remnant right ventricular lead in place.

IMPRESSION: Endotracheal tube tip is 0.6 cm from the carina. Retraction is recommended.


SubjectID: 11021643, StudyID: 59554324, Comparison: 0.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with SOB // ? pulmonary edema

IMPRESSION: As compared to previous radiograph from 1 day earlier, cardiomegaly is accompanied by worsening pulmonary edema and slight increase in size of a right pleural effusion   Keywords: worse, increase. No other relevant changes   Keywords: no other relevant change.


SubjectID: 11021643, StudyID: 55275190, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with SOB and O2 requirement // ? volume overload ? volume overload

COMPARISON: Comparison to ___ at 15:03

FINDINGS: Portable AP upright chest radiograph ___ at 02:18 is submitted.

IMPRESSION: Stably enlarged postoperative cardiac and mediastinal contours status post median sternotomy. There has been slight interval worsening of mild to moderate interstitial and pulmonary edema   Keywords: worse. The right hemidiaphragm remains slightly elevated of uncertain significance. No pneumothorax.


SubjectID: 11021643, StudyID: 58747537, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CAD and asthma admitted with suspected CAP and asthma exacerbation, acute worsening in respiratory status today concerning for pulm edema vs. worsening asthma exacerbation // intrval change, increase in pulmonary edema?

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Cardiomediastinal silhouette is unchanged. As compared to the previous study there is interval improvement in pulmonary edema but still present nodular opacities in the mid and lower left lung that although might represent enlarged vessels, infectious process is a possibility and assessment of the patient with chest CT would be highly recommended at this point   Keywords: improve.


SubjectID: 11021643, StudyID: 55090029, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with systolic heart failure and pnemonia s/p diuresis // evaluate for interval change in pulmonary edema

EXAMINATION: CHEST (PORTABLE AP)

TECHNIQUE: Portable Chest radiograph, frontal view

COMPARISON: Chest radiograph ___

FINDINGS: There is coalescence of opacity in the left lower lung, concerning for pneumonia. The opacity is increased compared to ___. There is no pleural effusion or pneumothorax. Moderate cardiomegaly is similar to prior.

IMPRESSION: There is coalescence of opacity in the left lower lung, concerning for progressive pneumonia.


SubjectID: 11021643, StudyID: 58112332, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Asthma, shortness of breath, evaluation for pneumonia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Status post sternotomy, clips in position. No overt pulmonary edema. No pleural effusions. No pneumonia.


SubjectID: 11021643, StudyID: 52368910, Comparison: None

FINAL REPORT

HISTORY: Chest pain, dyspnea. Question acute cardiopulmonary disease.

COMPARISON: Prior chest radiograph from ___.

TECHNIQUE: PA and lateral chest radiographs.

FINDINGS: The cardiac silhouette is mildly enlarged. Median sternotomy wires are again noted. There is mild pulmonary vascular congestion. No overt pulmonary edema noted. No focal consolidations concerning for pneumonia identified. No pleural effusion or pneumothorax seen.

IMPRESSION: Mild pulmonary vascular congestion and mild cardiomegaly. No focal consolidation concerning for pneumonia.


SubjectID: 11021643, StudyID: 58022881, Comparison: None

FINAL REPORT

HISTORY: Coronary artery disease status post CABG presenting with hyperglycemia and chest pain.

TECHNIQUE: Frontal and lateral views of the chest.

COMPARISON: ___.

FINDINGS: The patient is status post median sternotomy and CABG. The cardiomediastinal silhouette is stable. Relatively linear left base retrocardiac opacity most likely represents atelectasis. No definite focal consolidation is seen. There is no pleural effusion or pneumothorax. Degenerative changes are seen at the left shoulder and left acromioclavicular joints.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 11021643, StudyID: 55390294, Comparison: None

FINAL REPORT

HISTORY: Patient with blood pressure difference between arms, evaluate mediastinal widening or other acute process.

COMPARISON: ___.

FINDINGS: Portable single frontal chest radiograph was obtained. The lungs are fully expanded and clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are stable. There is no pleural effusion or pneumothorax.

IMPRESSION: No widening of cardiomediastinal silhouette or other acute cardiopulmonary process.


SubjectID: 11021643, StudyID: 52339249, Comparison: worse

FINAL REPORT

INDICATION: ___ year old woman with CAD s/p PCI and CABG with flash pulmonary edema and heart failure exacerbation // compare to prior

EXAMINATION: CHEST (PORTABLE AP)

TECHNIQUE: Portable Chest radiograph, frontal view

COMPARISON: Chest radiograph ___

FINDINGS: There is mild to moderate pulmonary edema, increased from ___   Keywords: increase   Keywords: increase. Moderate cardiomegaly is unchanged. Prominent vascular pedicle and bronchial cuffing is noted. There is bibasilar mild atelectasis. There is no pleural effusion.

IMPRESSION: There is mild to moderate pulmonary edema, increased from ___


SubjectID: 11021643, StudyID: 53903086, Comparison: -1.0

FINAL REPORT

INDICATION: ___ year old woman with chest pain and shortness of breath // eval for flash pulm edema

EXAMINATION: CHEST (PORTABLE AP)

TECHNIQUE: Portable Chest radiograph, frontal view.

COMPARISON: Chest radiograph ___ 5:29 am

FINDINGS: There is slightly increased mild pulmonary vascular congestion compared to 5 hr prior   Keywords: increase. Left lower lobe opacification is similar to prior   Keywords: similar. Moderate cardiomegaly is unchanged.

IMPRESSION: Slightly increased mild pulmonary vascular congestion compared to 5 hr prior   Keywords: increase.


SubjectID: 11021643, StudyID: 51955879, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with LLL infiltrate on ED x-ray // Evaluate for progression of pneumonia vs. pulmonary edema Evaluate for progression of pneumonia vs. pulmonary edema

IMPRESSION: In comparison with the study of ___, there is again moderate enlargement of the cardiac silhouette in a patient with intact midline sternal wires. No definite pulmonary vascular congestion at this time. There is some increased opacification at the left base. This could reflect developing consolidation in the appropriate clinical setting. A lateral view would be most helpful for further evaluation if the condition of the patient permits. .


SubjectID: 11021643, StudyID: 51547615, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with cough, fever, dyspnea // PNA?

COMPARISON: ___

FINDINGS: AP portable upright view of the chest. Mild cardiomegaly is again noted. Midline sternotomy wires and mediastinal clips are present. Increased retrocardiac opacity is concerning for a left lower lobe pneumonia. Band like opacity in the right mid lung may represent atelectasis. No large effusion or pneumothorax is seen. Imaged osseous structures are intact.

IMPRESSION: Mild cardiomegaly, retrocardiac opacity concerning for left lower lobe pneumonia. Right midlung atelectasis.


SubjectID: 11028216, StudyID: 59839569, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF and afib with bilateral pleural effusions // Progression of pleural effusions? Progression of pleural effusions?

IMPRESSION: In comparison with the study of ___, there is little overall change   Keywords: little overall change. Again there are low lung volumes with cardiomegaly, some evidence of mild elevation of pulmonary venous pressure, and bilateral pleural effusions with compressive atelectasis at the bases.


SubjectID: 11028216, StudyID: 53858795, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with dyspnea // ?pulmonary edema/effusion?

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, there is a mild increase in extent of the bilateral pleural effusions. The lung volumes are still very low. Bilateral areas of atelectasis are slightly more extensive than on the previous image. No overt pulmonary edema. No evidence of pneumonia.


SubjectID: 11028216, StudyID: 59723351, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF, AFib, CAD, HTN, and bilateral pleural effusions. // Any progression in bilateral pleural effusions? Any progression in bilateral pleural effusions?

IMPRESSION: In comparison with the study of ___, the substantially lower lung volumes makes it difficult to compare the degree of pleural effusion with the previous study. The hemidiaphragms are ___ not sharply seen bilaterally and the findings are again consistent with layering pleural effusions and compressive basilar atelectasis. The upper zones are clear and there is no definite vascular congestion.


SubjectID: 11028216, StudyID: 55065224, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF, AF, HTN, T2DM, and pulmonary HTN that presents with bilateral pleural effusions. // Whether bilateral pleural effusions are worsneing? Whether bilateral pleural effusions are worsneing?

COMPARISON: Comparison to prior study dated ___ at 07:28

FINDINGS: Portable AP upright chest film ___ at 07:44 is submitted.

IMPRESSION: A dual lead left-sided pacer remains in place with its leads terminating over the expected location of the right atrium and right ventricle, respectively. Overall cardiac mediastinal contours are stable. There continues to be bibasilar opacity which is likely not significantly changed and more likely represents partial lower lobe atelectasis given the presence of stable small pleural effusions, although pneumonia or aspiration cannot be entirely excluded. No evidence of pulmonary edema. No pneumothorax.


SubjectID: 11028216, StudyID: 50327912, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF, atrial fibrillation, CAD, and recurrent bilateral pleural effusions. // Whether bilateral pleurx catheters and bilateral pleural effusions are stable? Whether bilateral pleurx catheters and bilateral pleural eff

COMPARISON: Comparison to prior study ___ at 07:44

FINDINGS: Portable AP upright chest film ___ at 07:44 is submitted.

IMPRESSION: Dual lead left-sided pacer is unchanged. Overall cardiac mediastinal contours are stable. Bilateral pleural catheters remain in place. No large pleural effusions are appreciated, although more focal opacity at the left base could reflect either lobar atelectasis or a loculated collection. There are stable patchy opacities at both bases suggestive of atelectasis. No pulmonary edema. No pneumothorax is appreciated.


SubjectID: 11028216, StudyID: 59105331, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF, bilateral pleural effusions // help guide chest tube placement

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, a pre-existing opacity at the right lung base has completely resolved. On the left, the small pleural drain is seen in unchanged manner. Mild elevation of the right hemidiaphragm persists. Partial left lower lobe atelectasis. No pneumothorax.


SubjectID: 11028216, StudyID: 52558580, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF and b/l pleural effusions // improvement of bilateral pleural effusions s/p L thoracentesis

COMPARISON: ___

IMPRESSION: Left pleural effusion has decreased in size with residual small effusion remaining and no visible pneumothorax. Associated improved aeration of left lung base. Small right pleural effusion and adjacent right basilar lung opacity are not appreciably changed.


SubjectID: 11028216, StudyID: 58326900, Comparison: None

FINAL REPORT

HISTORY: NG tube placement.

FINDINGS: The nasogastric tube extends to the fundus of the stomach with the sidehole distal to the esophagogastric junction. Mild elevation of the right hemidiaphragm with atelectatic changes at the base.


SubjectID: 11028216, StudyID: 52141995, Comparison: None

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Left lower lobe crackles and elevated white blood cell count.

COMPARISONS: Scout view from prior CT performed on ___.

TECHNIQUE: Chest, PA and lateral.

FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged. There is no pleural effusion or pneumothorax. There is again moderate elevation of the right hemidiaphragm compared to the left side, not significantly changed. The lungs appear clear.

IMPRESSION: No evidence of acute disease.


SubjectID: 11028216, StudyID: 57900681, Comparison: None

WET READ: ___ ___ 11:11 AM Moderate size left and small right bilateral pleural effusions, similar compared to the previous study. Bibasilar airspace opacities likely reflect compressive atelectasis though infection and aspiration cannot be completely excluded. Gaseous dilatation of a small bowel loop on the lateral view. Consider abdominal radiographs for further assessment. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: Dyspnea on exertion, lower extremity swelling

TECHNIQUE: Chest PA and lateral

COMPARISON: ___

FINDINGS: Moderate left and small right bilateral pleural effusions are re- demonstrated, similar in extent compared to the previous exam. The cardiac silhouette size is difficult to assess given obscuration from the adjacent pleural effusions. Bibasilar airspace opacities likely reflect compressive atelectasis though infection cannot be excluded. The mediastinal and hilar contours appear unchanged. There is no pulmonary edema. Degenerative changes are noted within the imaged thoracolumbar spine. On the lateral view, there is focally dilated small bowel loop measuring up to 3.8 cm.

IMPRESSION: Moderate size left and small right bilateral pleural effusions, similar compared to the previous study. Bibasilar airspace opacities likely reflect compressive atelectasis though infection and aspiration cannot be completely excluded. Gaseous dilatation of a small bowel loop on the lateral view. Consider abdominal radiographs for further assessment.


SubjectID: 11028216, StudyID: 54505129, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with bilateral pleural effusions, s/p pleurex placement // s/p pleurex

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: After placement of thorax catheter on the right there is substantial interval decrease in right pleural effusion. Left PleurX catheter in the amount of left pleural effusion is difficult to appreciate since the patient has been differently position but the impression is that there is interval increase in the effusion. No pneumothorax is seen. Cardiomediastinal silhouette is unchanged.


SubjectID: 11028216, StudyID: 54201309, Comparison: None

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPH

INDICATION: ___ year old man with chf and bilateral recurrent pleural effusions s/p bialteral pleurx placement // eval effusions eval effusions

TECHNIQUE: AP portable chest radiograph.

COMPARISON: Chest radiograph from ___.

FINDINGS: Left-sided pacemaker remains in unchanged position, with leads terminating in the right atrium and right ventricle. Bilateral pleural effusions appear improved, however could also relate to patient's more erect positioning. Evaluation of the cardiac silhouette is limited. No pneumothorax is identified. No focal consolidation is seen. A right-sided pleural drain is unchanged.

IMPRESSION: Bilateral pleural effusions appear decreased in size, small on the right and moderate on the left, however these findings could also relate to patient's more erect positioning.


SubjectID: 11028216, StudyID: 54423272, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with dyspnea, cough // eval heart and lungs

COMPARISON: Prior study from ___. Chest CT from ___.

FINDINGS: AP portable semi upright view of the chest. Dual lead pacemaker is unchanged with leads extending to the region the right in right ventricle. Catheter tubing projects over the left upper quadrant likely representing a drain as seen on prior chest CT from ___. There is a partially layering right pleural effusion which is moderate to large in size. A left pleural effusion is small to moderate in size. Overall, there has been no significant change from prior exam   Keywords: no significant change. Heart size cannot be assessed. No large pneumothorax. Bony structures intact.

IMPRESSION: Unchanged from prior.


SubjectID: 11028216, StudyID: 53072882, Comparison: None

FINAL REPORT

INDICATION: ___M with R empyema s/p drainage evaluate for thoracentesis tube placement.

TECHNIQUE: Portable frontal chest radiograph was obtained.

COMPARISON: CT chest and chest radiograph from ___

FINDINGS: There has been interval placement of a right pleural catheter with minimal interval decrease in the size of the large loculated right pleural effusion. A small left pleural effusion is unchanged. The PleurX catheter projects over the left lung base. The cardiac silhouette remains moderately enlarged. There is no pneumothorax. Dual lead pacemaker is again noted with leads in unchanged positions. Included upper abdomen is unremarkable.

IMPRESSION: Status post placement of a right pleural catheter with minimal interval decrease in the large loculated right pleural effusion.


SubjectID: 11028216, StudyID: 51142171, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with h/o CHF (EF ___%, LVH, MR), AF on coumadin, CAD s/p NSTEMI (___, no PCI), pulmonary HTN (unclear etiology), HTN, DMII, schizophrenia, ___'s disease, and lymphoma presenting with worsening dyspnea x2days, with bilateral pleural effusions

TECHNIQUE: Frontal chest radiograph

COMPARISON: ___

FINDINGS: Moderate, bilateral pleural effusions are slightly larger . Left lower lobe opacity can atelectasis alone or a combination of atelectasis and pneumonia. P acer wires are unchanged in their expected locations. There is no pulmonary edema. No pneumothorax is seen. Cardiomediastinal silhouette is unchanged as compared to previous examination.

IMPRESSION: Bilateral effusions equivocally getting worse. Left lower lobe opacity which could be atelectasis alone or combination of atelectasis and pneumonia.


SubjectID: 11028216, StudyID: 50650504, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with pleural effusions s/p bilateral pigtails on evening of ___. Please obtain in the morning of ___ prior to 7am. // Interval change. Please obtain in the morning of ___ prior to 7am.

COMPARISON: ___

IMPRESSION: Bilateral pigtail pleural catheters remain in place, with persistent small left pleural effusion and probable minimal right pleural effusion. Worsening patchy bibasilar opacities may reflect atelectasis, aspiration, and less likely developing pneumonia. Short-term followup radiographs may be helpful in this regard.


SubjectID: 11028216, StudyID: 50514176, Comparison: None

WET READ: ___ ___ 11:07 AM There is a small right and moderate left pleural effusion with atelectasis of the bilateral lower lungs. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: Dyspnea in a patient with a history of pleural effusion.

COMPARISON: Chest radiograph from ___.

FINDINGS: Lung volumes are low, with chronic elevation of the right hemidiaphragm. There is a small right and moderate left pleural effusion with significant atelectasis of the bilateral lower lungs. There is pulmonary vascular engorgement and perihilar opacities suggestive of mild edema. There is no pneumothorax. Cardiac pacemaker and leads are present.

IMPRESSION: Findings suggestive of decompensated congestive heart failure, with pulmonary vascular engorgement, mild central pulmonary edema and bilateral pleural effusions.


SubjectID: 11033072, StudyID: 51838569, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: COPD, hypoxia, evaluation for pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is unchanged evidence of non-characteristic apical scarring as well as of moderate overinflation. Moderate cardiomegaly persists, and areas of atelectasis and bronchiectasis are seen in the lower lungs. There is no convincing evidence of a new parenchymal opacity, but the pre-existing right lower lobe opacity is slightly larger than on the previous image, raising concern for developing pneumonia, as previously noted. No pneumothorax.


SubjectID: 11033072, StudyID: 51645890, Comparison: worse

FINAL REPORT

EXAM: Chest, AP upright and lateral views. CLINICAL INFORMATION: Hypoxia.

COMPARISON: ___.

FINDINGS: Frontal and lateral views of the chest were obtained. The cardiac silhouette remains enlarged. There is prominence of the interstitial markings bilaterally suggesting mild interstitial edema. A more confluent area of opacity at the right lung base is seen, non-specific, could relate to underlying edema; however, consolidation due to aspiration or pneumonia is not excluded. The lungs remain hyperinflated, most consistent with chronic obstructive pulmonary disease. There is slight blunting of the right costophrenic angle which may be due to pleural thickening, although trace pleural effusion is not excluded.

IMPRESSION: Persistent enlargement of the cardiac silhouette. Increase in interstitial markings bilaterally suggests mild pulmonary edema   Keywords: increase. More confluent opacity at the right lung base, underlying aspiration or infection is not excluded. Slight blunting of the right costophrenic angle may be due to pleural thickening and underlying COPD, although a trace effusion is not excluded.


SubjectID: 11045286, StudyID: 59100060, Comparison: worse

FINAL REPORT

HISTORY: Atrial fibrillation on Coumadin and COPD, now with shortness of breath and productive cough. Evaluate for pneumonia, worsening edema/effusion, or other acute pulmonary process.

COMPARISON: Chest radiograph from ___.

FINDINGS: A portable frontal chest radiograph demonstrates multiple sternotomy wires with the inferior-most wire disrupted, unchanged. The cardiomediastinal silhouette is similar in appearance and there is increased vascular congestion   Keywords: increase. Increased retrocardiac opacity is likely secondary to atelectasis, but in the right clinical setting, pneumonia cannot be excluded. There is no pneumothorax or large pleural effusion.

IMPRESSION: 1. Increased vascular congestion   Keywords: increase. 2. Increased retrocardiac opacity is likely secondary to atelectasis, but in the right clinical setting, pneumonia cannot be excluded. These findings were communicated via telephone by ___, MD, to ___ ___, MS4/___, at ___ on ___.


SubjectID: 11047741, StudyID: 59566456, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p trach this AM. // position of trach position of trach

IMPRESSION: Comparison to ___. The patient has received a tracheostomy tube. The endotracheal tube was removed. The position of the tracheostomy tube is normal. No complications, notably no pneumothorax. Stable size of the cardiac silhouette and normal appearance of the lung parenchyma. The right internal jugular vein catheter is unremarkable.


SubjectID: 11047741, StudyID: 59189784, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CAD, dCHF, MCA stroke s/p PA arrest // fluid status; ? new consolidation, concern aspiration

TECHNIQUE: Single frontal view of the chest.

COMPARISON: Chest radiograph dated ___.

FINDINGS: Compared with chest radiograph from ___, poor aeration of the left lung base continues. Mild right lower lobe atelectasis is unchanged. Tracheostomy tube and right IJ line unchanged in standard placements. There is no focal consolidation, effusion or pneumothorax. There is no vascular engorgement or pulmonary edema. Moderate cardiomegaly continues to improve since ___.

IMPRESSION: 1. No evidence of cardiac decompensation. No evidence of aspiration or pneumonia. 2. Persistent moderate left lower lobe atelectasis and mild right lower lobe atelectasis. 3. Moderate cardiomegaly has been improving since ___.


SubjectID: 11047741, StudyID: 54781930, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with s/p cardiac arrest intubated // evaluate for pulmonary edema evaluate for pulmonary edema

IMPRESSION: ET tube tip is 3.7 cm above the carinal. NG tube passes below the diaphragm terminating in the stomach. Right internal jugular line tip is at the level of mid SVC. Cardiomegaly is severe. Mediastinal silhouette is stable. Large bilateral pleural effusions and bibasal consolidations are present. There is no pneumothorax.


SubjectID: 11047741, StudyID: 59319406, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___-year-old woman with weakness in 4 extremities x 2 weeks with subjective unilateral numbness.

TECHNIQUE: AP and lateral

COMPARISON: Chest radiograph ___.

FINDINGS: Moderate cardiomegaly is unchanged. There are small bilateral pleural effusions. Elevation of the left hemidiaphragm is new from ___. Right lung is grossly clear. There is mild interstitial edema. Median sternotomy wires are intact. Postsurgical catheter overlies the left hemithorax. Multiple lower thoracic compression deformities are new from ___. There are severe degenerative changes of the right acromioclavicular joint.

IMPRESSION: 1. Mild interstitial edema and small bilateral pleural effusions. 2. Elevation of the left hemidiaphragm, new from ___. 3. Unchanged moderate cardiomegaly. 4. Lower thoracic spine compression deformities new from ___, otherwise age indeterminate.


SubjectID: 11047741, StudyID: 58909076, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with altered mental status and leukocytosis // please eval for pna

COMPARISON: The comparison is made with prior studies including ___.

IMPRESSION: The evaluation of the left base is difficult due to patient rotation. There is no definite new consolidation present. There is no CHF or pneumothorax. There is stable cardiomegaly and postoperative change. There is no significant interval change   Keywords: no significant interval change.


SubjectID: 11047741, StudyID: 58892610, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (AP AND LAT)

INDICATION: History: ___F with weakness, cough

TECHNIQUE: Upright AP and lateral views of the chest

COMPARISON: Chest radiograph ___

FINDINGS: Patient is status post median sternotomy, CABG, with epicardial pacing leads noted projecting over the left heart border. Severe cardiomegaly is relatively unchanged compared to the previous study. Atherosclerotic calcifications are noted at the aortic knob. There is mild pulmonary vascular congestion, unchanged   Keywords: unchanged. Small pleural effusions are likely similar. There is no pneumothorax. No focal consolidation is present. No acute osseous abnormality is present.

IMPRESSION: Mild pulmonary vascular congestion and small bilateral pleural effusions, relatively unchanged from previous study   Keywords: unchanged. No focal consolidation.


SubjectID: 11047741, StudyID: 51184950, Comparison: None

FINAL REPORT

INDICATION: ___F with s/p aspiration? // eval for pna

TECHNIQUE: AP and lateral views of the chest.

COMPARISON: ___ at 09:00.

FINDINGS: Somewhat streaky right basilar opacity is noted. Small bilateral pleural effusions persist, not definitely changed given differences in positioning. Cardiomediastinal silhouette is stable. Median sternotomy wires, mediastinal clips, and abandoned epicardial leads are again noted.

IMPRESSION: Persistent small pleural effusions. Streaky right basilar opacity may be atelectasis although aspiration or infection would be difficult to exclude. No new confluent consolidation.


SubjectID: 11047741, StudyID: 53072486, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with PEA arrest, being diuresed // interval change

COMPARISON: The comparison is made with prior studies including ___.

IMPRESSION: Endotracheal tube tip is approximately 3 cm above the carina. Nasogastric tube tip is in the stomach. The right IV line is unchanged. There is no pneumothorax. There is persistent cardiomegaly with slight decrease an upper zone redistribution as compared to the earlier study. There are probable effusions in both lung bases. The left base is difficult to evaluate due to the cardiomegaly.


SubjectID: 11047741, StudyID: 54474316, Comparison: None

FINAL REPORT

EXAMINATION: Semi-upright portable chest radiograph

INDICATION: ___ year old woman with heart failure, intubated s/p arrest // Interval change?

TECHNIQUE: Semi-upright portable chest radiograph

COMPARISON: Chest radiograph from ___

FINDINGS: Compared to prior, the upper lobes are clear without evidence of pulmonary edema. Mild decreased cardiomediastinal silhouette is likely due to positioning. Small right pleural effusion and right basal atelectasis are unchanged compared to prior. There is stable appearance of retrocardiac opacity, likely combination of left basal atelectasis and small pleural effusion. Monitoring and support lines are unchanged in position, including esophageal probe coiling in the cervical esophagus with its tip in the oropharynx since ___. On the mediastinal anatomy wires are aligned is intact. Abandoned pacer leads project over the left lung.

IMPRESSION: 1. Esophageal probe with its tip in the oropharynx. 2. Stable bilateral minimal basal atelectasis and small pleural effusions.

NOTIFICATION: The findings were discussed with ___, ___ by ___, M.D. on the telephone on ___ at 11:54 AM, 15 minutes after discovery of the findings.


SubjectID: 11047741, StudyID: 51597836, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF s/p PEA arrest // Interval change

IMPRESSION: In comparison to ___ chest radiograph, mild pulmonary edema has resolved and a right pleural effusion has decreased in size   Keywords: resolve. The Support and monitoring devices are unchanged in position with persistent coiling of a catheter or tube overlying the lower cervical and upper thoracic region, potentially due to a structure external to the patient. Clinical correlation suggested.


SubjectID: 11047741, StudyID: 50925973, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with cardiac arrest, intubated/sedated // Please assess for interval change

IMPRESSION: Allowing for differences in technique, there has not been a relevant change in the appearance of the chest since recent study of 1 day earlier.


SubjectID: 11047741, StudyID: 50402679, Comparison: None

FINAL REPORT

HISTORY: PICC placement.

FINDINGS: In comparison with the earlier study of this date, the tip of the opaque wire within the PICC line extends only to the subclavian vein. There then is the suggestion of an ill-defined linear opacity that curls downward toward the region of the superior portion of the SVC. However, it is unclear whether this represents a true catheter or merely a fortuitous combination of shadows. This information was telephoned to ___, the IV nurse, indicating that the apparent tip of the catheter would be the appropriate distance correlating with her evaluation of the relative position of the wire with the tip of the tube. However, it is impossible to be completely certain that this is the situation.


SubjectID: 11052273, StudyID: 58377417, Comparison: None

WET READ: ___ ___ ___ 6:21 PM Mild edema. Mild to moderate cardiomegaly. Cardial pulmonary vascular congestion. No large pleural effusion. No pneumothorax. Elevation a left hemidiaphragm appears chronic similar to ___. No definite focal pneumonia. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with recurrent GI bleed, admitted with melena, leukocytosis. // ? PNA ? PNA

COMPARISON: Prior chest radiographs since ___ most recently ___.

IMPRESSION: Moderate cardiomegaly is comparable, but pulmonary vascular congestion and upper lobe redistribution of blood flow have developed. There is no pulmonary edema or appreciable pleural effusion. No pneumothorax. No focal consolidation to suggest pneumonia.


SubjectID: 11052273, StudyID: 57433211, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ y/o woman with hx multiple LGIB, severe diverticulosis, diastolic CHF, DM2 presenting with bloody stools and acute on chronic anemia, now with RVR 150s and new O2 requirement // new O2 requirement new O2 requirement

COMPARISON: ___

IMPRESSION: Heart size and mediastinum are stable. No change in mild cardiomegaly and prominence of the main pulmonary arteries present. Mild vascular congestion is present but there is no overt pulmonary edema. No appreciable pleural effusion or pneumothorax.


SubjectID: 11053589, StudyID: 59077937, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with post TAVR // volume status, post procedural cxr

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: Moderate cardiomegaly is a stable. Aorta stent is in unchanged position. Right IJ catheter sheath tip is in the confluence of the brachiocephalic veins. There is no pneumothorax or large pleural effusions. There is no pulmonary edema or lung consolidations with resolution of left opacity seen in the prior study.

IMPRESSION: Resolved opacities in the left mid lung. The lungs are clear.


SubjectID: 11053589, StudyID: 56374336, Comparison: None

FINAL REPORT

INDICATION: ___M w/ severe biscuspid AV, CM EF ___%, Afib RVR, T2DM, htn/hl, newly diagnosed cirrhosis, deemed not to be a candidate for surgical valve repair, now s/p TAVR // eval for interval changes

TECHNIQUE: AP chest x-ray

COMPARISON: ___

FINDINGS: Since the prior study, the patient has had a TAVR, which has the expected appearance. There is mildly increased opacity in the left midlung with peribronchial opacity that likely reflects a small amount of pulmonary edema. The right lung remains clear. Cardiomegaly persists.


SubjectID: 11053589, StudyID: 53612432, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with s/p TAVR // interval change interval change

IMPRESSION: The lung volumes are normal. Borderline size of the cardiac silhouette. Normal hilar and mediastinal contours. A previously seen right central venous access line has been removed in the interval. No pleural effusions. No pneumonia, no pulmonary edema.


SubjectID: 11055094, StudyID: 59651421, Comparison: worse

FINAL REPORT

HISTORY: ___-year-old male with shortness of breath and cough.

TECHNIQUE: Frontal and lateral chest radiographs were obtained.

COMPARISON: ___.

FINDINGS: Ovoid opacity projecting over the right mid lung likely represents fissural fluid and appears similar compared to prior. No new consolidation or pneumothorax is seen. Heart and mediastinal contours are stable. There is mildly increased interstitial prominence compared to prior. Aortic calcification is noted.

IMPRESSION: New mild interstitial prominence, which could represent mild edema or viral process   Keywords: new.


SubjectID: 11055094, StudyID: 50277612, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Positive PPD.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has received a double-lumen right-sided dialysis catheter. The catheter shows a normal course, the tip projects over the right atrium. There is no evidence of pneumothorax or other complications. Unchanged in appearance and size is a known intrafissural right-sided pleural effusion. No evidence of TB or other lung infection. No pulmonary edema. Mild cardiomegaly with tortuosity of the thoracic aorta.


SubjectID: 11055697, StudyID: 57929717, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p PEA arrest, with MOSF. // interval change

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: ET tube tip is 5 cm above the carinal. Cardiomegaly is unchanged. Mediastinal silhouette is stable. Mild improvement in pulmonary edema is demonstrated but large bilateral pleural effusions are unchanged   Keywords: improve. There is no pneumothorax.


SubjectID: 11055697, StudyID: 55312044, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with multiorgan failure and acute desaturation. // acute change, edema, pneumonia?

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___ obtained at 03:46

IMPRESSION: ET tube is 4.5 cm above the carinal. NG tube tip is in the stomach. Pulmonary edema appears to be slightly increased since the prior study associated with large bilateral pleural effusions   Keywords: increase.


SubjectID: 11055697, StudyID: 52995455, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman newly tranfered from OSH s/p PEA arrest with hypoxemic respiratory failure, ?CHF, liver and renal failure, intubated with R L central access // please evaluate for acute process

COMPARISON: None.

FINDINGS: An ET tube tip lies approximately is 6.1 cm above the carina, below the level of the clavicular heads. . An NG tube is present, tip overlying the stomach. No pneumothorax is detected. There is moderate cardiomegaly. Prominence of the mediastinal silhouette is noted, but could relate to vascular structures and supine positioning. Upper zone redistribution and diffuse vascular blurring is compatible CHF and inter, stitial edema. Hazy opacity at the right base could represent a small to moderate layering pleural effusion with underlying collapse and/or consolidation. There is increased retrocardiac density, consistent with left lower lobe collapse and/or consolidation. The left costophrenic sulcus is grossly clear.

IMPRESSION: 1. Lines and tubes as described. 2. Moderate cardiomegaly. 3. Increased upper zone vasculature and diffuse vascular blurring, consistent with CHF   Keywords: increase. 4. Bibasilar collapse and/or consolidation, with probable layering right effusion.


SubjectID: 11055697, StudyID: 52122702, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with shock, respiratory failure // evaluate interval change

IMPRESSION: As compared to ___ chest radiograph, cardiomegaly is accompanied by I improved pulmonary vascular congestion and persistent bilateral partially layering pleural effusions with adjacent bibasilar atelectasis and or consolidation   Keywords: improve.


SubjectID: 11055697, StudyID: 56952750, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with sCHF, ARF, dyspnea // acute intrathoracic process?

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the patient has been extubated and the nasogastric tube and the left central venous access line were removed. The right PICC line is in unchanged position and a new right hemodialysis catheter was inserted. No complications, notably no pneumothorax. Otherwise, the radiograph is not substantially changed. Mild cardiomegaly. Bilateral pleural effusions. Basal and retrocardiac atelectasis.


SubjectID: 11055697, StudyID: 54431074, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with COPD, CHF with acute aspiration event, desat to ___% // eval for aspiration, PNA

IMPRESSION: As compared to previous radiograph of 1 day earlier, allowing for differences in technique and positioning, there has not been a relevant change in the appearance of the chest.


SubjectID: 11055697, StudyID: 55864014, Comparison: None

FINAL REPORT

EXAMINATION: Portable AP chest radiograph

INDICATION: ___ year old woman with shock liver, renal failure on CRRT, intubated s/p PEA arrest at OSH // please evaluate for interval change

COMPARISON: Chest radiograph dated ___ at 1300h.

FINDINGS: ETT in standard position. Enteric tube traverses the midline and its tip and sideport are in the stomach. Right PICC line ends in the mid to upper SVC, unchanged. Left internal jugular venous catheter ends in the left brachiocephalic vein-SVC, pointing caudad. The heart is top-normal in size, unchanged. No mediastinal widening. The hila are within normal limits. No frank pulmonary edema. Retrocardiac opacity is unchanged, likely atelectasis. Overall no change in small right pleural effusion or atelectasis. Left pleural effusion, if present, is small. No pneumothorax.

IMPRESSION: No significant interval change in right atelectasis and effusion.


SubjectID: 11055697, StudyID: 53965319, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman intubated with new OGT. // placement OGT

IMPRESSION: Chest radiograph obtained for assessment of nasogastric tube placement demonstrates a nasogastric tube terminating in the stomach with side port below the level of the gastroesophageal junction. As compared to the recent chest radiograph from earlier the same date, pulmonary vascular congestion is accompanied by minimal interstitial edema   Keywords: same. Bilateral pleural effusions are again demonstrated, with interval improvement on the right and apparent slight worsening on the left. Positional differences may contribute to these apparent changes.


SubjectID: 11057357, StudyID: 59588973, Comparison: None

FINAL REPORT

HISTORY: Evaluate ET tube placement. New intubation. CHEST, SINGLE AP PORTABLE VIEW Rotated positioning. Allowing for this, the ET tube is present, tip approximately 4.5 cm above the carina. A left-sided pacemaker device is present, with tips over right atrium and right ventricle. Compared with ___ at 5:36 a.m., cardiomediastinal silhouette is unchanged, with cardiomegaly and prominence of the left ventricle. There is prominent patchy opacity in the right-greater-than-left upper zones, with subtle opacities in the right mid/lower zones and in the left perihilar region. These appear more extensive compared with ___, even allowing for differences in technique. Retrocardiac density consistent with left lower lobe collapse and/or consolidation is stable.Possible minimal blunting of the left costophrenic angle.

IMPRESSION: 1) Patchy pulmonary opacities, predominantly in right-greater-than-left upper zones, but also subtly present in lower zones, worse compared with ___. 2) Left lower lobe collapse and/or consolidation is stable.


SubjectID: 11057357, StudyID: 54186831, Comparison: better

FINAL REPORT

HISTORY: CHF, status post intubation for airway protection being diuresed. Question interval change, infiltrates too. CHEST, SINGLE AP PORTABLE VIEW. Lines and tubes are grossly unchanged. Dual-lead pacemaker again noted. Cardiomediastinal silhouette is enlarged but stable. The left hemidiaphragm is better visualized on the current examination. Increased retrocardiac opacity persists. Faint biapical opacities remain visible, possibly slightly improved. The mid and lower zones of the right lung are clear, except for minimal opacity in the cardiophrenic region, which also appears improved.

IMPRESSION: Lines and tubes and cardiomediastinal silhouette stable. Faint opacities remain visible, but have improved compared with ___ at 20:05 p   Keywords: improve.m.


SubjectID: 11057357, StudyID: 52788918, Comparison: better

FINAL REPORT

INDICATION: ___-year-old female with prior flash pulmonary edema.

COMPARISON: Radiograph available from ___. FRONTAL CHEST RADIOGRAPH: The heart is enlarged. A left-sided cardiac generator pack projects leads into the right atrium and ventricle. Since ___, the patient has been extubated and an orogastric tube removed. Bilateral upper zone opacities are improved. The hilar contours are within normal limits. There is no effusion, edema, or pneumothorax.

IMPRESSION: Improved bilateral upper zone opacities   Keywords: improve. No superimposed edema.


SubjectID: 11057357, StudyID: 59579128, Comparison: None

WET READ: ___ ___ ___ 7:16 PM Mod-severe cardiomegaly. Probable central venous congestion with cephalization of pulm vasculature. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___.

COMPARISON: ___. CLINICAL

HISTORY: Chest pain, shortness of breath, assess for pleural effusion.

FINDINGS: AP upright portable chest radiograph obtained. A dual-lead AICD projects over the left chest wall with lead tips extending into the right atrium and right ventricle as well as the tips extending along the epicardium at the level of the left atrium. There is mild pulmonary interstitial edema with cardiomegaly. No large pleural effusion is seen. No pneumothorax.

IMPRESSION: Cardiomegaly with interstitial edema.


SubjectID: 11057357, StudyID: 57518928, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Likely COPD exacerbation, intubation.

COMPARISON: ___, 7:33 p.m.

FINDINGS: As compared to the previous radiograph, the position of the endotracheal tube, the nasogastric tube, the pacemaker wires and the right central venous access line are unchanged. The previously seen right upper lobe predominant opacities are minimally decreased. This could be defect of increased ventilatory pressure. The size of the cardiac silhouette is unchanged. No parenchymal opacities have newly appeared. Currently, there is no evidence of pulmonary edema.


SubjectID: 11057357, StudyID: 53156857, Comparison: worse

WET READ: ___ ___ ___ 7:20 PM ETT 3 cm from carina, retract 2 cm. Mod-severe cardiomegaly. Inc mild edema and venous congestion with cephalization of pulm vasculature. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: Prior study from earlier today. CLINICAL

HISTORY: Intubated, assess ET tube position.

FINDINGS: AP supine portable chest radiograph obtained. Interval placement of an endotracheal tube which is seen with its tip approximately 2.7 cm above the carina. There has also been placement of an orogastric tube with its tip coiled in the left upper abdomen. There is increased opacity in the upper lungs bilaterally, right greater than left, which given the interval change could reflect aspiration. Cardiomegaly is unchanged. AICD is also unchanged.

IMPRESSION: ET and OG tubes positioned appropriately. Increased opacities in the upper lungs, right greater than left, question aspiration   Keywords: increase.


SubjectID: 11057357, StudyID: 54547730, Comparison: None

FINAL REPORT

INDICATION: Dyspnea and congestive heart failure. Evaluate for fluid overload.

COMPARISON: Chest radiographs ___, ___ and ___.

TECHNIQUE: Upright PA and lateral radiographs of the chest.

FINDINGS: Left chest wall pacer defibrillator has leads terminating in the right atrium and right ventricle as well as epicardial leads on the left ventricle. The lungs are slightly hyperexpanded with flattening of the hemidiaphragms similar to the prior study. The heart is not enlarged. The mediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. There is no focal airspace opacity to suggest pneumonia and no evidence of pulmonary edema.

IMPRESSION: No acute cardiopulmonary abnormality. No evidence of pneumonia or pulmonary edema.


SubjectID: 11057357, StudyID: 54235322, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF and COPD exacerbation and new cough // pneumonia, edema, effusion

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is noted   Keywords: no relevant change. The size of the cardiac silhouette has slightly increased, caused by LS a inspiratory air Ford. There is no evidence of pneumonia, pulmonary edema or pleural effusions. The pacemaker leads are constant in position.


SubjectID: 11057357, StudyID: 51017605, Comparison: None

WET READ: ___ ___ ___ 7:04 PM No substantial change from prior. NG tube not visualized.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with severe constipation and dropping Hct // NGT placement

COMPARISON: ___

IMPRESSION:

FINDINGS: As compared to the previous radiograph, the size of the cardiac silhouette has minimally decreased and the lung volumes have minimally increased, likely reflecting a stronger inspiratory effort Ford. There is no evidence of pneumonia. No pulmonary edema. No pleural effusions. Unchanged course of the pacemaker leads. On the current radiograph. There is no evidence for nasogastric tube placement.


SubjectID: 11057357, StudyID: 51816479, Comparison: None

FINAL REPORT

PORTABLE AP CHEST FILM, ___ AT 12:17 CLINICAL

INDICATION: ___-year-old with CHF flare, now with worsening respiratory status, new leukocytosis, question pneumonia. Comparison to ___ at 19:04. Portable AP upright chest film, ___ at 12:17 is submitted.

IMPRESSION: Dual-lead left-sided pacer in place with the leads terminating over the expected location of the right atrium and right ventricle, respectively. The heart remains enlarged with the left ventricular prominence, suggestive of left ventricular hypertrophy. The aorta remains somewhat tortuous. Streaky layering opacities in both upper lungs as well as at the right base are stable, most likely reflecting post-inflammatory scarring or parenchymal changes related to underlying emphysema. In either case, there does not appear to be superimposed pulmonary edema or a definite acute infectious process. Followup imaging should be considered if the patient's symptoms persist or worsen. No pneumothorax. No pleural effusions.


SubjectID: 11057357, StudyID: 51316689, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Dyspnea and desaturation.

COMPARISONS: ___.

TECHNIQUE: Chest, portable AP upright.

FINDINGS: A pacemaker/ICD device appears unchanged. The heart is again moderately enlarged with a left ventricular configuration. The aorta is mildly tortuous. The cardiac, mediastinal and hilar contours appear unchanged. There is no definite pleural effusion. No pneumothorax is demonstrated. The lungs appear clear.

IMPRESSION: No evidence of acute disease.


SubjectID: 11098660, StudyID: 59920147, Comparison: None

WET READ: ___ ___ ___ 7:37 PM No acute cardiac or pulmonary process.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

AP CHEST, 5:52 P.M. ___

HISTORY: A ___-year-old man with chest pain and cough.

IMPRESSION: PA and lateral chest compared to ___ and ___ at 9:50 a.m.: Severe cardiomegaly which progressed between ___ and ___ has increased slightly over the past 10 days. Pulmonary vascular engorgement is minimal if any, and mediastinal veins are also only slightly larger. Patient has had median sternotomy and aortic valve replacement. Clinical consideration should be given to the clinical significance of increasing cardiac diameter, including possible pericardial effusion. There is no pneumonia and no pleural effusion currently.


SubjectID: 11098660, StudyID: 52749837, Comparison: None

FINAL REPORT

HISTORY: Right pleural effusion

COMPARISON: Chest radiograph ___ through ___.

FINDINGS: Two PA and 1 lateral chest radiograph were obtained. The lungs are well expanded and clear. There is no focal consolidation, effusion or pneumothorax. Median sternotomy wires and aortic valve replacement are intact. Mild cardiomegaly is stable.

IMPRESSION: Resolution of right pleural effusion. No acute cardiopulmonary process.


SubjectID: 11098660, StudyID: 58411833, Comparison: better

FINAL REPORT

INDICATION: ___ year old man with s/p redo, AVR, Asc. aorta-- CTs d/c'd // evaluate for pneumothorax

TECHNIQUE: Portable AP chest

COMPARISON: Chest radiographs ___ and ___.

FINDINGS: Right internal jugular central venous catheter terminates in the upper SVC. Median sternotomy wires appear intact. Pleural drains have been removed. Lung volumes remain low with bibasilar atelectasis. Moderate cardiomegaly is unchanged. Faint lucency along the left heart border is diminishing, likely reflecting resolving pneumopericardium. Mild interstitial pulmonary edema is improved   Keywords: improve. There is no large pleural effusion or pneumothorax.

IMPRESSION: 1. Stable mild cardiomegaly with mild improved interstitial pulmonary edema   Keywords: improve. 2. No pneumothorax.Resolving pneumopericardium.


SubjectID: 11098660, StudyID: 50841392, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with as above // s/p redo AVR/ascending aorta replacement w/dropping HCT r/o effusion

TECHNIQUE: Plain film

COMPARISON: ___ at ___ 26

FINDINGS: Portable semi upright AP chest radiograph shows tip of the into tracheal tube 5 cm above the chronic, and no change in positioning of the Swan-Ganz catheter, mediastinal catheter and nasogastric tube. The left hemidiaphragm remains obscured and left basilar consolidation appears denser but lucency paralleling the heart on the earlier study is less pronounced suggesting decreasing pneumopericardium.

IMPRESSION: Increasing left basilar consolidation/ atelectasis and decreasing pneumopericardium


SubjectID: 11098660, StudyID: 57595015, Comparison: worse

FINAL REPORT

HISTORY: ___-year-old man with A/V endocarditis, story of paravalvular leak, closure today for AV dehiscence. New clinical symptoms with HTN and desaturation. Pulmonary edema?

TECHNIQUE: Chest x-ray in 2 projections.

COMPARISON: exam is compared with ___.

FINDINGS: Endotracheal tube and Swan ganz were placed, the latter has the tip in the outflow tract The alignment of the sternotomy wires is unchanged. Heart appears bigger, with increased perihilar vascular drawings for vascular congestion   Keywords: increase. There is pleural effusion on the left side. No signs of pneumothorax

IMPRESSION

IMPRESSION: There is an increased vascular congestion along with pleural effusion on the left side   Keywords: increase. Positioning of monitoring device


SubjectID: 11098660, StudyID: 55506538, Comparison: same

FINAL REPORT

INDICATION: History of fevers and shortness of breath. Please evaluate for an intrathoracic process.

COMPARISON: Multiple chest radiographs dated back to ___ as well as CTA chest from ___.

TECHNIQUE: Single AP portable exam of the chest.

FINDINGS: There has been interval removal of an ET tube. The Swan-___ catheter is in appropriate position with the tip in the outflow tract. There is stable mild-to-moderate cardiomegaly with pulmonary vascular congestion and mild pulmonary edema   Keywords: stable. There appears to be a more crowded appearance to the bronchopulmonary vasculature compared to the prior exam, likely secondary to poor inspiratory effort. There is no pneumothorax. No large pleural effusion is seen. Note is made of a prosthetic aortic valve and median sternotomy wires.

IMPRESSION: 1. Mild bilateral pulmonary edema. 2. There appears to be a more crowded appearance to the bronchopulmonary vasculature compared to the prior exam, likely secondary to a poor inspiratory effort.


SubjectID: 11098660, StudyID: 56378519, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with swan-ganz cath // placement

COMPARISON: ___

IMPRESSION: As compared to the previous image, there is unchanged correct position of the Swan-Ganz catheter. Mild cardiomegaly, the sternal wires are intact. No evidence of pulmonary edema. Pleural effusions or pneumonia.


SubjectID: 11098660, StudyID: 56049447, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with PA line // ___ placemet

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the Swan-Ganz catheter is in unchanged position. The size of the cardiac silhouette has mildly increased but there is no evidence of pulmonary edema   Keywords: increase. No pleural effusions. No pneumonia.


SubjectID: 11098660, StudyID: 55475063, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i

INDICATION: ___ year old man with AI, dCHF, pulm a placement // PA catheter placement

COMPARISON: Chest radiographs ___.

IMPRESSION: New Swan-Ganz catheter ends in the right pulmonary artery. No pneumothorax, pleural effusion, or mediastinal widening. Patient has had median sternotomy. Moderate cardiomegaly is chronic, but improved since ___. Lungs are fully expanded and clear. Pulmonary vasculature is normal. There is a definite sternal wound lucency. Unless the patient has had recent sternotomy, it should be be evaluated clinically to look for evidence of an unstable sternum. Sternal wires are intact and aligned.


SubjectID: 11098660, StudyID: 55639066, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i

INDICATION: ___ year old man s/p CABG, redo x5, bentall // eval for pleural effusions

COMPARISON: Chest radiographs ___ through septae ___.

IMPRESSION: Right middle lobe is still collapsed. Cardiomediastinal silhouette is a normal postoperative appearance. Sternum is still open. Bilateral pleural drains in place. No pneumothorax or substantial pleural effusion. There is no pulmonary edema. Tip of the endotracheal tube is above the upper margin of the clavicles, no less than 8.5 cm from the carina. It should be advanced 3-4 cm for more secure seating. Tip of the Swan-Ganz catheter projects over the main or proximal right pulmonary artery. Nasogastric drainage tube ends in the upper portion of the nondistended stomach.


SubjectID: 11098660, StudyID: 55017438, Comparison: better

FINAL REPORT

INDICATION: Status post CABG.

COMPARISON: Compared to prior radiographs from ___.

IMPRESSION: Lines and tubes are unchanged in position. There is unchanged cardiomegaly. There is mild improved aeration at the right base. There remains mild pulmonary vascular congestion, slightly improved   Keywords: improve. No pneumothoraces are present.


SubjectID: 11098660, StudyID: 52025444, Comparison: None

WET READ: ___ ___ 11:44 AM NSR

WET READ VERSION #1 ___ ___ ___ 12:20 AM Endotracheal tube terminates 5.5 cm above the Carina. Swan-Ganz catheter, orogastric tube and chest tubes appear in a good position. There are probably small bilateral pleural effusions. There is mild pulmonary vascular congestion. No significant pneumothorax identified. NSR ______________________________________________________________________________

FINAL REPORT

INDICATION: ___ year old man s/p Sternal washout and closure // FAST TRACK EARLY EXTUBATION CARDIAC SURGERY

IMPRESSION: Endotracheal tube terminates 5.5 cm above the carina. Swan-Ganz catheter, orogastric tube and chest tubes appear in a good position. There is mild pulmonary vascular congestion. No pneumothorax is identified. There has been reduction in the fluid within the right minor fissure.


SubjectID: 11124675, StudyID: 59955274, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post fall, shock, respiratory failure, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the monitoring and support devices are unchanged, except for the removal of a right internal jugular vein introduction sheath. Lung volumes continue to be low. The tip of the endotracheal tube projects 3.7 cm above the carina. There is moderate cardiomegaly and mild-to-moderate pulmonary edema with likely presence of mild-to-moderate bilateral pleural effusions. Relatively extensive retrocardiac atelectasis. No other changes   Keywords: no other change.


SubjectID: 11124675, StudyID: 59225926, Comparison: same

FINAL REPORT

HISTORY: Hypoxic respiratory failure.

FINDINGS: In comparison with the study of ___, there is some improvement in the diffuse infiltrative pulmonary abnormality that most likely reflects pulmonary edema, especially in view of the continued enlargement of the cardiac silhouette   Keywords: continue. Poor definition of the right hemidiaphragm with hazy opacification at the base, suggests layering effusion with compressive atelectasis. Left hemidiaphragm is also not well seen, consistent with volume loss in the lower lobe. Nasogastric tube extends well into the stomach. Right IJ sheath remains in place.


SubjectID: 11124675, StudyID: 52819409, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluation for interval change.

COMPARISON: ___, 11:17.

FINDINGS: As compared to the previous radiograph, the patient has been extubated and the endotracheal tube has been replaced by a tracheostomy tube. The position of the tracheostomy tube is unremarkable, its tip projects approximately 3.8 cm above the carina. The course of the nasogastric tube and the right PICC line are unchanged. Slightly more severe than on the previous exam are the very widespread bilateral parenchymal opacities, that has a reticulonodular appearance on the image. Unchanged moderate cardiomegaly with retrocardiac atelectasis and a likely very small left effusion.


SubjectID: 11124675, StudyID: 53568337, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Respiratory failure, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The monitoring and support devices are constant. Moderate pulmonary edema. Borderline size of the cardiac silhouette. The presence of small pleural effusion cannot be excluded. Moderate retrocardiac atelectasis. No newly appeared focal parenchymal opacities   Keywords: new.


SubjectID: 11124675, StudyID: 59134208, Comparison: None

FINAL REPORT

EXAM: Chest, AP portable view. CLINICAL INFORMATION: ___-year-old female with history of intubation.

COMPARISON: ___ at 16:17.

FINDINGS: Single AP portable view of the chest was obtained. Endotracheal tube is seen terminating approximately 4.6 cm above the level of the carina. Nasogastric tube is seen, coursing below the level of the diaphragm, distal tip not well seen. There are diffuse bilateral airspace opacities worrisome for severe pulmonary edema. Cardiac silhouette is mildly enlarged. No large pleural effusion or pneumothorax is seen, although the right costophrenic angle is not fully included on the image.


SubjectID: 11124675, StudyID: 56681984, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Respiratory failure, intubation, evaluation for interval change.

COMPARISON: ___, 3:30 p.m.

FINDINGS: As compared to the previous radiograph, there is little overall change   Keywords: little overall change. The widespread, part reticular and part alveolar opacities in both lungs are constant. There is no evidence of severe interstitial fluid overload. No evidence of pleural effusions. Unchanged borderline size of the cardiac silhouette with moderate bilateral areas of atelectasis.


SubjectID: 11124675, StudyID: 56571285, Comparison: same

FINAL REPORT

INDICATION: ___-year-old woman, intubated status post self-extubation, now reintubated. Evaluate tube placement.

COMPARISONS: Chest port line placement from ___. Portable AP chest radiograph from ___.

FINDINGS: There is an ET tube in place with the tip approximately 3 cm from the carina. A right PICC line is present with the tip now in the distal SVC. Compared to the prior radiograph, there has been no significant change   Keywords: no significant change. Again seen are bilateral diffuse pulmonary opacities and cardiomegaly.

IMPRESSION: ET tube in good position. Right PICC catheter tip now in the distal SVC. No significant change from prior radiograph   Keywords: no significant change.


SubjectID: 11124675, StudyID: 51739989, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Bilateral opacities, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the monitoring and support devices are in unchanged position. There is evidence of widespread bilateral severe parenchymal opacities with diffuse distribution. The opacities are unchanged in severity and extent since several previous radiographs, part of which come from outside hospitals   Keywords: unchanged. Unchanged moderate cardiomegaly and retrocardiac atelectasis.


SubjectID: 11124675, StudyID: 50254338, Comparison: same

FINAL REPORT

INDICATION: ___-year-old woman status post bronchoscopy and esophageal balloon placement. Evaluate for pneumothorax.

COMPARISONS: Portable AP chest radiograph from ___.

FINDINGS: Since the most recent prior radiograph, there has been no significant change   Keywords: no significant change. There is no pneumothorax or pneumomediastinum. Support lines and tubes are unchanged in position.


SubjectID: 11124675, StudyID: 58331311, Comparison: better

FINAL REPORT

AP CHEST, 2:38 A.M. ON ___

HISTORY: Persistent ventilator requirement.

IMPRESSION: AP chest compared to ___ through ___: Since ___, previous mild pulmonary edema has improved if not cleared   Keywords: improve. Heart size normal, but decreased. Nevertheless, there is compression of possible left atrial enlargement. ET tube is in standard placement, nasogastric tube passes below the diaphragm and out of view, and a right PIC line ends low in the SVC. No pneumothorax.


SubjectID: 11124675, StudyID: 56596422, Comparison: same

FINAL REPORT

INDICATION: ___-year-old woman, intubated, question interval change.

COMPARISONS: Multiple prior radiographs, most recently portable AP radiograph from ___.

FINDINGS: ET tube is 5.6 cm from the carina. NG tube is seen coursing below the diaphragm; however, is not completely imaged. Since the most recent prior radiograph, lung volumes are slightly lower. There is no focal consolidation, pleural effusion, or pneumothorax. Cardiomediastinal silhouette is unchanged. A right PICC line has been removed.

IMPRESSION: Slightly lower lung volumes. Otherwise, no significant change   Keywords: no significant change.


SubjectID: 11124675, StudyID: 50631255, Comparison: better

FINAL REPORT

INDICATION: ___-year-old female with respiratory failure, remains intubated.

COMPARISON: ___. CHEST, AP: Endotracheal tube has been retracted, and now terminates 5.9 cm above the carina. Nasogastric tube courses through the stomach and inferiorly beyond the film. There is no significant pneumothorax or pleural effusion. Right lower lobe atelectasis has decreased. Heart size is top normal. There has been interval improvement in mild interstitial pulmonary edema. Continued central venous congestion.

IMPRESSION: Decreased pulmonary edema   Keywords: decrease.


SubjectID: 11124675, StudyID: 58164054, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: To evaluate for the position of the Dobbhoff tube.

TECHNIQUE: Single supine portable chest view was read in comparison with multiple prior radiographs with the most recent from ___.

FINDINGS: A newly positioned Dobbhoff tube ends into the fundus/body of the stomach. An orogastric tube courses below the diaphragm into the stomach; however, its distal end is off the radiographic view. Right-sided PICC line tip is at mid SVC and tracheostomy tube is in standard position. Bilateral lungs are diffusely hazy with obscuration of bronchovascular markings, suggestive of mild pulmonary edema, is little more sever since ___. The upper left mediastinal shadow at the aortic arch is more prominent with lateral bulge than it was on ___. If this reflects engorged mediastinal vessels or acute aortic pathology, cannot be determined on this supine view alone. Pleural effusions, if any, are minimal bilaterally. Top-Normal heart size is unchanged, aorta is generally tortuous, and the mediastinal and hilar contours have a stable appearance.

IMPRESSION; In order to differentiate recent widening of left upper mediastinum due to engorged mediastinal vessels which appears reasonable as reflected by interval worsening mild pulmonary edema vs acute aortic pathology, erect view is recommended for further evaluation   Keywords: worse.


SubjectID: 11124675, StudyID: 54326095, Comparison: same

CLINICAL INFORMATION & QUESTIONS TO BE ANSWERED: ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: ARDS, assessment for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Unchanged evidence of minimal interstitial fluid overload   Keywords: unchanged. Minimal atelectasis at the right lung base. Borderline size of the cardiac silhouette. No overt pulmonary edema. No pleural effusions. No pneumonia.


SubjectID: 11124675, StudyID: 53453335, Comparison: None

FINAL REPORT

AP CHEST 4:20 A.M., ___

HISTORY: COPD, obesity, hypoventilation. Delirium. Intubated.

IMPRESSION: Views of the torso centered at the diaphragm and in the left upper abdominal quadrant show a nasogastric feeding tube, absent. The wire stylet, ending in the mid stomach. Volumes are still low and mediastinal widening is most likely due to vascular engorgement. Aside from right basal atelectasis there is no focal pulmonary abnormality. Pulmonary edema which was present on ___, not recurred. Tracheostomy tube in standard placement.


SubjectID: 11124675, StudyID: 57907252, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old woman with acute increase in FiO2 requirement, concern for aspiration or acute process.

COMPARISONS: Multiple prior radiographs, most recently portable AP radiograph from ___.

FINDINGS: Since prior radiograph, the lung volumes are increased; however, there appears to be increased bilateral diffuse opacities likely due to pulmonary edema. A more focal consolidation at the right base is concerning for atelectasis or possible aspiration. ET tube is 7 cm from the carina. NG tube is seen coursing below the diaphragm. No pneumothorax. Cardiomediastinal silhouette is unchanged.

IMPRESSION: Interval worsening of bilateral diffuse opacities in the setting of increased lung volumes is concerning for worsening pulmonary edema   Keywords: increase, worse. Also focal opacity at the right base may represent aspiration. These findings were discussed with Dr. ___ by Dr. ___ ___ telephone at 4 p.m.


SubjectID: 11124675, StudyID: 54990948, Comparison: None

FINAL REPORT

AP CHEST 10:57 A.M. ___

HISTORY: Diffuse alveolar hemorrhage. Swan-Ganz placement.

IMPRESSION: AP chest compared to ___ at 8 p.m.: Swan-Ganz catheter has been advanced to the right descending pulmonary artery and should be withdrawn 3 cm to avoid inadvertent cannulation of a small arterial branch. Top normal heart size, unchanged. There has been an increase in pulmonary vascular effusion, but no strong evidence for recurrence of pulmonary hemorrhage. Dr. ___ was paged to discuss these findings at the time of dictation.


SubjectID: 11124675, StudyID: 50155102, Comparison: None

FINAL REPORT

HISTORY: CIOD, OSA, hypoxic failure. CHEST, SINGLE AP PORTABLE VIEW. An ET tube is present, tip approximately 6.1 cm above the carina. An NG tube is present, tip beneath diaphragm off film. A right IJ central line is present, tip over distal IJ, near confluence with subclavian. A PICC line is present, tip partially obscured, but likely overlying distal SVC. There is rotated positioning. Allowing for this, there is probable cardiomegaly. There is upper zone re-distribution and diffuse vascular blurring, consistent with CHF. There is some patchy retrocardiac opacity, with air bronchograms, though the left hemidiaphragm remains visible. No gross effusion.

IMPRESSION: 1. Lines and tubes, as described. 2. Probable cardiomegaly, unchanged. 3. CHF, with interstitial edema. 4. Left lower lobe collapse and/or consolidation.


SubjectID: 11124675, StudyID: 57579023, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hypoxia and confusion. Evaluate for change in pulmonary edema or effusion.

TECHNIQUE: Portable AP radiograph of the chest from ___.

COMPARISON: ___.

FINDINGS: Mild pulmonary edema is slightly increased   Keywords: increase. There is stable cardiomegaly and unchanged mediastinal widening, which is due to a combination of prominent mediastinal fat, lymphadenopathy and prominent vasculature. There is no pneumothorax. No appreciable interval

IMPRESSION: Slight interval worsening of mild pulmonary edema with stable cardiomegaly   Keywords: worse.


SubjectID: 11124675, StudyID: 54827982, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with hypoxia // Eval for cardiopulmonary process

TECHNIQUE: Portable AP view of the chest

COMPARISON: Chest CT on ___.

FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is mildly engorged and there is mild septal thickening consistent with mild pulmonary edema. No pleural effusion or pneumothorax is seen.

IMPRESSION: Mild pulmonary vascular engorgement consistent with mild pulmonary edema.


SubjectID: 11124675, StudyID: 57516354, Comparison: None

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old woman with morbid obesity.

FINDINGS: Comparison is made to previous study from ___. Endotracheal tube, feeding tube, and right-sided PICC line are unchanged in position. There is prominence of pulmonary interstitial markings and cardiomegaly. No large pneumothoraces are seen. Overall, the findings are stable.


SubjectID: 11124675, StudyID: 52972230, Comparison: better

FINAL REPORT

PORTABLE AP CHEST FILM ___ AT 13:30 CLINICAL

INDICATION: Question tip position. Portable semi-erect chest film ___ at ___ submitted and compared to the prior study of ___ at 3:09.

IMPRESSION: The right subclavian PICC line is seen with its tip in the mid SVC. A nasogastric tube is seen coursing below the diaphragm with the tip not identified. The pulmonary edema appears to be improving   Keywords: improving. Overall, cardiac size is stable. The left upper lung is not included on the current examination. Results of the PICC position were communicated by phone to ___, the IV nurse on ___ at 2:12 p.m.


SubjectID: 11124675, StudyID: 52960556, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old woman with respiratory failure thought to be ARDS, question interval change.

COMPARISONS: Multiple prior radiographs, most recently from ___.

FINDINGS: Since the most recent prior radiograph, the lung volumes are low. There is now increasing opacity at the right lower lung zone most likely due to aspiration. Also seen is increased prominence of pulmonary vasculature likely worsening pulmonary edema   Keywords: increase, worse. ET tube is 3.3 cm from the carina. NG tube is seen but cannot be followed distal to the diaphragm. There is a right PICC line which is unchanged in position. Cardiomediastinal silhouette is stable.

IMPRESSION: 1. Increasing opacity in the right lower lung zone consistent with aspiration. 2. Worsening pulmonary edema and low lung volumes   Keywords: worse. These findings are communicated with Dr. ___ by Dr. ___ ___ telephone at 9:40 a.m.


SubjectID: 11124675, StudyID: 52473039, Comparison: None

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old woman with respiratory failure, pulled out OG tube, now has been replaced.

FINDINGS: There has been placement of a feeding tube whose distal tip and sideport are below the gastroesophageal junction appropriately sited. Lower lung fields are grossly clear.


SubjectID: 11124675, StudyID: 57474669, Comparison: same

FINAL REPORT

TYPE OF

EXAMINATION: Chest, AP portable single view.

INDICATION: ___-year-old female patient with hypoxic respiratory failure, evaluate interval change.

FINDINGS: AP single view of the chest has been obtained with patient in sitting semi-upright position. Analysis is performed in direct comparison with the next preceding similar study dated ___. The patient remains on the respirator, the ETT in unchanged position. The same holds for the NG tube which reaches well into the stomach. Unchanged position of previously described PICC line, terminating overlying mid portion of SVC. The lungs remain clear, and compared with the next preceding study, no interval change can be identified   Keywords: no interval change.

IMPRESSION: Stable chest findings during latest one day examination interval. No new pulmonary abnormalities and no pneumothorax.


SubjectID: 11126593, StudyID: 55713842, Comparison: None

FINAL REPORT

AP CHEST, 12:09 P.M. ON ___

HISTORY: ___-year-old man with a single-chamber pacemaker. Evaluate for pneumothorax.

IMPRESSION: AP chest compared to ___: Tip of the new left subclavian transvenous pacemaker lead projects over the floor of the distal right ventricle. Moderate cardiomegaly is stable. Small left apical pneumothorax is new. Lung volumes are low causing crowding of vessels, but there is no pulmonary edema. Atelectasis at the base of the right lung in either middle or lower lobe is new. Dr. ___ was paged at 1:34 p.m., one minute following recognition of radiographic findings and we discussed the findings by telephone at 1:36p.m.


SubjectID: 11126593, StudyID: 55458121, Comparison: None

FINAL REPORT

HISTORY: ___-year-old male with atrial fibrillation status post pacemaker placement with pneumothorax. Evaluate for change.

COMPARISON: ___, ___.

FINDINGS: A left apical pneumothorax is not significantly changed though remains small. A left chest pacemaker with a single right ventricular lead is unchanged. The lung volumes remain somewhat low, though are improved compared with prior. There is a probable small right pleural effusion with bibasilar atelectasis. The pulmonary vasculature is normal. The cardiac silhouette and mediastinal contours are unchanged.

IMPRESSION: Residual small left apical pneumothorax.


SubjectID: 11127819, StudyID: 59502534, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with heart failure // eval placement of PA catheter

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Swan-___ catheter tip is at the level of the right main pulmonary artery. Biventricular pacer is in unchanged position. Cardiomegaly is moderate, unchanged. Mediastinal contours are stable. No interval increase in interstitial opacities demonstrated   Keywords: increase. No pneumothorax is seen.


SubjectID: 11127819, StudyID: 50172455, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF with PA catheter // eval swan position

IMPRESSION: Swan-Ganz catheter tip terminates in the right hilum within the expected location of the interlobar right pulmonary artery. Stable cardiomegaly, pulmonary vascular congestion and interstitial edema   Keywords: stable.


SubjectID: 11127819, StudyID: 51979301, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with fevers, cough // eval for pneumonia

IMPRESSION: As compared to ___ chest radiograph, Swan-Ganz catheter has been removed, with no visible pneumothorax. Cardiomegaly is stable in appearance and interstitial edema has slightly decreased in severity   Keywords: decrease. Increased opacity overlying the lower thoracic spine on the lateral view raises a concern for basilar pneumonia, probably in the right lower lobe based on increased opacity of the right retrocardiac region on the PA view. Lungs remain hyperinflated, consistent with emphysema. .


SubjectID: 11148580, StudyID: 57284997, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old male with respiratory distress status post ET tube positioning. Question location.

COMPARISON: ___.

FINDINGS: Single frontal view of the chest demonstrates an ET tube ending 5.6 cm above the carina. An enteric tube traverses inferiorly out of view with side port below the GE junction. A left subclavian approach Port-A-Cath has tip terminating in the lower SVC. The heart is prominent. The lungs are mildly hyperinflated, consistent with known emphysema. There is increased hazy opacities in the left upper lung, which likely represents asymmetric edema, versus consolidation   Keywords: increase. There is also right upper upper lung opacity, raising question of consolidation. There is also subsegmental volume loss in the lower lung zones. Previously seen right lower lobe consolidation has improved.

IMPRESSION: 1. Appropriate ET tube positioning. 2. Prominent cardiac contour and increased left greater than right upper lung opacification, likely representing cardiac decompensation and asymmetric edema   Keywords: increase. 3. Can't exclude supervening infection in the upper lungs. Consider reevaluation following treatment for pulmonary edema. Improving right lower lobe consolidation. 4. Severe emphysema, basal predominant, in keeping with known Alpha-1 antitrypsin deficiency.


SubjectID: 11148580, StudyID: 52786469, Comparison: same

FINAL REPORT

INDICATION: Patient with history of alpha-1 antitrypsin deficiency, now with respiratory failure.

COMPARISONS: Chest radiographs from ___ to ___ and CTA chest of ___.

FINDINGS: AP portable view of the chest demonstrates ET tube terminating 6.6 cm above the carina. Nasogastric tube is seen coursing through the esophagus, its tip out of field of view. Left subclavian central venous catheter tip projects over cavoatrial junction. Diffuse bilateral rounded lucencies predominantly at the lung bases signify emphysema, better assessed on CT exam of ___. There is no pleural effusion or pneumothorax. Hilar and mediastinal silhouettes are unchanged. Heart size is normal. Perihilar vascular congestion is noted. Upper lobe heterogeneous opacities, left greater than right, are unchanged, which may represent infection or asymmetric pulmonary edema   Keywords: unchanged. Retrocardia opacity is new since ___.

IMPRESSION: 1. Heterogeneous opacities in the upper lungs, left greater than right, not significantly changed since ___ exam. Retrocardiac opacity is new since prior. Above findings may represent asymmetric pulmonary edema or multifocal infection 2. Moderate emphysema with basal predominance, compatible with patient's given history of alpha-1 antitrypsin deficiency.


SubjectID: 11151938, StudyID: 57389232, Comparison: None

FINAL REPORT

HISTORY: Pacer leads, to exclude pneumothorax.

FINDINGS: In comparison with study of ___, the pacer leads are in the region of the right atrium and apex of the right ventricle. Low lung volumes accentuate the prominence of the transverse diameter of the heart. No definite evidence of pneumothorax.


SubjectID: 11151938, StudyID: 53020796, Comparison: same

WET READ: ___ ___ 8:56 PM Low lung volumes. No evidence of pneumothorax. Stable moderate to severe cardiomegaly. Abandoned fractured lead projects over the mediastinum with dual lead pacemaker/defibrillator in conventional position. ___ d/w ___ ___ ______________________________________________________________________________

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON STUDY: ___.

FINDINGS: ICD pacing device is present, with interval placement of a new right atrial lead within expected location in the right atrium. Standard PA and lateral chest radiograph may be helpful to confirm appropriate localization when the patient's condition allows. Note is also made of an abandoned fractured lead overlying the left upper mediastinum. Lateral chest radiograph would be helpful to better localize this as well. There is no pneumothorax. Stable cardiomegaly, with interval resolution of interstitial edema since the prior radiograph   Keywords: stable.


SubjectID: 11153132, StudyID: 57220960, Comparison: same

WET READ: ___ ___ ___ 11:14 PM Severe cardiomegaly. No large pneumothorax. Opacity at the right midde and lower lobe persists. Moderate pulmonary edema has improved. Probable small bilateral pleural effusions. -NSR

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Mitral valve repair, evaluation for pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has received a new valvular device. Status post sternotomy. The nasogastric tube has been removed. Venous introduction sheath in the right internal jugular vein. The lung volumes are slightly increased, likely reflecting improved ventilation. Moderate cardiomegaly persists. Signs of mild fluid overload are present in almost unchanged manner   Keywords: unchanged.


SubjectID: 11153132, StudyID: 50899861, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the venous introduction sheath on the right has been removed. The lung volumes have slightly increased, likely reflecting improved ventilation. Moderate cardiomegaly and post-operative changes after valvular repair persist.


SubjectID: 11153132, StudyID: 57032513, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with acute mental status changes. // Signs of aspiration, PNA?

COMPARISON: Chest radiograph from ___.

FINDINGS: AP portable upright view of the chest. Multiple sternal wires, cardiac valve, right-sided PICC, and left-sided pacemaker are unchanged in position since the ___ study. The heart is mildly enlarged. There is no pneumothorax or pleural effusion. Bilateral linear opacities remains stable, likely reflecting atelectasis.

IMPRESSION: No interval change since ___   Keywords: no interval change. Specifically, no superimposed consolidation detected.


SubjectID: 11153132, StudyID: 51536048, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hx of CHF, here for ASD repair. // r/o PNA, effusions

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, there is unchanged evidence of moderate cardiomegaly of the valvular replacement. The sternotomy wires and the left pectoral pacemaker are unchanged. Unchanged position of the right PICC line. A pre-existing pleural effusion on the right as well as an area of parenchymal opacity, likely atelectatic, at the bases of the right upper lobe is constant in appearance. No pneumothorax. No new parenchymal changes.


SubjectID: 11153132, StudyID: 54642949, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with rheumatic MS ___/p MVR, refractory AT now s/p AVJ ablation and single-chamber (RV) PPM // lead positioning

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, a the patient has received a left pectoral pacemaker. The seen lead is projecting over the right atrium. There is no evidence of complications such as pneumothorax. The appearance of the cardiac silhouette, the sternal wires, the valvular replacement and the right PICC line are constant.


SubjectID: 11153132, StudyID: 53613403, Comparison: None

FINAL REPORT

HISTORY: Atrial fibrillation.

FINDINGS: In comparison with study of ___, there is again substantial enlargement of the cardiac silhouette with prosthetic valve. Increased opacification in the right infrahilar region could represent merely atelectasis, though pneumonia would have to be seriously considered in the appropriate clinical setting. No overt pulmonary edema, though there could be some elevation of pulmonary venous pressure.


SubjectID: 11167924, StudyID: 58533862, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with hx AFib on___ transferred from OSH s/p fall, found to have intracranial hemorrhage (SAH/SDH), L acetabular/pelvic fracture, and temporal bone fracture. Now with unclear source of fever. // ? PNA. unclear source of fever

TECHNIQUE: Single frontal view of the chest

COMPARISON: CT abdomen pelvis ___. Portable chest x-ray ___.

FINDINGS: A new consolidation in the left lower lobe obscuring the left hemidiaphragm is consistent with a pneumonia. There is a small left pleural effusion which is better seen on prior CT chest. Again seen is right basal atelectasis. There is mild pulmonary vascular congestion. Severe cardiomegaly is stable. There is no pneumothorax.

IMPRESSION: Left lower lobe pneumonia.


SubjectID: 11167924, StudyID: 53564850, Comparison: better

FINAL REPORT

EXAMINATION: Chest radiograph.

INDICATION: ___ year old man doboff placement

TECHNIQUE: Portable chest radiograph.

COMPARISON: Chest radiograph ___.

FINDINGS: Subsequent images in placement of a Dobhoff tube with the final image demonstrating the tube in the stomach. The tip is not included on this film. Pulmonary edema has improved   Keywords: improve. Left basilar opacity persists. There is no pneumothorax.

IMPRESSION: 1. Dobhoff tube ends in the stomach with the tip not included on this radiograph. Recommend repeat imaging of the abdomen for complete visualization. 2. Improved pulmonary edema   Keywords: improve. 3. Persistent left basilar opacity.

NOTIFICATION: Dr. ___ was paged by Dr. ___ at the time the study was interpreted.


SubjectID: 11167924, StudyID: 58284664, Comparison: better

WET READ: ___ ___ ___ 8:34 AM There is similar appearance of the chest. Endotracheal tube and enteric tube terminating in similar position. There is a left PICC which terminates in the right atrium. Recommend pull back by approximately 4 cm.

WET READ VERSION #1 ___ ___ ___ 7:53 PM There is similar appearance of the chest. Endotracheal tube and enteric tube terminating in similar position. There is a left PICC which terminates in the right atrium. Recommend pull back by approximately 4 cm. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p bronch // eval for PTX

COMPARISON: CHEST X-RAY FROM ___ at 15:39

FINDINGS: The ET tube tip lies approximately 5.2 cm above the carina. The left subclavian PICC line tip overlies the right atrium and could be retracted by approximately 4 cm to lie in the distal SVC. An enteric type tube is present, extent beneath the diaphragm, off the film. No obvious pneumothorax is identified. Cardiac silhouette remains slightly enlarged. Again seen is increased retrocardiac density consistent with left lower lobe collapse and/or consolidation. The more patchy opacity previously seen at the left base is less apparent hand may have resolved. Patchy opacity at the right cardiophrenic region is again noted. Minimal platelike atelectasis in the right mid zone laterally. Upper zone redistribution. Slight interval improvement in degree of vascular plethora   Keywords: improve. A rounded density measuring approximately 13 mm in diameter of the was pre the same projecting over the lateral right mid zone overlies the rib cage on the current examination and therefore lies outside the long. Clips noted along the lower right neck/thoracic edema.

IMPRESSION: Left subclavian PICC line tip overlying the right atrium. If clinically indicated, retraction by approximately 4 cm could be considered. Left lower lobe collapse and/or consolidation, similar to the prior film. Patchy opacity right cardiophrenic region also similar to the prior film. No pneumothorax detected. A tiny right apical pneumothorax would be difficult to fully exclude . Stable cardiomegaly. Upper zone redistribution, with slight improvement in degree of previously seen vascular plethora   Keywords: improve.


SubjectID: 11167924, StudyID: 53560111, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with new onset PVCs after PICC line placmenet // assess PICC line placement

TECHNIQUE: Single frontal view of the chest

COMPARISON: Portable chest x-ray ___

FINDINGS: The left-sided PICC terminates deep in the right atrium and could be retracted approximately 5 cm to lie in the distal SVC. An ET tube is appropriate position an enteric tube extends into the stomach. No pneumothorax identified. Moderate cardiomegaly is stable. Again seen is an opacity in the left lower lobe obscuring the left hemidiaphragm and left heart border consistent with left lower lung collapse. The opacity at the right base medially is more prominent and a pneumonia cannot be excluded in this location. Again seen is the rounded density projecting over the lateral right midzone which when compared to the prior exam appears to lie outside of the lung.

IMPRESSION: 1. Left-sided PICC terminates deep in the right atrium and could be retracted 5 cm to lie in the distal SVC. 2. The opacity at the right lung base medially appears more prominent and a pneumonia cannot be excluded.


SubjectID: 11167924, StudyID: 53315692, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pneumonia // ? worsening Pneumonia

COMPARISON: Chest x-ray from ___ at 05:34

FINDINGS: Again seen is relatively pronounced cardiomegaly and prominence of the pulmonary hila, similar to the prior film. There is upper zone redistribution and mild vascular plethora, without other evidence of CHF. Platelike atelectasis again noted in the right mid zone, slightly more extensive. The right costophrenic angle is not well visualized and the possibility of a small right pleural effusion, new compared with the prior study, cannot be excluded. Left costophrenic angle is excluded from the film. Some increased retrocardiac opacity is again seen, with minimal atelectasis at the lateral left lung base. An NG/Oro-gastric type tube is present, extending beneath the diaphragm, off the film. Clips noted in the right supraclavicular region.

IMPRESSION: 1. Cardiomegaly. Prominent hila suggestive of chronic pulmonary hypertension. These findings are not significantly changed. 2. Mild vascular plethora, possibly slightly worse, but without other evidence of CHF   Keywords: worse. 3. Possibility of a new small right pleural effusion cannot be excluded. 4. Persistent retrocardiac opacity consistent with left lower lobe collapse and/or consolidation, similar to the prior study.


SubjectID: 11167924, StudyID: 50923267, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with hx AFib on___ transferred from OSH s/p fall, found to have intracranial hemorrhage (SAH/SDH), L acetabular/pelvic fracture, and temporal bone fracture, now with pneumonia and high amount of secretion // ETT placement

COMPARISON: CHEST X-RAY FROM ___ AT 07:47

FINDINGS: ARE. POSITIONING. AGAIN SEEN IS CARDIOMEGALY. THE HILA ARE BOTH PROMINENT. ON THE RIGHT, FOCAL ENLARGEMENT OF THE HILUM IS SUGGESTED. THERE ARE HAZY OPACITIES, WITH SUGGESTION OF AIR BRONCHOGRAMS IN BOTH AT BOTH LUNG BASES MEDIALLY, ON THE RIGHT THIS IS MORE PRONOUNCED THAN ON THE EARLIER FILM. THERE IS UPPER ZONE REDISTRIBUTION, WITHOUT OVERT CHF, SIMILAR PRIOR   Keywords: similar. POSSIBLE SMALL RIGHT EFFUSION. NO GROSS LEFT EFFUSION BUT THE EXTREME LEFT COSTOPHRENIC ANGLE IS EXCLUDED FROM THE FILM. CLIPS NOTED ALONG THE RIGHT LOWER NECK. ALLOWING FOR LORDOTIC POSITIONING. NO OBVIOUS PNEUMOTHORAX IS IDENTIFIED. AN ET TUBE IS PRESENT, TIP APPROXIMATELY 5.1 CM ABOVE THE CARINA, NEW COMPARED WITH THE PRIOR FILM. AN NG TYPE TUBE IS PRESENT, TIP EXTENDING BENEATH DIAPHRAGM, OFF FILM. SMALL RADIODENSITIES OVERLIES THE LOWER MEDIASTINUM AN UPPER ABDOMEN FLUID IS NOT CLEAR WHETHER THESE LIE WITHIN OR OUTSIDE THE THE PATIENT.

IMPRESSION: 1. ET TUBE TIP APPROXIMATELY 5.1 CM ABOVE THE CARINA. 2. PATCHY OPACITIES AT BOTH LUNG BASES MEDIALLY, POSSIBLY ATELECTASIS. HOWEVER, THE POSSIBILITY OF AREAS OF EARLY PNEUMONIC INFILTRATE OR ASPIRATION CANNOT BE EXCLUDED. FOCAL AREAS OF HEMORRHAGE ARE CONSIDERED LESS LIKELY. 3. MILD VASCULAR PLETHORA, WITHOUT OVERT CHF. 4. POSSIBLE SMALL RIGHT EFFUSION. 5. PROMINENCE OF BOTH PULMONARY ARTERIES, NOT FULLY CHARACTERIZED. THE POSSIBILITY OF LYMPHADENOPATHY CANNOT BE EXCLUDED. 6. CARDIOMEGALY.


SubjectID: 11167924, StudyID: 50586216, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with fevers ?pneumonia // interval change

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Moderate to severe cardiomegaly is a stable. ET tube is in standard position. Left PICC tip is in the lower SVC. NG tube tip is out of view below the diaphragm. Diffuse multifocal consolidations asymmetric larger on the right lung have improved in the right upper lobe. Presumed small left effusion is grossly unchanged. There is no evident pneumothorax


SubjectID: 11167924, StudyID: 53145633, Comparison: same

FINAL REPORT

EXAMINATION: DX CHEST PORTABLE PICC LINE PLACEMENT

INDICATION: ___ year old man with PICC line // evaluate for PICC line migration after pulling back 2-3 cm. evaluate for PICC line migration after pulling back 2-3 cm.

IMPRESSION: Comparison to ___. The left PICC line has been pulled back. The tip currently projects over the upper SVC. No complications, notably no pneumothorax. The course of the feeding tube is unchanged. Unchanged moderate pulmonary edema   Keywords: unchanged. Moderate retrocardiac atelectasis, moderate cardiomegaly as well as a small left pleural effusion.


SubjectID: 11170345, StudyID: 56690651, Comparison: None

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPHS

INDICATION: Right-sided chest pain of acute onset.

COMPARISON: Ocrober ___, ___.

TECHNIQUE: Chest, AP upright and lateral views.

FINDINGS: Again seen is a dual-lead pacemaker/ICD device with leads terminating in the right atrium and ventricle, respectively. The heart is again moderately enlarged, not necessarily changed, however, allowing for differences in technique. However, some widening of the vascular pedicle including venous distention is suspected in system as well as pulmonary vessels. There is no definite pleural effusion or pneumothorax. No focal opacity is identified aside from streaky mid lung opacity on the right suggesting minor atelectasis along the minor fissure versus fissural thickening.

IMPRESSION: Probably unchanged cardiomegaly allowing for substantial differences in technique including AP versus PA view and low lung volumes. Findings suggest pulmonary venous hypertension which is more striking than before, however without overt pulmonary edema.


SubjectID: 11170345, StudyID: 55849217, Comparison: same

WET READ: ___ ___ ___ 8:05 AM The lung volumes are low and there is moderate pulmonary vascular congestion. No focal opacity concerning for infection. ___ ___.

WET READ VERSION #1 ___ ___ ___ 9:20 PM The lung volumes are low and there is moderate pulmonary vascular congestion. No focal opacity concerning for infection. ___ ___. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hotn sp dccv // pna?

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Low lung volumes. Moderate cardiomegaly and minimal fluid overload. No overt pulmonary edema. No pneumonia, no pleural effusions. Left pectoral pacemaker is in unchanged position.


SubjectID: 11170345, StudyID: 54113716, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF // edema

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: There is moderate cardiomegaly. Pacer leads are in standard position. There is no pneumothorax or pleural effusion. Bibasilar atelectasis are minimal


SubjectID: 11172056, StudyID: 58773439, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with diastolic dysfunction and hypercarbia presenting with respiratory distress // evaluate for pulmonary edema

COMPARISON: ___ at 16 16

FINDINGS: The patient's chin and mask overlie and obscure the upper portion of both lungs. Inspiratory volumes are lower than on the prior film and the patient appears more kyphotic. Allowing for this, the cardiomediastinal silhouette is grossly unchanged. Mild vascular plethora and bibasilar atelectasis is similar to the prior film. No frank consolidation or gross effusion. Incidental note made of bilateral severe glenohumeral osteoarthritis.

IMPRESSION: As above.


SubjectID: 11172056, StudyID: 51677223, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with dyspnea and history of congestive heart failure

TECHNIQUE: Portable upright AP view of the chest

COMPARISON: ___

FINDINGS: Moderate enlargement of the cardiac silhouette persists. The aorta remains tortuous. Hilar contours are relatively unchanged. There is no pulmonary edema. Minimal streaky atelectasis is noted lung bases without focal consolidation. No pleural effusion or pneumothorax is present. Clips from prior cholecystectomy are demonstrated in the right upper quadrant of the abdomen. Partially imaged is cervical spinal fusion hardware. Degenerative changes are noted throughout the imaged thoracolumbar spine as well as within the glenohumeral joints bilaterally.

IMPRESSION: No acute cardiopulmonary abnormality.


SubjectID: 11172056, StudyID: 57954115, Comparison: same

FINAL REPORT

PORTABLE CHEST ___ ___

COMPARISON: ___ radiograph.

FINDINGS: Stable cardiomegaly accompanied by pulmonary vascular congestion and interstitial edema   Keywords: stable. Worsening patchy opacity at right lung base could reflect patchy atelectasis, aspiration, or developing pneumonia. Small right pleural effusion is again demonstrated with intrafissural component.


SubjectID: 11172056, StudyID: 53244198, Comparison: same

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with COPD, CHF, change in pulmonary edema or pleural effusion.

COMPARISON: ___ to ___.

FINDINGS: There is again increase in the right lung base opacification, part of it is explained by pleural effusion, but is still worrisome for pneumonia. Mild pulmonary edema is unchanged   Keywords: unchanged. Mediastinal contour enlargement due to lymphadenopathy was better depicted in the recent CT scan. Possible persistence of the left upper lobe consolidation described on the CT could be reassessed with CT if clinically warranted. There is no pneumothorax.

CONCLUSION: 1. Stable mild pulmonary edema   Keywords: stable. 2. Increase in right basal lung opacity is probably a mix of pleural effusion and pneumonia. 3. Mediastinal lymphadenopathy. 4. Left upper lobe consolidation described on ___ CT scan is possibly persistent and it could be reassessed with dedicated CT if clinically warranted.


SubjectID: 11172056, StudyID: 50473614, Comparison: same

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with CHF and hypoxia, pulmonary edema.

COMPARISON: ___ to ___.

FINDINGS: Mild pulmonary edema is unchanged   Keywords: unchanged. Right basal opacification is slowly increasing and is worrisome for either infection or aspiration. Mediastinal contour enlargement seen in the chest CT of ___ is due to enlarged lymphadenopathy. On the previous chest CT, a consolidation of unknown etiology was seen in the posterior left upper lobe, possibly persistent on this chest x-ray. If clinically warranted, a repeat chest CT could be done to reassess this area.

CONCLUSION: 1. Unchanged mild pulmonary edema   Keywords: unchanged. 2. Increase in right basal consolidation which could represent pneumonia or aspiration as mentioned on yesterday's chest x-ray. 3. Known mediastinal lymphadenopathy. 4. Repeat chest CT could be considered to reassess the left upper lobe consolidation described in the CT of ___.


SubjectID: 11172056, StudyID: 57534111, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with dyspnea and CXR infiltrate suspicious for infarction vs pneumonia. Please assess interval change in infiltrate.

TECHNIQUE: Single portable AP view of the chest.

COMPARISON: Chest radiograph from ___, ___, ___, and ___.

FINDINGS: Mild to moderate cardiomegaly is stable. Pulmonary edema is new and obscures the previously described right lung opacities   Keywords: new. No new focal consolidation concerning for pneumonia or pneumothorax.

IMPRESSION: Interval development of significant pulmonary edema obscures the previously described right lung opacities   Keywords: development.


SubjectID: 11172056, StudyID: 53799032, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with hypoxia

TECHNIQUE: Semi-erect AP view of the chest

COMPARISON: ___ chest radiograph, ___ chest CT

FINDINGS: Heart size remains mild to moderately enlarged. Mediastinal contour is unchanged with prominence of the superior mediastinal contour likely due to underlying lymphadenopathy. Mild pulmonary vascular congestion is present. Ill-defined focal opacity within the right upper lobe appears relatively unchanged. Patchy atelectasis is seen in both lung bases. No pleural effusion or pneumothorax is detected. Clips from prior cholecystectomy are demonstrated in the right upper quadrant of the abdomen. Degenerative changes are noted in both glenohumeral joints.

IMPRESSION: 1. Persistent focal ill-defined opacity in the right upper lobe which remains concerning for infection, but is non-specific and infarction is not excluded. Consider chest CTA for further assessment. 2. Mild pulmonary vascular congestion.


SubjectID: 11172056, StudyID: 52147659, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with cough, O2 requirement, fevers, "wedge shaped infarct" seen on admit // Evaluate for pulmonary edema, is "wedge shaped infarct" seen on admit (___) still present?

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Moderate cardiomegaly and widening mediastinum due to tortuous aorta are unchanged. Mild pulmonary edema has improved   Keywords: improve. Multifocal Underlying opacities in the right lung have minimally increased from ___. There is no pneumothorax or increasing effusions


SubjectID: 11172056, StudyID: 53733554, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST, ___

HISTORY: New-onset atrial fibrillation, CHF and pulmonary edema.

IMPRESSION: AP and lateral chest compared to ___: Several small regions of atelectasis or consolidation, particularly in the lower lungs are stable. Mild cardiomegaly is unchanged. Thoracic aorta is generally large and tortuous, not appreciably changed since ___. There is no pulmonary edema. Pleural effusions are minimal.


SubjectID: 11172056, StudyID: 51618496, Comparison: None

FINAL REPORT

INDICATION: New-onset atrial fibrillation with cough and weakness.

COMPARISONS: Chest radiograph from ___. PORTABLE UPRIGHT RADIOGRAPH OF THE CHEST: There is mild pulmonary edema, with a new more focal area of consolidation in the right lower lung field. There is no pneumothorax or large pleural effusion. Heart size is unchanged. There are incompletely imaged cervical spinal hardware.

IMPRESSION: Mild pulmonary edema, resulting from decompensated congestive heart failure. In the right clinical setting, the more focal opacity in the right lower lung could represent infectious consolidation. Repeat imaging may be obtained after diuresis to better assess this region.


SubjectID: 11172056, StudyID: 52910812, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with pneumonia, CHF and ? pulm infarct // evaluate for pulm edema, please comment on whether "wedge shaped opacity" on right is still present evaluate for pulm edema, please comment on whether "wedge sh

IMPRESSION: In comparison with the study of ___, there again are somewhat low lung volumes. Enlargement of the cardiac silhouette with tortuous aorta but less widening of the superior mediastinum. Indistinctness of pulmonary vessels is consistent with elevated pulmonary venous pressure. Streaks of atelectasis are seen at both bases. There are several suggested coalescent areas of opacification in the right lung an infrahilar region, though they do not appear as prominent as on prior studies. No "Wedge shaped opacity " is appreciated.


SubjectID: 11208359, StudyID: 56978955, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with stroke and sob // concern for fluid overload

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Cardiomegaly is substantial, unchanged. Mediastinal silhouette is stable. There is no evidence of pulmonary edema. Severe degenerative changes and potentially all fractures in both humeral head are re- demonstrated. Several loose bodies are suspected on the right Left pleural effusion is most likely present, small to moderate.


SubjectID: 11208359, StudyID: 56023538, Comparison: same

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: History: ___F with AMS // Eval for infiltrate

TECHNIQUE: Chest: Frontal and Lateral

COMPARISON: ___

FINDINGS: The cardiac and mediastinal silhouettes are grossly stable given differences in patient position. Left basilar atelectasis/ scarring is seen without definite focal consolidation no large pleural effusion or pneumothorax. No pulmonary edema. Chronic deformities of the bilateral shoulders and acromioclavicular joints

IMPRESSION: No significant interval change   Keywords: no significant interval change.


SubjectID: 11213912, StudyID: 59413020, Comparison: worse

WET READ: ___ ___ ___ 8:29 PM Stable mild to moderate pulmonary edema with improvement in bibasilar opacities. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with heart failure, possible PNA, increased work of breathing. // Please eval for edema, interval change.

TECHNIQUE: Portable AP radiograph of the chest.

COMPARISON: ___.

FINDINGS: Moderate bilateral interstitial and airspace opacities have slightly increased   Keywords: increase. Right upper lobe volume loss is not appreciably changed. Layering moderate bilateral pleural effusions are unchanged. There is no pneumothorax. A right pectoral single lead pacemaker partially obscures the right lung apex.

IMPRESSION: Worsening moderate pulmonary edema and layering bilateral pleural effusions   Keywords: worse. Partial right upper lobe atelectasis, possibly secondary to mucous plugging is unchanged. Consider bronchoscopic correlation.


SubjectID: 11213912, StudyID: 54403683, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with LAD STEMI s/p DES x1, BMS x1, cardiogenic shock with bradycardia and pauses is now s/p temoorary external pacemaker // Assess for external pacemaker lead placement

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the pacemaker is in unchanged position. Unchanged bilateral pleural effusions. Moderate cardiomegaly, mild to moderate pulmonary edema and basal areas of atelectasis. No new focal parenchymal opacities   Keywords: new.


SubjectID: 11213912, StudyID: 51786680, Comparison: 1.0

FINAL REPORT

INDICATION: ___ year old man with pulmonary edema now with elevated lactate, interval change.

COMPARISON: Comparison is made to multiple chest radiographs dating back to ___.

TECHNIQUE A portable upright view of the chest.

FINDINGS: Right chest wall pacer lead projects over the left ventricle. Again seen, is moderate bilateral interstitial and airspace opacities most pronounced at the lung bases   Keywords: again. A right upper lobe opacity is also present and likely represents a combination of atelectasis and pleural fluid. There is no pneumothorax. There are bibasilar pleural effusions. Enlarged cardiac silhouette is unchanged. Dense retrocardiac atelectasis is also present.

IMPRESSION: Moderate pulmonary edema, may be mildly improved compared to prior, although direct comparison is difficult due to differences in position   Keywords: improve.


SubjectID: 11213912, StudyID: 58528233, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with new ETT // Please eval ETT position

COMPARISON: ___ AT 08:41

FINDINGS: COMPARED WITH EARLIER THE SAME DAY, AN ET TUBE HAS BEEN PLACED. THE TIP OF THE TUBE LIES APPROXIMATELY 6.5 CM ABOVE THE CARINA, AT THE UPPER EDGE OF THE CLAVICULAR HEADS. AN NG TYPE TUBE IS PRESENT, TIP EXTENDING BENEATH DIAPHRAGM, OFF FILM. OF NOTE, THE RADIO OPAQUE TIP OF THE THE INTRA AORTIC BALLOON PUMP SEEN ON THE PRIOR FILM, IS NO LONGER VISUALIZED. THE CARDIOMEDIASTINAL SILHOUETTE IS UNCHANGED. THERE IS UPPER ZONE REDISTRIBUTION, WITHOUT OTHER EVIDENCE OF CHF. PROBABLE MINIMAL ATELECTASIS AT BOTH LUNG BASES. NO FRANK CONSOLIDATION. NO GROSS EFFUSION. NO PNEUMOTHORAX DETECTED. OLD HEALED RIGHT PROXIMAL HUMERAL FRACTURE INCIDENTALLY NOTED.

IMPRESSION: 1. ET TUBE TIP AT THE UPPER EDGE OF THE CLAVICULAR HEADS. CLINICAL CORRELATION REGARDING POSSIBLE ADVANCEMENT (E.G. ___ CM) IS REQUESTED . 2. INTRA AORTIC BALLOON PUMP NO LONGER VISUALIZED.


SubjectID: 11213912, StudyID: 57911083, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with new balloon pump position // plewase eval IABP position plewase eval IABP position

IMPRESSION: In comparison with the earlier study of this date, the tip of the IABP again is somewhat close to the superior aspect of the aortic arch. The tip could be pulled back approximately 2 cm to be in the midportion between the left bronchus and the top of the aortic arch. Otherwise no change   Keywords: no change.


SubjectID: 11213912, StudyID: 57795291, Comparison: None

WET READ: ___ ___ ___ 10:14 AM IABP tip is 2 cm above the carina, satisfactory position. Swan-Ganz catheter from inferior approach. No other significant interval change.

WET READ VERSION #___ ___ ___ ___ 12:49 AM IABP tip is 2 cm above the carina, satisfactory position. Swan-Ganz catheter from inferior approach. No other significant interval change. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with newly placed balloon pump. // balloon pump placement? balloon pump placement?

IMPRESSION: In comparison with the earlier study of this date, there has been placement of a Swan-Ganz catheter from below with the tip in the right pulmonary artery. There has also been placement of an IABP with the tip about halfway between the upper aspect of the left bronchus and the superior aspect of the aortic arch, in good position.


SubjectID: 11213912, StudyID: 54057635, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with STEMI and IABP // IABP position

COMPARISON: None.

FINDINGS: The heart does not appear enlarged. The aorta is unfolded, contributing to prominence of the mediastinal silhouette. The hila are also slightly prominent, with a tapered appearance. An IABP is present -- the tip overlies the expected location of the descending aorta. However, the radiopaque tip probably lies approximately 2.5 cm below the inferior edge of the aortic arch itself. There is upper zone redistribution, without overt CHF. No focal consolidation. Minimal bibasilar atelectasis. No gross effusion. No pneumothorax detected.

IMPRESSION: The IABP tip overlies the descending aorta, approximately 2.5 cm below the expected site of the inferior edge of the aortic arch. Clinical correlation regarding potential advancement is requested. Addendum: At this time, a subsequent chest x-ray is available and shows that the balloon pump has been removed.


SubjectID: 11213912, StudyID: 53968226, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with SOB after extubation // please eval for acute process

IMPRESSION: Following extubation, there is apparent symmetrical narrowing of the subglottic airway, likely due to edema. Cardiomediastinal contours are within normal limits, and lungs are clear except for minor basilar atelectasis.


SubjectID: 11213912, StudyID: 52477564, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cordis placement // please eval postion of CVL

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: Prior study obtained the same the early a

IMPRESSION: Right internal jugular line tip is at the level of superior SVC. Heart size and mediastinum are unchanged. Slight interval progression of vascular enlargement is noted   Keywords: progression. There is no pneumothorax.


SubjectID: 11213912, StudyID: 50944750, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with LAD STEMI, s/p BMS, DES, IABP, and Swan Ganz catheter. Having significant ectopy. // Placement of Swan catheter, placement of IABP? Placement of Swan catheter, placement of IABP?

IMPRESSION: In comparison with the study of ___, the Swan-Ganz catheter has been pulled back to the pulmonary outflow tract. The IABP catheter has migrated superiorly. It could be pulled back approximately 2 cm to be in ideal position. The pulmonary vessels are engorged and not sharply seen, suggesting some elevated pulmonary venous pressure. The hemidiaphragms are not as well seen, especially on the left, which could be a manifestation of pleural effusions and compressive atelectasis at the bases.


SubjectID: 11213912, StudyID: 58252338, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p STEMI c/b cardiogenic shock requiring IABP; Currently with persistent dyspnea and now increasing leukocytosis // Please evaluate for interval change; evaluate for any consolidations

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, there is a minimal decrease in extent of the bilateral pleural effusions and an increase in radiolucency of the right upper lobe, indicating a decrease in extent and severity of the pre-existing parenchymal opacity located in this region. Moderate cardiomegaly persists. No pneumothorax. Unchanged position of the right pectoral pacemaker.


SubjectID: 11213912, StudyID: 56118982, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man p/w STEMI c/b cardiogenic shock with persistent tachypnea // Interval change Interval change

TECHNIQUE: Portable AP chest radiographs were obtained.

COMPARISON: Frontal chest radiographs ___ through ___ at 09:09.

IMPRESSION: Severe pulmonary edema is worsened progressively since ___   Keywords: worse. It could obscure concurrent pneumonia. Moderate moderate to large right and small to moderate left pleural effusions are increasing. Heart is moderately enlarged, not appreciably changed. No pneumothorax.


SubjectID: 11213912, StudyID: 51884832, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with STEMI c/b cardiogenic shock now with persistent hypoxia and cough concerning for PNA // Interval change; evaluate for evidence of consolidation and pulm edema Interval change; evaluate for evidence of consolidation and

IMPRESSION: In comparison with the study of ___, the patient has taken a better inspiration. Extensive bilateral opacifications are more prominent, consistent with bilateral pleural effusions and compressive atelectasis along with enlargement of the cardiac silhouette and elevation of pulmonary venous pressure. Otherwise little change   Keywords: little change.


SubjectID: 11213912, StudyID: 56732590, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with STEMI, cardiogenic shock, IABP in place. // IABP placement, worsening effusion, evidence of volume overload?

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Large right and moderate left pleural effusions have increased. Moderate Pulmonary edema has slightly increased   Keywords: increase. Right IJ catheter tip is in the upper SVC. Intra-aortic balloon pump is in unchanged position the tip is approximately 2 cm from the top of the aortic arch. Ascending Swan-Ganz catheter tip is close to the pulmonic valve Cardiomegaly is unchanged


SubjectID: 11213912, StudyID: 50725818, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with worsening hypoxia and SOB // please eval for acute pulmonary process

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Cardiomediastinal silhouette is unchanged though the evaluation is limited due to the presence of increasing bilateral large pleural effusions and mild worsening of moderate pulmonary edema   Keywords: worse. Right IJ catheter, Swan-Ganz and intra-aortic balloon pump are in unchanged standard position


SubjectID: 11213912, StudyID: 57564865, Comparison: None

WET READ: ___ ___ 8:44 AM Right IJ Swan-Ganz catheter with tip terminating distally in the lower right pulmonary artery. Recommend repositioning more centrally for optimal placement. The findings were discussed by Dr. ___ with Dr. ___ ___ telephone on ___ at 7:08 PM, 2 minutes after discovery of the findings.

WET READ VERSION #1 ___ ___ 7:11 PM Right IJ Swan-Ganz catheter with tip terminating distally in the lower right pulmonary artery. Recommend repositioning more centrally for optimal placement. The findings were discussed by Dr. ___ with Dr. ___ ___ telephone on ___ at 7:08 PM, 2 minutes after discovery of the findings. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cardiogenic shock s/p PA catheter placement // r/o pneumothorax r/o pneumothorax

IMPRESSION: In comparison with the earlier study of this date, there is an placement of a Swan-Ganz catheter that extends to the right pulmonary artery. It could be pulled back about 4 cm to be within the mediastinal contours. Otherwise, little change in the appearance of the heart and lungs. .


SubjectID: 11213912, StudyID: 57111599, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with recent anterior STEMI c/b cardiogenic shock now admitted with worsening respiratory failure, evaluate for pulmonary edema and evidence of consolidation .

COMPARISON: Comparison is made to multiple chest radiographs dating back to ___.

TECHNIQUE Portable view of the chest.

FINDINGS: A Swan-Ganz catheter extends to the right pulmonary artery, and can be pulled back approximately 4 cm. Endotracheal tube in appropriate position. Transvenous pacing veins ending in the right atrium and right ventricle. A nasoenteric to the crosses the left hemidiaphragm with its tip not visualized. Since prior, the appearance of the lungs is not significantly changed with diffuse bilateral airspace opacities, most pronounced at the right upper lung zone   Keywords: not significantly changed. The cardiac silhouette is stably enlarged with persistent retrocardiac atelectasis. There is no pneumothorax. There are bilateral layering pleural effusions.

IMPRESSION: 1. Swan-Ganz catheter extends to the right pulmonary artery and can be pulled back approximately 4 cm. 2. Persistent diffuse bilateral airspace opacities most pronounced in the right upper lobe, compatible with pulmonary edema although a multifocal infection would have to be considered in the correct clinical setting   Keywords: persistent.


SubjectID: 11213912, StudyID: 52025847, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with recent STEMI c/b cardiogenic shock now with concern for PNA // Interval change; evaluate for consolidation vs pulm edema

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: The ET tube is 4 cm above the Carina and is pointed on to the right with the tip likely against the right side of the trachea. NG tube tip is off the film but the proximal port is in the proximal stomach. There is bilateral moderate effusions layering posteriorly that have increased compared to prior. The heart is moderately enlarged. The Swan-Ganz catheter tip is in the right descending pulmonary artery. Dual lead pacemaker is again visualized. There is bilateral hazy alveolar infiltrate right greater than left.

IMPRESSION: Worsened pulmonary edema   Keywords: worse. An underlying infectious infiltrate cannot be exclude


SubjectID: 11213912, StudyID: 52006050, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pulmonary edema and HCAP, PA line in place to assist septic v cardiogenic shock management, unable to wedge and PA line in deeper than signed out to nursing, ?change/drift in position // please evaluate interval change in PA line positioning

TECHNIQUE: Portable chest

COMPARISON: 328 AT 08:00

FINDINGS: The Swan-Ganz catheter tip is in the main pulmonary artery pointed to the right. This is slightly less peripherally located than previously the cardiac silhouette is enlarged and is larger than it was previously. In particular there is right peritracheal widening the ET tube, dual lead pacemaker, pulmonary edema, volume loss in the lower lobes, bilateral effusions, and right upper lobe infiltrate are unchanged


SubjectID: 11213912, StudyID: 50981690, Comparison: same

FINAL REPORT

INDICATION: ___M s/p intubation // ett placement

TECHNIQUE: Single portable view of the chest.

COMPARISON: Film from earlier the same day at 08:10.

FINDINGS: Endotracheal tube is seen with tip 5.2 cm from the carina. Enteric tube passes below the inferior field of view. Otherwise, there has been no significant interval change   Keywords: no significant interval change.


SubjectID: 11213912, StudyID: 50943351, Comparison: same

FINAL REPORT

INDICATION: ___M with sob // ? pna

TECHNIQUE: Single portable view of the chest.

COMPARISON: ___.

FINDINGS: There persistent bilateral pleural effusions. Superimposed bibasilar and bilateral upper lung right greater than left opacities are again identified   Keywords: again. Elevation of the minor fissure suggest upper lobe volume loss on the right. Dense retrocardiac opacity in left silhouetting the descending thoracic aorta also suggests left lower lobe atelectasis. The cardiomediastinal silhouette is stable. Left chest wall dual lead pacing device is identified. No acute osseous abnormalities.

IMPRESSION: No significant interval change with multifocal, bilateral airspace opacities and bilateral pleural effusions. Findings could be related to edema and/or infection.


SubjectID: 11213912, StudyID: 50720027, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF presented with tachypnea, now intubated. // Please eval for pulm edema and also placement of ET and OG tube Please eval for pulm edema and also placement of ET and OG t

IMPRESSION: In comparison with the earlier study of this date, the tip of the endotracheal tube remains about 5 cm above the carina. Orogastric tube again extends into the stomach, though the side-hole is at or above the level of the esophagogastric junction. There again are diffuse bilateral airspace consolidations, which according to the clinical history is consistent with pulmonary edema. In the appropriate clinical setting, superimposed pneumonia would have to be considered. Hazy opacification at the bases is consistent with layering effusions. Retrocardiac opacification is consistent with substantial volume loss in the left lower lobe.


SubjectID: 11213912, StudyID: 56444449, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p STEMI in cardiogenic shock with IABP // Interval change; IABP in place Interval change; IABP in place

IMPRESSION: In comparison with the study of ___, there is little overall change in the appearance of the intra aortic balloon pump, which is too close to the apex of the aortic knob   Keywords: little overall change. Remainder the study is essentially unchanged.


SubjectID: 11213912, StudyID: 56675995, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF and bilat pleural effusions // Pneumothorax? Chest tubes in place bilaterally

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: ET tube tip is 5 cm above the carinal. NG tube tip is in the stomach. Heart size and mediastinum are overall unchanged but there is substantial interval improvement in pulmonary edema with still present large bilateral pleural effusions   Keywords: improve. Left pigtail catheter is in place. No pneumothorax is seen


SubjectID: 11213912, StudyID: 55758469, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with rising WBC, known pleural efusion. // evaluate for pleural effusion/PNA evaluate for pleural effusion/PNA

IMPRESSION: In comparison with the study of ___, the monitoring and support devices are essentially unchanged. Diffuse bilateral pulmonary opacifications are again seen, especially in the right upper lobe, in a patient with moderate cardiomegaly and layering pleural effusions.


SubjectID: 11213912, StudyID: 53388322, Comparison: None

FINAL REPORT

INDICATION: ___ year old man s/p recent MI who presented with acute respiratory distress ___ HCAP as well as pulmonary edema secondary to cardiogenic shock // eval for interval change

COMPARISON: Radiographs from ___

IMPRESSION: Endotracheal tube, left-sided pacemaker, and right-sided PICC line are unchanged position. There is improved aeration at the right base and at the upper lobes. There remains a left retrocardiac opacity. Small bilateral pleural effusions are seen. There are no pneumothoraces.


SubjectID: 11213912, StudyID: 51287074, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with respiratory failure // eval for interval change

COMPARISON: Radiographs from ___.

IMPRESSION: Support lines and tubes are unchanged in position. Cardiomediastinal silhouette is enlarged but stable. There are small bilateral effusions. There is a left retrocardiac opacity. There is mild pulmonary interstitial edema. There is an opacity within the right upper lobe which is stable. There are no pneumothoraces.


SubjectID: 11213912, StudyID: 53841787, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with STEMI, IABP in place. // IABP positioning, interval change? IABP positioning, interval change?

IMPRESSION: In comparison with the study of ___, the IABP tip has been retracted so that it is in good position with respect to the superior aspect of the aortic arch and left mainstem bronchus. Little change in the diffuse bilateral pulmonary opacifications.


SubjectID: 11213912, StudyID: 56027606, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p STEMI, s/p sinus pace with external pacer, resolving cardiogenic shock // please evaluate for interval change please evaluate for interval change

IMPRESSION: In comparison with the study of ___, the cardio mediastinal silhouette is stable with continued bilateral pleural effusions and compressive atelectasis at the bases. Pacer lead again extends to the apex of the right ventricle. Retrocardiac opacification is consistent with volume loss in the left lower lobe.


SubjectID: 11213912, StudyID: 54821169, Comparison: None

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPHS

INDICATION: Coronary disease status post myocardial infarction and atrioventricular block with dual-chamber pacemaker placement.

TECHNIQUE: Chest, AP upright and lateral.

COMPARISON: ___.

FINDINGS: There is a dual lead pacemaker/ ICD device that is in changed with leads again terminating in the right atrium and ventricle, respectively. The cardiac, mediastinal and hilar contours appear stable. There is persistent suspected pleural effusion on the left, probably at least small to moderate in size in addition to mild diffuse opacification suggestive of pulmonary edema. This appearance is somewhat heterogeneous, however including the possibility of developing focal opacity in the right upper lobe, in addition to persistent focal lower lobe opacities. Possible nodule appears less distinct on this study; the image is less sharp. There is no pneumothorax.

IMPRESSION: 1. Worsening multifocal opacification, notably with suspicion for developing new right upper lobe opacity. This appearance raises concern for multifocal pneumonia versus a heterogeneous presentation of pulmonary edema, and regardless there is probably an element of fluid overload. 2. No definite persistent visualization of a nodule which appears more vague on this study in the left upper lobe. However, continued radiographic followup is recommended and if the finding were not to resolve entirely chest CT should then be considered.


SubjectID: 11213912, StudyID: 53662866, Comparison: None

FINAL ADDENDUM ADDENDUM Left upper lobe relatively a rounded opacity is present, 17 mm, new and might potentially represent superimposed finding but attention on the subsequent radiographs is recommended ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pacer, CHF // ?pacer position, e/o CHF

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Cardiomediastinal silhouette is stable. Bilateral pleural effusions and bibasal consolidations are unchanged. Improvement of the right upper lobe opacity is noted. No pneumothorax is seen. The pacemaker lead terminates most likely in the expected position of the right ventricle.


SubjectID: 11213912, StudyID: 55945451, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p recent STEMI c/b cardiogenic shock now with HCAP and continued respiratory failure // Interval change

TECHNIQUE: Portable chest

COMPARISON: ___ at 16:16

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change.


SubjectID: 11213912, StudyID: 50315761, Comparison: same

FINAL REPORT

INDICATION: ___ y/o male with recent prolonged hospitalization at ___ (___ thru ___) after an anterior STEMI. Presents from rehabilitation center with hypotension and hypoxia likely in setting of CHF exacerbation. Evaluate for pneumonia, edema, or interval change.

TECHNIQUE: Portable frontal chest radiograph was obtained.

COMPARISON: Multiple priors with direct comparison made to study from ___

FINDINGS: A right IJ central venous and the Swan-Ganz catheter have been removed. Remaining support and monitoring devices are in unchanged positions. There appears to be some slight interval improvement in the bilateral pleural effusions, although this may be due to upright patient positioning. Focal opacity in the right mid lung is more prominent and compatible with known pneumonia seen on recent chest CT. There is bibasilar atelectasis. The cardiac silhouette remains mildly enlarged with mild pulmonary vascular congestion   Keywords: remains. There is no pneumothorax.

IMPRESSION: 1. Interval improvement in bilateral pleural effusions, although this could also be due to upright patient positioning. 2. Focal opacity in the right mid lung compatible with known pneumonia seen on recent CT chest. 3. Persistent mild cardiomegaly with pulmonary vascular congestion   Keywords: persistent.


SubjectID: 11213912, StudyID: 50747041, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with LAD STEMI s/p DES x1, BMS x1, cardiogenic shock with bradycardia and pauses is now s/p temoorary external pacemaker // Assess for external pacemaker lead placement

EXAMINATION: CHEST (PORTABLE AP)

TECHNIQUE: Portable Chest radiograph, frontal view.

COMPARISON: Chest radiograph ___ 18:00

FINDINGS: There is right pectoral pacemaker with a lead terminating at right ventricle. Pulmonary vessel congestion is similar to prior. Bilateral small to moderate pleural effusions and compressive atelectasis of lung bases are also similar to prior. Cardiomediastinal silhouette is unchanged.

IMPRESSION: There is right pectoral pacemaker with a lead terminating at right ventricle.


SubjectID: 11213912, StudyID: 54235938, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with heart failure, pleural effusions, now s/p thoracentesis on ___ // Please eval for edema, interval change in effusions Please eval for edema, interval change in effusions

IMPRESSION: In comparison with the study of ___, the monitoring and support devices remain in place. There is again enlargement of the cardiac silhouette with elevation of pulmonary venous pressure. Bilateral pleural effusions persist, more prominent on the left, with compressive basilar atelectasis. More focal area of opacification remains in the right perihilar and suprahilar region. Retrocardiac opacification again is consistent with substantial volume loss in the left lower lobe.


SubjectID: 11213912, StudyID: 51537543, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with LAD STEMI, cardiogenic shock, and volume overload. // interval change in volume? interval change in volume?

IMPRESSION: In comparison with the study of ___, there has been substantial decrease in the bilateral opacifications, though a large amount remains   Keywords: decrease. The IABP has been removed. No change in the other monitoring and support devices.


SubjectID: 11213912, StudyID: 50413905, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF, hypoxia // Please eval for edema, PNA

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the monitoring and support devices are in unchanged position. Mild decrease in extent of the pre-existing opacities, notably in the right upper lobe. The opacities, continue to be the predominant finding in both lungs   Keywords: continue. Moderate cardiomegaly. The presence of small bilateral pleural effusions is likely. The left pectoral pacemaker is unchanged.


SubjectID: 11227224, StudyID: 59525927, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with CHF with acute desat to mid 80s. Eval for pneumonia vs pulmonary edema // evidence of pulm edema/infection

COMPARISON: Radiographs from ___

IMPRESSION: The left-sided PICC line has been removed. Cardiac silhouette is enlarged but stable. Calcifications of the thoracic aorta are seen. Calcified coronary artery is identified. There has been increase in the left-sided pleural effusion and left perihilar consolidation since the prior study. Atelectasis at the right lung base is seen. There are no pneumothoraces.


SubjectID: 11227224, StudyID: 58982408, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with respiratory faillure // OGT placement OGT placement

IMPRESSION: In comparison with the earlier study of this date, there is an placement of a nasogastric tube that extends at least to the lower body of the stomach. The endotracheal tube tip now is approximately 3.8 cm above the carina. Otherwise little change   Keywords: little change.


SubjectID: 11227224, StudyID: 56073065, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with Afib (on warfarin), COP/ILD, CAD s/p PCI, recent UGIB, now p/w c. diff infection, Afib s/p TEE/DCCV, dCHF, UTI. New delirium and leukocytosis. // Assess for pneumonia

TECHNIQUE: Single AP portable radiograph of the chest

COMPARISON: ___

FINDINGS: Lines and Tubes: There is a left-sided PICC terminating in the distal left subclavian and could be advanced by approximately 3.5 cm. EKG leads overlie the chest wall. Lungs: The lung volumes are low. Interval improvement in the right visual effusion with a persistent small residual left digital effusion. Dense left retrocardiac opacity likely atelectasis and/ or pneumonia. Pleura: Bilateral small pleural effusions left greater than right. Mediastinum: There is cardiomegaly as before. Aortic knob calcification persists. Bony thorax: No interval change   Keywords: no interval change

IMPRESSION: Low lung volumes with dense left retrocardiac opacity, likely atelectasis and/or pneumonia in the right clinical setting. Left PICC terminates in the distal left subclavian ___, ___ be advanced by approximately 3.5 cm. Stable cardiomegaly with interval improvement in bilateral fissural effusions with unchanged small pleural effusions left greater than right.


SubjectID: 11227224, StudyID: 54907458, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with Afib (on warfarin), COP/ILD, CAD s/p PCI, recent UGIB, now p/w c. diff infection, Afib s/p TEE/DCCV, dCHF. with change in mental status // evidence of pneumonia, worsening pleural effusion/pulm edema evidence of pneumonia, worsening pleural effusion/pulm edema

IMPRESSION: In comparison with the study of ___, there is continued enlargement of the cardiac silhouette without definite vascular congestion. This again suggests cardiomyopathy or pericardial effusion. Retrocardiac opacification is consistent with some combination of left effusion and substantial volume loss in the left lower lobe. The right lung remains essentially clear except for relatively mild atelectatic changes.


SubjectID: 11227224, StudyID: 53442858, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with respiratory failure s/p intubation // s/p intubation s/p intubation

IMPRESSION: In comparison with the study of earlier in this date, there has been placement of an endotracheal tube with its tip approximately 2.4 cm above the carina. Otherwise, little change in the appearance of the heart and lungs.


SubjectID: 11227224, StudyID: 59223653, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with RESPIRATORY failure, pneumonia // pneumonia, effusion?

COMPARISON: ___.

IMPRESSION: No relevant change as compared to the previous examination   Keywords: no relevant change. Monitoring and support devices are in unchanged position, with the exception of the PICC line that shows a tip coiled inwards and potentially positioned in the azygos vein. No other relevant changes   Keywords: no other relevant change.


SubjectID: 11227224, StudyID: 59136142, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with prior PNA, prior imaging c/f multi-focal PNA with pulm edema, now with worsening hypoxia. bilateral crackles on exam. // interval change in pulm edema or PNA

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the lung volumes have decreased. The areas of multifocal bilateral parenchymal opacities, reflecting multifocal pneumonia, are unchanged in extent and severity. No pleural effusions. No pulmonary edema. Moderate cardiomegaly persists.


SubjectID: 11227224, StudyID: 52038415, Comparison: worse

FINAL REPORT

EXAMINATION: PA AND LATERAL CHEST RADIOGRAPHS

INDICATION: ___-year-old female with shortness of breath, hypoxia, recent cardioversion. Evaluate for acute process.

TECHNIQUE: PA and lateral chest radiographs

COMPARISON: Multiple prior chest radiographs, most recent on ___, ___, on ___. CT chest from ___.

FINDINGS: The prior radiographs from ___ showed extensive pulmonary pathology. The radiograph on ___ is considered to be the patient's baseline appearance. When compared to baseline there are bilateral patchy opacities, more prominent in the region of the right cardiophrenic angle, the right mid lung and the periphery of the left mid lung suggesting an infectious/inflammatory process. There is also bilateral diffuse increased interstitial thickening, vascular upper redistribution and hilar indistinctness suggesting interstitial pulmonary edema and vascular congestion   Keywords: increase. A small right-sided pleural effusion is present. There is no pneumothorax. Moderate cardiomegaly is unchanged.

IMPRESSION: Findings compatible with multifocal pneumonia on the background of interstitial pulmonary edema and vascular congestion. Stable moderate cardiomegaly.


SubjectID: 11227224, StudyID: 50620987, Comparison: worse

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___ year old woman with hypoxia, pneumonia and CHF // ?interval change

TECHNIQUE: AP view chest radiograph

COMPARISON: Chest x-ray ___ and ___.

FINDINGS: As compared to the prior radiograph performed yesterday morning, there is interval enlargement of an area of opacification in the right perihilar region, which most likely represents worsening pulmonary edema   Keywords: worse. However, an underlying infection cannot be excluded. A small right pleural effusion is noted. There is no pneumothorax. The heart remains enlarged. Atherosclerotic calcifications are noted in the aortic arch.

IMPRESSION: Increased right perihilar opacity most likely represents worsening pulmonary edema, though underlying infection cannot be excluded   Keywords: worse. Recommend follow-up CXR after diuresis to differentiate, if clinically appropriate.


SubjectID: 11227224, StudyID: 58346081, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with dCHF, now with PICC out 1cm from prior. // Assess for PICC positioning; please also assess for pneumonia Assess for PICC positioning; please also assess for pneumoni

IMPRESSION: In comparison with the study of ___, the tip of the PICC line is somewhat difficult to see, though it appears to be in the mid to upper portion of the SVC. The left and right hemidiaphragms are much more sharply seen. This could reflect improvement in pleural effusion or merely be a manifestation of a more upright position of the patient. Several dense streaks of atelectasis are seen in the mid zones bilaterally, and there is atelectatic change at the right base and possibly left base as well.


SubjectID: 11227224, StudyID: 53851204, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with Afib (on warfarin), COP/ILD, CAD s/p PCI, recent UGIB, now p/w c. diff infection, Afib s/p TEE/DCCV, dCHF, UTI. Now with PICC displaced again additional 1cm out. // Please assess PICC position

TECHNIQUE: Portable AP radiograph of the chest.

COMPARISON: ___.

FINDINGS: The left PICC line continues to projects over the left brachiocephalic vein. Advancement by 7-8 cm would position its tip at the superior cavoatrial junction. Right middle lobe atelectasis is unchanged. Bilateral lower lobe airspace opacities are unchanged   Keywords: unchanged. Small bilateral pleural effusions are stable. Left basilar airspace opacification likely due to atelectasis is also stable. Moderate cardiomegaly despite the projection is unchanged.

IMPRESSION: Left PICC line projects over left brachiocephalic vein. Advancement by 7-8 cm would position its tip at the superior cavoatrial junction. Stable right middle lobe atelectasis. Unchanged left midlung airspace opacity may be due to atelectasis. Stable small bilateral pleural effusions.


SubjectID: 11227224, StudyID: 54587252, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with l picc unsure if still in correct position // eval for picc position, changes from previous

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Left central venous line tip is at the level of lower SVC. Cardiomediastinal silhouette appears to be unchanged since the prior study. Bilateral pleural effusions are noted. There is no pneumothorax.


SubjectID: 11227224, StudyID: 52351151, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with A-fib, ILD, C-diff, and CHF // Assess for interval change in left lower lobe consolidation

COMPARISON: ___.

IMPRESSION: The left lower lobe atelectasis is unchanged. Platelike atelectasis at the level of the right hilus is slightly more expressed than on today's examination. The presence of a minimal right pleural effusion is unchanged.


SubjectID: 11227224, StudyID: 53275025, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: History of atrial fibrillation and pulmonary edema with weakness.

TECHNIQUE: Chest PA and lateral

COMPARISON: Several prior chest radiographs dating from ___ through ___.

FINDINGS: Moderate cardiomegaly is unchanged. Calcifications noted of the aortic knob. Mediastinal silhouette and hilar contours unchanged compared with ___. Upper zone redistribution, without other evidence of CHF. No pulmonary edema. No focal infiltrate identified. Pleural surfaces are clear without effusion or pneumothorax.

IMPRESSION: Cardiomegaly and upper zone redistribution. Otherwise, doubt acute pulmonary process.


SubjectID: 11227224, StudyID: 53052489, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with interstitial lung disease, atrial fibrillation here with a presumed GI bleed. // Does this woman have acute pulmonary edema?

COMPARISON: Chest x-ray from ___

FINDINGS: Compared with 1 day earlier and allowing for technical differences, I doubt significant interval change. Probable background hyperinflation. Mild cardiomegaly. Upper zone redistribution, without overt CHF. Minimal bibasilar atelectasis, but no focal consolidation. No gross effusion. On today's examination, the left hemidiaphragm is slightly elevated. Incidental note is made of advanced glenohumeral osteoarthritis on both sides and multiple loose bodies in the left shoulder joint.

IMPRESSION: Doubt significant interval change compared with 1 day earlier. Upper zone redistribution, without other evidence for CHF. Bibasilar atelectasis.


SubjectID: 11244926, StudyID: 59568820, Comparison: same

FINAL REPORT

HISTORY: Interstitial lung disease with worsening hypoxia.

FINDINGS: In comparison with study of ___, there is little change in the huge enlargement of the cardiac silhouette with diffuse prominence of the interstitial markings consistent with a combination of known interstitial lung disease and pulmonary edema   Keywords: little change. The possibility of superimposed pneumonia would be impossible to exclude in the appropriate clinical setting.


SubjectID: 11244926, StudyID: 56582041, Comparison: None

FINAL REPORT

HISTORY: Hypoxia and shortness of breath.

TECHNIQUE: Upright AP view of the chest.

COMPARISON: Chest CTA ___ chest radiographs and ___ ___.

FINDINGS: The cardiac and mediastinal contours remain moderately enlarged, and underlying mediastinal lymphadenopathy as detected on the prior chest CT can not be excluded. There is mild pulmonary vascular engorgement. Chronic interstitial abnormality within the periphery of both lungs likely reflects UIP. Assessment for pleural effusion is limited, but no large pleural effusion is detected. No pneumothorax is noted. There is likely mild bibasilar atelectasis. No acute osseous abnormality is seen.

IMPRESSION: Mild pulmonary vascular engorgement on a background of chronic interstitial lung disease previously characterized as UIP.


SubjectID: 11247575, StudyID: 59160851, Comparison: better

FINAL REPORT

HISTORY: MI, to assess for change.

FINDINGS: In comparison with study of ___, the degree of pulmonary vascular congestion appears somewhat decreased   Keywords: decrease. Continued bilateral pleural effusions with compressive atelectasis at the bases. The nasogastric tube remains in good position.


SubjectID: 11247575, StudyID: 52039549, Comparison: worse

FINAL REPORT

INDICATION: Assess interval change after NSTEMI.

COMPARISON: Chest radiograph ___; ___.

FINDINGS: Cardiomediastinal contours are stable. Small bilateral pleural effusions are present. There is no pneumothorax. Indistinctness of the hila with increased interstitial markings indicative of pulmonary edema, roughly stable since the prior study   Keywords: increase. ET tube is present approximately 3 cm above the carina, and an enteric tube is present with tip in the stomach. Median sternotomy wires are stable.

IMPRESSION: Worsening bilateral pleural effusions with stable interstitial edema   Keywords: worse.


SubjectID: 11262894, StudyID: 59980258, Comparison: same

FINAL REPORT

INDICATION: ___M with IJ // line placement

TECHNIQUE: Single portable view of the chest.

COMPARISON: ___ at 10:31.

FINDINGS: New right-sided central venous catheter seen with tip projecting over the lower SVC. There is no other change   Keywords: no other change. There is no pneumothorax. Left pleural effusion is again noted with adjacent atelectasis.

IMPRESSION: New right-sided central venous catheter with tip over the lower SVC. No pneumothorax.


SubjectID: 11262894, StudyID: 50151690, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___M with lower extremity edema, history of congestive heart failure// Please eval for pulmonary edema

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph ___, chest CT ___

FINDINGS: Cardiac silhouette size is normal. The aortic knob is calcified. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is not engorged. A small left pleural effusion is new since the prior CT with associated left lower lobe atelectasis. The right lung is clear. No focal consolidation or pneumothorax is present. Previously noted pulmonary nodules on CT are not clearly visualized on the current radiograph. There are mild degenerative changes noted in the thoracic spine.

IMPRESSION: Interval development of small left pleural effusion with associated left basilar atelectasis.


SubjectID: 11262894, StudyID: 58985246, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF exacerbation // pulmonary edema

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Small left pleural effusion with subsequent retrocardiac atelectasis. No pulmonary edema. No new focal parenchymal opacities   Keywords: new. Unchanged position of the left Port-A-Cath.


SubjectID: 11262894, StudyID: 52398524, Comparison: None

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: History: ___M with sob // acute process

TECHNIQUE: Chest: Frontal and Lateral

COMPARISON: ___

FINDINGS: Moderate left pleural effusion with overlying atelectasis is seen, underlying consolidation is not excluded. Trace right pleural effusion is difficult to exclude. Otherwise, the right lung is grossly clear. The cardiac silhouette is top-normal. The aorta is calcified and tortuous. A left-sided Port-A-Cath terminates in the region of the low SVC/cavoatrial junction.

IMPRESSION: Moderate left pleural effusion with overlying atelectasis, underlying consolidation is not excluded.


SubjectID: 11262894, StudyID: 58961919, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old male with respiratory failure.

FINDINGS: Comparison is made to prior study from ___. The endotracheal tube has been removed. The feeding tube, right IJ central line are stable in position. Heart size is prominent but unchanged. There is atelectasis at the lung bases. There is a persistent left retrocardiac opacity and left-sided pleural effusion. No overt pulmonary edema is seen. There are no pneumothoraces.


SubjectID: 11262894, StudyID: 53283035, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with ___ year old man s/p Whipple // interval changes, pulmonary edema

TECHNIQUE: Portable chest

COMPARISON: ___.

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change.


SubjectID: 11262894, StudyID: 52318935, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p Whipple // interval changes, pulmonary edema

TECHNIQUE: Plain film

COMPARISON: ___

FINDINGS: Retrocardiac consolidation on the left is new compared to yesterday's study. Bilateral central venous catheters and endotracheal tube appears in unchanged positions. Taking into account the lower degree of inspiration on the current study there is probably no significant central pulmonary vascular congestion.

IMPRESSION: New left retrocardiac consolidation which could be atelectasis or pneumonia, consider aspiration pneumonia.


SubjectID: 11262894, StudyID: 51218648, Comparison: None

FINAL REPORT

INDICATION: ___ year old man s/p Whipple // interval changes

TECHNIQUE: Portable chest x-ray.

COMPARISON: Prior radiographs of the chest dated ___ through ___.

FINDINGS: Portable semi-upright radiograph of the chest demonstrates low lung volumes which results in bronchovascular crowding. Bibasalar atelectasis is unchanged. The left-sided pleural effusion has increased slightly over the interval. The cardiomediastinal and hilar contours are unchanged. No pneumothorax. A right-sided internal jugular central venous line ends in the cavoatrial junction. The left-sided Port-A-Cath ends in the proximal right atrium. The endotracheal tube ends 6 cm from the carina. In nasogastric tube courses into the stomach and out of the field of view.

IMPRESSION: 1. Slight increase in left pleural effusion. Stable bibasalar atelectasis. 2. The endotracheal tube ends 6 cm from the carina, which is acceptable if the patient's chin is in the neutral or elevated position, but is too high if the chin is low.


SubjectID: 11288587, StudyID: 56081314, Comparison: 1.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cough, heart failure // interval change in intrathoracic process? eval for pna?

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the lung volumes remain low. The sternal wires of the CABG are constant. Unchanged moderate cardiomegaly. The signs indicative of pulmonary edema have mildly decreased   Keywords: decrease. No larger pleural effusions. Platelike areas of atelectasis at the left lung bases. No new focal parenchymal opacities   Keywords: new.


SubjectID: 11288587, StudyID: 55989486, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with ongoing cough, being diuresed - checking for opacification uncovered by resolution of pulm edema // interval change ?

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the lung volumes have increased, likely reflecting improved ventilation. In particular, the right lung base is better ventilated than on the previous image. There is no evidence of new parenchymal opacities in the lung parenchyma   Keywords: new. No larger pleural effusions. Mild fluid overload but no overt pulmonary edema. The sternal wires are in unchanged normal alignment.


SubjectID: 11292424, StudyID: 59487738, Comparison: None

WET READ: ___ ___ ___ 5:40 PM Mild CMG and vascular congestion. No edema. No PNA.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

INDICATION: ___-year-old woman with cough. Please assess for pneumonia.

TECHNIQUE: Single frontal radiograph of the chest was obtained.

COMPARISON: Chest radiograph from ___ and from ___.

FINDINGS: The lung volumes are low with secondary widening of the cardiomediastinal silhouette and vascular congestion. There is no pleural effusion and no pneumothorax. There is mild cardiomegaly and mild pulmonary edema.

IMPRESSION: Mild cardiomegaly and mild pulmonary edema. Repeat CXR after diuresis is recommended to assess.


SubjectID: 11292424, StudyID: 53250126, Comparison: better

FINAL REPORT

PORTABLE CHEST FILM, ___ AT 7:25 CLINICAL

INDICATION: ___-year-old with CHF, crackles on exam, question worsening effusions. Comparison is made to the patient's previous study dated ___ at 11:02. A portable AP upright chest film ___ at 7:25 is submitted.

IMPRESSION: 1. Heart remains stably enlarged. Lungs are now well inflated without evidence of focal airspace consolidation and therefore the previously described findings did in fact represent pulmonary edema that has now resolved   Keywords: resolve. No pleural effusions. No evidence of focal airspace consolidation to suggest pneumonia. No pneumothorax.


SubjectID: 11292424, StudyID: 54283790, Comparison: better

FINAL REPORT

INDICATION: ___-year-old female with end-stage renal disease, on dialysis, now with pulmonary edema, here to evaluate for interval changes.

COMPARISON: Chest radiographs, last performed on ___. PORTABLE FRONTAL CHEST RADIOGRAPH: Low inspiratory lung volumes are unchanged from the preceding radiograph. There is mildly improved but persistent bilateral moderate pulmonary edema and pulmonary vascular congestion from ___. The costophrenic angles are visualized without appreciable pleural effusion. No large pneumothorax or focal consolidation is present. The cardiac silhouette is enlarged but stable. Mediastinal and hilar contours are unchanged.

IMPRESSION: Mildly improved moderate pulmonary edema from ___ consistent with decreased fluid overload   Keywords: decrease, improve.


SubjectID: 11292424, StudyID: 53790866, Comparison: worse

FINAL REPORT

EXAM: Chest, single AP upright portable view. CLINICAL INFORMATION: ___-year-old female with history of acute onset shortness of breath/crackles, left greater than right, question CHF.

COMPARISON: ___.

FINDINGS: There has been interval increase in moderate-to-severe pulmonary edema   Keywords: increase. Cardiac silhouette is enlarged. Mediastinal contours are stable. Given low lung volumes and lack of lateral views, it is difficult to exclude small pleural effusions. No pneumothorax.

IMPRESSION: 1. Interval increase in marked pulmonary edema   Keywords: increase. 2. Cardiomegaly.


SubjectID: 11293517, StudyID: 57774874, Comparison: same

FINAL REPORT

INDICATION: Questioning aspiration pneumonia.

COMPARISON: Comparison made to frontal portable chest radiograph performed the same day.

FINDINGS: Chest PA and lateral radiographs redemonstrate mild interstitial edema and mild cardiomegaly. No signs of aspiration and no change from prior CXR   Keywords: no change.


SubjectID: 11293517, StudyID: 55831566, Comparison: None

FINAL REPORT

INDICATION: Cough. Please evaluate for infection.

COMPARISON: Comparison is made to chest radiograph performed ___.

FINDINGS: Frontal and lateral chest radiographs demonstrate mediastinal and hilar contours are unremarkable. Stable mild cardiomegaly identified. Mild interstitial edema noted No pleural effusion or pneumothorax. No osseous abnormality identified. Stable positioning of atrioventricular ICD leads. Abandoned leads again noted in the right chest wall. Surgical clips project over the upper mediastinum.

IMPRESSION: Mild cardiomegaly with mild interstitial pulmonary edema.


SubjectID: 11293517, StudyID: 50845269, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: Prior exam from ___. CLINICAL

HISTORY: Confusion and fever, assess for pneumonia.

FINDINGS: AP upright and lateral views of the chest were provided. Left chest wall pacer pack is again seen with leads extending into the right heart. Abandoned pacing leads are also noted in the right chest wall extending into the right heart. The heart remains moderately enlarged. Lung volumes are low, with equivocal ground-glass opacity on the frontal view, which appears less conspicuous on the lateral view most likely attributable to underpenetrated technique. No gross evidence for pneumonia or pulmonary edema. No large effusions are seen. There is no pneumothorax. Bony structures are intact.

IMPRESSION: Limited study demonstrating moderate cardiomegaly and no overt edema or pneumonia.


SubjectID: 11296936, StudyID: 56494116, Comparison: same

FINAL REPORT

CHEST, TWO VIEWS: ___.

HISTORY: ___-year-old male with shortness of breath and fever. History of CHF.

COMPARISON: ___.

FINDINGS: Slightly low lung volumes are again noted although mild pulmonary edema is seen   Keywords: again. There is no confluent consolidation. Small right pleural effusion is unchanged from prior. The cardiac silhouette is moderately enlarged. No acute osseous abnormality is identified.

IMPRESSION: Mild pulmonary edema and persistent right effusion, similar to prior   Keywords: similar, persistent.


SubjectID: 11296936, StudyID: 52375071, Comparison: better

FINAL REPORT

PA AND LATERAL CHEST, ___

COMPARISON: Radiograph ___.

FINDINGS: Cardiomegaly is accompanied by pulmonary vascular congestion and improving pulmonary edema   Keywords: improving. More confluent opacities at the bases have worsened, and are concerning for possible infectious or aspiration pneumonia given history of fever. Small pleural effusions are present, but there is no visible pneumothorax.


SubjectID: 11296936, StudyID: 55973488, Comparison: same

FINAL REPORT

HISTORY: ESRD and cocaine history, to assess for acute process.

FINDINGS: In comparison with study of ___, there are lower lung volumes, which may account for some of the increased prominence of the transverse diameter of the heart. Again, there is moderately severe pulmonary edema   Keywords: again.


SubjectID: 11296936, StudyID: 52699744, Comparison: better

FINAL REPORT

INDICATION: Fluid overload, look for interval changes.

TECHNIQUE: Supine portable chest view was read in comparison with prior chest radiograph acquired eight to nine hours apart. Moderately severe pulmonary edema has improved over last seven to eight hours. The retrocardiac density reflecting combination of left lower lung atelectasis and pulmonary edema is also better. Top normal heart size, mediastinal and hilar contours are unchanged.

IMPRESSION: Over the last seven to eight hours, moderately severe pulmonary edema has improved   Keywords: improve.


SubjectID: 11296936, StudyID: 52352541, Comparison: 1.0

FINAL REPORT

CHEST RADIOGRAPH

TECHNIQUE: ___ man with end-stage renal disease, fluid overload, concern for pneumonia or crackle pneumonitis.

TECHNIQUE: Portable upright chest view was reviewed in comparison with multiple prior radiographs with the most recent from ___, acquired 12 hours apart.

FINDINGS: Moderate-to-severe pulmonary edema has improved over the last 12 hours   Keywords: improve. A dual lumen left subclavian catheter tip is at upper right atrium. Increased retrocardiac density which is likely due to combination of atelectasis and pulmonary edema is minimally worsened   Keywords: worse. Top normal heart size, mediastinal and hilar contours are unchanged.

IMPRESSION: Over the last 12 hours, moderate-to-severe pulmonary edema has improved   Keywords: improve.


SubjectID: 11296936, StudyID: 55718502, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with cough and shortness of breath.

COMPARISON: Chest radiograph ___ AP PORTABLE UPRIGHT CHEST RADIOGRAPH: The hilar and mediastinal contours are stable, with a mildly tortuous thoracic aorta. Again, seen is a moderate-sized right pleural effusion with mild right basal atelectasis. Bilateral perihilar and pulmonary alveolar opacities are most suggestive of moderate-to-severe pulmonary edema. Left IJ approach central venous dialysis catheter ends in the right atrium. There is no pneumothorax.

IMPRESSION: Moderate-sized right pleural effusion with moderate pulmonary edema.


SubjectID: 11296936, StudyID: 53461257, Comparison: better

FINAL REPORT

PORTABLE CHEST ___

COMPARISON: Study of earlier the same date.

FINDINGS: Overall, there has been slight improvement in diffuse bilateral alveolar opacities following reported history of diuresis   Keywords: improve. However, one area in the left perihilar region appears more confluent than on the prior study. Bilateral pleural effusions, right greater than left, have not appreciably changed.


SubjectID: 11296936, StudyID: 51357481, Comparison: None

FINAL REPORT

PORTABLE CHEST OF ___

COMPARISON: ___ radiograph.

FINDINGS: Cardiac silhouette remains enlarged. Bilateral diffuse airspace opacities affecting the right lung to a greater degree than the left have slightly worsened in the interval and likely represent progressive asymmetrical pulmonary edema. Superimposed pneumonia in the right lung is also a possibility, and followup radiographs after diuresis may be helpful in this regard. Moderate right and small left pleural effusions are unchanged.


SubjectID: 11296936, StudyID: 50218289, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: ___-year-old man with chest pain, dialysis, concerning for pulmonary edema, to look for interval changes.

TECHNIQUE: Portable semi-erect chest view was read in comparison with multiple prior radiographs with the most recent from ___.

FINDINGS: Dual-lumen left central line catheter tip lies at right upper atrium. The ___ severe pulmonary edema is unchanged in severity but has redistributed, with interval improvement in the left lung and worsening on the right side   Keywords: unchanged. Normal heart size, mediastinal and hilar contours are stable. No pneumothorax. Small right pleural effusion is unchanged.

IMPRESSION: Since ___ severe pulmonary edema is unchanged in severity but has distribution with interval worsening in the right lung and improved on the left side   Keywords: unchanged.


SubjectID: 11296936, StudyID: 53205426, Comparison: None

FINAL REPORT

INDICATION: Evaluation of patient with cough and shortness of breath.

COMPARISON: Chest radiograph from ___.

FINDINGS: There are bilateral hazy interstitial opacities likely representative of moderate pulmonary edema. Cardiomediastinal silhouette appears enlarged in comparison to prior study. There is a small right pleural effusion. Overall, these findings are representative of heart failure. Furthermore, a focal 1.5 x 1.2 cm nodularity is noted in the right upper lobe. No acute fractures identified.

IMPRESSION: 1. Bilateral hazy interstitial opacities with enlarged cardiomediastinal silhouette are representative of heart failure. 2. 1.5 x 1.2 cm nodularities in the right upper lobe. Dedicated chest radiographs post-diuresis are recommended to evaluate this region.


SubjectID: 11296936, StudyID: 51547312, Comparison: better

FINAL REPORT

PA AND LATERAL CHEST

INDICATION: Patient with CHF, COPD, shortness of breath, resolution of pulmonary edema.

COMPARISON: ___.

FINDINGS: Moderate-to-severe pulmonary edema that was present on ___, has significantly improved and is now mild   Keywords: improve. Bibasilar opacity has also improved. Moderate cardiac enlargement is stable. Small pleural effusion has also improved. There is no pneumothorax.

CONCLUSION: Pulmonary edema has significantly improved and is now mild   Keywords: improve.


SubjectID: 11297219, StudyID: 55368200, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man s/p atrial lead placement for CRT-D device // PTX, leads PTX, leads

IMPRESSION: In comparison with the study of ___, there is little interval change   Keywords: little interval change. Continued enlargement of the cardiac silhouette with minimal elevation of pulmonary venous pressure. Pacer leads are unchanged and there is no evidence of pneumothorax.


SubjectID: 11297219, StudyID: 53539022, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___M with defib that fired // eval positioning of defib leads

TECHNIQUE: Chest PA and lateral

COMPARISON: Multiple chest radiographs from ___ through ___

FINDINGS: The heart is enlarged but unchanged from ___. The mediastinal contours are within normal limits. A left-sided pacemaker with transvenous right atrial and left ventricular pacing wires as well as a right ventricular pacer/ defibrillator lead follow their expected courses. There is no pneumothorax, pleural effusion or mediastinal widening. The pulmonary vasculature is distended but unchanged from the prior study. There is no frank pulmonary edema.

IMPRESSION: 1. Cardiomegaly unchanged. 2. Transvenous right atrial and left ventricular pacing wires as well as a right ventricular pacer/ defibrillator follow expected courses. 3. No pneumothorax


SubjectID: 11297219, StudyID: 55119442, Comparison: 0.0

FINAL REPORT

INDICATION: Biventricular ICD upgrade. Evaluate lead position and rule out pneumothorax.

TECHNIQUE: Single frontal view of the chest.

COMPARISON: ___.

FINDINGS: There are now 2 pacemaker leads, with leads positioned in expected positions. A new left-sided generator pack is seen. Significant cardiomegaly persists. There are no focal pulmonary nodules, pleural effusions, or evidence of pneumothorax. Increased pulmonary vascular engorgement persists   Keywords: increase.

IMPRESSION: 1. Status post change of pacemaker generator pack with ventricular leads, in expected locations. No pneumothorax. 2. Persistent pulmonary vascular engorgement and severe cardiomegaly   Keywords: persistent.


SubjectID: 11297219, StudyID: 50955892, Comparison: same

FINAL REPORT

INDICATION: History of biventricular ICD upgrade. Please evaluate lead position. Please rule out pneumothorax.

COMPARISONS: Chest radiographs dated back to ___.

TECHNIQUE: PA and lateral radiographs of the chest.

FINDINGS: Moderate cardiomegaly has been stable compared to exams dated back to ___. There may be a small left pleural effusion. The leads appear to be in appropriate position. There is mild pulmonary vascular congestion. There is no evidence of a pneumothorax. Visualized osseous structures are unremarkable.

IMPRESSION: No evidence of a pneumothorax. Persistent mild pulmonary vascular congestion   Keywords: persistent. Mild pulmonary edema.


SubjectID: 11298819, StudyID: 52228665, Comparison: same

FINAL REPORT

HISTORY: Ascending aorta repair.

FINDINGS: In comparison with study of ___, there are somewhat better lung volumes in this patient with extensive midline wires following cardiac surgery. Central catheter again extends to the mid-to-lower portion of the SVC. Opacification at the left base is again consistent with some combination of volume loss in the lower lobe and pleural effusion. There is evidence of pulmonary edema persisting   Keywords: persisting.


SubjectID: 11298819, StudyID: 57737942, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST, ___

HISTORY: Possible right lower lobe pneumonia and aortic dissection.

IMPRESSION: AP and lateral chest compared to AP chest on ___ shows that the generally enlarged and tortuous thoracic aorta is generally larger than it was in ___. This appearance is more characteristic of an aneurysmal dissection and a simple thoracic aortic aneurysm. Heart size is normal and there is no pulmonary vascular engorgement. There are no findings to suggest pneumonia. Small pleural effusion collecting posteriorly is probably on the right side, seen only on the lateral view. Findings and their clinical significance were discussed with Dr. ___ at the time of dictation.


SubjectID: 11298819, StudyID: 56013572, Comparison: None

FINAL REPORT

AP CHEST 11:19 P.M. ON ___

HISTORY: ___-year-old woman with altered mental status and cough, rule out pneumonia.

IMPRESSION: AP chest compared to ___: Because of the large volume with overlying soft tissue and leftward rotation of the patient it is difficult to say whether there is consolidation in the right lower lobe. I would strongly recommend conventional chest radiographs. Left lung is clear. The heart is mildly enlarged. Thoracic aorta is generally quite large and tortuous, no less than 58 mm in diameter in the aortic arch, probably larger today than it was in ___. Whether this is simple aneurysm or chronic dissection is radiographically indeterminate. ___ and I discussed the findings and their clinical significance by telephone at the time of dictation..


SubjectID: 11304959, StudyID: 59954694, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF s/p IABP // confirm placement of IABP.

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the intra-aortic balloon pump is no longer visible. The right internal jugular vein catheter remains in situ. The lung volumes have decreased. Unchanged appearance of the heart and the lung parenchyma.


SubjectID: 11304959, StudyID: 59925028, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with CHF s/p IABP // confirm placement of IABP

EXAMINATION: CHEST (PORTABLE AP)

TECHNIQUE: Chest radiograph, frontal view

COMPARISON: Chest radiograph ___

FINDINGS: Right internal jugular venous catheter terminates in mid SVC. The tip the IABP terminates 3 cm below the top of aortic arch. Increased attenuation in bilateral lungs is likely due to layering bilateral pleural effusions which appear similar as before. Mild pulmonary edema is stable   Keywords: stable. Left lower lobe atelectasis in retrocardiac region is persistent. Mildly enlarged cardiac silhouette is stable.

IMPRESSION: IABP is in appropriate position. Mild pulmonary edema and Bilateral pleural effusions appear similar as before   Keywords: similar.


SubjectID: 11304959, StudyID: 59399307, Comparison: same

WET READ: ___ ___ ___ 6:25 PM Intra-aortic balloon pump, endotracheal tube, right internal jugular venous line and mediastinal surgical clips are in similar position. Enteric tube terminates in the stomach. The continues to be a retrocardiac opacity. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP) CLINICAL

HISTORY ___ year old man with balloon pump and new OG placement // new OG placement new OG placement

COMPARISON: ___ at ___ 58

FINDINGS: The right chest is not entirely included. The orogastric tube has been replaced and now terminates below the level of the diaphragm. The side hole appears to be below the level of the diaphragm as well. There is no other significant change   Keywords: no other significant change.

IMPRESSION: Orogastric tube is proper position.


SubjectID: 11304959, StudyID: 59804379, Comparison: None

FINAL REPORT

INDICATION: ___ man with valvular HF, intubated with IABP // check proper placement of endotracheal tube and IABP

EXAMINATION: CHEST (PORTABLE AP)

TECHNIQUE: Portable chest radiograph, frontal view

COMPARISON: Chest radiograph ___

FINDINGS: Right internal jugular venous catheter terminates in mid SVC. ET tube terminates 66 mm above the carina. The transesophageal tube courses below the diaphragm and not of view. Intra-aortic balloon pump is in unchanged position. Right apical pleural thickening is unchanged. Bibasilar opacities are likely secondary to atelectasis and pleural effusions, similar to prior. Mildly enlarged cardiac silhouette is unchanged.

IMPRESSION: ET tube and intra-aortic balloon pump are in appropriate positions, unchanged.


SubjectID: 11304959, StudyID: 55909586, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with IABP, intubated // interval changes interval changes

IMPRESSION: In comparison with the study of ___, the multiple monitoring and support devices are essentially unchanged. Again there is enlargement of the cardiac silhouette with bilateral layering pleural effusions and compressive basilar atelectasis. The degree of pulmonary vascular congestion is very difficult to determine in the face of the extensive a fusions.


SubjectID: 11304959, StudyID: 52048498, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with heart failure // eval ETT and OG tube placement eval ETT and OG tube placement

IMPRESSION: In comparison with the earlier study of this date, there is again diffuse bilateral pulmonary opacifications   Keywords: again. There has been placement of an endotracheal tube with its tip approximately 6.2 cm above the carina. Nasogastric tube extends to the upper to mid portion of the stomach, where it crosses the lower margin of the image.


SubjectID: 11304959, StudyID: 59458226, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with acute decompensated heart failure and new fever // ___ year old man with acute decompensated heart failure and new fever ___ year old man with acute decompensated heart failure and n

IMPRESSION: In comparison with the study of ___, the endotracheal tube and nasogastric tube have been removed. Little overall change in the appearance of the heart and lungs.


SubjectID: 11304959, StudyID: 52526027, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with IABP s/p MitraClip placement // Interval change

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Moderate to severe cardiomegaly is stable. Large bilateral effusions larger on the right are grossly unchanged. Intra-aortic balloon pump tip is at the level of the left main bronchus. There is no evident pneumothorax. Right IJ catheter tip is in the lower SVC. Surgical clips projecting in the lower left hemi thorax are again noted. ,


SubjectID: 11304959, StudyID: 51752676, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with CHF and MR ___/p MitraClip, intubated with IABP // position of IABP, ET tube

TECHNIQUE: Chest PA and lateral

FINDINGS: ET tube and nasogastric tube is in standard placement. Right jugular line ends in the mid SVC. Tip of the intra-aortic balloon pump below the lower margin of the left main bronchus along the left lateral vertebral body is approximately 7 cm from the aortic arch. Combination of severe bilateral lower lobe atelectasis and small to moderate pleural effusions has not changed over the past several days, but heart size remains enlarged and the component of pulmonary edema has largely cleared   Keywords: remains. No pneumothorax.

IMPRESSION: Tip of the intra-aortic balloon pump below the lower margin of the left main bronchus along the left lateral vertebral body is approximately 7 cm from the aortic arch No additional relevant change.


SubjectID: 11304959, StudyID: 57772862, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF exac, urosepsis // interval change interval change

IMPRESSION: In comparison with the study of ___, there are better lung volumes, though there is little change in the cardiomegaly, vascular congestion, and layering pleural effusions with compressive atelectasis at the bases, especially in the retrocardiac region where there is significant volume loss in the left lower lobe   Keywords: little change. . Areas of patchy opacification, especially in the upper lung zones, could reflect developing aspiration or pneumonia in the appropriate clinical setting.


SubjectID: 11304959, StudyID: 54197787, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF exac // interval changes in pulmonary edema interval changes in pulmonary edema

IMPRESSION: In comparison with the study of ___, there is again substantial enlargement of the cardiac silhouette with prominent pulmonary edema. Retrocardiac opacification with silhouetting of the hemidiaphragm suggests substantial volume loss in the left lower lobe with probable small pleural effusions bilaterally.


SubjectID: 11304959, StudyID: 57637736, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with SSS s/p PPM // r/o pneumo and lead placement

TECHNIQUE: Portable AP chest radiograph.

COMPARISON: Multiple prior studies most recent dated ___

FINDINGS: There has been interval placement of a dual lead pacemaker projecting over the left hemi thorax. The tip of the ventricular lead is not visualized on this study. A nasoenteric tube is in-situ, the tip is not visualized on this study. There is a persistent left pleural effusion, superior to have increased somewhat when compared to the prior study. The right pleural effusion is not well visualized on this study as the right costophrenic angle cannot be visualized. There is persistent silhouetting of both the right and left hemidiaphragms, likely due to atelectasis. Superimposed infection cannot be excluded but appearances are really unchanged compared to multiple prior studies. No pneumothorax seen.


SubjectID: 11304959, StudyID: 57565136, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF and malnutrition // 2 step dobhoff placement

TECHNIQUE: Single frontal view of the chest

COMPARISON: Study performed the same day earlier.

IMPRESSION: Dobhoff tube tip isin the stomach. No other interval change from prior study   Keywords: no other interval change.


SubjectID: 11304959, StudyID: 56347813, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF c/b pulmonary edema, delirium // interval change

TECHNIQUE: Supine portable chest radiograph

COMPARISON: Chest radiographs dated ___.

FINDINGS: The left pleural effusion has improved significantly. The right pleural effusion remains unchanged. The pulmonary vasculature is normal. Stable cardiomegaly. No pneumothorax is seen.

IMPRESSION: 1. Improvement in left pleural effusion. 2. Unchanged right pleural effusion.


SubjectID: 11304959, StudyID: 55210861, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with SSS s/p PPM // r/o pneumo and lead placement

TECHNIQUE: AP and lateral chest radiographs

COMPARISON: Serial chest radiographs most recent dated ___

FINDINGS: A dual lead pacemaker is in-situ. Both leads are visualized on the current study. Presumed mitral valve clips are also seen projecting over the heart. No pneumothorax seen. There are large bilateral pleural effusions with associated compressive atelectasis. These appear grossly stable when compared to the prior studies. Superimposed infection cannot be excluded. The tip of the Dobhoff tube is not visualized on the frontal projection but is seen to be in the expected location of the stomach on the lateral view

IMPRESSION: Expected appearances following transvenous pacemaker placement. The tip of the Dobhoff tube is not visualized on the AP view but appears to be in the stomach on the lateral projection. Large bilateral pleural effusions with associated compressive atelectasis. Superimposed infection cannot be excluded.


SubjectID: 11304959, StudyID: 54563775, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with valvular heart failure (LVEF ___%, severe MR), CAD s/p inferior/posterior MI, HTN, HLD, prostate cancer, and lymphoma who was transferred from OSH to FICU for septic shock ___ MRSA PNA and then to CCU with cardiogenic shock, now s/p MV clip c/b by episode of hypotension requiring 2L of fluid, IABP, and one unit of blood for post-op Hg of 6.6, now extubated, off pressors and IABP. Now status post PEG tube by GI. // assess for pulm edema

IMPRESSION: As compared to ___ chest radiograph, moderate on the right and moderate to large on the left. Positional differences limit comparison of the size of the effusions. Exam is otherwise remarkable for interval removal of a feeding tube.


SubjectID: 11304959, StudyID: 56918802, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___-year-old man with a history of CHF, now status post repositioning of Dobhoff tube.

TECHNIQUE: Portable AP chest radiograph

COMPARISON: Multiple prior chest radiographs, most recent from ___ at 14:45.

FINDINGS: Dobhoff tube now ends in the proximal stomach. Stable, mild cardiomegaly. Unchanged moderate right pleural effusion and moderate to large left pleural effusion. Substantial bibasilar atelectasis. Normal mediastinal and hilar contours.

IMPRESSION: Dobhoff tube now ends in the proximal stomach. Unchanged moderate right pleural effusion and moderate to large left pleural effusion.


SubjectID: 11304959, StudyID: 51555628, Comparison: worse

FINAL REPORT

INDICATION: ___ year old man s/p NGT placement // please evaluate for placement

TECHNIQUE: Portable

COMPARISON: ___

FINDINGS: The feeding tube tip is in the lower esophagus and needs to be advanced at least 8 cm. There are low lung volumes, which has worsened since the prior examination. Persistent dense retrocardiac opacity, mild pulmonary edema and layering effusions have increased   Keywords: increase.No pneumothorax. The cardiac shadow remains enlarged.

IMPRESSION: The feeding tube tip is in the lower esophagus and needs to be advanced at least 8 cm. Increasing moderate to large bilateral pleural effusions and severe bibasilar atelectasis.


SubjectID: 11304959, StudyID: 55541025, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF, sepsis, crackles on lung exam // Interval change

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: There has been dramatic worsening in the appearance of the chest with severe cardiomegaly, bilateral pleural effusions, pulmonary vascular redistribution with hazy alveolar infiltrate in a batwing appearance.

IMPRESSION: Pulmonary edema


SubjectID: 11304959, StudyID: 53490931, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with SOB, CHF vs pneumonia sepsis // Interval change Interval change

IMPRESSION: In comparison with the earlier study of this date, there is little interval change in the enlargement of the cardiac silhouette with elevation of pulmonary venous pressure and left pleural effusion with compressive basilar atelectasis. The lateral view shows that there is increased opacification just behind 1 of the major fissures and possibly also just anterior to the fluid collections   Keywords: increase. In view of the clinical history, this is worrisome for developing pneumonia


SubjectID: 11304959, StudyID: 52435999, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF and concern for pulmonary edema // Pulmonary edema? Pulmonary edema?

IMPRESSION: In comparison with the study of ___ from an outside facility, there is now all enlargement of the cardiac silhouette with elevated pulmonary venous pressure and left pleural effusion with compressive atelectasis at the base. No definite acute focal pneumonia, though the possibility of a superimposed consolidation in the retrocardiac region cannot be excluded, especially in the absence of a lateral view P


SubjectID: 11304959, StudyID: 55522696, Comparison: None

FINAL REPORT

CHEST, TWO VIEWS: ___.

HISTORY: ___-year-old male with increasing shortness of breath and leg swelling, question congestive failure.

COMPARISON: None.

FINDINGS: AP and lateral views of the chest. Indistinct pulmonary vascular markings are seen bilaterally. There are moderate bilateral pleural effusions. The cardiomediastinal silhouette is not well assessed due to the bibasilar opacities but is at least slightly enlarged. Surgical clips project over the mid upper abdomen.

IMPRESSION: Moderate bilateral effusions and moderate pulmonary edema. Please note that superimposed infection at the bases would be difficult to exclude.


SubjectID: 11304959, StudyID: 55121267, Comparison: None

FINAL REPORT

EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 2 EXAMS

INDICATION: ___ year old man with new dobhoff placement // Dobhoff placement

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Dobhoff tube tip isin the stomach. Right IJ catheter View projects in the cavoatrial junction. There is no pneumothorax. Right pleural effusion has decreased. . Layering moderate left pleural effusion and adjacent atelectasis are stable. There is no pneumothorax No other interval change from prior study.


SubjectID: 11315296, StudyID: 59930575, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with new systolic heart failure and pulm edema // pulm edema?

TECHNIQUE: Portable chest x-ray.

COMPARISON: Chest radiographs dated ___. ___.

FINDINGS: Portable semi-upright radiograph of the chest demonstrates well expanded, clear lungs. The cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation.

IMPRESSION: No evidence of pulmonary edema.


SubjectID: 11315296, StudyID: 54982187, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF, DM, and CKD who p/w SOB and found to have volume overload. // interval change

TECHNIQUE: Plain film

COMPARISON: ___.

FINDINGS: Notable interval clearing in bilateral perihilar and basilar edema is noted with some residual opacity in the left retrocardiac region and probably small remaining right pleural effusion. Cardiac size and contours and bony structures appear normal.

IMPRESSION: Notable but incomplete clearing of edema and effusions


SubjectID: 11315296, StudyID: 59487173, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with new dx of CHF // amount of pulm edema?

TECHNIQUE: Portable chest

COMPARISON: None.

FINDINGS: There dense bilateral lower lobe infiltrates which obscure the cardiac silhouette and are confluent with perihilar infiltrates. There bilateral pleural effusions that are moderate in size. There is mild pulmonary vascular redistribution.

IMPRESSION: CHF. An underlying infectious infiltrate cannot be excluded P


SubjectID: 11315296, StudyID: 52148623, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman with myocardial infarction, new heart failure and large pleural effusion.

FINDINGS: Comparison is made to prior study from ___. There are diffuse airspace opacities in the lower lung fields. There are also large bilateral pleural effusions. This is unchanged since the previous study. There is likely an element of pulmonary edema. Overall, these findings are stable. No pneumothoraces are present.


SubjectID: 11315296, StudyID: 58149698, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___F with left sided weakness, admitting to stroke service. Evaluate for underlying infection

TECHNIQUE: Chest PA and lateral

COMPARISON: ___

FINDINGS: PA and lateral views the chest provided. Midline sternotomy wires and mediastinal clips are again noted. No focal consolidation, large effusion or pneumothorax is seen. The heart size is normal. Mediastinal contour is unremarkable. No signs of hilar congestion or edema. Bony structures are intact. No free air below the right hemidiaphragm seen.

IMPRESSION: No acute intrathoracic process.


SubjectID: 11315296, StudyID: 53296565, Comparison: None

FINAL REPORT

EXAMINATION: PA and lateral views of the chest

INDICATION: ___ year old woman with fever. // ?PNA

TECHNIQUE: Chest: Frontal and Lateral

COMPARISON: Prior radiographs on ___

FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Median sternotomy wires and mediastinal clips are stable in position.

IMPRESSION: No pneumonia.


SubjectID: 11317570, StudyID: 58202150, Comparison: worse

FINAL REPORT

PORTABLE CHEST FILM ___ AT 8:03. CLINICAL

INDICATION: ___-year-old status post cardiac surgery with unclear fluid status, assess for interval change. Comparison is made to the patient's prior study of ___ at 15:18. Portable semi-erect chest film ___ at 8:03 is submitted.

IMPRESSION: Endotracheal tube has its tip 4 cm above the carina. Nasogastric tube is seen coursing below the diaphragm with the tip not identified. Right internal jugular central line has its tip in the distal SVC. The patient is status post median sternotomy for CABG with stably enlarged cardiac and mediastinal contours. There is worsening mild pulmonary interstitial edema   Keywords: worse. Small layering bilateral effusions are seen. No pneumothorax.


SubjectID: 11317570, StudyID: 51812943, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH.

INDICATION: Status post cardiac arrest, evaluation for interval changes.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The monitoring and support devices are constant. Mild cardiomegaly with pleural effusions and signs of mild fluid overload, unchanged as compared to the previous examination   Keywords: unchanged. No other relevant changes   Keywords: no other relevant change.


SubjectID: 11317570, StudyID: 51911622, Comparison: None

FINAL REPORT

HISTORY: Chest tube removal, to assess for pneumothorax.

FINDINGS: In comparison with the study of ___, the left chest tube has been removed and there is no convincing evidence of pneumothorax. Decreased opacification at the bases with better visualization of the hemidiaphragms, most likely represents a more erect position of the patient, though some improvement in effusions could be considered. Continued substantial enlargement of the cardiac silhouette.


SubjectID: 11317570, StudyID: 50380489, Comparison: better

FINAL REPORT

HISTORY: Intubated for arrest, now needing assessment of ETT position.

COMPARISON: Comparison made with chest radiographs from ___ in ___.

FINDINGS: Single portable semi-erect frontal image of the chest. The ET tube terminates 2 cm above the carina. The balloon on the ETT is noted to be overinflated and is distending the trachea. The lungs are well expanded. No focal opacity is seen. Very mild pulmonary edema is seen. Bilateral pleural effusions have slighltly improved from prior exam. There is no pneumothorax. Cardiomediastinal silhouette is top normal in size.

IMPRESSION: 1. ET tube 2 cm above the carina. 2. Balloon on the ETT overinflated and distending the trachea. 3. Very mild pulmonary edema with slight interval improvement of bilateral pleural effusions   Keywords: improve. These findings were communicated to Dr. ___ at 8:26 a.m. on ___ by phone.


SubjectID: 11319594, StudyID: 57612303, Comparison: worse

FINAL REPORT

INDICATION: Shortness of breath. Evaluate for cause.

TECHNIQUE: AP and lateral views of the chest.

COMPARISON: Chest radiograph from ___. Chest radiograph from ___.

FINDINGS: The lung volumes are low. Since the prior exam, there is increased vascular congestion and mild pulmonary edema   Keywords: increase. There is no focal consolidation to suggest pneumonia. There is no pleural effusion or pneumothorax. The hilar contours are enlarged. This is unchanged from ___, and likely due to pulmonary hypertension. The mediastinal contours are normal. The heart size is at the upper limits of normal. A left-sided pacemaker is unchanged, and in satisfactory position.

IMPRESSION: Mild pulmonary edema.


SubjectID: 11319594, StudyID: 57293538, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: :___ with PMH of CHF, afib on anticoagulation, CAD, HTN, tachybrady s/p pacer who presents with one week of worsening shortness of breath; now with increased SOB // ?interval change

IMPRESSION: As compared to ___ chest radiograph, pulmonary vascular congestion and interstitial edema have slightly improved   Keywords: improve. There remains moderate elevation of the right hemidiaphragm.


SubjectID: 11319594, StudyID: 54222108, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with dCHF, afib p/w incresed SOB admitted for diuresis // r/o focal conslidation

COMPARISON: ___.

IMPRESSION: As compared to the previous image, no relevant change is seen   Keywords: no relevant change. Low lung volumes. Borderline size of the heart. Left pectoral pacemaker. No pneumonia, no pulmonary edema, no pleural effusions.


SubjectID: 11319594, StudyID: 50085051, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with cough, rhonchi on exam // please evaluate for pna v. pulm edema

COMPARISON: ___.

IMPRESSION: Minimal decrease in lung volumes as compared to the previous examination. Otherwise unchanged radiograph   Keywords: unchanged radiograph. Mild cardiomegaly. No pulmonary edema. No pleural effusions. Unchanged position of the pacemaker wires. No pneumonia.


SubjectID: 11319594, StudyID: 53195256, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with worsening SOB, cough // Evidence pna? Evidence pna?

IMPRESSION: In comparison with the study ___ ___, there again are low lung volumes. The cardiac silhouette remains within normal limits and there is no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. Leads of the dual pacer device again extend to the right atrium and apex of the right ventricle.


SubjectID: 11325169, StudyID: 57056934, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: Prior chest radiograph from ___. CLINICAL

HISTORY: Dyspnea, question acute intrathoracic process.

FINDINGS: PA and lateral views of the chest provided. There is interstitial edema which is new from prior exam with probable tiny bilateral pleural effusions   Keywords: new. The heart is within normal limits of size. Mediastinal contour is normal. No pneumothorax is seen. Bony structures are intact.

IMPRESSION: Mild interstitial edema with tiny bilateral pleural effusions.


SubjectID: 11325169, StudyID: 53638962, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, evaluation for endotracheal tube position.

COMPARISON: ___.

FINDINGS: On the second of two radiographs, the one acquired at 7:59 p.m., the endotracheal tube projects 3 cm above the carina and the nasogastric tube is in correct position. As compared to the previous image, there is a substantial increase in severity of the bilateral predominantly central pulmonary edema and of the coexisting parenchymal opacities, slight increase in extent of the pre-existing pleural effusions. The size of the cardiac silhouette is unchanged.


SubjectID: 11325169, StudyID: 53502778, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Respiratory failure, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is improved ventilation of the lungs with a decrease in the overall extent of the pre-existing severe parenchymal opacities. Also decreased is the extent of pleural effusions, this decrease is more obvious on the left than on the right. Moderate cardiomegaly persists. No pneumothorax.


SubjectID: 11325169, StudyID: 56851366, Comparison: worse

FINAL REPORT

EXAMINATION: PA and lateral chest radiograph.

INDICATION: History: ___F with CHF and crackles on lung exam // Pulmonary edema?

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph dated ___.

FINDINGS: The trans subclavian right ventricular pacer defibrillator lead is continuous from the left pectoral generator. Mild to moderate pulmonary edema and mild to moderate cardiomegaly have progressed since ___   Keywords: progressed. New consolidation at the base of the right lung could be either asymmetric edema or concurrent pneumonia. Small bilateral pleural effusions are stable. Moderate cardiomegaly has progressed

IMPRESSION: Moderate pulmonary edema moderate cardiomegaly increased since ___   Keywords: increase. Right lower lobe asymmetric edema or concurrent pneumonia. Followup advised.

NOTIFICATION: The findings specifically regarding the possibility for concurrent pneumonia were discussed by Dr. ___ with Dr. ___ on the ___ ___ at 8:06 AM, after morning readout.


SubjectID: 11325169, StudyID: 53218067, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF s/p ICD, DM1, ESRD s/p renal transplant on immunosuppression, CAD, and CVA with worsening chest pain s/p catheterization. // Evidence of dissection s/p catheterization

COMPARISON: ___ and ___ chest radiographs

IMPRESSION: As compared to the recent study from earlier the same date, diffuse pulmonary edema has slightly worsened and is accompanied by slight increase in bilateral pleural effusions   Keywords: worse. Overall appearance of thoracic aortic contour is unchanged, but please note that conventional radiographs are relatively insensitive for detecting aortic dissection. If this diagnosis is suspected clinically, dedicated CT angiography would be recommended.


SubjectID: 11325169, StudyID: 54352697, Comparison: same

FINAL REPORT

INDICATION: ___-year-old female status post kidney transplant. Study is to evaluate for placement of endotracheal tube.

COMPARISON: Semi-erect AP radiograph of the chest taken earlier the same day.

TECHNIQUE: Semi-erect portable chest radiograph.

FINDINGS: Study essentially unchanged from prior. Endotracheal tube is appropriately positioned terminating no less than 6 cm from the carina. Bilateral pulmonary edema is unchanged   Keywords: unchanged.

IMPRESSION: Unchanged bilateral pulmonary edema   Keywords: unchanged. Endotracheal tube appropriately positioned.


SubjectID: 11325169, StudyID: 51219281, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female status post kidney transplant.

COMPARISON: Portable supine chest radiograph, ___.

TECHNIQUE: Portable semi-erect AP radiograph of the chest.

FINDINGS: There is extensive bilateral pulmonary edema with alveolar opacification and cardiomegaly. There is a small quantity of pleural effusion bilaterally. There is no pneumothorax. A right-sided IJ line is seen appropriately positioned within the mid SVC. Endotracheal tube is seen terminating 6 cm from the carina. NG tube is appropriately positioned, entering the stomach and terminates out of view.

IMPRESSION: Extensive bilateral pulmonary edema, most likely cardiogenic in nature.


SubjectID: 11325169, StudyID: 50162733, Comparison: None

FINAL REPORT

HISTORY: Worsening white count in patient with pneumonia.

FINDINGS: In comparison with study of ___, there is little change in the appearance of the bilateral regions of consolidation. Little change in the appearance of the right IJ catheter.


SubjectID: 11327174, StudyID: 57945309, Comparison: worse

FINAL REPORT

INDICATION: ___M with resp ditress pls eval for pna vs edema // History: ___M with resp ditress pls eval for pna vs edema

TECHNIQUE: Single portable view of the chest.

COMPARISON: ___.

FINDINGS: Exam is limited secondary to portable technique and patient body habitus. Within this limitation, there is apparent increased degree of pulmonary vascular markings   Keywords: increase. There is no large confluent consolidation. Blunting of the costophrenic angles could be due to overlying soft tissues although effusions cannot be excluded. Cardiomediastinal silhouette is stable. Bilateral shoulder arthroplasties are identified.

IMPRESSION: Limited exam with suspected pulmonary vascular congestion.


SubjectID: 11327174, StudyID: 52927345, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with dyspnea, ?CHF exac vs PE // acute processes acute processes

IMPRESSION: In comparison with these study of ___, the examination is again limited secondary to the portable technique an scatter radiation related to the size of the patient. The cardiomediastinal silhouette is stable. There is increasing pulmonary vascular congestion   Keywords: increasing.


SubjectID: 11344751, StudyID: 59386197, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with dyspnea // edema? effusions? pna?

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: There are low lung volumes. Given this, the cardiac silhouette is top-normal to mildly enlarged. No focal consolidation is seen. There is no large pleural effusion or pneumothorax. There may be mild central pulmonary vascular engorgement without overt pulmonary edema.


SubjectID: 11344751, StudyID: 54446367, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with SOB // ?acute intrapulmonary process ?pulmonary edema

TECHNIQUE: Chest single view

COMPARISON: 327

IMPRESSION: There has been interval increase in the cardiac silhouette with hazy bilateral vasculature and alveolar edema   Keywords: increase. There are not bilateral effusions layering posteriorly. The overall impression is that of worsened fluid overload   Keywords: worse. An underlying infectious infiltrate cannot be excluded.


SubjectID: 11344751, StudyID: 59108751, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with multisystem organ failure // ETT position

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the lung volumes have decreased. There is a minimal increase in lung density at the bases of the right hemi thorax. Improved ventilation in the retrocardiac lung region. All monitoring and support devices are in correct position, the tip of the endotracheal tube continues to project 2.5 cm above the carina.


SubjectID: 11344751, StudyID: 58693814, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with HIV and shock of unknown etiology // Evaluate for interval change

COMPARISON: ___.

IMPRESSION: No relevant change since the previous examination   Keywords: no relevant change. The monitoring and support devices are all in correct position. Low lung volumes. Moderate cardiomegaly, moderate centralized pulmonary edema with a noticeable interstitial component. No pneumothorax, no larger pleural effusions.


SubjectID: 11344751, StudyID: 50132124, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with HIV and shock

COMPARISON: Chest radiograph from ___.

FINDINGS: AP view of the chest provided. Compared to prior study, there is interval increase in right lung opacity, more confluent in the bases with air bronchograms. There is no shift in mediastinum. Findings concern developing pneumonia. The opacity is stable. Endotracheal tube, left IJ line, right IJ dialysis catheter are in appropriate positions. Nasogastric tube is seen coursing into the stomach and out of view.

IMPRESSION: Worsening right lower lobe pneumonia compared to prior study 1 day ago.


SubjectID: 11344751, StudyID: 50097463, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with intubation // interval change, change in pulmonary edema, ET tube interval change, change in pulmonary edema, ET tube

IMPRESSION: In comparison with the study of ___, the monitoring and support devices remain in place. Again there is enlargement of the cardiac silhouette with elevation of pulmonary venous pressure and extensive opacification in the retrocardiac area consistent with volume loss in the lower lobe. In the appropriate clinical setting, it would be difficult to exclude superimposed pneumonia.


SubjectID: 11344751, StudyID: 58548816, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old feamle with history of HIV on HAART with CD4 count of 877, undetectable viral load, seronegative rheumatoid arthritis, dCHF w/ recent exacerbation, here w/ dyspnea and weakness, found to have dCHF exacerbation, leukocytosis 20K w/ rising LDH 600 concerning for occult malignancy versus infection. Now has fever to 101. // ?pneumonia ?pneumonia

IMPRESSION: In comparison with the study of ___, there again are low lung volumes. Continued enlargement of the cardiac silhouette with elevated pulmonary venous pressure and layering pleural effusions with compressive atelectasis at the bases. In view of all of these changes, it is difficult to assess for possible superimposed pneumonia.


SubjectID: 11344751, StudyID: 57271483, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old feamle with history of HIV on HAART with CD4 count of 877, undetectable viral load, seronegative rheumatoid arthritis on Prednisone and Methotrexate here with leukocytosis and found to be hypoxic with likely dCHF exacerbation on admission and being transferred to the ICU for altered mental status. // eval interval change

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Low lung volumes. Mild to moderate pulmonary edema. Moderate cardiomegaly. Minimal retrocardiac atelectasis. No pleural effusions.


SubjectID: 11344751, StudyID: 53188222, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF // s/p NGT placement

IMPRESSION: As compared to ___ radiograph, nasogastric tube is been placed, with tip coursing below the diaphragm. Cardiomediastinal contours are stable allowing for patient rotation. Apparent worsening opacification in the right perihilar and basilar regions could reflect asymmetrical edema or secondary process such as aspiration or infectious pneumonia   Keywords: worse. Short-term followup radiographs may be helpful in this regard


SubjectID: 11344751, StudyID: 51489459, Comparison: same

FINAL REPORT

INDICATION: ___ year old feamle with history of HIV on HAART with CD4 count of 877, undetectable viral load, seronegative rheumatoid arthritis on Prednisone and Methotrexate here with leukocytosis and found to be hypoxic with likely dCHF exacerbation on admission and being transferred to the ICU for altered mental status. // interval change

COMPARISON: Radiographs from ___.

IMPRESSION: Support lines and tubes are unchanged in position. Cardiac silhouette is enlarged and stable. There is again seen pulmonary edema, unchanged   Keywords: again, unchanged. There is mild improved aeration at the left base. There are no pneumothoraces.


SubjectID: 11344751, StudyID: 50525805, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old feamle with history of HIV on HAART with CD4 count of 877, undetectable viral load, seronegative rheumatoid arthritis on Prednisone and Methotrexate here with leukocytosis and found to be hypoxic with likely dCHF exacerbation on admission and being transferred to the ICU for altered mental status nwo intubated. // eval ETT placement

IMPRESSION: Interval placement of endotracheal tube with tip in standard position. As compared to the previous study from earlier the same date, pulmonary edema pattern now appears more symmetrical and is overall slightly improved as compared to earlier study of ___   Keywords: same.


SubjectID: 11344751, StudyID: 55823762, Comparison: better

FINAL REPORT

INDICATION: ___ year old woman with new dialysis line // ?pneumothorax

COMPARISON: Radiographs from ___ at 04:08.

IMPRESSION: There is a new right IJ central line with the distal lead tip in the mid SVC. The endotracheal tube and left IJ central line are unchanged in position as is the enteric tube. Heart size is within normal limits. There is some improvement of the pulmonary edema   Keywords: improve. There remains a left retrocardiac opacity. There are no pneumothoraces.


SubjectID: 11386629, StudyID: 55690725, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man with CHF, evaluate for pulmonary edema.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest x-ray from ___

FINDINGS: The left hemidiaphragm is obscured, likely due to atelectasis at the left lung base. The use right lung is clear. The heart is moderately enlarged. Mediastinal contours are stable. There is no pleural effusion or pneumothorax.

IMPRESSION: Obscuration of the left hemidiaphragm, which likely due to atelectasis of the left lung base. No evidence of overt edema.


SubjectID: 11386629, StudyID: 52850628, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with HF exacerbation // Eval for interval change Eval for interval change

COMPARISON: Prior chest radiographs since ___, most recently ___.

IMPRESSION: Moderate cardiomegaly unchanged. No pulmonary or mediastinal vascular engorgement. Lungs clear. No appreciable pleural effusion.


SubjectID: 11386629, StudyID: 50572884, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ yo male with history of chronic systolic heart failure ___ amyloid cardiomyopathy, DM, AF, OSA, presenting with increased dyspnea likely acute on chronic systolic CHF exacerbation. // eval for pulm edema eval for pulm edema

IMPRESSION: Comparison to ___. Moderate cardiomegaly. Elongation of the descending aorta. No pulmonary edema, no pneumonia, no pleural effusions.


SubjectID: 11387260, StudyID: 58633801, Comparison: None

FINAL REPORT

HISTORY: Intubations with bloody airway secretions.

FINDINGS: In comparison with the earlier study of this date, the tip of the endotracheal tube measures approximately 4.5 cm above the carina. Nasogastric tube and right IJ catheter remain in place. The overall appearance of the heart and lungs is essentially unchanged.


SubjectID: 11387260, StudyID: 55944538, Comparison: None

FINAL REPORT

HISTORY: MI, to assess for change.

FINDINGS: In comparison with the earlier study of this date, the monitoring and support devices remain in place. Again there is enlargement of the cardiac silhouette with some elevation of pulmonary venous pressure and bilateral pleural effusions with compressive atelectasis at the bases.


SubjectID: 11387260, StudyID: 50504882, Comparison: same

FINAL REPORT

HISTORY: OG tube placement.

FINDINGS: In comparison with the earlier study of this date, the orogastric tube extends well into the stomach with the tip at least in the lower body. Otherwise, little change   Keywords: little change.


SubjectID: 11387260, StudyID: 58084629, Comparison: better

FINAL REPORT

HISTORY: MI, to assess for worsening edema.

FINDINGS: In comparison with the study of ___, there is continued improvement in the pulmonary vascular status   Keywords: improve. The right basilar atelectasis has essentially cleared. Retrocardiac opacification is again consistent with volume loss in the lower lobe and there is blunting of the costophrenic angle suggestive of small pleural effusion. Monitoring and support devices are essentially unchanged.


SubjectID: 11387260, StudyID: 54187163, Comparison: same

WET READ: ___ ___ 8:48 PM NGT with the tip in the stomach. Status post extubation with persistent mild left basilar atelectasis. Slight interval worsening of vsacular congestion since the prior exam. No new focal opacity. Unchanged heart size. Nonobstructive gas pattern.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post extubation and nasogastric tube placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has been extubated and the nasogastric tube has been replaced. The current tube shows a normal course. The sidehole projects over the gastroesophageal junction, and the tip is located in the proximal parts of the stomach. Tube could to be re-advanced by approximately 5 cm. The right internal jugular vein catheter has been removed. Otherwise, no changes   Keywords: no change. Normal lung volumes. Unchange opacities in the right and left upper lobe as well as in the retrocardiac lung areas. Unchanged tortuosity of the thoracic aorta and borderline size of the cardiac silhouette.


SubjectID: 11387260, StudyID: 52862063, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Intubation, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the lung volumes have minimally decreased, potentially reflecting decreased ventilatory pressure. The size of the cardiac silhouette is constant. There is unchanged evidence of mild-to-moderate pulmonary edema and of bilateral areas of atelectasis   Keywords: unchanged. Moderate cardiomegaly persists. The presence of a minimal right pleural effusion cannot be excluded.


SubjectID: 11390987, StudyID: 56779554, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with right heart failure, hypoxic respiratory failure // please eval for aspiration event, fluid overlaod

COMPARISON: ___.

IMPRESSION: No relevant change as compared to the previous image   Keywords: no relevant change. Moderate cardiomegaly, potential minimal left pleural effusion. Mild fluid overload but no overt pulmonary edema. No new focal parenchymal opacities   Keywords: new.


SubjectID: 11390987, StudyID: 54287648, Comparison: None

WET READ: ___ ___ ___ 9:30 AM Mild pulmonary vascular congestion. Small left pleural effusion. Severe cardiomegaly is similar as before.

WET READ VERSION #1 ___ ___ 3:23 AM Mild pulmonary vascular congestion. Small left pleural effusion. Severe cardiomegaly is similar as before. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with r heart failure and atrial arrhythmia, with changed altered mental status and leukocytosis // Pneumonia vs fluid overload

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, there is now minimal pulmonary edema. Moderate cardiomegaly persists. No pleural effusions. No pneumonia.


SubjectID: 11422357, StudyID: 58107119, Comparison: worse

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: History: ___M with PMH of CHF with increasing SOB and fall with L knee pain // ?CHF, as well as rib fracture and knee fracture

TECHNIQUE: Chest: Frontal and Lateral

COMPARISON: ___

FINDINGS: Single lead left-sided AICD is seen with lead extending the expected location of the right ventricle. Status post median sternotomy. Increased interstitial markings again seen bilaterally consistent with chronic lung disease, although appear slightly more prominent compared to the prior study which may be due to component of superimposed pulmonary edema   Keywords: increase   Keywords: increase. No pleural effusion is seen. Cardiac and mediastinal silhouettes are stable.

IMPRESSION: Single lead left-sided AICD is seen with lead extending the expected location of the right ventricle. Status post median sternotomy. Increased interstitial markings again seen bilaterally consistent with chronic lung disease, although appear slightly more prominent compared to the prior study which may be due to component of superimposed pulmonary edema. No pleural effusion is seen. Cardiac and mediastinal silhouettes are stable.


SubjectID: 11422357, StudyID: 55995256, Comparison: -1.0

FINAL REPORT

INDICATION: ___M with DOE, h/o CHF with low EF, now desatting in sleep. // assess for evidence of worsening pulmonary edema

TECHNIQUE: PA and lateral views the chest.

COMPARISON: ___.

FINDINGS: When compared to prior, there has been no significant interval change   Keywords: no significant interval change. There are increased interstitial markings throughout the lungs, unchanged   Keywords: increase. There is no superimposed acute cardiopulmonary process, no consolidation or effusion. The cardiac silhouette is enlarged but stable compared to prior. Median sternotomy wires and mediastinal clips are again seen in addition to dual lead left chest wall pacing device. No acute osseous abnormalities.

IMPRESSION: Increased interstitial markings throughout the lungs likely in part due to interstitial edema, similar when compared to prior   Keywords: increase. No superimposed consolidation or other process.


SubjectID: 11433898, StudyID: 57043884, Comparison: None

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Hypoxia.

COMPARISONS: ___.

TECHNIQUE: Chest, portable AP upright.

FINDINGS: The patient is status post mitral valve replacement. A dual-lead pacemaker/ICD device appears unchanged, with leads terminating in the right atrium and ventricle, respectively. The heart is again enlarged. The main pulmonary artery contour is likewise enlarged, as seen previously. There is dense new opacification of the left mid to lower lung, probably including the left lower lobe and lingula, with a pleural effusion of substantial size, moderate and possibly large. In addition, there is a moderate predominantly central interstitial abnormality with hazy perihilar opacification, consistent with moderate pulmonary edema. There is no pneumothorax or clear evidence for pleural effusion on the right.

IMPRESSION: 1. Dense left basilar opacification with pleural effusion. Differential considerations include atelectasis associated with a substantial pleural effusion versus pneumonia. 2. Findings suggesting moderate pulmonary vascular congestion.


SubjectID: 11451232, StudyID: 59225043, Comparison: None

FINAL REPORT

HISTORY: Mitral stenosis with valvuloplasty.

FINDINGS: No previous images. There is enlargement of the cardiac silhouette, especially the left atrium, with posterior prominence of the upper portion of the cardiac silhouette and elevation of the left main stem bronchus. Some prominence of central vessels is consistent with elevated pulmonary venous pressure. Marked tortuosity of the aorta is seen. Blunting of the costophrenic angles posteriorly could represent small effusions or pleural thickening. No evidence of acute focal pneumonia. Of incidental note is substantial degenerative change involving the lower thoracic and upper lumbar spine.


SubjectID: 11451232, StudyID: 53647852, Comparison: worse

FINAL REPORT

INDICATION: Shortness of breath and weakness after cardioversion. Evaluate for pneumonia.

COMPARISON: Chest radiograph from ___.

TECHNIQUE: PA and lateral chest radiograph.

FINDINGS: Compared with the prior examination, there is significant increase in conspicuity of interstitial markings, more pronounced in the lung bases, with indistinctness of the hila   Keywords: increase. There might be small bilateral pleural effusion, which were not clearly seen in the prior exam. There is no pneumothorax. Unchanged cardiomegaly.

IMPRESSION: Constellation of findings compatible with mild interstitial edema.


SubjectID: 11459120, StudyID: 57101262, Comparison: None

FINAL REPORT

INDICATION: History of fall, left shoulder and hip pain. Evaluate for traumatic process.

COMPARISON: Chest radiograph from ___.

FINDINGS: PA and lateral chest radiographs were provided. Lungs are well expanded. There is no focal consolidation, pleural effusion or pneumothorax. Left chest wall pacemaker is noted with leads in the right atrium and right ventricle. The visualized cardiac silhouette is normal. The bones are intact. A left humeral replacement is noted.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 11459120, StudyID: 56140571, Comparison: same

FINAL REPORT

HISTORY: Hypoxia.

FINDINGS: In comparison with the earlier study of this date, there are slightly lower lung volumes with continued evidence of bilateral opacifications that could well reflect some degree of elevated pulmonary venous pressure   Keywords: continue. Continued subtle opacity in the right mid zone.


SubjectID: 11459120, StudyID: 56145431, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with dypsnea // acute cardiopulm disease

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, a pre-existing mild and subtle right upper lobe opacity has completely resolved. However, the lung volumes have decreased and today's examination shows minimal bilateral parenchymal opacities   Keywords: decrease. Although these could be atelectatic in origin, the presence of developing pneumonia cannot be excluded. The size of the cardiac silhouette is within normal borders. No pleural effusions. Status post removal of the right PICC line.


SubjectID: 11459120, StudyID: 55919538, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with leukocytosis, atelectasis vs. pneumonia on prior X-ray // ?pneumonia

COMPARISON: ___

IMPRESSION: As compared to the previous image, the pre-existing right lower lung opacity has completely resolved. There is no remnant opacities seen on the current image. Borderline size of the cardiac silhouette without pulmonary edema. No pleural effusion on both the frontal and the lateral radiograph. The left pectoral pacemaker is in unchanged position.


SubjectID: 11459120, StudyID: 54729631, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with shortness of breath, cough // please evaluate for interval change please evaluate for interval change

IMPRESSION: In comparison with the study of ___, there is increase in the opacity in the right mid lung zone, consistent with developing pneumonia. Otherwise little change   Keywords: little change.


SubjectID: 11459120, StudyID: 51556348, Comparison: None

WET READ: ___ ___ ___ 9:16 AM 1. New subtle opacity within the right upper lobe is worrisome for pneumonia. Of note this is similar in location to patient's recurrent pneumonias dating back to ___. 2. Linear right lower lobe atelectasis. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: Chest radiograph.

INDICATION: ___F with cough, weakness. Assess for pneumonia.

COMPARISON: Chest radiograph ___, ___, ___, ___. CTA chest ___.

FINDINGS: Frontal and lateral chest radiographs demonstrate mildly hypoinflated lungs. The left lung is clear. Within the right upper lobe there is new subtle opacity. Right lower lobe linear opacity is most consistent with linear atelectasis. No pleural effusion or pneumothorax. Stable mild cardiomegaly. Mediastinal contour and hila are otherwise unremarkable. Aortic arch calcifications are present. Left chest wall dual lead pacing device is again noted.

IMPRESSION: 1. New subtle opacity within the right upper lobe is worrisome for pneumonia. Of note this is similar in location to patient's recurrent pneumonias dating back to ___. 2. Linear right lower lobe atelectasis.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 8:56 AM, 5 minutes after discovery of the findings.


SubjectID: 11459120, StudyID: 53348537, Comparison: None

FINAL REPORT

INDICATION: Evaluation of patient with hypoxia.

COMPARISON: Chest radiograph from ___.

FINDINGS: Again visualized are bibasilar atelectatic changes, greater at the left base. Otherwise, lungs are without a focal consolidation. Mild increase in central venous pressure is again noted. A dual-lead AICD terminates in place. Cardiac silhouette remains mildly stably enlarged. Atherosclerotic calcifications are noted at the aortic arch.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 11459120, StudyID: 51204663, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Tracheobronchomalacia, history of PE, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Left pectoral pacemaker with unchanged lead position. Borderline size of the cardiac silhouette, pleural effusions. No pneumothorax, no pneumonia. No pulmonary edema.


SubjectID: 11459825, StudyID: 56144961, Comparison: None

FINAL REPORT

INDICATION: Evaluate for fluid overload in a patient with a history of CHF, now with shortness of breath.

COMPARISON: Chest radiographs from ___, ___, ___.

FINDINGS: A portable frontal chest radiograph demonstrates slightly lower lung volumes with increased prominence of the cardiac silhouette and bronchovascular crowding. Allowing for this and differences in technique, heart size is likely unchanged. There is increased opacity overlying the bilateral lower lobes, with evidence of a small left pleural effusion, consistent with mild pulmonary edema. A right pleural effusion is trace, if any. There is no pneumothorax. No definite focal consolidation is seen, though the presence of underlying consolidation at the left base would be difficult to exclude. Old healed right sided rib fractures again noted. Clips projecting over the left axilla are unchanged. The visualized upper abdomen is grossly unremarkable.

IMPRESSION: 1. Mild to moderate cardiomegaly, grossly unchanged. 2. CHF with interstitial and mild alveolar edema, with a small left pleural effusion and underlying left base collapse/consolidation.


SubjectID: 11459825, StudyID: 52973660, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with pulm edema // interval change

IMPRESSION: As compared to prior radiograph from 1 day earlier, pulmonary edema has slightly changed in distribution due to positional differences, and overall severity has slightly decreased. Small to moderate right and small left pleural effusions are noted with adjacent bibasilar atelectasis and or consolidation.


SubjectID: 11472206, StudyID: 58518786, Comparison: worse

FINAL REPORT

HISTORY: GI bleed status post intubation, evaluate for ET tube position.

TECHNIQUE: A single frontal portable view of the chest.

COMPARISON: Chest radiographs ___, ___ and ___.

FINDINGS: The endotracheal tube is in satisfactory position, 2.8 cm above the carina. There is new moderate pulmonary edema with small bilateral pleural effusions   Keywords: new. Fluid is seen within the minor fissure. The cardiac silhouette is moderately enlarged. Enlargement of the mediastinum is unchanged from ___. There is no pneumothorax.

IMPRESSION: 1. Satisfactory ET tube position. 2. New moderate pulmonary edema   Keywords: new. These findings were discussed with Dr. ___ by Dr. ___ at 10:59 a.m. on ___ via telephone at the time of discovery.


SubjectID: 11472206, StudyID: 52667209, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Dyspnea, leukocytosis, evaluation for pneumonia.

COMPARISON: ___.

FINDINGS: Compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Moderate cardiomegaly with retrocardiac atelectasis, normal alignment of sternal wires and without evidence of parenchymal opacities, with the exception of minimal atelectasis in the retrocardiac lung region. The lateral radiograph, however, shows a small dorsal effusion. No overt pulmonary edema.


SubjectID: 11472206, StudyID: 54732928, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST, ___

HISTORY: Unusual air collection.

IMPRESSION: PA and lateral chest compared to ___ at 8:24 p.m. and chest CT performed concurrently but reported separately: This is a very unusual midline gas collection, has no strict correlate on the chest CTA, which does however show gaseous distention of the esophagus, which is the explanation for the radiographic appearance, unchanged since earlier in the evening. Moderate-to-severe cardiomegaly and mediastinal venous engorgement are unchanged. Lungs are clear and there is no pleural effusion or pneumothorax.


SubjectID: 11472206, StudyID: 51589307, Comparison: None

WET READ: ___ ___ 8:45 PM Irregular air collection projecting over mid mediastinum; question esphageal pathology, possibly inflammation, hernia or even leak?

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Dyspnea. History of anemia and congestive heart failure.

COMPARISONS: Prior chest radiographs from ___ and ___, as well as CT of the abdomen from ___.

TECHNIQUE: Chest, AP upright and lateral.

FINDINGS: The patient is status post sternotomy. The heart is moderately enlarged. Projecting over the mid chest, and seen only on the frontal view, is an irregular air collection projecting below the level of the carina. Otherwise, the mediastinal and hilar contours appear unchanged. There is no pleural effusion or pneumothorax. Mild loss in lower vertebral body heights appears unchanged. The bones may be demineralized to some degree.

IMPRESSION: Irregular air collection projecting over the central lower mediastinum, probably referring to the esophagus; the etiology is uncertain. There are variety of possibilities including esophageal pathology, including the possibility of perforation, although dilatation due to dysmotility or inflammation of the esophagus may explain the appearance.


SubjectID: 11474179, StudyID: 59900327, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female with acute shortness of breath and chest pain. Evaluate for pulmonary edema.

COMPARISON: Multiple prior radiographs of the chest dated ___ through ___.

FINDINGS: Portable semi-upright radiograph of the chest demonstrates low lung volumes with associated bronchovascular crowding. There is slight increase in plate-like atelectasis at the right lung base. Moderate cardiomegaly is unchanged. The patient is status post CABG. Possible slight improvement in left basilar opacity may be due to positioning of the patient.

IMPRESSION: Slight increase in plate-like atelectasis at the right lung base.


SubjectID: 11474179, StudyID: 55102016, Comparison: None

FINAL REPORT

EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Shortness of breath.

COMPARISON: ___.

FINDINGS: Frontal and lateral views of the chest were obtained. Patient is status post median sternotomy and CABG. There are low lung volumes. Mild bibasilar atelectasis is seen without definite focal consolidation. There is slight blunting of the right costophrenic angle, and trace pleural effusion is not excluded. The cardiac and mediastinal silhouettes are stable. There may be minimal pulmonary vascular congestion. There is an old fracture of the right-sided posterolateral sixth rib.

IMPRESSION: Low lung volumes with possible minimal vascular congestion. Bibasilar atelectasis without focal consolidation.


SubjectID: 11507392, StudyID: 57463875, Comparison: None

FINAL REPORT

HISTORY: Dyspnea.

TECHNIQUE: PA and lateral views of the chest.

COMPARISON: ___.

FINDINGS: The heart size may be mildly enlarged though assessment is somewhat limited due to presence of a new small to moderate size right pleural effusion. Mild pulmonary edema is present. Bibasilar airspace opacities, more pronounced in the right may reflect compressive atelectasis but infection or aspiration is not excluded. There is no pneumothorax. There are no acute osseous abnormalities identified.

IMPRESSION: Mild pulmonary edema and small to moderate size right pleural effusion. Bibasilar airspace opacities could reflect atelectasis but infection or aspiration cannot be excluded.


SubjectID: 11507392, StudyID: 56976759, Comparison: better

FINAL REPORT

AP CHEST, 7:53 A.M., ___

HISTORY: Type 2 diabetes, remote colon CA. One week of acute-onset dyspnea.

IMPRESSION: AP chest compared to ___: Previously asymmetric pulmonary edema has more evenly distributed, and improved, particularly in the left lung   Keywords: improve. There is still substantial bibasilar consolidation, presumably atelectasis, and no appreciable change in moderate right pleural effusion which is distributed differently because of changes in patient's position. Heart is only top normal size. I discussed by telephone with Dr. ___, at 9:30 a.m.


SubjectID: 11507392, StudyID: 51390201, Comparison: None

FINAL REPORT

PORTABLE CHEST FILM ON ___ AT 7:16 CLINICAL

INDICATION: ___-year-old with hypertension, hyperlipidemia and dyspnea, assess for pleural effusion. Comparison is made to the patient's previous study dated ___ at 7:53. Portable AP upright chest film ___ and 7:16 is submitted.

IMPRESSION: 1. There are layering bilateral effusions and bibasilar air-space disease with an evolving more focal opacity in the left mid lung. These findings are more concerning for aspiration and/or pneumonia rather than an asymmetric distribution of pulmonary edema given that the pulmonary vasculature appears well defined on the current examination. Clinical correlation is advised. No pneumothorax. Overall, cardiac and mediastinal contours are likely unchanged, although the left heart border is obscured by overlying air-space process. No pneumothorax.


SubjectID: 11507392, StudyID: 56626864, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___.

FINDINGS: Cardiac silhouette is mildly enlarged. Upper zone vascular redistribution is present without overt pulmonary edema. Rapid interval improvement in left mid and lower lung opacities, which may have been due to aspiration and/or atelectasis. Residual linear atelectasis remains. On the right, there is a persistent partially layering moderate-sized pleural effusion with adjacent basilar atelectasis.


SubjectID: 11508828, StudyID: 59107604, Comparison: 0.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pulm hemorrhage and concern for pneumonia // ?evolving pneumonia vs pulm hemorrhage ?evolving pneumonia vs pulm hemorrhage

IMPRESSION: In comparison with the study of ___, the bilateral opacifications appear to be slightly improved   Keywords: improve. Otherwise little change   Keywords: little change.


SubjectID: 11508828, StudyID: 53594773, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pna vs pulm hemorrhage, now desatting // progression of infiltrates progression of infiltrates

COMPARISON: ___

IMPRESSION: Heart size and mediastinum are stable. Interstitial opacities are unchanged   Keywords: unchanged. Replaced core valve aortic valve is in place. No interval increase in pleural effusion or development of pneumothorax noted.


SubjectID: 11508828, StudyID: 59067591, Comparison: same

WET READ: ___ ___ ___ 8:01 PM Pulmonary artery catheter has been retracted and now is positioned more proximally within the right main pulmonary artery. Nasogastric tube courses below diaphragm into the stomach. Moderate pulmonary edema is unchanged. Probable right effusion is unchanged. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with PA catheter, s/p repositioning // eval position of PA catheter

TECHNIQUE: Portable AP radiograph of the chest.

COMPARISON: ___.

FINDINGS: The Swan-Ganz catheter has been retracted, and now terminates in the proximal right pulmonary artery. The ET tube tip is in the mid trachea, and the NG tube courses below the hemidiaphragm to terminate in the stomach. Moderate diffuse bilateral airspace and interstitial opacities are most likely due to pulmonary edema. Small layering bilateral pleural effusions with bibasilar subsegmental atelectasis are unchanged. There is no pneumothorax. The heart and mediastinum are magnified by the projection. The patient has had prior cervical spine fusion.

IMPRESSION: Interval repositioning of the Swan-Ganz catheter with its tip now projecting over the proximal right pulmonary artery. Stable moderate pulmonary edema, small bilateral pleural effusions, and bibasilar subsegmental atelectasis   Keywords: stable.


SubjectID: 11508828, StudyID: 58566904, Comparison: None

WET READ: ___ ___ ___ 10:26 AM Endotracheal tube 3.5 cm above the carina. Nasogastric tube courses below the diaphragm with the stomach. Left internal jugular central line in the upper SVC. Findings compatible with severe pulmonary edema and small bilateral pleural effusions. The findings were discussed by Dr. ___ with Dr. ___ on ___ at 7:46 PM, immediately after discovery of the findings.

WET READ VERSION #1 ___ ___ ___ 7:47 PM Endotracheal tube 3.5 cm above the carina. Nasogastric tube courses below the diaphragm with the stomach. Left internal jugular central line in the upper SVC. Findings compatible with severe pulmonary edema and small bilateral pleural effusions. The findings were discussed by Dr. ___ with Dr. ___ on ___ at 7:46 PM, immediately after discovery of the findings. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: Portable supine chest

INDICATION: ___ year old man with cardiogenic shock, intubated // eval for pulm edema, position of ET tube

TECHNIQUE: Portable supine chest

COMPARISON: None

FINDINGS: ET tube terminates 3.5 cm above Carina. Left IJ CVC terminates in the upper SVC. Enteric tube extends to least the stomach, below image. Post ACDF. Inflated IABP is in appropriate position. Heart size likely within normal for technique. Small bilateral pleural effusions are present in addition to diffuse blurring of pulmonary vasculature and fluffy alveolar opacities within the right more than left chest, likely indicating CHF.

IMPRESSION: ET tube terminates 3.5 cm above Carina. Left IJ CVC terminates in the upper SVC. Inflated IABP is in appropriate position. Moderate to severe pulmonary edema and pleural effusions, probable CHF.


SubjectID: 11508828, StudyID: 57997011, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cardiogenic shock // interval change?

COMPARISON: ___.

IMPRESSION: The previous radiograph, there is a minimal increase in extent of the bilateral pleural effusions. Otherwise, the radiograph is unchanged. Moderate cardiomegaly. Bilateral areas of atelectasis. Moderate pulmonary edema. No pneumonia. No pneumothorax.


SubjectID: 11508828, StudyID: 57958096, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cardiogenic shock, pulmonary edema, hypoxic resp failure now intubated // eval pulmonary edema

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Cardiac size is normal. The aorta is tortuous. Lines and tubes are seen in standard position. Of note the tip of the Swan-Ganz catheter is in the distal right pulmonary artery. Moderate pulmonary edema is unchanged   Keywords: unchanged. There is no pneumothorax. Bilateral small effusions have minimally increased


SubjectID: 11508828, StudyID: 55462857, Comparison: better

FINAL REPORT

INDICATION: ___ year old man with cardiogenic shock, pneumonia, actively diuresing // eval for interval change

COMPARISON: Radiographs from ___

IMPRESSION: The distal tip of the right Swan-___ catheter is again seen in the right pulmonary artery. This could be pulled back 2-3 cm for more optimal placement as described previously. The intra-aortic balloon pump has been removed. There are bilateral pleural effusions, stable. There is persistent pulmonary edema which has improved minimally   Keywords: improve. Bibasilar subsegmental atelectasis is again seen. There are no pneumothoraces.


SubjectID: 11508828, StudyID: 52240463, Comparison: same

WET READ: ___ ___ ___ 10:41 AM Right pulmonary arterial catheter is within the right main pulmonary artery and may be retracted by 2-3 cm for more optimal positioning. Endotracheal tube and nasogastric tube have been removed. Moderate pulmonary edema is unchanged. Small left pleural effusion is again re- demonstrated. The findings were discussed by Dr. ___ with Dr. ___ on ___ at 8:25 PM, 10 minutes after discovery of the findings.

WET READ VERSION #1 ___ ___ ___ 8:24 PM Right pulmonary arterial catheter is within the right main pulmonary artery and may be retracted by 2-3 cm for more optimal positioning. Endotracheal tube and nasogastric tube have been removed. Moderate pulmonary edema is unchanged.

WET READ VERSION #2 ___ ___ ___ 8:26 PM Right pulmonary arterial catheter is within the right main pulmonary artery and may be retracted by 2-3 cm for more optimal positioning. Endotracheal tube and nasogastric tube have been removed. Moderate pulmonary edema is unchanged. Small left pleural effusion is again re- demonstrated. The findings were discussed by Dr. ___ with Dr. ___ on ___ at 8:25 PM, 10 minutes after discovery of the findings. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___ year old man with NSTEMI who was extubated today now with continued hypoxia // source of hypoxia

IMPRESSION: Right pulmonary arterial catheter is within the right main pulmonary artery and could be retracted by 2-3 cm for more optimal positioning. Endotracheal tube and nasogastric tube have been removed. Mild pulmonary edema is unchanged   Keywords: unchanged. Bilateral effusions are again seen.


SubjectID: 11508828, StudyID: 50450035, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cardiogenic shock // PA catheter placement

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the Swan-Ganz catheter is position more peripherally in the right pulmonary artery. The catheter should be pulled back by 4-5 cm. The other monitoring and support devices are in constant position. Constant appearance of the bilateral pleural effusions and the borderline sized cardiac silhouette. Mild to moderate pulmonary edema is seen in unchanged manner   Keywords: unchanged.


SubjectID: 11508828, StudyID: 57641173, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cardiogenic shock, pneumonia, concern for ARDS // eval for interval change

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Right internal jugular line tip is at the level of lower SVC. Heart size and mediastinum are stable. Bilateral pleural effusions and vascular congestion is demonstrated although slightly improved since the prior study, potentially due to fluctuations in the intravascular an interstitial volume   Keywords: improve. Swan-Ganz catheter has been replaced by right and at internal jugular vein introducer.


SubjectID: 11508828, StudyID: 50490976, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with ARDS awaiting AVR/CABG // Interval improvement? //

TECHNIQUE: Portable AP view of the chest, 2 exposures

COMPARISON: Series of radiographs dating back to ___

FINDINGS: Over the course of the past week, the patient's previously diffuse interstitial pulmonary abnormalities have improved. Compared to the most recent prior exam, there is little overall change in the still mild pulmonary abnormalities and bibasilar atelectasis, right greater than left. Small pleural effusions are likely present. A right jugular catheter terminates in the superior SVC. No pneumothorax is present. Dense aortic valve calcifications are present.

IMPRESSION: Overall similar appearance of the mild interstitial opacities with bibasilar atelectasis compared to the most recent radiograph.


SubjectID: 11508828, StudyID: 50555442, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: Mr. ___ is an ___ y/o man with extensive cardiac hx significant for severe AS s/p TAVR (___), CHFrEF (EF ___% ___), CAD s/p multiple PCI's (most recently high risk PCI w/Impella in ___ with DES to LAD and DES to Cx), recurrent pneumonia, CKD3, colon and prostate ca, afib on Coumadin who is now transferred from ___ with dyspnea and chest CT concerning for pulmonary hemorrhage, as well as chest pain at rest. // progression of PNA progression of PNA

IMPRESSION: As compared to ___, there is unchanged mild to moderate cardiomegaly. The pre-existing perihilar parenchymal opacities have decreased in extent and severity   Keywords: decrease. However, there is increasing radiodensity at the level of the right upper lobe, suspicious for pneumonia. No pleural effusions. No pneumothorax. Mild elongation of the descending aorta.


SubjectID: 11523129, StudyID: 59806889, Comparison: None

FINAL REPORT

INDICATION: ___F with intubation // eval for ETT placement

TECHNIQUE: Single supine view of the chest.

COMPARISON: Exam from earlier the same day at 11:10.

FINDINGS: There has been interval placement of an endotracheal tube with tip 3.5 cm from the carina. Enteric tube seen with tip extending below the inferior field of view, side-port is within the stomach. Otherwise, the appearance of the lungs has not significantly changed.

IMPRESSION: Interval placement of endotracheal and enteric tubes in appropriate position.


SubjectID: 11523129, StudyID: 58144246, Comparison: worse

FINAL REPORT

INDICATION: ___F with tachycardia, ams // ?pna

TECHNIQUE: Single portable view of the chest.

COMPARISON: ___.

FINDINGS: There are left and probable small right pleural effusions. Mild pulmonary edema seen bilaterally. There are bibasilar opacities potentially due to atelectasis or edema although developing infection is not excluded   Keywords: developing. Mild cardiomegaly is again noted. No acute osseous abnormalities.

IMPRESSION: Mild pulmonary edema with left and probable small right pleural effusions. Superimposed bibasilar opacities may be secondary to atelectasis, infection is not entirely excluded.


SubjectID: 11523129, StudyID: 57042752, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with severe metabolic acidosis, elevated lactate, and UTI. Intubated for metabolic acidosis with inappropriate respiratory compensation // on vent

IMPRESSION: As compared to ___ chest radiograph, diffuse pulmonary edema has slightly worsened with associated apparent increase in size of right pleural effusion   Keywords: increase, worse. Small left pleural effusion is unchanged with adjacent left retrocardiac opacification has worsened.


SubjectID: 11533366, StudyID: 59909608, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female with dyspnea.

COMPARISON: Chest x-ray and CT from ___ as well as chest x-ray from ___.

FINDINGS: Single portable view of the chest. Appearance of the right lung is unchanged with surgical chain sutures adjacent to the hilum underlying fibrotic changes in overall right hemithorax volume loss suggestive of prior lobectomy. Although the left lung is partially obscured due to overlying oxygenation mask and cardiac leads, there are multifocal regions of consolidation throughout the lung. The cardiomediastinal silhouette is unchanged. Atherosclerotic calcifications again seen at the aortic arch. Bilateral shoulder arthroplasties are identified.

IMPRESSION: Multifocal regions of consolidation in the left lung was concerning for infection. Continued follow up will be necessary to document resolution given patient's history of multiple malignancies.


SubjectID: 11533366, StudyID: 56521119, Comparison: None

FINAL REPORT

AP CHEST, 7:15 A.M., ___

HISTORY: A ___-year-old woman with multifocal pneumonia.

IMPRESSION: AP chest compared to ___: Moderate cardiomegaly is chronic. Heterogeneous opacification in the left lung may have improved, but the apparent change could also be due to improved lung volumes, since this is barely a day later. Right lung volume is quite low due to chronically elevated right hemidiaphragm, but there is a suggestion of small foci of infection on the right as well. Pleural effusions are small if any. If the presumed pneumonia fails to clear, I would perform a chest CT scan to make sure we are not dealing with lung nodules.


SubjectID: 11533366, StudyID: 50848804, Comparison: None

FINAL REPORT

HISTORY: Intubation with worsening wheezing.

FINDINGS: In comparison with the study of ___, again there is evidence of previous right upper lobectomy, which has led to increased opacification in the right upper zone as well as elevation of the hemidiaphragm. Central catheters are unchanged. The degree of pulmonary vascular congestion appears more prominent than on the previous study.


SubjectID: 11533366, StudyID: 58554068, Comparison: None

FINAL REPORT

CHEST, TWO VIEWS: ___.

HISTORY: ___-year-old female with cough and shortness of breath. Bilateral lower extremity edema.

COMPARISON: ___.

FINDINGS: AP and lateral views of the chest. Again, low lung volumes are seen with elevation of the right hemidiaphragm. Patient is status post right upper lobectomy. The lungs are clear of consolidation or effusion. Cardiomediastinal silhouette is stable. Right shoulder arthroplasty is seen without acute osseous abnormality.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 11533366, StudyID: 57923140, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with dyspnea

TECHNIQUE: A single portable AP view of the chest was obtained.

COMPARISON: Multiple prior chest radiographs, most recently ___.

FINDINGS: Cardiomediastinal silhouette including cardiomegaly is unchanged. Calcifications are again noted in the aortic arch. Low lung volumes persist. Blunting of the left costophrenic sulcus could be due to atelectasis or a small effusion. Linear opacity at the left base is most compatible with atelectasis. The lungs are clear. There is no pneumothorax.

IMPRESSION: Persistent low lung volumes and basilar atelectasis.


SubjectID: 11533366, StudyID: 58036198, Comparison: None

FINAL REPORT

INDICATION: CHF, COPD, diffuse crackles, hypoxia. Evaluate for effusion or pneumonia.

COMPARISON: Chest radiograph from ___ and CT torso from ___.

FINDINGS: Single portable supine chest radiograph was provided. Lung volumes are low. There is continued elevation of the right hemidiaphragm. Previously seen opacities in the right and left upper lung fields are no longer visualized. There is no definite evidence of focal consolidation or pneumothorax. There may be small bilateral pleural effusions. Cardiomediastinal silhouette is unchanged. A right humeral prosthesis is noted.

IMPRESSION: No evidence of pneumonia or CHF.


SubjectID: 11533366, StudyID: 56220227, Comparison: None

WET READ: ___ ___ ___ 6:59 PM No significant change compared to the prior study. No evidence of CHF or pneumonia given low lung volumes. ______________________________________________________________________________

FINAL REPORT

CLINICAL

HISTORY: CHF, possible pneumonia, evaluate. CHEST, PA AND LATERAL Patient is status post right upper lobe resection and radiation therapy. The right lung volumes are low consistent with previous therapy in this region. There has been no significant change since prior films dating back to ___. The left lung appears clear. No effusion is present. Cardiac size is somewhat enlarged, but there has been no significant change since ___.

IMPRESSION: No acute change.


SubjectID: 11533366, StudyID: 57372315, Comparison: None

WET READ: ___ ___ ___ 11:45 PM Bibasilar opacities which would be compatible with pneumonia in the proper clinical setting. Recommend repeat after treatment to document resolution. ______________________________________________________________________________

FINAL REPORT

HISTORY: ___-year-old female with COPD and bronchitis presents for shortness of breath and cough. Question pneumonia.

COMPARISON: ___.

FINDINGS: AP and lateral views of the chest. There is a new left lower lobe consolidation. There is also some right basilar opacity seen anteriorly on the lateral view. Superiorly, the lungs are unchanged. Tenting of the right hemidiaphragm is again seen. Probable changes from right-sided lobectomy is unchanged. Bilateral shoulder arthroplasties are seen.

IMPRESSION: Bibasilar opacities which would be compatible with pneumonia in the proper clinical setting. Recommend repeat after treatment to document resolution.


SubjectID: 11533366, StudyID: 51443775, Comparison: worse

FINAL REPORT

INDICATION: History of COPD and bronchitis, admitted with influenza, now with concern for secondary pneumonia.

COMPARISON: Chest radiographs, last performed on ___.

TECHNIQUE: Portable upright frontal radiograph of the chest.

FINDINGS: Elevation of the right hemidiaphragm with tenting and changes compatible with right thoracic volume loss are again noted. Biapical pleural thickening is again noted on the right greater than the left. Bibasilar small foci of peribronchial opacification are stable on the right and slightly increased on the left from the most recent prior study and new from prior studies of ___   Keywords: increase. No large pleural effusion or pneumothorax is detected. The cardiomediastinal silhouette appears stable. The trachea is midline. Bilateral shoulder replacements are again noted.

IMPRESSION: Several small peribronchial bibasilar opacities, stable on the right and slightly increased on the left from ___ but new from ___, could represent pneumonia in the appropriate clinical context.


SubjectID: 11533366, StudyID: 56840823, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with copd // PNA

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: AS COMPARED TO THE PRIOR STUDY THERE IS NO CHANGE IN THE CARDIOMEDIASTINAL SILHOUETTE AND ELEVATED RIGHT HEMIDIAPHRAGM. THERE IS SLIGHTLY MORE INCREASED OPACITY IN THE LEFT PERIHILAR AREA, MOST LIKELY RELATED TO SLIGHTLY DIFFERENT POSITION TO THE PATIENT AND LUNG LIKELY TO REPRESENT INTERVAL DEVELOPMENT OF INFECTIOUS PROCESS. ATTENTION TO THIS AREA ON THE SUBSEQUENT STUDY IS RECOMMENDED.


SubjectID: 11533366, StudyID: 54938282, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i

INDICATION: ___ year old woman with recent cardiac arrest now s/p cooling and extubation w/respiratory distress. // Please eval for interval change

COMPARISON: Chest radiographs ___.

IMPRESSION: Patient has been extubated. Little has changed except for slight increase in right basal atelectasis. Right hemidiaphragm is chronically elevated. Moderate cardiomegaly is long-standing. There is no pulmonary edema or pneumothorax. Pleural effusion is small if any on the right. Probably no pleural effusion on the left.


SubjectID: 11533366, StudyID: 52337450, Comparison: None

FINAL REPORT

PORTABLE CHEST ___

COMPARISON: ___ radiograph.

FINDINGS: Allowing for differences in technique and projection, there has not been a substantial change in the appearance of the chest since the recent radiograph of one day earlier.


SubjectID: 11533366, StudyID: 56717700, Comparison: None

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old woman with cardiac arrest. Evaluate for acute cardiopulmonary process.

FINDINGS: Comparison is made to prior study from ___. There is an endotracheal tube whose tip is 4.5 cm above the carina. This could be pulled back 2 more centimeters for more optimal placement. There is a nasogastric tube whose sideport is at the GE junctions and the tube could be advanced several centimeters. There is extensive cardiomegaly. There is increased density in the right upper lobe that may represent consolidation. There are no pneumothoraces. Low lung volumes are present.


SubjectID: 11533366, StudyID: 50479246, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old man with PEA arrest. Evaluate for pneumonia.

FINDINGS: Comparison is made to previous study from ___. The endotracheal tube tip has been pulled back slightly and the distal tip is now 3.8 cm from the carina. There are low lung volumes. There is mild elevation of the right hemidiaphragm. There is improved aeration at the right perihilar region. There are no signs for overt pulmonary edema or definite consolidation. No pneumothoraces are identified.


SubjectID: 11533366, StudyID: 56521239, Comparison: None

FINAL REPORT

HISTORY: Abdominal pain, nausea, vomiting. History of lung and breast cancer as well as radiation esophagitis.

TECHNIQUE: Upright AP view of the chest.

COMPARISON: Chest radiograph ___ and chest CT ___.

FINDINGS: Low lung volumes are present. The patient's chin obscures evaluation of the lung apices. There is evidence of volume loss in the right lung with elevation and tenting of the right hemidiaphragm. Postsurgical changes from prior right upper lobectomy are again noted. There is crowding of the bronchovascular structures, and fluffy opacification about the perihilar regions, more so on the right, may suggest mild pulmonary vascular engorgement or an infectious process. Previously noted diffuse hazy opacification in the right lung has improved. There is continued mild cardiomegaly. The mediastinal contours are unchanged. There is no large pleural effusion or pneumothorax. Partially imaged is a right humeral head prosthesis.

IMPRESSION: Limited study. Postsurgical changes in the right lung following right upper lobectomy. Perihilar fluffy opacities, right greater than left, may reflect mild pulmonary vascular engorgement but an infectious process or aspiration cannot be excluded. Consider repeat PA and lateral chest radiographs when the patient can take a deeper inspiration.


SubjectID: 11533366, StudyID: 54078317, Comparison: None

FINAL REPORT

PORTABLE AP CHEST X-RAY.

INDICATION: Patient with lung and tracheal cancer, here for nausea, vomiting, pneumonia, assess the NG tube.

COMPARISON: ___.

FINDINGS: The distal end of the NG tube is not included in this exam. The endotracheal tube is too low only at 8 mm above the carina. It should be pulled back around 3 cm. The right subclavian line ends in the mid SVC. The patient has a history of prior right upper lobe and middle lobe lobectomy. The increased density in the right apex is unchanged but still increased compared to the exam of ___. This could be concerning for recurrence as said in the previous exam. It is unchanged since the exam of yesterday. There are stable mild opacities in the left lung base. There is no pneumothorax and no significant pleural effusion.

CONCLUSION: 1. The end of the NG tube is not included in this exam. 2. The endotracheal tube is too low and can be pulled back around 3 cm. 3. The rest of the exam is unchanged. The medical team at the ICU has been verbally contacted for the results at 9:45. The exam was done at 9:18 a.m.


SubjectID: 11533366, StudyID: 52856777, Comparison: None

FINAL REPORT

INDICATION: Acute liver failure, right internal jugular vein catheter.

COMPARISON: ___, 7:33 p.m.

FINDINGS: As compared to the previous radiograph, the right internal jugular vein catheter has been pulled back. The tip now projects over the mid-to-low SVC. The endotracheal tube is in unchanged position. No evidence of complications, notably no pneumothorax. The size of the cardiac silhouette as well as the known bilateral parenchymal opacities, notably in the right upper lobe, are unchanged.


SubjectID: 11533366, StudyID: 52044510, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Pneumonia, evaluation.

COMPARISON: ___.

FINDINGS: Compared to the previous radiograph, the upper lung opacity on the right has substantially increased in severity and extent. The opacity is located at the region of former right upper lobectomy. The short time course of the changes suggests infection rather than a neoplastic recurrence. The pre-existing opacity on the left, located in the lung apex, unchanged. Unchanged size of the cardiac silhouette. Mild retrocardiac atelectasis.


SubjectID: 11533366, StudyID: 53576839, Comparison: same

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: ET tube placement. Patient with acute liver failure and renal failure.

COMPARISON: ___.

FINDINGS: Endotracheal tube ends 3.5 cm above carina. Right jugular line ends in cavoatrial junction. Stability of the apical density in this patient with prior history of right bilobectomy. Mediastinal and cardiac contours are unchanged. No pneumothorax. Unchanged mild volume overload   Keywords: unchanged.

CONCLUSION: There is no significant change since the previous exam   Keywords: no significant change. ET tube is in adequate position.


SubjectID: 11544655, StudyID: 59554394, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with r pleural effusion sp pigtail // Pneumothorax?

COMPARISON: ___

FINDINGS: Insertion of a right-sided pigtail catheter. No pneumothorax. Minimal interval decrease in the moderate right-sided pleural effusion. Given for differences in technique the left pleural effusion has not significantly changed. There is basal atelectasis. No interstitial edema. Moderate cardiomegaly.

IMPRESSION: No pneumothorax after right pigtail catheter insertion. Slight interval decrease in the right-sided moderate effusion.


SubjectID: 11544655, StudyID: 58484456, Comparison: better

FINAL REPORT

INDICATION: ___ year old woman with CHF exacerbation, Right sided pleural effusion // increased pulmonary edema noted, would like to assess for improvement with diuresis

TECHNIQUE: Portable

COMPARISON: ___

FINDINGS: Interval improvement of the interstitial pulmonary edema, with near resolution   Keywords: improve   Keywords: improve. Right-sided pleural effusion has decreased with persistent fluid in the right lower lung with adjacent peripheral lucency. This can represent a loculated small basal pneumothorax or fluid along the minor fissure with adjacent lung. Left pleural effusion is stable. Moderate to severe cardiomegaly is persistent.

IMPRESSION: Interval improvement of the interstitial pulmonary edema, with near resolution. Right-sided pleural effusion has decreased with persistent fluid in the right lower lung with adjacent peripheral lucency. This can represent a loculated small basal pneumothorax or fluid along the minor fissure with adjacent lung.


SubjectID: 11544655, StudyID: 54231207, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with r pleural effusion sp pigtail // Effusion change? Pneumothorax? Effusion change? Pneumothorax?

COMPARISON: Chest radiographs ___ through ___ at 16:54.

IMPRESSION: Large right pleural effusion is somewhat smaller following insertion of the right pigtail drainage catheter. Right middle and lower lobe are still collapsed. Small left pleural effusion and moderate to severe left lower lobe atelectasis are stable. No pneumothorax. There is greater pulmonary vascular engorgement today, which may indicate early cardiac decompensation. Severe enlargement of the cardiac silhouette is chronic and mitral annulus calcification may indicate mitral regurgitation.


SubjectID: 11544655, StudyID: 51205808, Comparison: None

WET READ: ___ ___ ___ 2:09 AM 1. Interval worsening of post antral right-sided pleural effusion. Unchanged small left pleural effusion. 2. Several thoracic vertebral compression deformities, unchanged from ___. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___-year-old female with a history of mitral valve clipping, presenting from outside hospital for evaluation of worsening shortness of breath x3 days.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph ___, chest radiograph ___

FINDINGS: In comparison to the prior radiograph on ___, there has been interval worsening of the substantial right pleural effusion. Aerated portion of the right lung apex is clear. A small pleural effusion is also present on the left, unchanged. There are bibasilar consolidations which most likely represent compressive atelectasis, although infection cannot be excluded in the appropriate clinical setting. No pneumothorax bilaterally. Right IJ catheter sheath has been removed. No acute osseous abnormalities identified. There are compression deformities involving several thoracic vertebra, which appear unchanged compared to the prior radiograph on ___. Otherwise no acute osseous abnormalities identified.

IMPRESSION: 1. Interval worsening of right-sided pleural effusion. Unchanged small left pleural effusion. 2. Several thoracic vertebral compression deformities, unchanged from ___.


SubjectID: 11544655, StudyID: 58475901, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with MVR s/p PA catheter place,eng // PA. Catheter placement

TECHNIQUE: Portable AP chest radiograph.

COMPARISON: Chest radiograph ___

FINDINGS: There has been interval placement of a Swan-Ganz catheter. The tip is in the right pulmonary artery, the edge of the mediastinum is difficult to evaluate due to the moderately large pleural effusion, however based on the relationship to the more proximal portion of the Swan-Ganz catheter, this is likely in appropriate position. There is a moderately large right pleural effusion, unchanged compared to the prior study. There is associated compressive atelectasis. Small left pleural effusion versus pleural scarring. The lungs are otherwise clear except note mild hyperinflation. Mitral valve calcification and a mitral valve clip are seen.

IMPRESSION: Swan-Ganz catheter, the tip positioned in the right pulmonary artery. It is difficult to assess how out into the pulmonary artery this is positioned as the mediastinal contours are obscured by a moderately large pleural effusion.


SubjectID: 11544655, StudyID: 56257031, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with pleural effusions // Please evaluate for interval change

IMPRESSION: As compared to ___ chest radiograph, Swan-Ganz catheter has been removed with residual internal jugular sheath remaining in place and no pneumothorax. Large right pleural effusion and small left pleural effusion are again demonstrated with adjacent regions of atelectasis and or consolidation in the right middle and both lower lobes.


SubjectID: 11544655, StudyID: 55883170, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with RIJ replaced // line R IJ adjustment

TECHNIQUE: Portable AP chest radiograph

COMPARISON: Chest radiographs ___ and ___

FINDINGS: In the interval since the prior study the right internal jugular catheter has been withdrawn, the tip is now in the proximal to mid SVC. No pneumothorax seen. There is persistent hyperinflation of the lung but with bilateral pleural effusions versus scarring, larger on the right than the left. This is unchanged compared to the earlier study. There is associated atelectasis in the right middle and lower lobes. Compared to the preoperative study there is increased airspace opacity in the right upper lung. A clip is seen projecting over the calcified mitral valve annulus. Heart size is unchanged compared to the prior study, moderately enlarged.

IMPRESSION: The right internal jugular catheter now terminates in the mid SVC.


SubjectID: 11545313, StudyID: 52561187, Comparison: None

FINAL REPORT

INDICATION: Cough, evaluate for pneumonia.

COMPARISON: ___.

FINDINGS: PA and lateral views of the chest. No focal consolidation, pleural effusion, or pneumothorax. Mild cardiomegaly. The cardiomediastinal and hilar contours are normal.

IMPRESSION: No acute cardiopulmonary process. Mild cardiomegaly.


SubjectID: 11545313, StudyID: 55006481, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman here w stroke. new cough // ? pna

TECHNIQUE: CHEST (PA AND LAT)

COMPARISON: ___

IMPRESSION: Cardiomegaly is substantial, unchanged. Mild interstitial pulmonary edema is present but slightly progressed since the prior study   Keywords: progressed. More focal opacity is noted in the left lower lung which might potentially represent developing infection, attention to this area on the subsequent studies is recommended Impression: Concern for left lower lobe pneumonia


SubjectID: 11545313, StudyID: 51245072, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with ? pna on prior cxr. // eval for interval change in LLL infiltrate

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Since the prior study there has been slight interval progression in the left perihilar and potentially lower lobe opacity as well as in the right costophrenic angle opacity although the difference may be explained by patient rotation. No overt pulmonary edema is seen. No increase in pleural effusion or development of pneumothorax is present


SubjectID: 11545787, StudyID: 56218062, Comparison: None

FINAL REPORT

HISTORY: Elevated white count, to assess for pneumonia.

FINDINGS: In comparison with study of ___, the patient has taken a somewhat better inspiration. Mild atelectatic changes are seen at the left base. No definite focal pneumonia or vascular congestion. Endotracheal tube and nasogastric tube have been removed.


SubjectID: 11554620, StudyID: 51998093, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___.

COMPARISON: None. CLINICAL

HISTORY: Dyspnea and hypotension.

FINDINGS: Portable AP upright chest radiograph obtained. The heart is moderately enlarged and there is moderate pulmonary edema. No large pleural effusion is seen. A focal eventration of the right hemidiaphragm is noted. There is moderate hilar congestion. No pneumothorax. Bony structures are intact.

IMPRESSION: Cardiomegaly with moderate pulmonary edema. Please refer to subsequent CT for further details.


SubjectID: 11576109, StudyID: 59803653, Comparison: 1.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with cabg // check ETT after intubation

IMPRESSION: In comparison to prior radiograph of 1 day earlier, an endotracheal tube is been placed, with tip directed towards the origin of the right main bronchus. At the time of this dictation, a subsequently performed chest radiograph documents repositioning. Exam is otherwise remarkable for slight improvement in the extent of pulmonary edema and associated slight decrease in bilateral pleural effusions   Keywords: improve, decrease. No other relevant change   Keywords: no other relevant change.


SubjectID: 11576109, StudyID: 58967037, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p CABG // eval for pleural effusions eval for pleural effusions

IMPRESSION: NG tube tip is in the stomach. Right internal jugular line terminates at the level superior SVC. Heart size and mediastinum are unchanged. Substantial pulmonary edema is present. Bilateral pleural effusions are large, left more than right, increased since the prior study.


SubjectID: 11576109, StudyID: 57928822, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p off pump CABG // eval for effusions

IMPRESSION: In comparison to previous study of ___, postoperative appearance of cardiomediastinal contours is unchanged considering differences in degree of rotation. Interval worsening of bibasilar atelectasis and small pleural effusions, left greater than right. Pulmonary vascular congestion and mild edema are not appreciably changed.


SubjectID: 11576109, StudyID: 56605986, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with sepsis/ s/p OPCAB // eval infiltrate/?pneumonia

IMPRESSION: In comparison to previous radiograph of 1 day earlier, endotracheal tube tip now terminates about 6 cm above the carina and Swan-Ganz catheter terminates in the junction of the main and right pulmonary artery. Mild cardiomegaly is accompanied by slight worsening of pulmonary edema and enlarging bilateral pleural effusions   Keywords: worse. Left retrocardiac atelectasis has slightly worsened, and right basilar atelectasis has slightly improved in the interval.


SubjectID: 11576109, StudyID: 55450015, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with s/p OPCAB // eval for pneumonia

TECHNIQUE: Portable supine AP chest

COMPARISON: Chest radiographs ___ through ___

FINDINGS: ET tube is unchanged approximately 5.6 cm from the carina. Swan-Ganz catheter terminates in the junction of the main and right pulmonary arteries. Lung volumes remain quite low. Mild cardiomegaly and moderate pulmonary edema are unchanged   Keywords: unchanged. There are small bilateral pleural effusions. Bibasilar atelectasis, left greater than right, is unchanged.

IMPRESSION: 1. No significant change including persistent moderate pulmonary edema and mild cardiomegaly   Keywords: no significant change, persistent. A superimposed pneumonia would be difficult to detect in the setting of pulmonary edema. Recommend repeat imaging after diuresis. 2. Moderate bibasilar atelectasis, left greater than right, is unchanged.


SubjectID: 11576109, StudyID: 57230071, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with dHF and chest pain, O2 sats ___%. // r/op pulmonary edema r/op pulmonary edema

IMPRESSION: In comparison with the study of ___, there has been some improvement in the still substantial pulmonary edema   Keywords: improve. Retrocardiac opacification again is consistent with volume loss in the left lower lobe. Small bilateral pleural effusions are again seen.


SubjectID: 11576109, StudyID: 50929718, Comparison: worse

FINAL REPORT

INDICATION: Chest pain. Evaluate for an acute process.

TECHNIQUE: Single upright AP view of the chest.

COMPARISON: Chest radiograph from ___.

FINDINGS: Since the prior exam, there has been significant interval worsening of pulmonary edema, which is now moderate to severe   Keywords: worse. There is no focal opacity to suggest pneumonia. There is no pleural effusion or pneumothorax. The mediastinal contours are normal. The heart size is at the upper limits of normal.

IMPRESSION: Moderate to severe pulmonary edema has worsened since the prior examination   Keywords: worse.


SubjectID: 11576703, StudyID: 55366028, Comparison: None

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Status post fall with right knee pain and difficulty to ambulate.

COMPARISONS: ___.

TECHNIQUE: Chest, AP upright and lateral.

FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged allowing for differences in technique including moderate tortuosity of the aorta. There is no pleural effusion or pneumothorax. The chest is hyperinflated. The lungs appear clear. The bones appear demineralized.

IMPRESSION: No evidence of acute disease.


SubjectID: 11576703, StudyID: 54673125, Comparison: None

FINAL REPORT

PA AND LATERAL RADIOGRAPHS OF THE CHEST CLINICAL

INDICATION: ___-year-old female with palpitations and weakness.

TECHNIQUE: PA and lateral radiographs of the chest were obtained.

COMPARISON: ___.

FINDINGS: Trace pleural fluid is suspected based on blunting of the right costophrenic angle. There is no evidence of pneumothorax. No focal consolidations are seen. There is patchy left lower lobe opacity most consistent with minor atelectasis. The heart is normal in size. Osseous structures are grossly unchanged.

IMPRESSION: Suspicion for trace right-sided pleural fluid without focal consolidation to suggest pneumonia.


SubjectID: 11580193, StudyID: 53545031, Comparison: None

FINAL REPORT

HISTORY: ___-year-old man with known heart failure and shortness of breath. Evaluate for pulmonary edema.

COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: The cardiomediastinal silhouette is markedly enlarged. Bilateral opacities are consistent with engorged vessels and pulmonary edema. The bones are intact. The hilar contours are unremarkable.

IMPRESSION: Cardiomegaly and pulmonary edema.


SubjectID: 11580193, StudyID: 50160701, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the signs indicative of pulmonary edema have decreased   Keywords: decrease. Moderate cardiomegaly with slight enlargement of the vascular diameters persist. No larger pleural effusions. Normal hilar and mediastinal contours.


SubjectID: 11581228, StudyID: 58601773, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with dyspnea. Question pneumonia.

COMPARISON: ___.

FINDINGS: Single frontal view of the chest demonstrates a left pectoral dual-channel pacemaker with leads terminating in the right atrium and right ventricle. New since preceding exam is a large right-sided pleural effusion with dense consolidation in the right lower lobe and likely also right middle lobe. This could represent a component of atelectasis, but concurrent infection cannot be excluded. There are several more linear areas of subsegmental atelectasis in the right upper lung. The left lung is relatively well aerated. There is no large left pleural effusion. The heart is likely enlarged but suboptimally assessed. The thoracic aorta is mildly unfolded, with arch calcifications. Multilevel lumbar spondylosis is present.

IMPRESSION: New right middle and lower lobe consolidation and enlarging right pleural effusion. While some of this could represent compressive atelectasis, concurrent pneumonia cannot be excluded.


SubjectID: 11581228, StudyID: 55828921, Comparison: same

WET READ: ___ ___ ___ 8:46 PM Moderate pulmonary edema, slightly worse. Moderate right pleural effusion with right basal atelectasis. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Respiratory distress, evaluation for pneumonia or fluid overload.

COMPARISON: ___, 3:18 p.m.

FINDINGS: As compared to the previous radiograph, there is a slight increase in extent of the right pleural effusion and of the subsequent right areas of atelectasis. No other relevant changes   Keywords: no other relevant change. The ventilated parts of the lung parenchyma show mild fluid overload. Moderate cardiomegaly, unchanged left pectoral pacemaker.


SubjectID: 11581228, StudyID: 57967794, Comparison: None

WET READ: ___ ___ 8:47 PM Tiny right apical lucency, unchanged since prior study of ___, likely extra-pleural fat-pad. No pneumothorax. Significant reduction in right pleural effusion with re-expansion of the R lung with mild re-expansion edema. ______________________________________________________________________________

FINAL REPORT

HISTORY: Right thoracentesis, to assess for pneumothorax.

FINDINGS: In comparison with the earlier study of this date, there has been removal of a significant amount of fluid from the right pleural space. There may be a tiny apical pneumothorax. The patient has taken a somewhat better inspiration. There is some mild reexpansion edema on the right and bibasilar atelectasis.


SubjectID: 11581228, StudyID: 55514186, Comparison: None

FINAL REPORT

INDICATION: CHF exacerbation with new hypoxia. Concern for aspiration or mucous plugging.

TECHNIQUE: Portable AP chest radiograph.

COMPARISON: Multiple priors, most recently ___. ___ chest radiograph on ___

FINDINGS: There is an enlarging right pleural effusion with associated atelectasis when compared to ___. Assymetric opacification of the right lung appears similar to the pattern on ___. There is also slight increase in vascular markings on the left. A small pleural effusion on this side is possible. The left pectoral pacemaker leads terminate in the right atrium and ventricle. There is no pneumothorax.

IMPRESSION: Increasing right pleural effusion. Asymmetrical edema versus edema coexisting with right lung pneumonia. Findings were discussed with Dr. ___.


SubjectID: 11594544, StudyID: 52121912, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Fevers, hypotension, shoulder pain, worsening expiration, questionable pulmonary edema.

COMPARISON: No comparison available at the time of dictation.

FINDINGS: The patient has undergone CABG, the sternal wires are in correct alignment. An area of non-characteristic pleural thickening is seen at the lateral bases of the left lung. In addition, better seen on the lateral than on the frontal radiograph, there is a minimal left pleural effusion. Also better depicted on the lateral image is fluid marking of the fissural structures as well as mild peribronchial cuffing. In combination with moderately enlarged cardiac silhouette, mild interstitial edema is likely. At the time of dictation and observation, 8:12 a.m., on the ___, the referring physician, ___. ___, covered by Dr. ___, was paged for notification.


SubjectID: 11594544, StudyID: 57691782, Comparison: 1.0

FINAL REPORT

PATIENT

HISTORY: ___-year-old woman with fever, assess for pneumonia.

COMPARISON: Exam is compared to chest x-ray, ___.

FINDINGS: Portable AP single view semi-erect chest x-ray shows interval improvement of bilateral pulmonary edema, now minimal, but still more severe to the right   Keywords: more severe. Bilateral bibasilar pleural effusion is minimal' Left base opacity is likely atelectasis. NG and ET tubes have been removed. Heart size is still mildly enlarged in patient with history of cardiac surgery as denoted by sternal wires. There is no pneumothorax.

IMPRESSION: Improvement of bilateral pulmonary edema, now minimal   Keywords: improve. Persistent bibasilar small pleural effusion and left lower lobe atelectasis.


SubjectID: 11594544, StudyID: 56563627, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Flash pulmonary edema, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there are new bilateral pleural effusions of mild-to-moderate extent. The signs of massive centralized pulmonary edema are seen in almost unchanged manner   Keywords: unchanged. Increasing retrocardiac atelectasis. Unchanged monitoring and support devices.


SubjectID: 11600106, StudyID: 57368606, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Atrial fibrillation. Shortness of breath.

COMPARISONS: Radiographs from ___ and chest CT from ___.

TECHNIQUE: Chest, PA and lateral.

FINDINGS: The patient is status post sternotomy. Mitral annular calcifications are prominent. The heart is again markedly enlarged. The mediastinal and hilar contours appear unchanged. There is a mild-to-moderate interstitial abnormality corresponding to pulmonary edema, which appears worse than on the prior radiographs   Keywords: worse. A small-to-moderate left-sided pleural effusion is suspected, but difficult to compare to the prior studies. On the right, aeration has improved, but there is probably still patchy right lower lobe opacification, suggesting atelectasis, but not specific. A small pleural effusion is also suspected on the right. There is no pneumothorax.

IMPRESSION: Findings consistent with mild-to-moderate pulmonary vascular congestion. Persistent left-sided pleural effusion and patchy basilar opacities, not specific, although typical for atelectasis.


SubjectID: 11600106, StudyID: 53285413, Comparison: None

WET READ: ___ ___ ___ 9:26 PM Bibasilar atelectasis with superimposed pleural effusions. No overall change since ___ at 08:20 ______________________________________________________________________________

FINAL REPORT

CLINICAL

HISTORY: Leukocytosis, evaluate for pneumonia. CHEST

COMPARISON: ___. Heart remains enlarged with left ventricular prominence and marked calcification of the annulus. The size of the left effusion is somewhat less than it was on the prior chest x-ray of ___ and there is less upper zone re-distribution.

IMPRESSION: Improving failure, no pneumonia.


SubjectID: 11600106, StudyID: 50159111, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female with tachy-brady syndrome.

COMPARISON: ___, ___.

FINDINGS: Portable semi-upright chest radiograph demonstrates moderate left and small right pleural effusions which are unchanged. The cardiac silhouette remains moderately enlarged, with marked calcification of the mitral valve annulus, and aortic arch. There is splaying of the carina and a double contour to the right heart border consistent with left atrial enlargement. The patient is status post median sternotomy, sternal wires are intact. The pulmonary vasculature is normal.

IMPRESSION: 1. Unchanged bibasilar atelectasis with superimposed moderate left and small right pleural effusion. 2. Moderate cardiomegaly, unchanged. No pulmonary edema.


SubjectID: 11600106, StudyID: 53796542, Comparison: None

FINAL REPORT

INDICATION: ___-year-old woman with AFib and RVR, assess for pulmonary edema.

TECHNIQUE: Frontal portable radiograph of the chest obtained.

COMPARISON: Portable radiograph from ___, ___ and CT of the chest from ___.

FINDINGS: Severe mitral annulus calcification. There is moderate-to-severe cardiomegaly, but no edema. The bibasilar atelectatic changes and right effusion have decreased from ___.

IMPRESSION: Interval decrease of bilateral atelectasis and right effusion compared to yesterday.


SubjectID: 11607177, StudyID: 59695557, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with heart failure. // Comparison to previous.

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The lung volumes are normal. The course and position of the Swan-Ganz catheter and of the pacemaker leads is constant, the tip of the Swan-Ganz catheter still projects over the proximal parts of the right pulmonary artery. There is moderate cardiomegaly but no evidence of overt pulmonary edema or pleural effusions. No pneumonia.


SubjectID: 11607177, StudyID: 58067977, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

COMPARISON: ___, 3:23 p.m.

FINDINGS: As compared to the previous radiograph, the Swan-Ganz catheter has been pulled back by approximately 2 to 3 cm. The tip, however, still projects along the course of the main right pulmonary artery. No evidence of complications, unchanged position of the pacemaker. No pleural effusions. No pulmonary edema.


SubjectID: 11607177, StudyID: 56595326, Comparison: None

FINAL REPORT

INDICATION: Heart failure requiring hemodynamic monitoring and placement of a PAC.

COMPARISON: Chest radiograph ___ and ___.

TECHNIQUE: Portable upright chest radiograph.

FINDINGS: A right pulmonary arterial catheter is unchanged in position from yesterday morning, likely terminating within the main pulmonary artery. The left pectoral pacemaker with leads terminating in the right atrium and through the coronary sinus is unchanged. The degree of cardiac silhouette enlargement is similar to ___. There is no pleural effusion, pneumothorax or focal airspace consolidation worrisome for pneumonia. No pulmonary edema. Mediastinal and hilar structures are unremarkable.

IMPRESSION: Unchanged position of the pulmonary arterial catheter. Lungs clear


SubjectID: 11607177, StudyID: 56566779, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Central line placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has received a new Swan-Ganz catheter inserted over the right internal jugular vein. The course of the catheter is unremarkable, the tip of the catheter follows the course of the right pulmonary artery. There is no evidence of complication, notably no pneumothorax. Borderline size of the cardiac silhouette. No pleural effusions. No pulmonary edema. The pacemaker is in unchanged position.


SubjectID: 11607177, StudyID: 50599766, Comparison: same

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old man with cardiogenic shock with swan catheter in place // Compare to prior

COMPARISON: Chest x-ray ___

FINDINGS: There are no significant changes compared to the last radiograph performed on ___   Keywords: no significant change. The support devices/ lines, including the pulmonary artery catheter and transvenous pacemaker, are unchanged in position. There are no new suspicious areas of focal consolidation, large pleural effusions or pneumothorax. The heart is enlarged, unchanged in appearance since ___.

IMPRESSION: No acute intrapulmonary process.


SubjectID: 11607177, StudyID: 59669161, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with ETT s/p ablation // pulm edema

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the patient has been intubated. The tip of the endotracheal tube projects 4.5 cm above the carinal. The Swan-Ganz catheter is still far to low within the right lower lobe periphery and should be pulled back by approximately 7-8 cm. Newly developed left retrocardiac atelectasis, potentially combined to a small left pleural effusion. The course of a newly inserted nasogastric tube is unremarkable, the tip projects over the middle parts of the stomach. The previously placed intra-aortic balloon pump is no longer visible.


SubjectID: 11607177, StudyID: 57564278, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cardiogenic shock // pulmonary edema, effusions

IMPRESSION: Stable cardiomegaly accompanied by mild pulmonary vascular congestion without overt pulmonary edema   Keywords: stable. Swan-Ganz catheter remains in the distal position within the right lower lobe pulmonary vasculature and could be withdrawn approximately 6 cm for more optimal positioning in the more central pulmonary vasculature.


SubjectID: 11607177, StudyID: 56878766, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with EF ___% on IABP // IABP position, pulm edema

FINDINGS: As compared to ___, the Swan-Ganz catheter has been advanced more distally within a segmental pulmonary artery branch in the right infrahilar region. Injury balloon pump has been slightly withdrawn, now terminating 4.5 cm below the superior aspect of the aortic knob. Otherwise no relevant change since the recent radiograph   Keywords: no relevant change.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone ___ ___ at 4:24 PM, 5 minutes after discovery of the findings.


SubjectID: 11607177, StudyID: 54291485, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with impella placed on ___. // assess impella placement, and for pulmonary edema

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Swan-Ganz catheter tip is at the right lower lobe pulmonary vein. Cardiomediastinal silhouette is unchanged. ET tube tip is 4.3 cm above the carinal. Vascular congestion has improved in the interim   Keywords: improve.


SubjectID: 11607177, StudyID: 53624693, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with VT // interval change in ET tube after repositioning

TECHNIQUE: Single frontal view of the chest

COMPARISON: Study performed 2 hours earlier

IMPRESSION: ET tube is in standard position the tip is 3.8 cm above the carina. Dobhoff tube tip isout of view, below the diaphragm. No other interval change from prior study   Keywords: no other interval change.


SubjectID: 11607177, StudyID: 52922844, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with IABP. // assess IABP placement and for any interval change

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Intra-aortic balloon pump tip is appropriately positioned, 4 cm below the roof of the aortic arch. Swan-Ganz catheter tip is deep in the right lower lobe segmental or subsegmental vein and should be pulled back as previously recommended at least 4 8 cm. Cardiomegaly is substantial and unchanged. Position of the pacemaker leads is unchanged. No pulmonary edema demonstrated


SubjectID: 11607177, StudyID: 51101768, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with VT s/p IABP placement // positioning of IABP

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___ obtained at 13:21

IMPRESSION: Intra-aortic balloon pump is currently 3 cm below the roof of the aortic arch, in appropriate position. Swan-Ganz catheter tip is deep into the right lower lobe segmental subsegmental branches and should be pulled back at least 6 cm. Cardiomegaly is substantial in unchanged. There is interval progression of mild interstitial pulmonary edema   Keywords: progression


SubjectID: 11607177, StudyID: 58357371, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with s/p LVAD // eval driveline/hemothorax

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The monitoring and support devices are constant. Moderate pulmonary edema. Massive cardiomegaly. No new focal parenchymal opacities   Keywords: new. The position of the LVAD is constant.


SubjectID: 11607177, StudyID: 56085617, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with s/p LVAD/CT pull // ?ptx

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, a left chest tube was pulled. There is no evidence of pneumothorax. All other monitoring and support devices are in constant position. Unchanged position of the LVAD. Moderate to severe cardiomegaly persists. Mild to moderate pulmonary edema is unchanged   Keywords: unchanged.


SubjectID: 11607177, StudyID: 55173318, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p LVAD/ desatting // eval for effusion

IMPRESSION: Small left apical pneumothorax is demonstrated as well as a medial component of the pneumothorax adjacent to the and left heart border. Overall size of pneumothorax is probably moderate given the supine positioning of the patient, but is difficult to quantify due to exclusion of left costophrenic sulcus from the study. Left chest tube remains in place. Cardiomediastinal contours are stable, with persistent cardiac enlargement and pulmonary vascular congestion accompanied by worsening edema   Keywords: worse. Persistent bilateral pleural effusions, not fully quantify due to exclusion of extreme lung bases from the radiograph.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 4:49 PM, 5 minutes after discovery of the findings.


SubjectID: 11607177, StudyID: 54779281, Comparison: same

WET READ: ___ ___ ___ 8:19 AM Lines and tubes in stable positions. Severe cardiomegaly persists. Small bilateral pleural effusions are likely present. Left pneumothorax appears stable. Pulmonary edema may be slightly worsened.

WET READ VERSION #1 ___ ___ ___ 10:11 PM Lines and tubes in stable positions. Severe cardiomegaly persists. Small bilateral pleural effusions are likely present. Left pneumothorax appears stable. Pulmonary edema may be slightly worsened. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with s/p VAD // eval for PTX

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The monitoring and support devices are in constant position. The known minimal left pneumothorax is stable. Moderate pulmonary edema and small bilateral pleural effusions persist.


SubjectID: 11607177, StudyID: 51848964, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with s/p cardiac surgery- initial dob hoff placement- evaluate for advancement // evaluate dob hoff tube

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: Compared to the prior study there has been interval increasing cardiomegaly and increasing bilateral pleural effusions with pulmonary vascular redistribution and hazy alveolar infiltrate consistent with worsening fluid status. The support devices in lines are unchanged. By the end of this series of 3 images, the Dobbhoff tube tip is seen crossing midline, probably in the distal stomach or proximal duodenum

IMPRESSION: Increased CHF   Keywords: increase


SubjectID: 11607177, StudyID: 50859800, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with s/p LVAD- new dob hoff placement- evaluate for position prior to advancement // evaluate dob hoff tube

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the patient has received a new Dobbhoff catheter. The course of the catheter is unremarkable. The tip of the catheter cannot be clearly identified on the current images. The LVAD and the other monitoring and support devices are in unchanged position. Unchanged size of the cardiac silhouette. Unchanged mild to moderate pulmonary edema   Keywords: unchanged.


SubjectID: 11607177, StudyID: 58252915, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with severe CHF // PTX? Swan position? PTX? Swan position?

IMPRESSION: In comparison with the earlier study of this date, there is little change in the appearance of the heart lungs and


SubjectID: 11607177, StudyID: 56328938, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with advanced heart failure, VT, AF s/p RHC today // pneumothorax, edema, effusion s/p RHC

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Right Swan-Ganz l catheter tip is in a right lower subsegmental artery, should be withdrawn approximately 8 cm for more standard position. Severe cardiomegaly is stable. Pacer leads are in standard position. Mild vascular congestion has improved   Keywords: improve. There is no pneumothorax or large effusions

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 2:24 PM, 5 minutes after discovery of the findings.


SubjectID: 11607177, StudyID: 55742461, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: In comparison with the study of ___,

IMPRESSION: The Swan-Ganz catheter tip has been pulled back slightly. It still it is outside of the mediastinum and would need to be pulled back approximately 6-7 cm to be within the mediastinal


SubjectID: 11607177, StudyID: 53456377, Comparison: 1.0

WET READ: ___ ___ ___ 1:42 PM IABP should be retracted 7cm for more appropriate positioning. ___ discussed with Dr. ___ ___ telephone at 13:39 on ___ at the time film was reviewed. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with IABP // IABP positioning

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: As compared to the prior study there is no change in the intra-aortic balloon pump that should be pulled back at least 3-4 cm   Keywords: no change. Cardiomegaly substantial in unchanged but there is interval improvement of pulmonary edema   Keywords: improve


SubjectID: 11607177, StudyID: 52682285, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF // ___ position?

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: There has been intra-aortic balloon pump inserted with its tip being too high, approximately 12 mm below the roof of the aortic arch and should be pulled back at least 1 cm. Swan-Ganz catheter tip is at the level of the right lower lobe pulmonary artery. Severe cardiomegaly is noted. There is interval development of mild pulmonary edema as well as potential additional layering of pleural effusions   Keywords: development.


SubjectID: 11607177, StudyID: 58191507, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with PA line // PA line positioning PA line positioning

IMPRESSION: In comparison with the study of ___, the Swan-Ganz catheter projects further outside of the mediastinum on the right. It would have to be pulled back approximately 4-5 cm to be within the mediastinal contours. Otherwise, little change in the appearance of the heart and lungs.


SubjectID: 11607177, StudyID: 51712078, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with severe CHF. // assess interval change

IMPRESSION: Swan-Ganz catheter continues to terminate distally in the infrahilar region within a branch of the right lower lobe pulmonary vasculature. Cardiac silhouette remains enlarged and is accompanied by pulmonary vascular congestion and development of interstitial edema   Keywords: development.


SubjectID: 11607177, StudyID: 50232103, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with new swan // swan positioning

COMPARISON: ___, 08:08

IMPRESSION: As compared to the previous radiograph, the Swan-___ catheter has been replaced by a new device inserted over the left internal jugular vein. The tip of the device projects over the pulmonary artery on the right, it should be pulled back by approximately 2-3 cm to be correctly positioned. No pneumothorax. Improvement of the pre-existing pulmonary edema   Keywords: improve. Unchanged low lung volumes and moderate cardiomegaly.


SubjectID: 11607177, StudyID: 58079472, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p heartmate ___ // eval PICC line

IMPRESSION: As compared to ___ radiograph, a right PICC continues to course cephalad in the right internal jugular vein. At the time of this dictation, the patient has been scheduled for right PICC repositioning. Exam is otherwise similar to the prior study except for apparent increase in size of a large, partially loculated left pleural effusion. This finding, and a pericardial effusion, can be better assessed by subsequently performed CT scan of the chest, which is reported separately.


SubjectID: 11607177, StudyID: 52910447, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p LVAD // follow up effusions

IMPRESSION: As compared to ___, there has been slight increase in interstitial edema but no other relevant changes since the recent study   Keywords: increase.


SubjectID: 11607177, StudyID: 57761864, Comparison: None

FINAL REPORT

INDICATION: PA catheter.

COMPARISON: Chest radiograph from ___.

TECHNIQUE: Frontal chest radiograph.

IMPRESSION: A Swan-Ganz catheter again terminates within the a right pulmonary artery, unchanged in position since ___. A left-sided pacemaker is unchanged in configuration. There is no pneumothorax, focal consolidation, or large effusion.


SubjectID: 11607177, StudyID: 50925319, Comparison: None

FINAL REPORT

INDICATION: Cardiomyopathy.

COMPARISON: Radiograph from ___.

TECHNIQUE: Frontal chest radiograph.

FINDINGS: A left-sided pacemaker projects leads into right ventricle and atrium. A Swan-Ganz catheter terminates within the right pulmonary artery, slighlty retracted from the prior study. There is no pneumothorax or focal consolidation.

IMPRESSION: Swan-Ganz catheter terminating within a right pulmonary artery, slighty retracted since the ___ examination.


SubjectID: 11607177, StudyID: 57488954, Comparison: None

FINAL REPORT

CLINICAL

HISTORY: Wheezing and fatigue. Assess for pneumonia or CHF. STUDY: PA and lateral chest.

COMPARISON: ___ chest x-ray.

FINDINGS: As before, there is moderately severe cardiomegaly and central pulmonary vascular enlargement, consistent with pulmonary vascular congestion. Minimal thickening of the fissures is noted and is unchanged from before. There is no frank pulmonary edema. There appears to be a trace right pleural effusion versus chronic pleural thickening. No pneumonia. Mediastinal contour is normal. No suspicious bone findings.

IMPRESSION: Cardiomegaly and pulmonary vascular congestion without frank pulmonary edema. No pneumonia.


SubjectID: 11607177, StudyID: 51169589, Comparison: None

FINAL REPORT

INDICATION: Cough.

COMPARISON: Radiograph available from ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: The heart is moderately enlarged. Lung volumes are low. Central pulmonary vascular congestion and moderate interstitial edema has worsened since the ___ examination. There is no pneumothorax. Trace pleural effusions are present.

IMPRESSION: Cardiomegaly with central pulmonary vascular congestion with moderate interstitial edema.


SubjectID: 11607177, StudyID: 56776323, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p Heartmate II LVAD // eval for hemothorax

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Severe cardiomegaly is unchanged. Left ventricular assisting device is partially imaged. Overall no substantial change in tubes and lines demonstrated. No interval increase in pulmonary edema is noted   Keywords: increase.


SubjectID: 11607177, StudyID: 56343837, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p Heartmate // check ETT placement

IMPRESSION: Tip of endotracheal tube terminates 4.6 cm above the carinal. Other support and monitoring devices are is stable in position since the recent radiograph of ___. Cardiomediastinal widening are also similar to the prior study, and note is made of apparent slight increase in size of small right and moderate left layering pleural effusions. No other relevant changes since recent examination   Keywords: no other relevant change.


SubjectID: 11607177, StudyID: 55409452, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with severe heart failure w swan ganz placed // Swan Ganz placed

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The position of the Swan-Ganz catheter is constant, there is no evidence of complications, notably no pneumothorax. Severe cardiomegaly without evidence of overt pulmonary edema. No pleural effusions. Mild retrocardiac atelectasis.


SubjectID: 11607177, StudyID: 54072659, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man POD 0 LVAD // eval for widening of mediastinum in bleeding patient s/p LVAD placement

IMPRESSION: As compared to the previous radiograph from several hours earlier, there has not been a relative change in the appearance of the chest.


SubjectID: 11607177, StudyID: 53899060, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with as above // s/p VAD w/increased chest tube output

IMPRESSION: Allowing for differences in technique and projection, there has not been a substantial change the appearance of the chest since the recent study performed a few hours earlier.


SubjectID: 11607177, StudyID: 56093289, Comparison: same

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ ___speaking man with chronic sHF (EF ___%), 3+ MR who underwent AVJ ablation BiV/ICD upgrade on ___ and has since been having increasing SOB over several weeks despite uptitration of home torsemide p/w dyspnea, orthopnea, ___ transferred to us s/p PAC placement with CI of 1.3 with need for tailored therapy. // any acute changes

TECHNIQUE: Portable chest radiograph

COMPARISON: Multiple chest x-ray since ___, most recent bony performed ___ at 07:51

FINDINGS: Since the prior chest radiograph performed earlier this morning, there has been no significant interval changes   Keywords: no significant interval change. The pulmonary artery catheter and transvenous pacemaker are unchanged in position. There is no evidence of pneumonia or pulmonary edema. Bronchovascular markings are accentuated by low lung volumes. Stable cardiomegaly.

IMPRESSION: 1. No acute intrapulmonary process. 2. Stable cardiomegaly.


SubjectID: 11607177, StudyID: 56462969, Comparison: worse

WET READ: ___ ___ ___ 11:14 AM Interval development of mild to moderate pulmonary edema. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with VT s/p CPR // rib fracture, edema, effusion

COMPARISON: ___

IMPRESSION: As compared to the previous examination, the patient has developed mild to moderate pulmonary edema, manifesting as this or apical blood flow redistribution   Keywords: develop. No pleural effusions. Unchanged moderate cardiomegaly. No pneumonia.


SubjectID: 11607177, StudyID: 55984905, Comparison: None

FINAL REPORT

INDICATION: ___M with pacer shock // Eval for infiltrate and pacer wires

TECHNIQUE: Frontal and lateral views of the chest.

COMPARISON: ___.

FINDINGS: The lungs are clear of focal consolidation, effusion, or overt pulmonary edema. Cardiomegaly is again noted. Left chest wall dual lead pacing device with coronary artery and right ventricular leads are again noted. Prior Swan-Ganz via right IJ central venous line are no longer seen.

IMPRESSION: Cardiomegaly without superimposed acute cardiopulmonary process.


SubjectID: 11607177, StudyID: 51065201, Comparison: same

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old man with CHF. // Comparison to previous.

COMPARISON: Multiple chest radiographs from ___ to ___

FINDINGS: There are no significant changes compared to the prior radiographs   Keywords: no significant change. Bronchovascular markings are accentuated by low lung volumes. No evidence of pneumonia, pulmonary edema or pneumothorax. Stable cardiomegaly which is unchanged since ___. Transvenous pacemaker is unchanged in position with leads terminating in the right atrium and coronary sinus. Pulmonary artery catheter terminates in the main pulmonary artery. No acute osseous abnormalities.

IMPRESSION: No significant interval changes   Keywords: no significant interval change. No pulmonary edema.


SubjectID: 11607177, StudyID: 54472775, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___-year-old man with systolic congestive heart failure who is undergoing tailored therapy via a swan/PA line. Evaluate PA line and interval change.

COMPARISON: Chest radiograph dated ___ at 20:31 h.

FINDINGS: No significant change compared to the prior exam   Keywords: no significant change. The positions of the pulmonary artery catheter and cardiac device are unchanged. No significant change in the mild pulmonary edema, cardiomegaly, and bilateral reduced lung volumes   Keywords: no significant change. No focal consolidation, pneumothorax, pneumomediastinum, or pleural effusion.

IMPRESSION: Appropriately positioned pulmonary artery catheter. No significant change from the prior exam   Keywords: no significant change.


SubjectID: 11607177, StudyID: 50831752, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF; with PA line placed // PLEASE REMOVE SURFACE EKG LINES FROM CHEST; PA LINE PLACEMENT.

COMPARISON: Chest radiograph from the same day, dated ___ at 13:22h.

FINDINGS: The pulmonary artery catheter appears appropriately placed with its tip within the mediastinal borders. The left-sided dual-lead cardiac device appears intact and unchanged in position. Stable lung volumes, mild pulmonary edema, and cardiomegaly   Keywords: stable. No pleural effusion or pneumothorax.

IMPRESSION: Appropriately positioned pulmonary artery catheter. Otherwise, no significant change from the prior exam   Keywords: no significant change.


SubjectID: 11607177, StudyID: 53502256, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p heartmate now Chest tube removal // eval for pneumo

COMPARISON: ___

IMPRESSION: Status post removal of a small bore left-sided chest tube. There is no evidence of left pneumothorax. Unchanged monitoring and support devices, unchanged appearance of the lung parenchyma and of the cardiac silhouette as well as of the cardiac assist device. A lucent line paralleling the upper margin of the right clavicle is part of the thoracic soft tissues and does not represent a pneumothorax.


SubjectID: 11607177, StudyID: 53064020, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with LVAD, SOB // ?ptx ?pleural effusion

COMPARISON: ___

IMPRESSION: As compared to the previous image, no relevant change is seen   Keywords: no relevant change. The monitoring and support devices are constant. There is no evidence for of a pneumothorax of the chest tube removal yesterday. The cardiac assisting device is in unchanged position. Unchanged moderate cardiomegaly and mild fluid overload   Keywords: unchanged. Given that the patient assumes a different position, the potentially loculated left lateral part of a pleural effusion, previously masked in part by the left pectoral pacemaker, is better visualized.


SubjectID: 11607177, StudyID: 50365707, Comparison: None

FINAL REPORT

HISTORY: ICD placement, to assess for pneumothorax.

FINDINGS: In comparison with study of ___, there has been placement of an ICD with the lead probably in the region of the apex of the right ventricle, though it has been excluded from the image. No evidence of pneumothorax. Scattered radiation related to the size of the patient greatly obscures detail. Again there is substantial enlargement of the cardiac silhouette with some element of pulmonary vascular congestion. The region behind the heart cannot be properly evaluated in the absence of a lateral view.


SubjectID: 11607177, StudyID: 51280926, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with sCHF s/p swan ganz placement. confirm location // swan ganz placement swan ganz placement

IMPRESSION: In comparison with the study of ___, there has and placement of a right IJ Swan-Ganz catheter that extends into the right pulmonary artery at the level of the outer aspect of the cardiac silhouette. Otherwise, little overall change   Keywords: little overall change. Enlargement of the cardiac silhouette process with some elevation of pulmonary venous pressure.


SubjectID: 11609880, StudyID: 59220340, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old male with aspiration PNA and CHF // eval for interval change

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the lung volumes are unchanged. The predominantly basal parenchymal opacities, reflecting both pneumonia and pulmonary edema, are constant in extent and severity. Improved ventilation of the retrocardiac lung regions. Unchanged mild cardiomegaly. Unchanged alignment of the sternal wires.


SubjectID: 11609880, StudyID: 59214517, Comparison: worse

FINAL REPORT

INDICATION: History: ___M with worsening tachypnea // eval for PE, worsening PNA

COMPARISON: Radiograph obtained same day approximately 2 hr prior.

FINDINGS: Single portable semi upright chest radiograph demonstrates demonstrates increased bibasilar opacities particularly within the upper lobes compatible with worsening pulmonary edema   Keywords: worse, increase. Patient is status post median sternotomy. The costophrenic angles bilaterally are obscured, likely reflective of small pleural effusions. Infection cannot be excluded.

IMPRESSION: Increase patchy bilateral opacities, small pleural effusions, cardiomegaly, most compatible with worsening pulmonary edema   Keywords: worse, increase.


SubjectID: 11609880, StudyID: 54910074, Comparison: None

FINAL REPORT

INDICATION: History: ___M with dyspnea

COMPARISON: Radiograph dated same day approximately 1.5 hr previously.

FINDINGS: Single AP portable radiograph of the chest demonstrates a patient rotated toward his left. Low lung volumes are seen. Sternotomy wires are intact. Patient is status post valvular repair. The heart is stably enlarged. Bilateral opacification diaphragms may reflect atelectasis though infection cannot be excluded. Obscuration of bilateral costophrenic angles likely reflects pulmonary effusions. Unchanged since most recent study, there are patchy parenchymal opacities bilaterally. In a patient with known heart failure, this likely reflects pulmonary edema.

IMPRESSION: Patchy bilateral opacities with small pleural effusions. In a patient with cardiomegaly, this is thought to reflect mild pulmonary edema. Obscuration of bilateral diaphragms likely reflects a component of atelectasis, though pneumonia cannot be excluded.


SubjectID: 11623772, StudyID: 53182170, Comparison: worse

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___ radiograph.

FINDINGS: ICD remains in place in standard position. Cardiomediastinal contours are stable. Pulmonary vascular congestion has improved, but note is made of worsening opacities at the lung bases, right greater than left   Keywords: worse. Differential diagnosis includes atelectasis, aspiration and developing infectious pneumonia, particularly at the right base. Small pleural effusions have slightly increased.


SubjectID: 11623772, StudyID: 52677326, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: CHF.

COMPARISON: ___, 1:45 a.m.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Left pectoral pacemaker in situ. Moderate cardiomegaly and signs of mild-to-moderate fluid overload. Presence of small bilateral pleural effusions cannot be excluded. Areas of atelectasis are seen at both lung bases. No new parenchymal opacity suggesting pneumonia. No pneumothorax.


SubjectID: 11625397, StudyID: 57612146, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with VT arrest, intubated // ET placement ET placement

IMPRESSION: In comparison with the study of ___, there has been placement of an endotracheal tube with its tip approximately 4 cm above the carina. Nasogastric tube extends to the mid to lower stomach, with the side port distal to the EG junction. Continued enlargement of the cardiac silhouette without appreciable vascular congestion. Retrocardiac opacification suggests mild atelectatic changes. No definite acute pneumonia, though this would be difficult to exclude in the retrocardiac region in the absence of a lateral view.


SubjectID: 11625397, StudyID: 52577654, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with VT and CHF exacerbation // ?interval changes ?interval changes

IMPRESSION: In comparison with the study of ___, the monitoring and support devices have been removed. Again there is substantial enlargement of the cardiac silhouette with only mild elevation in pulmonary venous pressure. This discordance again raises the possibility of cardiomyopathy. Mild atelectatic changes persist at the left base.


SubjectID: 11625397, StudyID: 51233665, Comparison: None

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPH

INDICATION: History: ___F with SOB // Please eval for pul edema vs pna Please eval for pul edema vs pna

TECHNIQUE: PA and lateral views of the chest.

COMPARISON: None available.

FINDINGS: The heart is moderately enlarged. Hilar contours are within normal limits. There is mild pulmonary vascular congestion and mild pulmonary edema. There is bibasilar atelectasis. Blunting of the costophrenic angles is likely secondary to a small amount of pleural fluid. No definite focal consolidation identified. There is no pneumothorax.

IMPRESSION: Cardiomegaly and mild pulmonary edema.


SubjectID: 11626997, StudyID: 55828329, Comparison: None

FINAL REPORT

PORTABLE AP CHEST FILM, ___ AT 9:41

INDICATION: ___-year-old with question volume overload. Comparison is made to the patient's prior study dated ___ at 9:56. Portable semi-erect chest film, ___ at 9:41 is submitted.

IMPRESSION: There has been prior median sternotomy. The heart remains enlarged, which may reflect cardiomegaly, although pericardial effusion cannot be entirely excluded. There has been interval improvement in aeration. However, there is fullness OF the perihilar vasculature suggesting mild perihilar and interstitial edema. No large effusions are seen. No pneumothorax is appreciated. Focal patchy opacity in the retrocardiac area could reflect partial lower lobe atelectasis, although aspiration or pneumonia should also be considered. Clinical correlation is advised.


SubjectID: 11626997, StudyID: 50131378, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with hyperglycemia, evaluate for pneumonia.

COMPARISONS: Chest radiographs, ___ and ___. SINGLE FRONTAL VIEW OF THE CHEST: The lung volumes are low. The patient is status post CABG with median sternotomy wires and mediastinal clips noted. Clips in left upper quadrant are appreciated. A retrocardiac opacity may represent atelectasis or pneumonia in the correct clinical setting. There is no pleural effusion or pneumothorax.

IMPRESSION: A left retrocardiac opacity may represent atelectasis or pneumonia in the correct clinical setting.


SubjectID: 11628624, StudyID: 58328487, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CKD, CHF, RLE ulcer now SOB, desat, hypotensive. // Eval pul edema vs pna Eval pul edema vs pna

IMPRESSION: Comparison to ___. Unchanged moderate cardiomegaly with mild fluid overload, but the severity of the pre-existing pulmonary edema has slightly decreased   Keywords: decrease. No pleural effusions. No pneumonia. Minimal retrocardiac atelectasis.


SubjectID: 11628624, StudyID: 54612109, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with systolic heart failure, chronic lymphedema, with oxygen requirement. // Please evaluate for pulmonary edema. Please evaluate for pulmonary edema.

IMPRESSION: Comparison to ___. The patient now shows moderate cardiomegaly and mild to moderate pulmonary edema. Retrocardiac atelectasis is present. No pleural effusions. No pneumonia.


SubjectID: 11628624, StudyID: 52596550, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with afib, CKD, HF, ___ edema and hypoxia // eval for pulm edema eval for pulm edema

IMPRESSION: Comparison to ___. No relevant change   Keywords: no relevant change. Moderate cardiomegaly. Moderate pulmonary edema. Retrocardiac atelectasis. No pleural effusions.


SubjectID: 11628624, StudyID: 53277727, Comparison: better

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old man with new atrial fibrillation. Evaluate for pulmonary congestion.

FINDINGS: Comparison is made to the prior study from ___. There is cardiomegaly. There is improvement of the pulmonary edema since the prior study   Keywords: improve. There remains a left retrocardiac opacity. No pneumothoraces are identified.


SubjectID: 11628624, StudyID: 51096665, Comparison: None

FINAL REPORT

HISTORY: Dyspnea.

TECHNIQUE: AP portable view of the chest.

COMPARISON: ___.

FINDINGS: There is moderate pulmonary vascular congestion. The cardiac silhouette remains enlarged. The aorta is tortuous and enlarged mediastinal contour is similar in appearance. No large pleural effusion or pneumothorax is seen.

IMPRESSION: Moderate pulmonary vascular congestion and cardiomegaly.


SubjectID: 11639193, StudyID: 59340163, Comparison: better

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___ radiograph.

FINDINGS: The patient is status post median sternotomy and aortic and mitral valve replacement procedures. Cardiomegaly is accompanied by pulmonary vascular congestion and moderate pulmonary edema, the latter improved from the prior study   Keywords: improve. Additionally, there is improvement in the extent of atelectasis at the lung bases, and slight decrease in size of small pleural effusions.


SubjectID: 11639193, StudyID: 52484453, Comparison: 1.0

FINAL REPORT

PATIENT

HISTORY: ___ years old woman with elevated white blood count and increased sputum, concern for pneumonia, please assess for pneumonia.

COMPARISON: Exam is compared to chest x-ray of ___ at 10:45 a.m.

FINDINGS: The patient has had median sternotomy and aortic and mitral valve replacement. As compared to previous chest x-ray, moderate cardiomegaly and vascular congestion are stable   Keywords: stable. Moderate pulmonary edema has improved, now mild   Keywords: improve. Persistent small left base pleural effusion and atelectasis. No pneumothorax.


SubjectID: 11658675, StudyID: 59713592, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Eosinophilic pneumonia, questionable hypoxia, evaluation of endotracheal tube placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the current image shows no evidence of an endotracheal tube and a nasogastric tube. The size of the cardiac silhouette has slightly increased. Also increased are bilateral areas of atelectasis and additional parenchymal opacities that could reflect pneumonia or aspiration. No pleural effusions. No evidence of pneumothorax.


SubjectID: 11658675, StudyID: 51670044, Comparison: None

WET READ: ___ ___ ___ 9:16 PM ET tube terminates 6 cm above the carina. A left upper extremity PICC terminates in the axilla. Enteric tube is within the stomach. Increasing opacities of the left lung base are likely atelectasis, though, developing infection/aspiration should be considered as well. No pneumothorax. ______________________________________________________________________________

FINAL REPORT

HISTORY: PICC placement.

FINDINGS: The left PICC line tip lies within the axilla. Other monitoring and support devices are essentially unchanged. Basilar opacifications most likely represent atelectasis. However, in the appropriate clinical setting, supervening pneumonia would have to be considered.


SubjectID: 11658675, StudyID: 59280671, Comparison: None

FINAL REPORT

STUDY: Chest radiograph.

INDICATION: Patient with pneumonia, query pneumonitis. For evaluation.

TECHNIQUE: Portable AP radiograph was obtained.

COMPARISON: ___. REPORT: There is significant bibasal infiltrate, much of which is linear suggesting an atelectatic component. While that in the left lower lung zone has improved somewhat compared to prior study, that on the right is unchanged, though not worsened. Poor inspiratory effort and low lung volumes. Allowing for projection, the heart size is normal. The remainder of the lung parenchyma is grossly clear.

CONCLUSION: Low lung volumes, with bibasal infiltrates. There is probably a large atelectatic component as an additional finding of note. Minor interval improvement over prior study.


SubjectID: 11658675, StudyID: 52972932, Comparison: None

FINAL REPORT

INDICATION: Fever, shortness of breath, and recent pneumonia.

COMPARISONS: Chest radiograph, ___. Chest radiograph, ___. CT chest, ___.

FINDINGS: The lung volumes are low with crowding of the vascular structures. At the right base there is a linear opacity most consistent with linear atelectasis. This is stable from the prior chest radiograph on ___. There is opacification of the left base, which appears slightly more dense than on the prior radiograph. It is likely due to chronic aspiration, although a new event or underlying infection cannot be excluded. There is no definite pleural effusion, although the left costophrenic angle is not well evaluated due to opacity, and a small pleural effusion may be present. There is no pneumothorax. The cardiomediastinal silhouette is normal. Atherosclerotic calcifications are noted within the aortic arch.

IMPRESSION: 1. Slightly worsening of the left basilar opacity may be secondary to chronic aspiration, although a new aspiration event or underlying pneumonia cannot be excluded. A small pleural effusion on the left may be present. Further evaluation with PA and lateral images would be helpful for further evaluation if/when patient able. 2. Stable right basilar atelectasis.


SubjectID: 11658675, StudyID: 59163358, Comparison: None

FINAL REPORT

INDICATION: Evaluate for interval change in patient with chronic aspiration pneumonia, now admitted for recurrence.

COMPARISON: Most recent chest radiograph from ___ as well as multiple prior radiographs dating back to ___.

TECHNIQUE: Portable semi-upright AP radiograph of the chest.

FINDINGS: Compared to the prior study performed nine hours earlier, there has been interval increase in density of the bibasilar opacities which likely represent aspiration pneumonia superimposed on chronic scarring and atelectasis at these locations. The upper lung fields are clear. There is no mediastinal widening. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal.

IMPRESSION: Aspiration pneumonia superimposed on chronic bibasilar lung scarring and atelectasis.


SubjectID: 11658675, StudyID: 57721416, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Shortness of breath.

COMPARISONS: ___.

TECHNIQUE: Chest, portable AP views.

FINDINGS: The lung volumes are low. The heart size is difficult to assess. Multifocal opacities in the lower lungs appear more confluent than on the prior study, particularly at the right lung base. The significance is uncertain since there has been opacification in the area suggesting chronic scarring. However, along the lateral right lung base, a new lateral component was not clearly present on recent prior radiographs and may represent superimposed pneumonia in the appropriate clinical setting.

IMPRESSION: Patchy lateral right lower lung opacity for which the possibility of pneumonia superimposed upon existing atelectasis could be considered in the appropriate setting.


SubjectID: 11658675, StudyID: 58173634, Comparison: None

FINAL REPORT

HISTORY: PICC placement.

COMPARISON: ___.

TECHNIQUE: Portable frontal chest radiograph, single view.

FINDINGS: The left PIC line now ends in the right atrium, 9cm below the level of the carina. Low lung volume accentuates the pulmonary vasculature and makes evaluation of the cardiac size difficult. Bibasilar opacities are mildly increased from prior study and are likely atelectatic. Plate-like atelectasis is noted in the left lower lung. The lung apices are clear. There is no pleural effusion or pneumothorax.

IMPRESSION: Left-sided PICC terminates in the right atrium. If positioning in the lower SVC is desired, the catheter should be retracted by 4 cm. Dr. ___ was paged at 9:17 a.m. on ___.


SubjectID: 11658675, StudyID: 57766562, Comparison: None

FINAL REPORT

INDICATION: ___M w/crash of his wheelchair into wall ___M w/crash of his wheelchair into wall // ___M w/crash of his wheelchair into wall

EXAMINATION: CHEST (PORTABLE AP)

TECHNIQUE: Chest radiograph, frontal view

COMPARISON: Chest radiograph ___

FINDINGS: Lung volume is low. Streak of atelectasis is noted in right mid lung. Otherwise lungs are clear. There is no pneumothorax or large pleural effusion. Cardiomediastinal silhouette is normal size. No fracture is identified.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 11658675, StudyID: 55622192, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with COPD and confusion with productive cough. // pneumonia?

IMPRESSION: As compared to previous radiograph of 2 days earlier, poorly defined opacities in the left lower lobe have worsened and may potentially represent a developing infectious pneumonia given clinical suspicion for this entity. Bandlike atelectasis has worsened in the right lower lobe. No other relevant changes   Keywords: no other relevant change.


SubjectID: 11658675, StudyID: 55846596, Comparison: None

WET READ: ___ ___ ___ 6:54 PM Stable appearance of the chest with bibasilar opacities slightly worse in the setting of lower lung volumes again could represent aspiration, infection or atelectasis.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

INDICATION: Chronic aspiration and hypoxia. Evaluate for change.

COMPARISONS: Chest radiograph from ___.

TECHNIQUE: A single semi-upright AP view of the chest was obtained.

FINDINGS: Since the prior exam, the bibasilar opacities have worsened, particularly on the left. The apices of the lungs are clear. There is no pulmonary edema, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal. High-density material in the mid thoracic spine is from a prior vertebroplasty.

IMPRESSION: Worsening bibasilar opacities, which most likely represent atelectasis. No definite evidence of pneumonia.


SubjectID: 11658675, StudyID: 52969674, Comparison: same

WET READ: ___ ___ 9:31 PM ETT ends at the level of T2-3, NG tube with passes below the diaphragm and out of view inferiorly. Otherwise stable appearance of chest.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

INDICATION: History of COPD, status post intubation. Evaluate endotracheal tube.

COMPARISON: Chest radiograph from ___ at 18:14.

TECHNIQUE: A single semi-upright AP view of the chest was obtained.

FINDINGS: An endotracheal tube is in satisfactory position 5.7 cm from the carina. An enteric tube courses below the diaphragm with the tip out field of view. The basilar opacities are very similar to the prior exam   Keywords: similar. The opacity on the left is larger than on the right. The apices of the lungs are clear. There is no pulmonary edema, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal.

IMPRESSION: 1. Satisfactory position of the endotracheal tube. 2. No significant change in the bibasilar opacities.


SubjectID: 11658675, StudyID: 50226278, Comparison: worse

FINAL REPORT

CHEST, TWO VIEWS: ___.

HISTORY: ___-year-old male with shortness of breath. Question pneumonia.

COMPARISON: ___.

FINDINGS: AP and lateral views of the chest. Again seen are relatively linear bibasilar opacities, left worse than right   Keywords: worse. There may have been interval progression at the left lung base compared to prior. Superiorly, the lungs remain clear. Cardiomediastinal silhouette is unchanged. Multilevel vertebroplasty changes are again seen.

IMPRESSION: Persistent bibasilar opacities, potentially due to atelectasis or scarring, noting that infection or aspiration is not completely excluded.


SubjectID: 11658675, StudyID: 53518463, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M intubated

TECHNIQUE: Upright AP view of the chest

COMPARISON: ___ at 08:46

FINDINGS: An endotracheal tube has been placed in the interval with tip approximately 6 cm from the carina. An enteric tube tip is within the distal esophagus, and needs to be advanced by approximately 15 cm to lie satisfactory within the stomach. Persistent low lung volumes with bibasilar atelectasis are re- demonstrated. The cardiac and mediastinal contours are unchanged. No pneumothorax is clearly seen. .

IMPRESSION: 1. Endotracheal tube in standard position. 2. Suboptimal positioning of the enteric tube within the distal esophagus, and should be advanced by at least 15 cm for satisfactory positioning.


SubjectID: 11658675, StudyID: 51622606, Comparison: None

FINAL REPORT

INDICATION: ___M with epistaxis

TECHNIQUE: Single portable AP chest radiograph

COMPARISON: ___

FINDINGS: Moderately low lung volumes persist. Previously noted patchy opacities in the left lower lung and bandlike atelectasis in the right lower lung have improved. Residual bibasilar opacities likely reflect atelectasis. There is no evidence of consolidation. No pleural effusion or pneumothorax. Cardiomediastinal silhouette is stable. A thick horizontally oriented radiodensity projecting over the heart relates to vertebroplasty material as seen on the CT from ___.

IMPRESSION: Persistent low lung volumes and bibasilar atelectasis.


SubjectID: 11658675, StudyID: 51040357, Comparison: None

WET READ: ___ ___ ___ 6:39 PM Significant interval worsening of bibasilar consolidations compared with exam performed 9 hours prior raises concern for worsening atelectasis in the setting of bibasilar pneumonia although aspiration cannot be excluded. ______________________________________________________________________________

FINAL REPORT

EXAM: Chest, single frontal view. Single AP portable view. CLINICAL INFORMATION: Question aspiration pneumonia.

COMPARISON: ___, 9:58.

FINDINGS: Interval significant worsening of bibasilar consolidations with now increased obscuration of the hemidiaphragms, particularly on the left. Findings may be due to worsening atelectasis, underlying consolidation in the setting of right basilar pneumonia. However, there may also have been interval aspiration. Endotracheal tube terminates 5.7 cm above the level of the carina. An enteric tube courses below the level of the diaphragm, inferior aspect not included on the image.


SubjectID: 11658675, StudyID: 50438854, Comparison: None

FINAL REPORT

EXAM: Chest single AP portable view. CLINICAL INFORMATION: Increasing oxygen requirement.

COMPARISON: ___ at 18:11.

FINDINGS: Endotracheal tube terminates 7 cm above the level of the carina. Enteric tube is seen coursing below the level of the diaphragm, inferior aspect of the image. There are persistent bibasilar opacities which may be due to atelectasis and aspiration versus possible infection. Blunting of the left costophrenic angle may be due to pleural effusion. Cardiac and mediastinal silhouettes are stable. There may be minimal pulmonary vascular congestion.


SubjectID: 11666315, StudyID: 59551907, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with sepsis, pneumonia and chronic ventilatory needs // evaluate for interval change

TECHNIQUE: Portable chest

COMPARISON: ___.

FINDINGS: There are hazy alveolar infiltrates most marked in the right lower lobe and left upper lobe there is pulmonary vascular redistribution. There is dense retrocardiac opacity. There are bilateral pleural effusions left greater than right. Tracheostomy tube and left-sided PICC catheter are unchanged.

IMPRESSION: CHF, similar to prior   Keywords: similar


SubjectID: 11666315, StudyID: 50014117, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic respiratory failure and pneumonia. Evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, no relevant change is seen in the extensive bilateral parenchymal opacities, the associated moderate pleural effusions, the areas of basal atelectasis and moderate cardiomegaly. The tracheostomy tube and the left PICC line are also unchanged. No new parenchymal opacities   Keywords: new. No pneumothorax.


SubjectID: 11666315, StudyID: 54271135, Comparison: better

FINAL REPORT

PORTABLE CHEST X-RAY, ___

COMPARISON: Radiograph of one day earlier.

FINDINGS: Tracheostomy tube is in standard position, and cardiomediastinal contours are stable. Bilateral asymmetrically distributed multifocal airspace opacities show interval improvement, possibly due to multifocal aspiration and/or aspiration pneumonia, although a component of pulmonary edema is also possible   Keywords: improve. Probable small left pleural effusion is also demonstrated.


SubjectID: 11666315, StudyID: 56238871, Comparison: None

FINAL REPORT

HISTORY: Hypotension concerning for pneumonia.

COMPARISON: Comparison is made with chest radiographs from earlier the same day, ___.

FINDINGS: Single frontal view of the chest. Left subclavian central line terminates in the mid SVC. Median sternotomy wires and mediastinal surgical clips are noted. There is an opacity at the right lung base, at least part of which looks like is due to pleural fluid tracking along the fissure. Medially, the opacity may represent focal atelectasis, but cannot rule out pneumonia or aspiration in the right clinical setting. The lungs are otherwise clear. There is no left pleural effusion. No pneumothorax is seen. The cardiomediastinal silhouette is unremarkable.

IMPRESSION: 1. Right lung base opacity, which may represent atelectasis but cannot exclude pneumonia versus aspiration in the right clinical setting. 2. Small right pleural effusion.


SubjectID: 11666315, StudyID: 52451916, Comparison: None

FINAL REPORT

HISTORY: Tracheostomy, worsening tachypnea.

COMPARISON: Comparison is made with chest radiographs from ___ and ___.

FINDINGS: Single frontal view of the chest. A tracheostomy is seen in adequate position. Bibasilar opacities are seen, which may represent atelectasis but cannot exclude pneumonia or aspiration in the right clinical setting. There is moderate right pleural effusion. The left costophrenic angle is not included on this exam, but no left pleural effusion is seen. There is no pneumothorax. The cardiomediastinal silhouette is unremarkable.

IMPRESSION: Bibasilar opacities and right pleural effusion. Findings may represent atelectasis, but cannot exclude pneumonia or aspiration in the right clinical setting.


SubjectID: 11666315, StudyID: 54927308, Comparison: None

FINAL REPORT

STUDY: AP CHEST, ___. CLINICAL

HISTORY: ___-year-old male with crepitus in the right neck. Evaluate for pneumomediastinum.

FINDINGS: Comparison is made to prior study from ___ at 4:41 a.m. There is again seen a curvilinear lucency along the right soft tissues of the neck. This likely represents subcutaneous gas. Please correlate with physical examination and if necessary, CT scan of the neck could be obtained. There is surrounding soft tissue swelling. There is a tracheostomy whose distal tip is at the level of the clavicular heads. There is a right-sided central line with distal lead tip at the cavoatrial junction. Heart size is within normal limits. There are bilateral pleural effusions and a left retrocardiac opacity which are stable. There are no pneumothoraces or pneumomediastinum identified. Findings of the subcutaneous gas within the neck has been discussed with the ___ team.


SubjectID: 11666315, StudyID: 50204880, Comparison: same

FINAL REPORT

STUDY: AP CHEST, ___. CLINICAL

HISTORY: ___-year-old man with possible pneumonia and CHF.

FINDINGS: Comparison is made to previous study from ___. There is a large right-sided pleural which is partially layering. This appears to have increased in size since the previous study. There is also a left-sided pleural effusion and left retrocardiac opacity. There remains some mild pulmonary edema   Keywords: remains. No pneumothoraces are seen. Tracheostomy tube is seen. There is a right-sided central line with the distal tip at the cavoatrial junction. The left-sided central line is removed. There is neck soft tissue swelling and linear lucency suspicious for subcutaneous gas. Further evaluation with neck radiographs or CT could be performed and this has been discussed with the clinical team.


SubjectID: 11667451, StudyID: 55866886, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with picc

TECHNIQUE: PA and lateral

COMPARISON: ___ 08:57

FINDINGS: There appears to be a pin like entity at the left axilla, please correlate with clinical exam. The right PICC line terminates at the low SVC. Biventricular device is seen with leads terminating in the likely right atrium and right ventricle as well as the left ventricle. A Swan-Ganz catheter is seen approximately 3.4 cm from the mediastinum for which it was already recommended to be pulled back approximately 3-4 cm. There is no pleural effusion or pneumothorax. There are no pulmonary consolidations. Cardiomediastinal silhouette appears unchanged as compared to prior and median sternotomy wires are intact.

IMPRESSION: Right PICC line terminating at the lower SVC. Swan-Ganz catheter seen approximately 3.4 cm distal to the mediastinum located in the right pulmonary artery.


SubjectID: 11667451, StudyID: 55793233, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with HF // ? swan placement

COMPARISON: ___

IMPRESSION: As compared to the previous image, the monitoring and support devices are constant, and the lack, the Swan-Ganz catheter is still projecting over relatively peripheral parts of the right pulmonary artery and should be pulled back by approximately 2-3 cm. Unchanged moderate cardiomegaly. Sternal wires are in constant normal alignment. No overt pulmonary edema. No pleural effusions. Minimal retrocardiac atelectasis.


SubjectID: 11686707, StudyID: 56910177, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman s/___ CRT upgrade // ptx leads

TECHNIQUE: Portable semi-upright AP chest

COMPARISON: Chest radiographs ___ through ___

FINDINGS: Aside from mild atelectasis at the right base the right lung is clear. There is worsening opacification of the left retrocardiac region with air bronchograms suggesting atelectasis. Moderate cardiomegaly is unchanged. New pacer lead has been placed via the coronary vein and projects over the left ventricle. Leads terminating in the right atrium and right ventricle are unchanged. There is no evidence of large pleural effusion or pneumothorax.

IMPRESSION: Coursing left basilar atelectasis. No evidence of large pleural effusion or pneumothorax.


SubjectID: 11686707, StudyID: 56592400, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman sCHF here s/p BiV upgrade of PPM // pulmonary edema?

COMPARISON: The comparison is made with prior studies including ___.

IMPRESSION: There is improved aeration as compared to the prior study. There is persistent atelectasis in the left lung base. There is stable cardiomegaly. There no pneumothorax or CHF.


SubjectID: 11686707, StudyID: 50592195, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman s/___ CRT upgrade // ptx, leads

COMPARISON: The comparison is made with prior studies including ___.

IMPRESSION: There is new consolidation or lobar atelectasis in the left lung base. There is no small area of atelectasis in the left upper lobe which is new. There is no pneumothorax or CHF. There is cardiomegaly. The shunt tube overlying the right neck chest and abdomen is again noted.


SubjectID: 11687053, StudyID: 54283238, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Myeloma, right lower lobe pneumonia and effusions, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the pleural effusion on the right has mildly increased. As a consequence, the opacity in the right lower lobe also appears slightly more severe than on the previous exam. There is slightly increasing evidence of fluid overload, as reflected by an increase in diameter of the pulmonary vasculature   Keywords: increasing. The heart continues to be enlarged.


SubjectID: 11696577, StudyID: 53840889, Comparison: same

WET READ: ___ ___ ___ 7:30 PM 1. interval placement of cervical hardware, ET tube (5.5-6 cm above carina), and endogastric tube. 2. similar to ___ preop cxr w/ mildly increased vascular congestion. 3. mediastinal width exaggerated by supine positioning - correlate clinically.

WET READ VERSION #1 ___ ___ 7:28 PM 1. interval placement of cervical hardware, ET tube (5.5-6 cm above carina), and endogastric tube. 2. similar to ___ preop cxr w/ low lung volumes and mildly increased vascular congestion. ______________________________________________________________________________

FINAL REPORT

PORTABLE AP CHEST FROM ___ AT 17:05 CLINICAL

INDICATION: ___-year-old status post orogastric tube placement. Comparison to prior study of ___ at 11:21. Supine portable chest film ___ at 17:05 is submitted.

IMPRESSION: 1. Endotracheal tube has its tip 5.4 cm above the carina. Nasogastric tube is seen coursing below the diaphragm with the tip not identified. Volumes remain low with crowding of the pulmonary vascularity   Keywords: remain. However, the pulmonary vascularity does appear more indistinct when compared to the preoperative study and therefore, this likely represents an element of superimposed mild interstitial edema. Overall, cardiac and mediastinal contours are likely stable given differences in patient rotation between the studies. Hardware overlies the lower cervical spine. There are degenerative changes of the left glenohumeral joint with flattening of the humeral head and associated sclerosis which raises concern for avascular necrosis secondary to prior humeral head fracture. Clinical correlation is advised.


SubjectID: 11696577, StudyID: 51499243, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Cervical fusion. Evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has received a cervical fusion. The endotracheal tube has been removed, the nasogastric tube is also removed, but the right PICC line remains in unchanged position. Unchanged moderate cardiomegaly with small areas of atelectasis but no evidence of pneumonia or other pathological changes. No pneumothorax.


SubjectID: 11714071, StudyID: 55205640, Comparison: None

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Left chest pain radiating to the jaw. History of coronary artery disease.

COMPARISONS: ___.

TECHNIQUE: Chest, PA and lateral.

FINDINGS: The cardiac, mediastinal and hilar contours appear stable. There is no pleural effusion or pneumothorax. The lungs appear clear. An inferior vena cava filter is visualized.

IMPRESSION: No evidence of acute disease.


SubjectID: 11714071, StudyID: 55027445, Comparison: None

FINAL REPORT

HISTORY: Left-sided crackles.

FINDINGS: In comparison with study of ___, there are lower lung volumes. Cardiac silhouette remains within normal limits in size. There is some indistinctness of pulmonary vessels consistent with the mild elevation of pulmonary venous pressure suggested clinically. No evidence of acute focal pneumonia.


SubjectID: 11714071, StudyID: 52986991, Comparison: same

FINAL REPORT

HISTORY: To evaluate for chest pain.

FINDINGS: In comparison with the study of ___, the patient has taken a somewhat better inspiration. The cardiac silhouette is at the upper limits of normal or slightly enlarged. Mild tortuosity of the aorta is again seen. Mild pulmonary vascular prominence persists   Keywords: persists. No evidence of acute pneumonia or pleural effusion.


SubjectID: 11714071, StudyID: 52512235, Comparison: None

FINAL REPORT

INDICATION: Abdominal and back pain.

COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: The heart size remains mildly enlarged, and the mediastinal and hilar contours are stable with tortuosity of thoracic aorta again noted. Mild pulmonary vascular prominence is unchanged, but no overt pulmonary edema is seen. No focal consolidation, pleural effusion or pneumothorax is present. An inferior vena cava filter is partially imaged, and clips in the right upper quadrant denote prior cholecystectomy. Right acromioclavicular degenerative changes are noted.

IMPRESSION: No radiographic evidence for pneumonia.


SubjectID: 11717234, StudyID: 59893138, Comparison: None

FINAL REPORT

HISTORY: Chest tube clamped, to check if there has been redevelopment of pneumothorax.

FINDINGS: In comparison with the earlier study of this date, there is no evidence of hydropneumothorax or pneumothorax. Right chest tube is in place. There is little change in the degree of left pleural effusion. Elevation of the right hemidiaphragmatic contour persists. Mild atelectatic changes are seen at the left base.


SubjectID: 11717234, StudyID: 56962760, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man with hydropneumothorax status post chest tube removal.

COMPARISON: Multiple chest radiographs from ___ through ___.

FINDINGS: Frontal and lateral views of the chest were obtained. Right upper lobe scarring and volume loss are unchanged. Small bilateral pleural effusions are unchanged from ___ with mild bibasilar atelectasis. There is no new opacity. Cardiac and mediastinal silhouettes and hilar contours are stable. Pacemaker leads end in the right atrium and right ventricle. Fracture of the inferior-most median sternotomy wire is unchanged. No pneumothorax.

IMPRESSION: No pneumothorax. Small bilateral pleural effusions are unchanged.


SubjectID: 11717234, StudyID: 55817146, Comparison: better

FINAL REPORT

INDICATION: ___-year-old male with bilateral pleural effusions and chest tube for hydropneumothorax.

COMPARISON: Comparison is made with chest radiographs from ___, ___, and ___.

FINDINGS: PA and lateral images of the chest demonstrate well expanded lungs. There has been interval improvement in the bilateral pleural effusions and pulmonary vascular congestion   Keywords: improve. There is no pneumothorax. Cardiomediastinal silhouette is unremarkable. Visualized osseous structures are unremarkable.

IMPRESSION: Improving pulmonary effusions and vascular congestion   Keywords: improving.


SubjectID: 11717234, StudyID: 51239754, Comparison: None

FINAL REPORT

HISTORY: Hydropneumothorax.

FINDINGS: In comparison with the earlier study of this date, the pigtail catheter has been removed. No definite pneumothorax is appreciated. Assessment for possible hydropneumothorax is not possible since this is not an upright view and therefore no air-fluid levels could be identified.


SubjectID: 11717234, StudyID: 50401148, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with CHF and recent hydropneumothorax and right-sided chest tube, now requiring assessment for interval change.

COMPARISON: Comparison is made with chest radiographs from ___, ___, and ___.

FINDINGS: PA and lateral images of the chest demonstrate well-expanded lungs. The hydropneumothorax appears to have completely resolved. There are stable bilateral pleural effusions, left greater than right, again seen. The lungs are otherwise clear. Cardiomediastinal silhouette is unchanged from previous imaging.

IMPRESSION: Resolved hydropneumothorax. Stable bilateral pleural effusions, left greater than right.


SubjectID: 11717234, StudyID: 57660746, Comparison: None

FINAL REPORT

CHEST, TWO VIEWS.

HISTORY: CHF, compressive atelectasis. REFERENCE EXAM: ___.

FINDINGS: There is a new moderate right hydropneumothorax. The amount of pleural fluid has increased on the right. There is also a small left pleural effusion. There is volume loss of both lower lungs and pulmonary vascular redistribution. Dual-lead pacemaker, sternal wires, and aortic calcification are unchanged. The finding of the new pneumothorax was called to Dr. ___ at 10:03 AM after identifying this new pneumothorax, at 9:49 by Dr. ___ by telephone.


SubjectID: 11717234, StudyID: 57523949, Comparison: same

FINAL REPORT

INDICATION: ___-year-old male with CHF and right hydropneumothorax, status post thoracostomy with pigtail catheter placement.

COMPARISON: Comparison is made with chest radiograph from ___, ___, and ___.

FINDINGS: PA and lateral images of the chest demonstrate well expanded lungs with prominent interstitial markings bilaterally. A very small pneumothorax remains, now this has improved since previous imaging. Right pigtail catheter is seen again in place in the right lower chest. Left pleural effusion is again seen, unchanged from prior imaging. Again seen is a collapsed lower thoracic vertebra which appears to be chronic since at least ___. Other visualized osseous structures are unremarkable.

IMPRESSION: Persistent prominent interstitial markings   Keywords: persistent. Resolving pneumothorax. Unchanged left pleural effusion.


SubjectID: 11717234, StudyID: 55643249, Comparison: None

FINAL REPORT

CHEST

HISTORY: Right hydropneumothorax status post chest tube placement.

FINDINGS: There is a new right-sided pigtail catheter with interval decrease in size in the right hydropneumothorax. There is a small residual right apical pneumothorax and a small amount of effusion, but overall the appearance of the right chest is much improved. There is a moderate left effusion that is increased in the interval. Dual-lead pacemaker is unchanged.


SubjectID: 11748036, StudyID: 57400412, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with sp inbutation // ETT placement

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: There has been interval placement of an endotracheal tube that terminates at the carina, low in position. Recommend withdrawal by approximately 3 cm for more optimal positioning. Left-sided pacer device with leads partially imaged, grossly stable in position. The cardiac and mediastinal silhouettes are stable. There is mild to moderate pulmonary edema. Likely bibasilar atelectasis is seen. No large pleural effusion or pneumothorax. Partially imaged left humeral prosthesis.

IMPRESSION: Interval placement of endotracheal tube terminates at the level of the carina, low in position. Recommend withdrawal by approximately 3 cm for more optimal positioning. Pulmonary edema.

NOTIFICATION: Findings and recommendation discussed with Dr. ___ at 22:08 on ___ via telephone


SubjectID: 11748036, StudyID: 54048066, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with possible pneumonia vs aspiration // interval change interval change

IMPRESSION: In comparison with the study of this ___, the patient has taken a better inspiration. Continued enlargement of the cardiac silhouette with dual-channel pacer in place. Some elevation of pulmonary venous pressure persists. The left hemidiaphragm is not well seen, suggesting pleural fluid and volume loss at the base. The perihilar opacification on the left is less prominent, which could be a manifestation of the better inspiration.


SubjectID: 11748036, StudyID: 53153546, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with septic shock from unclear source (pna?) // interval change

IMPRESSION: As compared to ___ radiograph, endotracheal tube has been repositioned, now terminating 4 cm above the carinal. Pulmonary vascular congestion has improved   Keywords: improve. Nonspecific left retrocardiac opacity favors atelectasis over infectious pneumonia and is associated with an adjacent small left pleural effusion.


SubjectID: 11748036, StudyID: 50856205, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with sob // pelm edema

TECHNIQUE: Single frontal view of the chest

COMPARISON: None

FINDINGS: Chronic right-sided rib deformities noted. Mild pulmonary edema is seen. No large pleural effusion is seen although a small left pleural effusion is difficult to exclude. The cardiac silhouette is mildly enlarged. The aortic knob is calcified. No pneumothorax is seen.

IMPRESSION: Mild pulmonary edema and mild enlargement of the cardiac silhouette.


SubjectID: 11748036, StudyID: 50691728, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with septic shock from unclear source (pna?) and congestive heart failure // Evaluate for interval change

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___ obtained at ___ a.m.

IMPRESSION: The patient was extubated in the meantime interval. No NG tube is seen. Heart size and mediastinum are stable. Left pleural effusion has slightly increased in there is also a left perihilar and to lesser extent right perihilar opacities that might represent interval development of mild interstitial edema   Keywords: development


SubjectID: 11748036, StudyID: 56329582, Comparison: None

FINAL REPORT

INDICATION: ___F with new right cordis placement // ? ptx

COMPARISON: None.

TECHNIQUE: Single portable view of the chest.

FINDINGS: A right central venous catheter is identified with tip in the upper SVC. There is no pneumothorax. There is moderate pulmonary edema. Blunting of lateral costophrenic angles could be due to small effusions. Cardiac silhouette appears slightly enlarged but likely exaggerated by technique. Left shoulder arthroplasty is identified.


SubjectID: 11748036, StudyID: 54565047, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with CHB s/p pacemaker. // r/o pneumothorax r/o pneumothorax

IMPRESSION: In comparison with the study of ___, there has been placement of a dual-channel pacemaker device from the left subclavian region, with the leads in the right atrium and apex of the right ventricle. No evidence of pneumothorax. Continued enlargement of cardiac silhouette with moderate pulmonary edema and blunting of the costophrenic angles   Keywords: continue.


SubjectID: 11748036, StudyID: 51438946, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p PPM placement with fever // PNA, pocket infection PNA, pocket infection

COMPARISON: Comparison to ___ at 14:59

FINDINGS: Portable semi-erect chest film ___ at 21:43 is submitted.

IMPRESSION: Dual lead left-sided pacer remains in place. The left humeral prosthesis is incompletely visualized. There continue be layering bilateral effusions with patchy airspace process at both base suggestive of patchy lower lobe atelectasis, although pneumonia cannot be excluded. There continues to be mild perihilar and interstitial edema   Keywords: continue. Heart remains stably enlarged. Lung apices are obscured by the patient's mandible. No pneumothorax.


SubjectID: 11751604, StudyID: 51063386, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with history of CHF, presents with shortness of breath. Evaluate for infiltrate or edema.

COMPARISONS: None.

FINDINGS: Frontal and lateral views of the chest were obtained. The heart is moderately enlarged. There is asymmetric parenchymal opacities, right greater than left. The right costophrenic angle is blunted, compatible with a small-to-moderate sized pleural effusion. The osseous structures are unremarkable. The wire of a single-lead left chest wall pacer terminates in the right ventricle.

IMPRESSION: 1. Asymmetric pulmonary edema, right greater than left. Component of superimposed infection not excluded. 2. Small-to-moderate sized right pleural effusion. 3. Moderate cardiomegaly.


SubjectID: 11760589, StudyID: 57612436, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Hypotension, evaluation of the cardiac silhouette.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The heart is still mildly enlarged, with enlargement of the left ventricle. Moderate tortuosity of the thoracic aorta. No pulmonary edema. No pleural effusions. No pneumonia.


SubjectID: 11760589, StudyID: 50434166, Comparison: None

FINAL REPORT

INDICATION: Evaluation of patient with shortness of breath.

COMPARISON: Chest radiograph from ___.

FINDINGS: Mild bibasilar atelectatic changes are again noted but overall aeration appears inimally improve in comparison to prior study from ___. Cardiomediastinal silhouette remains moderately enlarged but stable. Atherosclerotic calcifications are noted throughout the aortic arch and the aorta appears tortuous but stable. Otherwise, the lungs are without focal consolidation or pneumothorax. No acute fractures are identified.

IMPRESSION: 1. Mild bibasilar atelectasis with no acute cardiopulmonary process identified. 2. Enlarged cardiac silhouette appears stable. A pericardial effusion must be clinically excluded.


SubjectID: 11760589, StudyID: 54606891, Comparison: None

WET READ: ___ ___ ___:___ PM New right IJ central line terminates in mid SVC. No pneumothorax. Study otherwise unchanged from most recent prior. ___ ___ ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: New line placement.

COMPARISON: ___.

FINDINGS: The patient has received a new right internal jugular vein catheter. The course of the catheter is unremarkable, the tip of the catheter projects over the mid SVC. No evidence of complications, notably no pneumothorax. Otherwise, the radiograph is unchanged.


SubjectID: 11760589, StudyID: 52791554, Comparison: None

FINAL REPORT

CLINICAL

HISTORY: ___-year-old man with shortness of breath and history of pleural effusions, evaluate for fluid overload.

COMPARISON: ___. SINGLE AP VIEW OF THE CHEST: Cardiomediastinal silhouette remains enlarged. New right lower lobe opacity is concerning for pnuemonia. Additional hazy bibasilar opacities obscuring the costophrenic angles are likely again due to a combination of atelectasis as well as effusions. Mild vascular congestion is present in both lungs. Osseous and soft tissues are unremarkable.

IMPRESSION: 1) New right lower lobe opacity concerning for pneumonia. 2) Small effusions and mild congestion.


SubjectID: 11763439, StudyID: 59613138, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with HFpEF here with acute exacerbation, right pleural effusion now s/p pigtail placement // eval effusion eval effusion

IMPRESSION: In comparison with the study of ___, the opacification at the right base has decreased. However, this could merely be a manifestation of a more erect position of the patient. Otherwise little change   Keywords: little change.


SubjectID: 11763439, StudyID: 53554394, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with placement of chest tube // eval for interval change in effusion s/p CT, ?PTX

IMPRESSION: As compared to the previous radiograph from earlier today, a right pleural catheter has been placed with decrease in size of right pleural effusion, now moderate. No definite pneumothorax, but right lung apex is partially obscured and a small pneumothorax cannot be excluded. Exam is otherwise remarkable for improving aeration at the left lung base with residual small pleural effusion and adjacent atelectasis.


SubjectID: 11763439, StudyID: 51515214, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with acute decompensated HFpEF and paroxysmal afib with left-sided effusion // eval size of left-sided effusion

EXAMINATION: CHEST (PORTABLE AP)

TECHNIQUE: Portable Chest radiograph, frontal view

COMPARISON: Chest radiograph ___

FINDINGS: There at least moderate-sized bile pleural effusions, right greater than left. Compared to ___, the size of pleural effusions is stable. There is no pulmonary edema. There is no pneumothorax. Cardiac silhouette is enlarged. Hyperdensity projecting over the epigastrium is unchanged.

IMPRESSION: Least moderate-sized bilateral pleural effusions, right greater than left, are stable in size compared to ___.


SubjectID: 11775739, StudyID: 58670525, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF and hypoxia // Please eval for edema

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the lung volumes have decreased, causing an apparent increase in extent of the bilateral parenchymal opacity at the lung bases. However, no new opacities are seen   Keywords: new. Mild pulmonary edema persists   Keywords: persists. No pneumothorax. The right pectoral Port-A-Cath is in unchanged position.


SubjectID: 11775739, StudyID: 55017357, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with metastatic osteosarcoma with acute on chronic CHF who presented with SOB, evaluate for pulmonary edema

TECHNIQUE: Portable frontal chest radiograph was obtained.

COMPARISON: Multiple priors with direct comparison made to study from ___ and CT chest from ___

FINDINGS: Compared to the prior study patient has taken a deeper breath. There are persistent bilateral patchy and rounded opacities which may represent multifocal pneumonia and/or pulmonary edema, although these could also represent coalescing metastatic lesions as seen on previous chest CT   Keywords: persistent. A small right pleural effusion is present. There is no pneumothorax.

IMPRESSION: Persistent bilateral rounded and patchy opacities which could represent multifocal pneumonia and/or pulmonary edema versus coalescing metastatic lesions as seen on recent chest CT   Keywords: persistent.


SubjectID: 11775739, StudyID: 50557549, Comparison: None

WET READ: ___ ___ ___ 3:03 PM New focal parenchymal opacities bilaterally, predominantly in the lower lobes, worrisome for multifocal pneumonia. There may also be underlying pulmonary edema. Small bilateral pleural effusions. ______________________________________________________________________________

FINAL REPORT

INDICATION: History: ___M with exp // ? pna

TECHNIQUE: AP view of the chest.

COMPARISON: ___.

FINDINGS: The right central venous catheter is stable in position. There are new focal parenchymal opacities bilaterally, predominantly in the lower lobes, worrisome for multifocal pneumonia. There may also be underlying pulmonary edema. Mild cardiomegaly. Small bilateral pleural effusions.

IMPRESSION: New focal parenchymal opacities bilaterally, predominantly in the lower lobes, worrisome for multifocal pneumonia. There may also be underlying pulmonary edema. Small bilateral pleural effusions.


SubjectID: 11775739, StudyID: 57934737, Comparison: None

WET READ: ___ ___ ___ 8:55 AM Right apical pneumothorax appears unchanged from prior radiograph ___ at 14:50. Preliminary findings were communicated to Dr. ___ by Dr. ___, ___ phone on ___ at 5:40 AM, 1 minute(s) after discovery.

WET READ VERSION #1 ___ ___ ___ 5:42 AM Right apical pneumothorax appears unchanged from prior radiograph ___ at 14:50. Preliminary findings were communicated to Dr. ___ by Dr. ___, ___ phone on ___ at 5:40 AM, 1 minute(s) after discovery. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p VATs and chest tube and air leak // ? interval change

COMPARISON: ___, 14:50

IMPRESSION: As compared to the previous radiograph, the post operative right pneumothorax has minimally decreased in extent but is still clearly visible. The right chest tube is unchanged. Unchanged small air collection in the right soft tissues. No new opacities in the right lung. Unchanged position of the right pectoral Port-A-Cath. Unchanged appearance of the cardiac silhouette and of the left lung.


SubjectID: 11775739, StudyID: 57885753, Comparison: None

FINAL REPORT

EXAMINATION: Chest x-ray PA and lateral

INDICATION: ___ year old man s/p RUL/RML wedge // check interval change post CT removal

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest x-ray ___ at 05:17

FINDINGS: Since the prior CXR performed earlier this morning, the right chest tube has been removed. Right Port-A-Cath is unchanged in position. The known right apical pneumothorax has decreased in size since yesterday afternoon, but has remained stable since the most recent CXR performed this morning. Within the right hemithorax, there are two new air-fuid levels, compatible with hydropneumothorax. There are likely tiny bilateral pleural effusions. Stable cardiomediastinal silhouette. Elevation of the right hemidiaphragm suggest volume loss.

IMPRESSION: 1. Interval removal of the right chest tube. Stable right apical pneumothorax. 2. Two new air-fluid levels in the right lung, compatible with hydropneumothorax.


SubjectID: 11775739, StudyID: 53042439, Comparison: None

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old man with hip osteosarcoma, now with new R CT after RUL and RML wedge resection today// ? ptx

TECHNIQUE: Portable chest radiograph

COMPARISON: Chest x-ray ___

FINDINGS: Since the prior radiograph, patient is now s/p RUL and RML VATS wedge resection. There has been interval placement of a right chest tube. There is also a right port that terminates in the right atrium. There is a small right apical pneumothorax with no evidence of tension. Right upper lobe consolidation not seen on the most recent CT chest ___, likely represents post-operative hematoma. Bibasilar opacities are also noted, likely due to atelectasis. No pleural effusions. Stable cardiomediastinal silhouette.

IMPRESSION: 1. Small right apical pneumothorax with no evidence of tension. 2. Post-op hematoma in RUL. Recommend continued surveillance to document resolution.

NOTIFICATION: Findings telephoned to Dr. ___ by Dr. ___ on ___ at 10:32AM, time of discovery.


SubjectID: 11775739, StudyID: 51657638, Comparison: None

FINAL REPORT

EXAMINATION: Chest x-ray PA and lateral

INDICATION: ___ year old man s/p RUL,RML wedge on ___ // check interval change

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest x-ray ___

FINDINGS: The small right apical pneumothorax was noted on yesterday's CXR has expanded from 22 mm to 27 mm today. No evidence of tension. Postoperative right upper lobe hematoma has largely resolved. However, there is a new parenchymal opacity in the right mid-lung zone, of unclear significance. There is left lower lobe atelectasis. The right-sided port and right chest tube are unchanged in position. Stable cardiomediastinal silhouette. No acute osseous abnormalities.

IMPRESSION: 1. Interval worsening of small right apical pneumothorax. 2. New right mid-lung opacity. Differential is broad, including partial collapse vs. infection vs. new hematoma. Recommend close attention on follow-up imaging.

NOTIFICATION: Findings telephoned to ___, by Dr. ___ on ___ at 3:28PM, time of discovery.


SubjectID: 11779216, StudyID: 57662395, Comparison: better

FINAL REPORT

TYPE OF

EXAMINATION: Chest AP portable single view.

INDICATION: ___-year-old female patient with new onset of CHF. Evaluate for pulmonary edema.

FINDINGS: AP single view of the chest has been obtained with patient in sitting semi-upright position. Comparison is made with the next preceding similar study of ___. The AP single chest view demonstrates cardiac enlargement of similar magnitude as observed on the previous study. Cardiac configuration and appearance of thoracic aorta unchanged. The pulmonary vasculature is still congested, but has undergone significant improvement of the previously detectable perivascular haze in the pulmonary vasculature   Keywords: improve. Also, the previously described mild blunting of the lateral pleural sinuses has decreased and almost disappeared completely. There is no evidence of new pulmonary parenchymal infiltrates of pneumonic appearance. No pneumothorax can be identified in the apical area.

IMPRESSION: Regression of previously existing significant pulmonary vascular congestive pattern two days ago. Significant cardiac enlargement persists. No new additional inflammatory parenchymal infiltrates can be identified on this single view chest examination.


SubjectID: 11779216, StudyID: 55965776, Comparison: None

FINAL REPORT

EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Shortness of breath.

COMPARISON: ___.

FINDINGS: Frontal and lateral views of the chest were obtained. There is mild pulmonary edema. Minimal blunting of the costophrenic angles is seen and trace pleural effusions are not excluded. The patient is rotated to the left. The cardiac silhouette is top normal. The aorta is calcified and tortuous.

IMPRESSION: Findings suggests mild pulmonary edema; however, superimposed infection is difficult to exclude. Possible trace pleural effusions.


SubjectID: 11797249, StudyID: 52732190, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: Ms ___ is a ___ yr old female with metastatic colon cancercurrently C3D26 irinotecan/cetuximab who is admitted w/ worseningdyspnea on exertion, nausea and vomiting while on trip to ___.Found to have DVT in ___, CT chest in ED showed increased PEs. Currently spiked fever to 102. // any acute changes? PNA? any acute changes? PNA?

COMPARISON: Comparison to ___ at 18:48

FINDINGS: Portable upright chest radiograph ___ at 12:58 is submitted.

IMPRESSION: Right internal jugular Port-A-Cath unchanged in position. Overall cardiac and mediastinal contours are stable with the heart being mildly enlarged. Low lung volumes with crowding of the pulmonary vasculature but no focal airspace consolidation to suggest pneumonia. No pulmonary edema, pleural effusions or pneumothorax.


SubjectID: 11797249, StudyID: 50162978, Comparison: None

WET READ: ___ ___ ___ 9:22 AM Compared to the study performed earlier the same day of the chest there is little overall change. No large free intraperitoneal air. Nonspecific bowel gas pattern with a relative paucity of gas except for gas in the colon in the right upper quadrant. The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 4:20 AM, minutes after discovery of the findings.

WET READ VERSION #1 ___ ___ ___ 4:23 AM Compared to the study performed earlier the same day of the chest there is little overall change. No large free intraperitoneal air. Nonspecific bowel gas pattern with a relative paucity of gas except for gas in the colon in the right upper quadrant. The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 4:20 AM, minutes after discovery of the findings. ______________________________________________________________________________

FINAL REPORT

INDICATION: Worsening dyspnea on exertion, nausea, and vomiting.

COMPARISON: Radiographs from ___ at 12:58.

IMPRESSION: A right Port-A-Cath terminates at the upper right atrium. The heart size is normal. The hilar and mediastinal contours remain within normal limits. The lung volumes are low, resulting in bronchovascular crowding, however, there is no central pulmonary vascular congestion or edema. No pleural effusion is detected, although the right costophrenic angle is excluded from the view. There is no pneumothorax or focal consolidation. There is relative paucity of bowel gas, limiting evaluation for bowel dilation. No free air is detected.


SubjectID: 11801365, StudyID: 55085366, Comparison: None

FINAL REPORT

PORTABLE CHEST OF ___

COMPARISON: Study of one day earlier.

FINDINGS: Interval placement of a nasogastric tube, terminating within the stomach, which appears markedly distended, although less severely distended than on the prior abdominal radiograph of earlier the same date. Please see separately dictated CT abdomen and pelvis regarding findings concerning for obstruction. Within the chest, cardiomediastinal contours are stable, and there has been worsening of bibasilar atelectasis and persistent small left pleural effusion. Small right pleural effusion is seen to better detail on recent CT abdomen.


SubjectID: 11801365, StudyID: 50180751, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with dysarthria and altered mental status.

COMPARISON: Portable chest radiograph from ___ PA AND LATERAL CHEST RADIOGRAPHS: Lung volumes are low resulting in bronchovascular crowding. Opacity within the left lung base is likely a combination of atelectasis and a moderate effusion is slightly increased compared to recent prior. The upper lungs are clear. Cardiomediastinal and hilar contours are unchanged. Right humeral head deformity is unchanged.

IMPRESSION: Progressive left lower lobe opacity, likely ongoing atelectasis and moderate effusion, though underlying pneumonia is possible.


SubjectID: 11812923, StudyID: 58073416, Comparison: None

FINAL REPORT

INDICATION: History: ___M with SOB, lactate // eval for PNA

TECHNIQUE: Portable supine AP chest

COMPARISON: Chest radiograph ___ and ___.

FINDINGS: The lungs are mildly hypoexpanded. Minimal reticular opacity at the right base the similar to the study of ___. There is no pulmonary edema. Heart size is mildly enlarged. The mediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax.

IMPRESSION: Mild cardiomegaly. No evidence of pneumonia.


SubjectID: 11812923, StudyID: 51086604, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with sepsis and HF // Assess for interval change

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the lung volumes have decreased. There is increasing evidence of bilateral basal parenchymal opacities as well as fluid marking of the minor fissure on the right and slight dilatation of the pulmonary vessels   Keywords: increasing. Simultaneously, there is new blunting of the right costophrenic sinus, probably caused by a small right pleural effusion. Overall, the findings are suggestive of mild to moderate hydrostatic pulmonary edema. No convincing evidence of pneumonia. No pneumothorax.


SubjectID: 11832757, StudyID: 58621529, Comparison: worse

FINAL REPORT

CHEST, PORTABLE

INDICATION: ___-year-old woman with shortness of breath. Evaluate for pneumonia, heart failure. Comparison is made to prior examination of ___. There is cardiomegaly which is unchanged. In comparison to the prior study there has been an increase in haziness of the pulmonary vasculature as well as small patchy opacities in the right lower lobe. Small bilateral pleural effusions are also present however are stable.

IMPRESSION: Worsening CHF with interstitial and possibly intra-alveolar edema   Keywords: worse.


SubjectID: 11832757, StudyID: 51804175, Comparison: better

WET READ: ___ ___ ___ 11:28 PM edema appear similar to slightly progressed from prior exam. stable cardiomegaly ______________________________________________________________________________

FINAL REPORT

HISTORY: Dyspnea, flash pulmonary edema.

FINDINGS: In comparison with study of ___, there is continued enlargement of the cardiac silhouette with pulmonary edema, which may have slightly improved   Keywords: improve.


SubjectID: 11832757, StudyID: 50496098, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman with leukocytosis and fever. Evaluate for pneumonia.

FINDINGS: Comparison is made to previous study from ___. There is cardiomegaly which appears stable. There is tortuosity of thoracic aorta. There is some prominence of the pulmonary markings, particularly the lung bases, without definite consolidation. Findings are suggestive of mild pulmonary edema. No pneumothoraces are seen.


SubjectID: 11832757, StudyID: 50410535, Comparison: same

FINAL REPORT

HISTORY: ___-year-old female with bilateral rhonchi and rales.

COMPARISON: ___. ___. CT torso ___.

FINDINGS: AP and lateral views of the chest. There is persistent mild pulmonary edema   Keywords: persistent. There is no pleural effusion. Cardiac silhouette is enlarged but stable. The aorta appears enlarged, similar compared to prior. There are multiple compression deformities in the lower thoracic and upper lumbar spine which are not changed since ___ CT scan.

IMPRESSION: Mild persistent pulmonary edema and cardiomegaly   Keywords: persistent.


SubjectID: 11832757, StudyID: 50325089, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman with congestive heart failure, atrial fibrillation. Fever and leukocytosis.

FINDINGS: Comparison is made to prior study from ___. Heart size is enlarged. There is tortuosity and calcification of the thoracic aorta. There is coarsening of the bronchovascular markings with more confluent opacity at the lung bases. Underlying infiltrate in this location cannot be excluded. There are no pneumothoraces.


SubjectID: 11833490, StudyID: 55263070, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with large left effusion s/p pigtail placement // ? PTX

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the patient has received a left-sided pleural drain. The drain is in correct position. The tip of the PICC line projects over the brachiocephalic vein. There is no evidence for the presence of a left pneumothorax. Substantial improvement of the pre-existing extensive left pleural effusion. Linea areas of atelectasis at the left lung bases.


SubjectID: 11833490, StudyID: 52136943, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with metastatic prostate cancer s/p left pleurex placement today. Now with hypotension. // Please evaluate for acute pathology. Please evaluate for acute pathology.

IMPRESSION: In comparison with the earlier study of this date, the PleurX catheter is again seen and there is no evidence of pneumothorax. The left PICC line is difficult to see, though still probably is within the brachiocephalic vein. Areas of opacification at the left base again are consistent with volume loss in the left lower lobe and possible small pleural effusion.


SubjectID: 11845306, StudyID: 56623323, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p avr/cabg and ct removal // r/o ptx

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, all monitoring and support devices, except for the right venous introduction sheet, have been removed. Moderate cardiomegaly. Mild atelectasis at both the left and the right lung bases. No larger pleural effusions. No pneumothorax. The alignment of the sternal wires is constant.


SubjectID: 11845306, StudyID: 56447974, Comparison: same

FINAL REPORT

HISTORY: Line replacement.

FINDINGS: In comparison with the study of ___, the IJ sheath has been removed from the right and replaced with a catheter that extends to the lower SVC or cavoatrial junction. Specifically, no evidence of pneumothorax. Otherwise, little change   Keywords: little change.


SubjectID: 11845541, StudyID: 59952300, Comparison: better

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old male with acute renal failure and status post extubation. Evaluate for pulmonary edema.

FINDINGS: Comparison is made to previous study from ___. The patient has been extubated. The lungs are grossly clear, with improvement in pulmonary vascular congestion since the previous study   Keywords: improve. There is no focal consolidation. Heart size is within normal limits. The vascular pedicle is normal.

IMPRESSION: Status post extubation with resolution of pulmonary edema.


SubjectID: 11845541, StudyID: 53971533, Comparison: worse

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with chest pain, radiation to the back, widening of the mediastinum?

COMPARISON: ___.

FINDINGS: New ET tube ends in the proximal right mainstem and has to be repositioned. There is worsening of at least moderate pulmonary edema and left lower lobe atelectasis has worsened   Keywords: worse. Pleural effusions are small, if any. There is no pneumothorax. NG tube is below the diaphragm.

CONCLUSION: 1. ET tube is in the right mainstem and has to be repositioned. 2. Worsening of moderate pulmonary edema   Keywords: worse. 3. Worsening of left lower lobe atelectasis. The results have been discussed with the ICU team at the time of the finding at 2 p.m.


SubjectID: 11845541, StudyID: 50641569, Comparison: better

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old with hypoxia.

FINDINGS: Comparison is made to the previous study from ___. There is improvement in the pulmonary vascular congestion since the previous study   Keywords: improve. The endotracheal tube and enteric tube unchanged in position and appropriately sited. The endotracheal tube tip is off of the field of view of the study. The heart size is within normal limits. There is again seen some coarsening of the bronchovascular markings. There is no focal consolidation or pneumothoraces.


SubjectID: 11845541, StudyID: 55633338, Comparison: None

FINAL REPORT

HISTORY: ___ M with CHF and acute kidney injury. Evaluate for effusion, pneumonia.

TECHNIQUE: PA and lateral chest radiographs.

COMPARISON: None available.

FINDINGS: The lungs are well expanded and clear. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax.

IMPRESSION: Unremarkable chest radiographic examination.


SubjectID: 11845541, StudyID: 50760672, Comparison: None

WET READ: ___ ___ 7:57 PM Lower lung volumes. Stable mediastinal coutours without evidence of widening. Stable mild cardiomegaly. Mild vascular congestion without overt edema. No new consolidation, pleural effusion or pneumothorax.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

HISTORY: Acute shortness of breath.

FINDINGS: In comparison with the study of ___, there is mild prominence of the cardiac silhouette with some indistinctness of engorged pulmonary vessels consistent with elevated pulmonary venous pressure. No evidence of discrete consolidation. If there is serious concern for possible aortic dissection, MRI could be considered in the patient who cannot receive iodinated contrast material.


SubjectID: 11855597, StudyID: 54430572, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with left ___ and 8th rib fractures s/p mechanical fall, head laceration, pyuria and positive nitrites on U/A, now with vomiting and inability to take POs since ___. // Evaluate for possible aspiration pneumonia/lung changes from CT on ___ and portable chest XR on ___ Evaluate for possible aspiration pneumonia/lung changes from CT on ___ and portable chest XR on ___

IMPRESSION: Cardiomegaly is substantial, unchanged. Tortuosity of the aorta is unchanged. There is worsening of the right basal opacity concerning for progression pole of aspiration/infection.


SubjectID: 11855597, StudyID: 52419897, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with left ___ and 8th rib fractures s/p mechanical fall, head laceration, pyuria and positive nitrites on U/A // ? aspiration ? aspiration

IMPRESSION: In comparison with the study of ___, there again are relatively low lung volumes with enlargement of the cardiac silhouette and tortuosity of the aorta. There appears to have been some callus formation about the multiple rib fractures on the left with no evidence of pneumothorax or acute pneumonia.


SubjectID: 11868667, StudyID: 57195979, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with chf, anemia, increasing oxygen requirement // Eval Pulm edema

IMPRESSION: In comparison with the earlier study of this day, there is little overall change   Keywords: little overall change. Again there are diffuse bilateral pulmonary opacifications consistent with severe pulmonary edema with bilateral effusions and compressive atelectasis at the bases   Keywords: again. In the appropriate clinical setting, superimposed pneumonia would have to be considered.


SubjectID: 11868667, StudyID: 54874602, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___ radiograph.

FINDINGS: Cardiomegaly is accompanied by pulmonary vascular congestion, perihilar haziness, and asymmetrically distributed consolidation, predominantly in the right upper lobe and right infrahilar region. Observed findings could be due to clinically suspected pulmonary edema with asymmetrical distribution, but superimposed aspiration or infectious pneumonia in the right lung is also possible, and short-term followup radiographs after diuresis may be helpful in this regard.


SubjectID: 11893091, StudyID: 57330158, Comparison: worse

FINAL REPORT

PORTABLE CHEST RADIOGRAPH, ___.

COMPARISON: Radiograph of earlier the same date.

FINDINGS: Newly placed endotracheal tube terminates approximately 3.6 cm above the carina, and a nasogastric tube courses below the diaphragm. A 3-cm diameter rounded lucency is identified lateral to the endotracheal tube and nasogastric tube to the left of midline. Although potentially representing an over-distended endotracheal tube cuff, the position is more lateral than expected for this condition. Alternative possibilities include an air-filled diverticulum arising from the trachea or esophagus. Findings were communicated by telephone with Dr. ___ on ___ at 4:00 p.m. at the time of discovery. Exam is otherwise remarkable for persistent cardiomegaly and worsening congestive heart failure with increasing perihilar edema and persistent small right pleural effusion   Keywords: increasing, worse.


SubjectID: 11893091, StudyID: 56555909, Comparison: None

FINAL REPORT

PORTABLE CHEST RADIOGRAPH, ___

COMPARISON: ___ chest radiograph.

FINDINGS: Mild-to-moderate cardiomegaly is accompanied by upper zone vascular redistribution, vascular indistinctness and mild interstitial edema. A slightly more confluent opacity at the right lung base medially may reflect asymmetrical dependent edema, but followup radiographs may be helpful to exclude a developing infection in this region. Small bilateral pleural effusions have improved since previous study. Calcified right hilar lymph nodes are unchanged.


SubjectID: 11893091, StudyID: 50901361, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Endotracheal tube placement.

COMPARISON: Fluoroscopy from ___ and chest x-ray from ___.

FINDINGS: As compared to the previous image, the patient has received an external pacemaker. The tip of the pacemaker is in expected correct position, as documented on the previous fluoroscopy. Unchanged position of the other monitoring and support devices. Moderate cardiomegaly with signs of mild pulmonary edema. No pleural effusions. No pneumothorax. Left apical pleural calcification. Mild atelectasis at the left lung bases. No evidence of pneumonia.


SubjectID: 11893091, StudyID: 55255832, Comparison: same

FINAL REPORT

INDICATION: ___-year-old female who presents for evaluation of lead position.

COMPARISONS: ___, ___, ___ and ___ chest radiographs.

TECHNIQUE: PA and lateral chest radiographs.

FINDINGS: The lead positions of the dual-chamber pacemaker is unchanged compared to the prior exam. There is moderate cardiomegaly. The lungs demonstrate moderate pulmonary edema but no evidence of pleural effusions or pneumothorax. Mild atelectatic changes at the lung bases are unchanged. Incidental note is made of chronic stable calcified scarring in the left apex. There are no new parenchymal opacities   Keywords: new. There is no evidence of pneumothorax.

IMPRESSION: Unchanged lead positions from recently inserted dual-chamber pacemaker.


SubjectID: 11893091, StudyID: 53794474, Comparison: same

WET READ: ___ ___ ___ 6:44 PM Status post new 2 lead pacemaker with no evidence of a pneumothorax. External pacemaker, ET tube, and enteric tube have been removed. Moderate cardiomegaly and mild pulmonary edema persist.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the monitoring and support devices, including the temporal right pacemaker, have all been removed. The patient is in unchanged moderate pulmonary edema, with moderate cardiomegaly but without pleural effusions   Keywords: unchanged. No newly appeared parenchymal opacities   Keywords: new. Unchanged mild atelectatic changes at the lung bases. No other relevant changes   Keywords: no other relevant change.


SubjectID: 11901665, StudyID: 56481032, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with chest pain, evaluate to rule out acute process.

COMPARISON: CTA chest on ___.

FINDINGS: One portable AP view of the chest. There are low lung volumes which crowd the pulmonary vasculature. Within that limitation, the lungs are grossly clear without any obvious consolidation. There is no pneumothorax. There is no large pleural effusion. Cardiac, mediastinal, and hilar contours are normal. No evidence of pulmonary edema.

IMPRESSION: No acute cardiopulmonary process. Low lung volumes.


SubjectID: 11901665, StudyID: 53985379, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Fevers, questionable pneumonia.

COMPARISON: ___.

FINDINGS: Compared to the previous radiograph, there is an increase of the lung volumes, likely reflecting improved ventilation. No evidence of pulmonary edema, pleural effusions or pneumonia. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours.


SubjectID: 11919347, StudyID: 53926130, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, acute shortness of breath.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The distribution of the right pleural effusion is mildly different, but overall unchanged in extent. Unchanged evidence of moderate cardiomegaly and overall moderate pulmonary edema. Atelectasis at both the left and right lung bases.


SubjectID: 11919347, StudyID: 52446430, Comparison: same

FINAL REPORT

PORTABLE AP CHEST FROM ___ AT 22:35. CLINICAL

INDICATION: ___-year-old with CHF on Lasix with acute respiratory distress. Comparison is made to the patient's prior study of ___ at 16:39. A single portable upright chest film ___ at 22:35 was obtained. These are the best possible images obtained in this patient given his current clinical condition.

IMPRESSION: 1. A left-sided pacer remains in place, likely unchanged, although the distal portion of both leads is not well seen due to differences in technique. The patient's mandible obscures the right lung apex. Lung volumes are low and there are likely bilateral effusions, right greater than left which are likely not significantly changed. Overall, the degree of pulmonary edema is stable   Keywords: stable. The heart remains enlarged, which may reflect cardiomegaly, although pericardial effusion should also be considered. Clinical correlation is advised. No pneumothorax is seen given the limitations of this examination.


SubjectID: 11919347, StudyID: 50055540, Comparison: None

FINAL REPORT

PORTABLE AP CHEST FILM ___ AT ___ CLINICAL

INDICATION: ___-year-old with CHF, increasing dyspnea post-intubation and orogastric tube placement. Comparison to prior study dated ___ at ___. A portable erect chest film ___ at ___ is submitted.

IMPRESSION: 1. Interval intubation with the endotracheal tube having its tip approximately 3.5 cm above the carina. A nasogastric tube is seen at least to just below the level of the diaphragm but the tip is not identified. A dual-lead left-sided pacer is again seen with the right atrial lead in appropriate position and the tip of the right ventricular lead not included on the image. Overall, there is slight improvement in aeration at both lung bases. There are persistent, right greater than left, pleural effusions with moderate pulmonary edema with associated bibasilar compressive atelectasis and/or pneumonia. Clinical correlation is advised. No pneumothorax. Heart remains enlarged, likely reflecting cardiomegaly, although pericardial effusion cannot be excluded. Overall stable mediastinal contours.


SubjectID: 11919347, StudyID: 52926356, Comparison: better

FINAL REPORT

AP CHEST, 8:16 A.M. ___

HISTORY: ___-year-old man with CHF and pleural effusions after extubation.

IMPRESSION: AP chest compared to ___ through ___: Lung volumes have not diminished following tracheal extubation. Mild pulmonary edema in the upper lungs has improved slightly   Keywords: improve. Severe cardiomegaly, moderate to large right pleural effusion and left lower lobe atelectasis persist. Right jugular introducer ends just above the junction of brachiocephalic veins. Transvenous right atrioventricular pacer leads in standard placements. No pneumothorax.


SubjectID: 11919347, StudyID: 51499272, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the extent of the bilateral pleural effusions is unchanged. Unchanged moderate pulmonary edema and relatively massive cardiomegaly   Keywords: unchanged. The monitoring and support devices are constant, except for the removal of the Swan-Ganz catheter, while the right venous introduction sheath remains in place.


SubjectID: 11919347, StudyID: 50468895, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Respiratory failure, chronic heart failure, intubation, questionable changes.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The monitoring and support devices are constant, including the Swan-Ganz catheter. The Swan-___ catheter, however, needs to be pulled back by approximately 2-3 cm, as the tip is relatively far advanced in the right pulmonary artery. Minimally improved ventilation of the lung apices. However, substantial pleural effusions and signs of moderate pulmonary edema persist bilaterally. Unchanged moderate cardiomegaly.


SubjectID: 11919942, StudyID: 56714941, Comparison: None

WET READ: ___ ___ ___ 8:34 PM Multifocal opacities in the RLL, RML and LLL, similar to prior CT, c/w known multi-focal pneumonia. No effusion or pneumothorax. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Pneumonia, oxygen requirement, evaluation for progression.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the pre-existing volume loss in the middle lobe has improved. However, the pre-existing right basal opacity, predominantly in peribronchial location and displaying multiple air bronchograms, unchanged. Minimal improvement of a pre-existing retrocardiac atelectasis, a pre-existing plate-like atelectasis at the left lung base has resolved. Unchanged moderate cardiomegaly, no indication for pleural effusions. Signs of mild fluid overload might be present.


SubjectID: 11919942, StudyID: 51989296, Comparison: worse

FINAL REPORT

AP CHEST, 3:36 A.M., ___

HISTORY: ___-year-old woman with cough, fever and hypoxia.

IMPRESSION: AP chest compared to ___, 5:24 p.m.: Volume loss has developed in a region of prior consolidation in the right lower lobe, probably in the course of developing pneumonia with retained secretions. Atelectasis in the left mid lung is more linear. Moderate cardiomegaly and mediastinal vascular engorgement have increased suggesting a component of mild cardiac decompensation   Keywords: increase. Pleural effusions are small, if any. No pneumothorax.


SubjectID: 11919942, StudyID: 56197397, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Shortness of breath.

COMPARISONS: None.

TECHNIQUE: Chest, portable semi-upright AP portable.

FINDINGS: The heart is mild to moderately enlarged. Mild unfolding of the thoracic aorta is noted. The pulmonary vascularity is minimally prominent. Streaky left mid and lower lung opacities are probably compatible with minor atelectasis, but there is also a vague retrocardiac opacity. There is more widespread but patchy opacification involving the right lower lung, probably in the right middle lobe, raising concern for pneumonia.

IMPRESSION: Basilar opacities worrisome for pneumonia in the appropriate clinical setting although lower airway inflammation, atelectasis or even aspiration are other etiologies that could be considered in the appropriate clinical setting. Although there is perhaps minimal vascular prominence, since opacities are focal in the lower lungs, pulmonary edema is doubted as the primary etiology but could be seen with an atypical pattern.


SubjectID: 11922236, StudyID: 55951510, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with COPD, rising lactate over the course of the day despite fluid hydration // eval lung fields eval lung fields

IMPRESSION: In comparison with the study of ___, there is little interval change   Keywords: little interval change. Continued enlargement of the cardiac silhouette with pulmonary vascular congestion and probable bilateral small pleural effusions with compressive atelectasis   Keywords: continue. The asymmetry on the right with a more coalescent pattern at the base would raise the possibility of superimposed pneumonia in the appropriate clinical setting.


SubjectID: 11922236, StudyID: 52312811, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with COPD presenting with dyspnea, concern for COPD exacerbation, on BIPAP when admitted // eval lung fields

TECHNIQUE: Portable AP chest radiograph.

COMPARISON: Chest radiograph ___

FINDINGS: Patchy opacities of the bilateral lung bases are likely due to atelectasis although infection cannot be excluded. No other areas concerning for consolidation are seen. No pneumothorax or pleural effusion. The cardiomediastinal contour is unchanged compared to the prior study with mild prominence bilateral hila. No frank pulmonary edema.

IMPRESSION: Bibasilar atelectasis, this has progressed slightly when compared to the prior study.


SubjectID: 11922236, StudyID: 51077514, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with shortness of breath

COMPARISON: ___

FINDINGS: AP portable upright view of the chest. Patient's chin obscures the upper lungs. Remainder of the lungs appear clear. Previously noted consolidation in the right middle lobe has resolved in the interval. No large effusion. Heart size is unchanged. Bony structures are grossly intact

IMPRESSION: Resolved pneumonia. Limited evaluation of the lung apices. No convincing evidence for pneumonia or edema.


SubjectID: 11922236, StudyID: 54529333, Comparison: None

FINAL REPORT

HISTORY: Shortness of breath.

COMPARISON: Comparison is made with chest radiographs from ___ and ___.

FINDINGS: Single portable upright frontal image of the chest. The lungs are well expanded and clear. No large pleural effusion or pneumothorax is seen. The cardiomediastinal silhouette is enlarged.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 11922236, StudyID: 54516756, Comparison: None

FINAL REPORT

INDICATION: Chronic diastolic congestive heart failure, weight gain, edema and wheezing.

COMPARISON: Chest radiograph dated ___.

TECHNIQUE: PA and lateral radiographs of the chest.

FINDINGS: The inspiratory lung volumes are low with resultant bronchovascular crowding. There is no focal consolidation concerning for pneumonia, pleural effusion or pneumothorax. No pulmonary vascular congestion or edema is seen. The cardiac silhouette is enlarged, but stable. The mediastinal contours are prominent, with tortuosity of the thoracic aorta, which is unchanged.

IMPRESSION: Low lung volumes. No evidence of heart failure or volume overload.


SubjectID: 11936095, StudyID: 59846180, Comparison: 0.0

FINAL REPORT

INDICATION: ___F with left IJ placement, evaluate central venous line.

COMPARISON: Chest radiographs from ___ at 01:24 and 00:06.

TECHNIQUE Portable view of the chest

FINDINGS: There has been interval placement of a right IJ central venous catheter which projects over the mid SVC. Lung volumes are low with increased hazy perihilar opacities, consistent with pulmonary edema   Keywords: increase. There are small bilateral pleural effusions. There is no pneumothorax. Otherwise, no significant change compared to the prior study   Keywords: no significant change.

IMPRESSION: Left IJ central venous catheter projects over the mid SVC. Unchanged pulmonary edema   Keywords: unchanged.


SubjectID: 11936095, StudyID: 59563516, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with acute respiratory failure // line locations/ interval change to be done at 9AM

IMPRESSION: As compared to the recent radiograph from earlier today, support and monitoring devices are unchanged in position, and cardiomediastinal contours are stable. Perihilar edema has decreased in severity, and right pleural effusion has apparently decreased in size   Keywords: decrease. Exam is otherwise unchanged.


SubjectID: 11936095, StudyID: 59253654, Comparison: worse

FINAL REPORT

INDICATION: ___F s/p chest compressions, intubated, evaluate for rib fractures..

COMPARISON: Chest radiograph ___ at 00:00.

TECHNIQUE Portable view of the chest.

FINDINGS: Compared to chest radiograph from 2 hr prior, there is no significant change in the appearance of the lines and tubes. Lung volumes are low with increased perihilar and hazy opacities, compatible with pulmonary edema   Keywords: increase. Small bilateral pleural effusions again seen. There is no evidence of pneumothorax. No displaced rib fractures identified. Severe levoconvex scoliosis of the lumbar spine.

IMPRESSION: No displaced rib fractures seen, but if there is high clinical concern further imaging can be obtained. Worsening pulmonary edema   Keywords: worse.


SubjectID: 11936095, StudyID: 55416683, Comparison: same

FINAL REPORT

INDICATION: ___F with resp distress s/p intubation, evaluate endotracheal tube position..

COMPARISON: Outside hospital chest CT and radiograph ___.

TECHNIQUE Portable view of the chest.

FINDINGS: Endotracheal tube in appropriate position. Nasoenteric tube enters the stomach. Compared to prior radiograph, there is improved aeration of the lungs bilaterally. Lung volumes remain low with bibasilar opacities, left greater than right   Keywords: remain. Heart size is normal. Mediastinal contour is unremarkable. Surgical clips noted within the right upper quadrant. No acute osseous abnormality. Severe levoconvex scoliosis of the lumbar spine.

IMPRESSION: Endotracheal tube in appropriate position. Improved aeration of the lungs compared to outside hospital chest radiograph.


SubjectID: 11936095, StudyID: 53816144, Comparison: None

FINAL REPORT

INDICATION: ___F with confusion, evaluate for pneumonia.

TECHNIQUE: Chest PA and lateral

COMPARISON: Multiple prior chest radiographs with direct comparison made to study from ___.

FINDINGS: The lungs are well inflated and clear. The cardiomediastinal silhouette and hilar contours are stable. There is no pleural effusion or pneumothorax. Degenerative changes are noted at the bilateral glenohumeral and acromioclavicular joints. Surgical clips are noted in the left upper abdomen.

IMPRESSION: No evidence of acute cardiopulmonary process.


SubjectID: 11936095, StudyID: 53168450, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with dyspnea.

TECHNIQUE: Chest PA and lateral

COMPARISON: Radiograph dated ___

FINDINGS: PA and lateral chest radiograph demonstrate a clear lungs with no focal consolidation convincing for pneumonia. Heart size is top-normal. No evidence of overt pulmonary edema. There is no large pleural effusion. Bibasilar atelectasis is present. Hilar and mediastinal contours are stable in appearance relative to prior study dated ___. No acute osseous abnormality is detected.

IMPRESSION: Stable appearance of the chest relative to prior study dated ___.


SubjectID: 11941410, StudyID: 58337093, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with blood pleurex output // ? hemothorax

TECHNIQUE: Portable chest radiograph

COMPARISON: Chest radiograph ___ at 11:00

FINDINGS: Lung volumes are low. There are bibasilar opacities which may represent atelectasis or aspiration in the appropriate clinical setting. Background mild pulmonary vascular congestion is also noted. Bilateral pleural effusions are stable to minimally improved. No pneumothorax. Heart size is moderately enlarged. Pacer leads terminate in the right atrium and right ventricle, as expected. Right chest tube appears unchanged in position.

IMPRESSION: 1. Stable pulmonary vascular congestion   Keywords: stable. 2. Small bilateral pleural effusions, stable to minimally improved. 3. Bibasilar opacities, atelectasis or aspiration.


SubjectID: 11941410, StudyID: 58241415, Comparison: same

WET READ: ___ ___ 12:50 AM No significant interval change. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with chest tube that was briefly off suction. // Eval for effusion, pneumothorax Eval for effusion, pneumothorax

IMPRESSION: Compared to chest radiographs since ___, most recently ___ and ___. Lung volumes have improved but left basal consolidation has worsened consistent with progressive pneumonia. Moderate atelectasis at the right lung base is stable. Heart size top-normal. Persistent mild pulmonary vascular and mediastinal congestion suggesting volume overload   Keywords: persistent. Right thoracostomy tube unchanged in position. No pneumothorax. Small bilateral pleural effusions are presumed, unchanged or decreasing on the right, increasing on the left. Indwelling transvenous right atrial right ventricular pacer leads unchanged in standard placements.


SubjectID: 11941410, StudyID: 57292313, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with recent pacer placement and hemothorax requiring chest tube // Please eval chest tube, interval change

COMPARISON: Radiographs from ___

IMPRESSION: Support lines and tubes are unchanged in position. Right chest tube tip is again seen at the medial lung base. Heart size is enlarged but stable. There has been worsening of the right basilar opacity since previous which may be partially due to atelectasis however developing infiltrate is not excluded. Bibasilar opacities stable   Keywords: stable. There are no pneumothoraces.


SubjectID: 11941410, StudyID: 54292232, Comparison: None

WET READ: ___ ___ ___ 6:33 PM Severe pulmonary edema is new compared to the prior study from ___, as well as a transvenous dual chamber pacer device with pulse generator overlying the left chest wall. A right pleural tube is again noted. There is no evidence of pneumothorax. Bilateral pleural effusions are present. The findings were discussed with ___, N.P. by ___, M.D. on the telephone on ___ at 6:21 PM, 5 minutes after discovery of the findings. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p pacemaker placed today via cephalic access. Experiencing sudden onset pain below left clavicle extending up to base of left neck // r/o pneumothorax or evidence for thrombosis at left chest r/o pneumothorax or evidence for thrombosis at left chest

IMPRESSION: As compared to the previous radiograph, the patient is in severe pulmonary edema. The edema is centralized. Minimal bilateral pleural effusions are visualized. Bilateral areas of atelectasis are present. No pneumothorax. Stable position of a newly inserted. Left-sided pacemaker.


SubjectID: 11941410, StudyID: 50614268, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with new dual chamber PPM // assess lead position assess lead position

IMPRESSION: Comparison to ___. Dual chamber pacemaker in place. 1 lead projects over the right atrium and 1 over the right ventricle. A right chest tube is in situ. The extent of the right pleural effusion has decreased. Moderate cardiomegaly persists but there is a substantial improvement in the severity of pulmonary edema that has decreased from severe to mild   Keywords: decrease, improve. Stable areas of bilateral basilar atelectasis. No pneumothorax.


SubjectID: 11941410, StudyID: 56885879, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with pleural effusion now s/p ___- asses for PTX/resid eff // s/p Rt thoracentesis - PTX? residual effusion?

TECHNIQUE: Chest PA and lateral

COMPARISON: ___

FINDINGS: No pneumothorax. Trace right-sided pleural effusion. No acute focal consolidation. Mild interstitial edema. The cardiopericardial silhouette is compared well.

IMPRESSION: Mild interstitial pulmonary edema with very small right-sided pleural effusion.


SubjectID: 11941410, StudyID: 56227521, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with pleural effusion // eval eval

IMPRESSION: In comparison with the study of ___, the right pleural effusion head is substantially decreased. The cardiac silhouette remains mildly enlarged and there is probably some decrease in the degree of pulmonary vascular congestion   Keywords: decrease.


SubjectID: 11941410, StudyID: 55133209, Comparison: None

WET READ: ___ ___ 9:06 AM No pneumothorax. Bilateral pleural effusions are decreased.

WET READ VERSION #1 ___ ___ ___ 11:52 PM No pneumothorax. Bilateral pleural effusions are decreased. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with b/l ___ // ? ptx

TECHNIQUE: Single frontal view of the chest

COMPARISON: Study performed 2 hours earlier

IMPRESSION: There is no evident pneumothorax. Patient's chin obscures the apices of the lungs. Bibasilar opacities have improved consistent with improving atelectasis and decreasing in pleural effusions. Right chest tube is in place. Enlargement of the main pulmonary arteries is better seen in prior CT. Cardiomegaly cannot be assessed. Pacer leads are in standard position


SubjectID: 11941410, StudyID: 52912178, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with tpx removal on ___. // Rule out pneumothorax, any new consolidations? Rule out pneumothorax, any new consolidations?

IMPRESSION: Comparison to ___. No evidence of pneumothorax. Minimal decrease in bilateral lung volumes with subsequent appearance of minimal atelectasis at the lung bases. Minimal pleural effusions, both on the left than on the right, cannot be excluded. Stable position of the left pectoral pacemaker.


SubjectID: 11941410, StudyID: 52388260, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with worsening dyspnea, heart failure, known pleural effusions with clogged Pleurex. // size of pleural effusions? size of pleural effusions?

IMPRESSION: Right chest tube is in place. Bilateral pleural effusions are large, unchanged. Vascular congestion is present. No pneumothorax is present.


SubjectID: 11941410, StudyID: 51793314, Comparison: None

WET READ: ___ ___ ___ 10:44 AM No notable interval change compared to 7 hr ago. No pulmonary edema.

WET READ VERSION #1 ___ ___ ___ 1:01 AM No notable interval change compared to 7 hr ago. No pulmonary edema. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___ year old woman with hypoxia. // Pulmonary edema?

TECHNIQUE: Portable

FINDINGS: As compared to chest radiograph from the same day, right-sided pleural drain has a similar medial course.Moderate pleural effusions with bibasilar opacities has not substantially changed. Moderate cardiomegaly. No pneumothorax.

IMPRESSION: Stable appearance of moderate pleural effusions, and lower lobe opacities, better assessed on recent CT thorax.


SubjectID: 11941410, StudyID: 50455603, Comparison: same

WET READ: ___ ___ 11:52 PM No pneumothorax. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with recent pleurX removal. // Rule out pneumothorax? Rule out pneumothorax?

IMPRESSION: Status post PleurX removal. No pneumothorax. No larger pleural effusions. Lung volumes remain low and mild pulmonary edema persists   Keywords: persists, remain.


SubjectID: 11941410, StudyID: 54889622, Comparison: same

FINAL REPORT

INDICATION: ___F with hypoxia // eval for pleural effusion

TECHNIQUE: Single portable view of the chest.

COMPARISON: ___.

FINDINGS: When compared to prior, there has been no significant interval change   Keywords: no significant interval change. Persistent bibasilar opacities suggesting pleural effusions are again seen. Right-sided chest tube is in similar position. Superiorly, the lungs are clear. Cardiac silhouette is enlarged but stable. Left chest wall dual lead pacing device is unchanged. No acute osseous abnormalities.

IMPRESSION: Persistent bibasilar opacities likely due to effusions and atelectasis noting that superimposed infection is not excluded.


SubjectID: 11967908, StudyID: 59762551, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___F with fever // r/o infiltrate

COMPARISON: ___ and ___.

FINDINGS: PA and lateral views of the chest provided. Surgical clips are again noted projecting over the right axilla. The lungs are hyperinflated with partially calcified pleural parenchymal scarring at the right lung apex. A vascular stent projects in the left subclavicular region. Small pleural effusions are noted similar to recent CT exam. No signs of congestion edema or pneumonia. Cardiomediastinal silhouette is stable. Bony structures appear intact.

IMPRESSION: No evidence of pneumonia. Small pleural effusions.


SubjectID: 11967908, StudyID: 54382500, Comparison: worse

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: History: ___F with sudden worsening shortness of breath // Pulmonary edema?

TECHNIQUE: Chest: Frontal and Lateral

COMPARISON: ___, as well as ___ and chest CT from ___

FINDINGS: Right apical pleural thickening is re- demonstrated. Hilar prominence is again seen. The cardiac and mediastinal silhouettes are stable. Slight increased interstitial markings bilaterally is concerning for mild interstitial pulmonary edema   Keywords: increase. There is also slight increase in left base opacity which may be due a combination of interstitial edema and trace pleural effusions although consolidation is not excluded. There slight blunting of the bilateral posterior costophrenic angle suggesting trace pleural effusions. Pulmonary nodules were better assessed on chest CT.

IMPRESSION: Interval slight increase in interstitial markings diffusely bilaterally suggests mild interstitial edema   Keywords: increase. Trace pleural effusions. Increased opacity at the lung bases, particularly on the left, may be due to combination of interstitial edema and small pleural effusions however underlying consolidation is not excluded.


SubjectID: 11967908, StudyID: 59197851, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___F with chest pain // eval for any infiltrates

TECHNIQUE: Chest PA and lateral

COMPARISON: ___, CT chest dated ___

FINDINGS: The patient has undergone prior right mastectomy and axillary dissection. The cardiomediastinal silhouette and pulmonary vasculature are unchanged since the prior examination. Calcifications projecting over the right mid and upper lung have been demonstrated to be pleural based and are unchanged since the prior examination. Again noted is right upper lobe scarring with volume loss. There is no pleural effusion or pneumothorax. No definite focal consolidation is identified.

IMPRESSION: No acute intrathoracic abnormality.


SubjectID: 11967908, StudyID: 59154616, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with new fever, crackles right side // Eval for infiltrate, change from prior

COMPARISON: Radiograph from ___ and CT chest from ___

FINDINGS: AP portable upright view of the chest. Clips in the right axilla again noted. A left subclavian and axillary stent is in place. Calcified pleural plaque accounts for calcified density projecting over the right mid lung. Cardiomediastinal silhouette is stable. There is mild hilar congestion and mild interstitial pulmonary edema. Lower lung subtle opacities raise potential concern for a superimposed pneumonia. No large effusion or pneumothorax. Bony structures are intact.

IMPRESSION: Mild edema. Difficult to exclude superimposed pneumonia.


SubjectID: 11967908, StudyID: 54971944, Comparison: better

FINAL REPORT

INDICATION: ___ year old woman with ? PNA and fluid overload // Assess for consolidation

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph ___ at ___

FINDINGS: Left subclavian and axillary stent remains in place. Again there are surgical clips in the right axilla. Extensive coarse breast calcifications project over the right upper and mid hemi thorax. Pulmonary edema is resolved   Keywords: resolve   Keywords: resolve. There is a residual opacity in the periphery of the left base. There is no pleural effusion or pneumothorax. There is chronic apical pleural thickening and scarring.

IMPRESSION: Pulmonary edema is resolved. A residual opacity at the left base could reflect residual pulmonary edema or pleural fluid. Recommend continued follow-up.


SubjectID: 11967908, StudyID: 54148314, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with likely flash pulmonary edema // Please assess for interval change

TECHNIQUE: Portable semi-upright AP chest

COMPARISON: Chest radiographs ___ through ___. CT chest ___.

FINDINGS: Left subclavian and axillary stent remains in place. Again there are surgical clips in the right axilla. Extensive coarse breast calcifications project over the right upper and mid lung. There are postradiation fibrotic changes at the right apex in along the right upper mediastinum similar to prior studies. There is overall increased opacity of both lungs with ___ B-lines most evident along the periphery of the right lung suggestive of pulmonary edema. Heart size is normal. There is no pneumothorax.

IMPRESSION: Moderate pulmonary edema.


SubjectID: 11967908, StudyID: 58782385, Comparison: worse

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___ year old woman with pulm edema // resp distrses

TECHNIQUE: Portable AP view of the chest

COMPARISON: Chest radiographs from ___

FINDINGS: Left subclavian and axillary stents are unchanged. Clips in the right axilla are demonstrated. Coarse breast calcifications project over the right upper and mid hemi thorax as before. The cardiomediastinal and hilar contours are stable. Subtle bilateral pulmonary opacities are consistent with mild pulmonary edema, minimally increased from the prior examination   Keywords: increase. There is a small right pleural effusion. No pneumothorax. Scarring at the right apex is stable.

IMPRESSION: Mild pulmonary edema, minimally increased from the prior examination   Keywords: increase.


SubjectID: 11967908, StudyID: 57741335, Comparison: better

FINAL REPORT

INDICATION: ___-year-old female patient with breast cancer, lymphoma, now oliguric. Study requested for evaluation of volume overload.

COMPARISON: Prior chest radiograph from ___ through ___ and chest CT from ___.

TECHNIQUE: Portable AP chest radiograph.

FINDINGS: As compared to prior chest radiograph from ___, there is improved pulmonary vascular engorgement   Keywords: improve. There is no pulmonary edema. Smooth thickening of the right apical pleural margin and retraction of the right hilum is consistent with radiation changes. Speckled calcifications in the right upper lung are stable from prior chest radiograph. There is an indeterminate volume, likely small right pleural effusion. There are no focal consolidations or pneumothorax. The cardiomediastinal and hilar contours are within normal limits. Patient is status post right axial dissection with clips.

IMPRESSION: 1. Improved pulmonary vascular congestion, no pulmonary edema   Keywords: improve. 2. Stable small right pleural effusion. 3. Unchanged apical pleural thickening and calcification compatible with radiation changes from prior treatment of breast cancer.


SubjectID: 11967908, StudyID: 51206080, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old female with non-Hodgkin's lymphoma and CHF, presenting with generalized weakness. Rule out pneumonia.

COMPARISON: Chest radiograph from ___.

FINDINGS: AP and lateral chest radiographs were provided. There is prominence of the interstitial markings, slightly increased since the prior exam consistent with mild pulmonary edema   Keywords: increase. There is no focal consolidation or pneumothorax. Speckled calcifications in the right upper lung are stable from the prior CT chest. There are small bilateral pleural effusions, similar in appearance to the prior study. The cardiomediastinal silhouette is unchanged. Patient is status post right axial dissection with clips. The bones are intact.

IMPRESSION: Slightly worsened pulmonary edema   Keywords: worse. Stable small bilateral pleural effusions.


SubjectID: 11967908, StudyID: 57120808, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with pneumonia, now spiking on levofloxacin // Please evaluate for worsening infiltrate

COMPARISON: Radiographs from ___.

IMPRESSION: Cardiomediastinal silhouette is within normal limits. Lung fields are somewhat hyperexpanded. There are calcifications projecting over the right upper lobe which are stable. No overt pulmonary edema is seen. There are no large pleural effusions. No pneumothoraces are identified.


SubjectID: 11967908, StudyID: 51605422, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with ?PNA but subtle findings on CXR // assess for interval worsening of infiltrate

COMPARISON: ___ radiograph

IMPRESSION: Recently questioned early pneumonia in right lower lobe is no longer evident. Remainder of exam is unchanged except for resolution of pulmonary vascular congestion   Keywords: unchanged.


SubjectID: 11967908, StudyID: 53930672, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Worsening shortness of breath. Recent diagnosis of lymphoma.

COMPARISONS: ___.

TECHNIQUE: Chest, AP and lateral.

FINDINGS: Surgical clips are again present in the right axilla. The cardiac, mediastinal and hilar contours appear unchanged. Upward tenting of the medial right hemidiaphragm is very similar. There is a persistent small-to-moderate pleural effusion on the right witand a small one on the left. Fissures are mildly thickened. Subpleural thickening at the right lung apex appears stable. There is a new mild interstitial abnormality including Kerley B lines and peribronchial cuffing suggesting mild-to-moderate interstitial pulmonary edema   Keywords: new. However, there is no definite new focal opacity. Bony structures are unremarkable.

IMPRESSION: Findings most consistent with pulmonary edema.


SubjectID: 11967908, StudyID: 51184556, Comparison: same

FINAL REPORT

HISTORY: ___-year-old female with shortness of breath. Question pulmonary edema.

COMPARISON: ___.

TECHNIQUE: PA and lateral views of the chest.

FINDINGS: The patient has had a right axillary dissection and right lumpectomy. Cardiac silhouette is normal in size. There is suggestion of mild pulmonary edema, unchanged from the prior study   Keywords: unchanged. Upward tenting of the medial right hemidiaphragm is stable. Mild-to-moderate pleural effusion on the right and small on the left is also stable.

IMPRESSION: Unchanged mild pulmonary edema and bilateral effusions   Keywords: unchanged.


SubjectID: 11967908, StudyID: 53550715, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with history of lymphoma, ESRD on HD now with worsening dyspnea and hypoxemia. // ?worsening effusions/pulmonary edema, ?consolidation ?worsening effusions/pulmonary edema, ?consolidation

IMPRESSION: Heart size and mediastinum are stable. Diffuse interstitial opacities have slightly progressed concerning for progression of pulmonary edema   Keywords: progressed. Calcifications in the right mid thorax are unchanged. Bilateral pleural effusion is moderate in slightly increased since the prior study. There is more conspicuous opacity now at the mid left lung and might represent asymmetric edema but focus of infection is a possibility a attention to this area on the subsequent studies after diuresis is required to exclude the possibility of growing infection.


SubjectID: 11967908, StudyID: 52526644, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old female with a history of lymphoma, CAD (s/p PCI), CHF (LVEF ___%), ESRD (on HD ___), and hypogammaglobulinemia with recent admissions for chest pain and PNA (___, ___) who presents to the ED with 1 day history of dyspnea, cough, fevers, and hypotension. // please evaluate CT placement, interval changes please evaluate CT placement, interval changes

IMPRESSION: In comparison with the study of ___, the patient has taken a better inspiration. Cardiac silhouette remains at the upper limits of normal. Indistinctness of engorged pulmonary vessels is consistent with continued pulmonary edema   Keywords: continue. Left chest tube is in place and there is only minimal pleural effusion. No definite pneumothorax. Opacification at the left base silhouetting the hemidiaphragm is consistent with pleural fluid and underlying compressive atelectasis.


SubjectID: 11967908, StudyID: 51340097, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with chest tube // eval chest tube eval chest tube

IMPRESSION: In comparison with the study of ___, there is little change in the appearance of the heart and lungs. Right chest tube remains in place and there is no evidence of pneumothorax.


SubjectID: 11967908, StudyID: 53196247, Comparison: worse

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ yo woman with a PMH of CAD with MI x ___ s/p BMS, sCHF (EF ___%), HLD, breast ca s/p radiation/hormone therapy, and CKD on HD who presents with productive cough and fevers. // Please assess for pulmonary edema/evidence of volume overload.

TECHNIQUE: Portable chest radiograph

COMPARISON: Chest x-ray ___

FINDINGS: There is now moderate to severe alveolar pulmonary edema, worse compared to the prior CXR on ___   Keywords: worse. There are no large pleural effusions or pneumothorax. No evidence of pneumonia. Cardiomediastinal silhouette is unchanged. Surgical clips are again noted in the right axilla, and right hemidiaphragm.

IMPRESSION: Worsening alveolar pulmonary edema   Keywords: worse.


SubjectID: 11967908, StudyID: 51649994, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (AP AND LATERAL)

INDICATION: History: ___F with fevers/chills

TECHNIQUE: Upright AP and lateral views of the chest

COMPARISON: Chest CT ___ and chest radiograph ___

FINDINGS: Cardiac silhouette size is normal. Mediastinal and hilar contours are unchanged. Pulmonary vasculature is not engorged. Calcifications projecting over the right mid and upper lung fields are similar compared to the previous exam, reflecting a combination of pleural calcifications and chest wall calcifications. Scarring with bronchiectasis is again noted in the right apex. No new focal consolidation, pleural effusion or pneumothorax is visualized. Multiple clips are again seen in the right axillary region as well as overlying the right hemidiaphragm. No acute osseous abnormality is identified. Remote right proximal humeral fracture is again noted.

IMPRESSION: Similar scarring and bronchiectasis within the right apex and calcifications projecting over the right upper and mid lung fields. No focal consolidation.


SubjectID: 11967908, StudyID: 53032483, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with ESRD on HD, s/p removal of chest tube. // ?pneumothorax

IMPRESSION: In comparison to ___ chest radiograph, a right chest tube has been removed, with no visible pneumothorax and an unchanged small right pleural effusion. On the left, there has been improvement a small left pleural effusion and adjacent left basilar atelectasis. No other relevant change   Keywords: no other relevant change.


SubjectID: 11967908, StudyID: 50680568, Comparison: None

FINAL REPORT

INDICATION: Fever. Evaluate for pneumonia.

COMPARISON: Chest radiographs from ___, ___, ___, and ___.

FINDINGS: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette and well inflated lungs. Again seen is biapical pleural thickening, right greater than left and a rounded calcified opacities in the right upper lobe. Left base scarring is again seen, less prominent compared to the most recent chest radiograph. Slightly increased opacity in the lateral right lung base could represent an early pneumonia. There is no pleural effusion or pneumothorax.

IMPRESSION: Slightly increased opacity in the right lateral lung base could represent an early pneumonia.


SubjectID: 11969536, StudyID: 59874437, Comparison: None

FINAL REPORT

CLINICAL

HISTORY: Status post CABG and aortic valve replacement, now has increasing pleural effusions. CHEST, PA AND LATERAL:

COMPARISON: ___. The heart is enlarged. Bilateral pleural effusions are present. There is now better lung expansion since the prior chest x-ray and the effusions, particularly the left are decreased.

IMPRESSION: Decreased size of effusion.


SubjectID: 11969536, StudyID: 53019716, Comparison: None

FINAL REPORT

EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Shortness of breath, status post CABG and aortic valve replacement.

COMPARISON: ___.

FINDINGS: Frontal and lateral views of the chest are obtained. The patient is status post median sternotomy and CABG. Dual-lead left-sided pacemaker is again seen, relatively stable in position. The cardiomediastinal silhouette is stably enlarged. There are small bilateral pleural effusions, left greater than right. Interval removal of previously seen right internal jugular central venous catheter.

IMPRESSION: Bilateral pleural effusions. Enlarged cardiac silhouette. No definite focal consolidation, although left-sided consolidation would be difficult to exclude.


SubjectID: 11978101, StudyID: 59225917, Comparison: same

FINAL REPORT

INDICATION: Evaluate for improvement in fluid balance in a patient with CHF exacerbation.

COMPARISON: Chest radiograph from ___.

FINDINGS: There has been near-complete resolution of the cardiogenic pulmonary edema seen on the prior study. Moderate cardiomegaly is stable. There continues to be mediastinal vascular engorgement consistent with mild hypervolemia   Keywords: continue. There is no pneumothorax or pleural effusion.

IMPRESSION: Near-complete resolution of cardiogenic pulmonary edema with minimal remnant mediastinal vascular engorgement suggestive of mild hypervolemia.


SubjectID: 11978101, StudyID: 54570500, Comparison: worse

FINAL REPORT

HISTORY: ___-year-old female with acute shortness of breath and rales on exam.

COMPARISON: Chest radiograph from ___ PORTABLE FRONTAL CHEST RADIOGRAPH: There are diffuse alveolar opacities bilaterally with hazy lung bases, findings consistent with moderate pulmonary edema and probable bilateral pleural effusions. There is likely associated compressive atelectasis at the bases as well. No pneumothorax is evident. Mediastinal contours appear normal. Moderate cardiomegaly appears similar to prior. The bones remain diffusely osteopenic.

IMPRESSION: 1. New moderate pulmonary edema with probable bibasilar atelectasis and small bilateral pleural effusions   Keywords: new. 2. Unchanged moderate cardiomegaly


SubjectID: 11978101, StudyID: 59069951, Comparison: None

FINAL REPORT

CLINICAL

HISTORY: ___-year-old woman with cardiomyopathy status post biventricular ICD placement. Any evidence of pneumothorax.

COMPARISON: ___.

TECHNIQUE: There is a new biventricular ICD with a battery pack over the left hemithorax. There is no evidence of pneumothorax. Cardiac leads lead to the right ventricle and right atrium on this single projection. A third cardiac lead is also present. Minimal bibasilar atelectasis is present. However, no evidence of pneumonia.

IMPRESSION: No evidence of pneumothorax.


SubjectID: 11978101, StudyID: 56783352, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: Chest PA and lateral.

INDICATION: ___-year-old female patient with cardiomyopathy status post biventricular ICD. Are the leads in appropriate position?

FINDINGS: PA and lateral chest views were obtained with patient in upright position. Comparison is made with the next preceding single view chest examination of ___. On the frontal view, the findings are unchanged and there is no evidence of any pneumothorax. Again identified are the two standard electrodes in right atrial appendage position and apical portion of right ventricle correspondingly. The third electrode can now be located in greater detail with the help of the lateral view. This third wire is also connected with the same left-sided pacer passes along through the central venous system and when reaching the right atrium makes an anterior gentle curve to return in dorsal direction and apparently entering the venous coronary sinus. It continues for about 3 cm in posterior direction before it curves finally with its tip laterally, so that it rests in a posterior lateral obtuse marginal vein of the coronary venous system. Thus, the wire should activate region of the posterolateral left ventricle. Comparison is extended to a series of chest examinations in ___. The degree of cardiomegaly appears to be stable. There is no significant pulmonary vascular congestion or any pleural effusion in lateral or posterior pleural sinuses.

IMPRESSION: Appropriate position of all three endovascular pacer electrodes in right atrial appendage, right ventricular apical portion and left posterolateral coronary vein to stimulate left ventricle.


SubjectID: 11984732, StudyID: 58771235, Comparison: None

FINAL REPORT

AP CHEST, 8:07 A.M. ___

HISTORY: A ___-year-old woman with critical aortic stenosis and pulmonary edema after balloon valvuloplasty.

IMPRESSION: AP chest compared to ___, 11:06 p.m.: Mild pulmonary edema has changed in distribution, but not in severity. Appearance of the right lower lobe is most consistent with dependent atelectasis and edema. Left lower lobe remains severely atelectatic. With the chin down, position of the ET tube, 2.5 cm from the carina is acceptable. Moderate cardiomegaly is chronic. Some pleural effusion is presumed, but not substantial. Right PIC line can be traced as far as the low SVC where the tip is obscured by the upper enteric drainage tube passing into the stomach and out of view. Transvenous right atrial and right ventricular pacer leads are in their expected positions.


SubjectID: 11984732, StudyID: 50458000, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Fatigue and pneumonia. Evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Minimal moderate cardiomegaly with signs of mild-to-moderate pulmonary edema. Bilateral areas of atelectasis. Small pleural effusions. No new parenchymal opacities suggesting pneumonia.


SubjectID: 11984732, StudyID: 52524638, Comparison: better

FINAL REPORT

INDICATION: ___-year-old woman status post dual-chamber pacemaker for AV block. Assess pacemaker leads.

COMPARISONS: Chest radiograph from one day prior.

FINDINGS: Two views of the chest were obtained. Left-sided pacemaker and both pacemaker leads are in unchanged position, in the expected positions of the right atrium and ventricle. There is interval decrease of pulmonary edema with small bilateral effusions and atelectasis   Keywords: decrease. No pneumothorax is seen. Cardiomegaly, aortic calcifications, and post-CABG findings are stable. Right humerus is incompletely assessed on this image but appears high riding suggesting degenerative rotator cuff disease.

IMPRESSION: Interval decrease in degree of pulmonary edema with small bibasilar effusions   Keywords: decrease.


SubjectID: 11984732, StudyID: 50838294, Comparison: None

FINAL REPORT

HISTORY: Congestive heart failure, on BiPAP.

TECHNIQUE: Upright AP view of the chest.

COMPARISON: None.

FINDINGS: The patient is status post median sternotomy and CABG. There is mild enlargement of the cardiac silhouette. The aortic knob is calcified. Mild pulmonary edema is present with vascular indistinctness and perihilar haziness. Small bilateral pleural effusions are likely. No pneumothorax is identified. Widening of the right paratracheal stripe may suggest the presence of tortuous vessels. No acute osseous abnormality is seen.

IMPRESSION: 1. Mild congestive heart failure with small bilateral pleural effusions. 2. Widened right paratracheal stripe may be related to tortuous vessels but underlying lymphadenopathy is not excluded. Comparison with prior exams is recommended, or a CT of the chest can be obtained for further evaluation.


SubjectID: 11985034, StudyID: 59774873, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with AMS

COMPARISON: ___.

FINDINGS: AP portable upright view of the chest. Overlying EKG leads are present. Lung volumes are low. There is mild pulmonary edema with stable mild cardiomegaly   Keywords: stable. Linear density in the left mid lung could represent atelectasis or scarring. No large effusion is seen. Bony structures are intact.

IMPRESSION: Mild cardiomegaly and mild pulmonary edema.


SubjectID: 11985034, StudyID: 53440880, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with tachypnea after 3 L NS, r/o pulm edema // r/o pulm edema, infiltrate r/o pulm edema, infiltrate

IMPRESSION: In comparison with the study of ___, the patient has taken a better inspiration. There is again enlargement of the cardiac silhouette with pulmonary vascular congestion   Keywords: again. Retrocardiac opacification is consistent with atelectatic changes, though in the appropriate clinical settings superimposed pneumonia would have to be considered. The upper mediastinum and lungs are somewhat obscured by the chin of the patient.


SubjectID: 11985034, StudyID: 59466475, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with new hypoxia // pulm edema, effusion

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, there are new bilateral pleural effusions are of mild to moderate extent as well as an increase in extent and severity of the pre-existing parenchymal opacities, likely caused by now moderate pulmonary edema. Radiographic followup after diuresis is recommended to rule out coexisting pneumonia.


SubjectID: 11985034, StudyID: 57946758, Comparison: better

FINAL REPORT

EXAMINATION: Portable AP chest radiograph.

INDICATION: ___ year old woman with sepsis. Evaluate for consolidation.

COMPARISON: Chest radiograph dated ___.

FINDINGS: The right pleural effusions essentially resolved. The left pleural effusion, if present, is minimal. Significant improvement in left lower lung atelectasis, with mild residual atelectasis and persistent elevation of left hemidiaphragm and slight leftward shift of the mediastinum. Interval improvement in the edema   Keywords: improve. Mild cardiomegaly is overall unchanged. Median sternotomy wires are intact. No pneumothorax. Mild bilateral apical pleural thickening is unchanged.

IMPRESSION: Mild left lower lung atelectasis.


SubjectID: 11985034, StudyID: 58517602, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with s/p cabg // eval effusion eval effusion

IMPRESSION: In comparison with the study of ___, the right IJ sheath has been removed. Following removal of the left chest tube, there is no evidence of pneumothorax. The left subclavian catheter again extends well into the right atrium. Continued low lung volumes with cardiomegaly, vascular congestion, and bilateral pleural effusions with compressive atelectasis, more prominent on the right   Keywords: continue.


SubjectID: 11985034, StudyID: 57742496, Comparison: None

WET READ: ___ ___ ___ 12:28 PM Left PICC tip in azygos vein. Consider withdrawing 1.5 cm for upper SVC. Persistent right lower lobe opacity is most consistent asymmetric pulmonary edema and atelectasis however cannot exclude superimposed infection in the appropriate clinical setting. Small right pleural effusion, unchanged. ___ d/w ___ IV nurse, 12:25 PM. ___ ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with s/p mvr // s/p mt removal ? ptx

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Left PICC tip in azygos vein. Consider withdrawing 1.5 cm for upper SVC. Persistent right lower lobe opacity is most consistent asymmetric pulmonary edema and atelectasis however cannot exclude superimposed infection in the appropriate clinical setting. Small right pleural effusion, unchanged


SubjectID: 11985034, StudyID: 52107646, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with s/p mvr and cabg // eval for effusion or infiltrate eval for effusion or infiltrate

IMPRESSION: In comparison with the study of ___, there are continued low lung volumes with substantial enlargement of the cardiac silhouette, vascular congestion, and bilateral pleural effusions with compressive atelectasis, more prominent on the right. Retrocardiac opacification with obscuration of the hemidiaphragm is consistent with substantial volume loss in the left lower lobe. The left subclavian catheter again extends well into the right atrium.


SubjectID: 11985034, StudyID: 57880362, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with mitral valve endocarditis causing mitral stenosis // asess pulm edema

EXAMINATION: CHEST (PORTABLE AP)

TECHNIQUE: Chest radiograph, frontal radiograph

COMPARISON: Chest radiograph ___

FINDINGS: There are moderate to large bilateral pleural effusions, similar to prior. There is bibasal atelectasis. Pulmonary edema is similar to prior   Keywords: similar. Cardiomediastinal silhouette is within normal size and unchanged. Left PICC terminates in low SVC.

IMPRESSION: No notable interval change. Pulmonary edema, bilateral pleural effusions, and bibasilar atelectasis are similar to prior   Keywords: similar.


SubjectID: 11985034, StudyID: 56929615, Comparison: better

FINAL REPORT

INDICATION: ___ year old woman with mitral valve endocarditis, heart faliure, hypoxia // evaluate for worsening heart failure

EXAMINATION: CHEST (PORTABLE AP)

TECHNIQUE: Portable Chest radiograph, frontal view

COMPARISON: Chest radiograph ___

FINDINGS: There are large bilateral pleural effusions and bibasilar atelectasis, similar to prior. Moderate cardiomegaly is unchanged. Pulmonary edema is minimally improved   Keywords: improve   Keywords: improve. Left PICC line terminates in low SVC.

IMPRESSION: Persistent large bilateral pleural effusions and bibasilar atelectasis. Pulmonary edema is minimally improved.


SubjectID: 11985034, StudyID: 56581116, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with endocarditis, picc in left arm was in azygous vein, now repositioned. // Is PICC in correct position? Is PICC in correct position?

IMPRESSION: In comparison with the earlier study of this date, the left subclavian catheter has been redirected so that the tip lies in the region of the cavoatrial junction.


SubjectID: 11985034, StudyID: 55720010, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with mitral valve endocarditis and sepsis, now with desaturation to ___ on 2L acutely // ?volume overload

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___ obtained at 10:18

IMPRESSION: There is interval progression of pulmonary edema, substantial   Keywords: progression. Bilateral pleural effusions are noted, large. Cardiomediastinal silhouette is unchanged. Bibasal consolidations are unchanged.


SubjectID: 11985034, StudyID: 54660294, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with sob // eval for PNA

COMPARISON: ___ and ___ CT.

FINDINGS: AP portable upright view of the chest. Left upper extremity PICC line is again seen with its tip in the region of the low SVC. There is worsening pulmonary edema   Keywords: worse. Small bilateral pleural effusions are noted. Retrocardiac opacities increased which could reflect pneumonic consolidation. No pneumothorax. Cardiomediastinal silhouette is stable. Bony structures are intact.

IMPRESSION: Worsening pulmonary edema, stable small bilateral pleural effusions, worsening retrocardiac opacification concerning for pneumonia   Keywords: worse. PICC line unchanged with tip in low SVC.


SubjectID: 11985034, StudyID: 53108287, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with possible PNA. // Comparison to previous.

EXAMINATION: CHEST (PORTABLE AP)

TECHNIQUE: Portable Chest radiograph, frontal view

COMPARISON: Chest radiograph ___

FINDINGS: There is increased bibasilar opacities, possibly from redistribution of moderate bilateral pleural effusions. There is increased left lower lobe consolidation and mediastinal shift to the left. Mild pulmonary vessel congestion is similar to prior. Cardiomediastinal silhouette is normal size. Left PICC terminates in the azygos vein.

IMPRESSION: 1. Left PICC terminates in the azygos vein. 2. Slightly increased left lower lobe consolidation. Mild pulmonary vessel congestion and moderate bilateral pleural effusions are similar to prior.

NOTIFICATION: The findings regarding PICC position were text paged by Dr. ___ to Dr. ___ on ___ at 9:12 AM.


SubjectID: 12008763, StudyID: 59699100, Comparison: None

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Fast track early extubation, cardiac surgery.

COMPARISON: ___.

FINDINGS : The esophageal tube has been removed. The endotracheal tube, the Swan-Ganz, the NG tube and a chest tube are in unchanged position. Stability of the mediastinal and cardiac contour in this patient with recent sternotomy for CABG. There is no visible pneumothorax. Stability of the left mild-to-moderate pleural effusion and the bibasilar atelectasis.

CONCLUSION: There is no significant change since the previous exam except for the removal of the esophageal tube.


SubjectID: 12008763, StudyID: 58021359, Comparison: None

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with CABG. Evaluation for effusion.

COMPARISON: ___.

FINDINGS: The endotracheal tube, the Swan-Ganz, the mediastinal and chest tubes are in unchanged position. There is no visible pneumothorax. There is decreased amount of left mild pleural effusion. Stability of the left retrocardiac atelectasis. Status post median sternotomy for CABG. The mediastinal and cardiac contour are unchanged.

CONCLUSION: The left mild pleural effusion has decreased. The rest of the exam is unchanged.


SubjectID: 12008763, StudyID: 57848943, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: Chest AP portable single view.

INDICATION: ___-year-old male patient status post chest tube removal, evaluate for pneumothorax.

FINDINGS: AP single view of the chest has been obtained with patient in sitting semi-upright position. Analysis is performed in direct comparison with the next preceding similar study obtained three hours earlier during the same day. The patient remains intubated, the ETT in unchanged position. As before, status post recent cardiac surgery with sternotomy wires in midline. NG tube and Swan-Ganz catheter remain in place. A right-sided chest tube has been removed and the lung remains well aerated without evidence of pneumothorax. No new pulmonary abnormalities identified.


SubjectID: 12008763, StudyID: 52704320, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post CABG, now evaluation for hemothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the aortic balloon pump has been removed. The other monitoring and support devices, including the bilateral chest tubes are in situ. Unchanged low lung volumes with moderate cardiomegaly and basal areas of atelectasis. No newly appeared parenchymal opacities   Keywords: new. No pneumothorax.


SubjectID: 12008763, StudyID: 55998665, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Aortic balloon pump.

COMPARISON: ___, 6:29 p.m.

FINDINGS: As compared to the previous radiograph, the intra-aortic balloon pump has been advanced by approximately 2 cm. The other monitoring and support devices are constant. Constant appearance of the lung parenchyma and of the cardiac silhouette.


SubjectID: 12008763, StudyID: 52928308, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post CABG, postoperative bleeding, evaluation for hematoma.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. All monitoring and support devices, including the intra-aortic balloon pump, are in constant position. Low lung volumes with moderate cardiomegaly and areas of atelectasis at both lung bases. No evidence of new parenchymal, pleural or mediastinal opacities   Keywords: new.


SubjectID: 12008763, StudyID: 50835587, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Intra-aortic balloon pump placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the intra-aortic balloon pump has been pulled back by approximately 3 cm. The tip of the pump now projects approximately halfway between the aortic arch and the aortic hiatus. Otherwise, the radiograph is unchanged, with unchanged appearance of the lung, the heart and the monitoring and support devices.


SubjectID: 12009312, StudyID: 58459005, Comparison: better

FINAL REPORT

PA AND LATERAL CHEST OF ___

COMPARISON: ___ radiograph.

FINDINGS: The patient is status post median sternotomy and coronary artery bypass surgery. Cardiac silhouette has slightly decreased in size since the previous study, pulmonary edema has resolved   Keywords: resolve, decrease. Improving aeration at both lung bases. Residual patchy retrocardiac atelectasis and bibasilar linear atelectasis remaining. Small pleural effusions are also noted.

IMPRESSION: Resolution of pulmonary edema. Bibasilar atelectasis and small pleural effusions.


SubjectID: 12009312, StudyID: 51302380, Comparison: better

FINAL REPORT

HISTORY: Shortness of breath.

TECHNIQUE: Upright AP view of the chest

COMPARISON: ___.

FINDINGS: The patient is status post median sternotomy and CABG. Moderate enlargement of the cardiac silhouette size is unchanged. There continues to be mild to moderate pulmonary edema, slightly improved in the interval   Keywords: improve. Right internal jugular vascular sheath has been removed. Bilateral carotid stents are again demonstrated within the neck. Widening of the mediastinal contours are unchanged, compatible with expected postoperative findings. Small bilateral pleural effusions are likely present. No pneumothorax is present.

IMPRESSION: Mild to moderate pulmonary edema, slightly improved in the interval   Keywords: improve. Probable small bilateral pleural effusions.


SubjectID: 12009312, StudyID: 57413252, Comparison: None

FINAL REPORT

HISTORY: IABP position.

FINDINGS: The tip of the IABP has been pulled back slightly and is now perpendicular to the base of the image. The tip of the opaque portion of the tube lies about 1.5 cm above the ideal position just above the left main bronchus.


SubjectID: 12009312, StudyID: 55728865, Comparison: same

FINAL REPORT

INDICATION: ___-year-old gentleman status post CABG with chest tube removal, assess for pneumothoraces.

COMPARISONS: ___. Endotracheal tube, nasogastric tube, Swan-Ganz catheter, mediastinal drains and bibasilar chest tubes have been removed. Right IJ sheath is in position in the upper SVC. Small bilateral pleural effusions are slightly increased on this examination with accompanying atelectasis and unchanged mild pulmonary edema. No pneumothorax is identified. Moderate cardiomegaly persists.

IMPRESSION: No pneumothorax with increased small bilateral pleural effusions and atelectasis with unchanged mild pulmonary edema   Keywords: unchanged.


SubjectID: 12009312, StudyID: 54710937, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man status post CABG with chest tube on waterseal.

COMPARISONS: ___.

FINDINGS: Endotracheal tube, nasogastric tube, Swan catheter, mediastinal and bibasilar chest tubes are in unchanged position without evidence of pneumothorax. Retrocardiac atelectasis is unchanged. No pulmonary edema or pleural effusion is seen. Moderate cardiomegaly is unchanged.


SubjectID: 12009312, StudyID: 51634074, Comparison: worse

FINAL REPORT

INDICATION: Evaluate for pneumonia in a patient status post cardiac operation.

COMPARISONS: A series of chest radiographs dating back to ___, most recently from ___.

FINDINGS: A bedside AP radiograph of the chest demonstrates worsening bilateral moderate pleural effusions and atelectasis. There is also worsening mild pulmonary edema   Keywords: worse. Asymmetric opacification of the left mid lung field is present. Post-operative widening of the heart and mediastinum are unchanged. There is no pneumothorax. The sternotomy cerclage wires are intact and a right IJ Swan-Ganz catheter sheath remains in place. Bilateral carotid stents are also seen.

IMPRESSION: 1. Decompensated congestive heart failure as evidenced by worsening cardiogenic pulmonary edema and increasing moderate bilateral pleural effusions   Keywords: worse, increasing. 2. Asymmetric airspace opacification in the left mid lung field should be followed on subsequent examination to rule out developing infectious process.


SubjectID: 12009312, StudyID: 51547402, Comparison: None

WET READ: ___ ___ ___ 8:18 PM increased pulmonary edema compared to 1:47pm. no definite pneumothorax identified. ETT 6.2cm above carina, unchanged. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post CABG, assessment for left pneumothorax.

COMPARISON: ___, 1:47 p.m.

FINDINGS: As compared to the previous radiograph, there is minimal pulmonary edema. A pre-existing retrocardiac atelectasis is unchanged in severity. All monitoring and support devices are constant. Bilateral carotid stents are visible. There is no evidence of pneumothorax. No pleural effusions.


SubjectID: 12018901, StudyID: 57365738, Comparison: same

FINAL REPORT

HISTORY: Intubation.

COMPARISON: Multiple prior chest radiographs, most recently ___.

FINDINGS: Single frontal of the chest. Endotracheal tube terminates 4.9 cm above the carina. Left IJ central venous catheter terminates at the origin of the SVC. A NG tube passes into the stomach and terminates beyond the limits of the film. The heart remains severely enlarged. Upper mediastinal contours are stable. Widespread bilateral pulmonary opacities are consistent with severe pulmonary edema. Bibasilar consolidations are unchanged.

IMPRESSION: Stable severe cardiomegaly, pulmonary edema, and bibasilar consolidations   Keywords: stable.


SubjectID: 12018901, StudyID: 59140569, Comparison: same

FINAL REPORT

HISTORY: Chronic renal disease with volume overload and fever.

FINDINGS: In comparison with study of ___, there is again enlargement of the cardiac silhouette with pulmonary edema and bilateral pleural effusions with compressive atelectasis, more prominent on the right   Keywords: again.


SubjectID: 12018901, StudyID: 57497470, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with pHTN, CHF, vol overload from ESRD and hypoxia // interval change

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, there is improved ventilation at the right lung bases. The extensive bilateral parenchymal opacities, pre described on the previous image, however persist. Unchanged moderate cardiomegaly with bilateral areas of atelectasis at the lung bases. No new parenchymal opacities   Keywords: new. No larger pleural effusions.


SubjectID: 12018901, StudyID: 52682276, Comparison: -1.0

FINAL REPORT

PORTABLE CHEST X-RAY OF ___

COMPARISON: ___ radiograph.

FINDINGS: Support and monitoring devices are in standard position except for a nasogastric tube which terminates in the mid thoracic esophagus. Dr. ___ was paged on ___ at 9:20 a.m. at the time of discovery. Stable cardiomediastinal widening. Slight improvement in extent of pulmonary edema   Keywords: improve. Worsening basilar lung opacification probably represents a combination of partially layering pleural effusions, adjacent atelectasis, and a component of dependent edema   Keywords: worse.


SubjectID: 12018901, StudyID: 55407841, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: ___-year-old woman with respiratory failure requiring intubation, check for endotracheal tube placement.

FINDINGS: An AP upright chest radiograph shows lower position of endotracheal tube on the current study with the tip just over 2 cm above the carina. This is low in location, but at the time of dictation, a followup film has been obtained which shows better positioning. Nasogastric tube is seen with the tip and side hole both off the view of the film. Left-sided IJ central venous catheter tip is at the level of the proximal superior vena cava and the tip may abut the right lateral wall of the SVC. Marked cardiomegaly is again noted. Lung parenchyma remains diffusely hazy without focal consolidation or volume loss.

CONCLUSION: 1. Low positioning of endotracheal tube has already been corrected at the time of dictation. 2. Unchanged positioning of left central venous catheter may abut right lateral wall of the SVC. 3. Unchanged cardiomegaly and presumed edema   Keywords: unchanged.


SubjectID: 12018901, StudyID: 52852399, Comparison: same

FINAL REPORT

HISTORY: ___-year-old woman intubated for respiratory failure. Please evaluate for interval change.

FINDINGS: Portable semi-upright chest radiograph shows stable positioning of supporting lines and tubes. Note is again made that the left-sided central venous catheter tip is directed towards the right lateral wall of the SVC and could be advanced 2 cm or pulled back 1 cm. Diffuse haziness in the parenchyma, particularly in the perihilar regions where peribronchial cuffing is seen, suggests edema, though ARDS could give a similar picture   Keywords: similar. Marked cardiomegaly and atherosclerotic plaque in the thoracic aorta are unchanged.

CONCLUSION: No significant radiographic improvement in edema or ARDS and cardiomegaly   Keywords: improve. If left-sided central venous catheter tip is to be longstanding, recommend either withdrawal 1 cm or advancement of approximately 2 cm to avoid tip abutting right lateral wall of SVC.


SubjectID: 12018901, StudyID: 55346741, Comparison: better

FINAL REPORT

INDICATION: History: ___F with AMS and cough // eval for pna, effusions

TECHNIQUE: AP and lateral views of the chest

COMPARISON: ___ at 18:05

FINDINGS: In comparison to the prior study there is mild improvement in severe diffuse pulmonary edema   Keywords: improve. Moderate cardiomegaly is unchanged. Focal consolidation would be difficult to exclude given the degree of pulmonary edema. There is no large pleural effusion or pneumothorax.

IMPRESSION: Mild improvement in severe diffuse bilateral pulmonary edema with continued severe pulmonary edema and stable moderate cardiomegaly   Keywords: improve.


SubjectID: 12018901, StudyID: 51864542, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i

INDICATION: ___ year old woman with ESRD on HD with pulmonary edema on previous film now s/p dialysis // evidence of retrocardiac consolidation, improvement of pulm edema

COMPARISON: CHEST RADIOGRAPHS SINCE ___ MOST RECENTLY

IMPRESSION: Severe enlargement of the cardiac silhouette due to cardiomegaly and/or pericardial effusion improved substantially between ___ and ___ one, subsequently unchanged. Mild pulmonary edema earlier in the day has cleared. Pleural effusions are small if any. No pneumothorax.


SubjectID: 12019930, StudyID: 59810074, Comparison: None

FINAL REPORT

HISTORY: Bronchiectasis and COPD.

FINDINGS: In comparison with the study of ___, there is little interval change in the appearance of the bilateral pleural effusions in a patient with diffuse severe chronic pulmonary disease. Areas of atelectasis are again seen. No region of distinct focal consolidation.


SubjectID: 12019930, StudyID: 52122347, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST, ___

COMPARISON: ___ radiograph.

FINDINGS: Cardiac silhouette is upper limits of normal in size and stable compared to the prior study. Moderate left pleural effusion has increased in size since the previous study, and a small right pleural effusion is also slightly increased from the prior radiograph. Adjacent areas of basilar atelectasis are present. Elsewhere in the lungs, small branching opacities are present, corresponding to areas of mucus plugging and small airways disease on prior chest CTA of ___. The lungs are overinflated. Bones are diffusely demineralized, and compression deformities are present within the spine.

IMPRESSION: Slight increase in moderate left and small right pleural effusions with adjacent basilar atelectasis.


SubjectID: 12019930, StudyID: 54406761, Comparison: None

FINAL REPORT

CHEST, TWO VIEWS: ___.

HISTORY: ___-year-old female with shortness of breath.

FINDINGS: Frontal and lateral views of the chest are compared to previous xray and CT from ___ and xray from ___. Lungs are hyperinflated. There are small bilateral pleural effusions, slightly larger on the left than on the right. Streaky linear opacities projecting over the cardiac silhouette on the lateral is compatible with bronchiectasis and scarring in right middle lobe on prior CT scan. There is also an area of scarring in the right mid lung stable back to ___. There is no large confluent consolidation. Cardiomediastinal silhouette is unchanged as are the osseous and soft tissue structures.

IMPRESSION: Small left greater than right bilateral pleural effusions, new since ___. No other acute cardiopulmonary process.


SubjectID: 12020348, StudyID: 50874347, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Status post endotracheal intubation. History of coronary artery disease and congestive heart failure.

COMPARISONS: ___.

TECHNIQUE: Chest, AP view.

FINDINGS: The patient is status post endotracheal intubation. The endotracheal tube terminates approximately 2 cm above the carina. An orogastric tube courses into the stomach; its tip is not imaged, however. The heart is mildly enlarged. There are new perihilar opacities suggesting pulmonary edema   Keywords: new. A retrocardiac opacity with air bronchograms appears unchanged, and although not entirely specific as the etiology, could be seen with substantial atelectasis. Mild relative elevation of the right hemidiaphragm is similar to somewhat increased. A trace left-sided pleural effusion is suspected. There is no pneumothorax. Cholecystectomy clips project over the right upper quadrant.

IMPRESSION: Status post endotracheal intubation. New perihilar opacities suggesting pulmonary edema   Keywords: new. Persistent retrocardiac opacity, which could reflect atelectasis, although an infectious cause cannot be excluded.


SubjectID: 12027688, StudyID: 58655063, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with SOB, CHF, new productive cough // ? infiltrate, PNA

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, signs indicative of pulmonary edema have increased in severity   Keywords: increase. The patient is now in moderate pulmonary edema. Moderate cardiomegaly. No larger pleural effusions. No pneumonia. At the time of dictation and observation, the referring physician ___. ___ was paged for notification, 09:19, on the ___. Findings were discussed on the telephone ___ min later.


SubjectID: 12027688, StudyID: 55181297, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF, CKD, new O2 requirements // evolution of pulm edema evolution of pulm edema

IMPRESSION: In comparison with the study of earlier in this date, allowing for differences in degree of inspiration there is probably little overall change in the pulmonary edema and enlargement of the cardiac silhouette   Keywords: little overall change.


SubjectID: 12029365, StudyID: 58256863, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___M s/p VATS RUL wedge ___ for 3.2cm RUL lesion FGD avid with negative biopsies // Interval assesment

COMPARISON: ___.

IMPRESSION: No relevant change as compared to the previous examination   Keywords: no relevant change. The right apical paramediastinal and right basal parenchymal opacities are constant. No progression. Low lung volumes. Moderate cardiomegaly. No pneumothorax.


SubjectID: 12029365, StudyID: 57768664, Comparison: None

FINAL REPORT

INDICATION: ___M s/p VATS RUL wedge ___ for 3.2cm RUL lesion FGD avid with negative biopsies // interval xray

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiographs dated ___ and ___.

FINDINGS: The lung volumes continue to remain low. Unchanged position of pacemaker projecting over the left mid zone and lateral chest wall with intact pacer wires. There are new patchy opacities in the right lower lobe that may represent atelectasis and/ or consolidation. Continued interval resolution of right upper lobe hematoma seen. There is interval mild improvement in left retrocardiac opacities. No pleural effusion. Tiny right apical pneumothorax Visualized bones are unchanged. There are multiple air-fluid levels in the stomach and, presumably in the transverse colonic loops, partially visualized.

IMPRESSION: 1. Low lung volumes with new patchy opacities in the right lower lobe may represent atelectasis and/or consolidation. Aspiration pneumonitis is a possibility in the right clinical setting. 2. Continued interval improvement in right upper lobe hematoma and left retrocardiac opacities. 3. Tiny right apical pneumothorax.


SubjectID: 12029365, StudyID: 55784983, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p RUL wedge // eval for tube placement and post op appearance

TECHNIQUE: AP view of the chest

COMPARISON: ___

FINDINGS: A left-sided pacer and leads are in stable position. A chest tube overlies the right hemi thorax. Increased density at the apex of the right lung likely reflects atelectasis and possible, focal hemorrhage status post right upper lobe wedge resection. Bilateral pulmonary opacities and pulmonary vascular engorgement likely reflects chronic heart failure. No large pneumothorax is identified. The cardiomediastinal and hilar contours are stable.

IMPRESSION: Post biopsy atelectasis and/or focal hemorrhage. No pneumothorax. Bilateral opacities and pulmonary vascular engorgement likely reflect chronic heart failure.


SubjectID: 12029365, StudyID: 50286998, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___M s/p VATS RUL wedge for 3.2cm RUL lesion FGD avid with negative biopsies // interval cxr

TECHNIQUE: CHEST (PA AND LAT)

COMPARISON: ___

IMPRESSION: Right chest tube is in place. Cardiomediastinal silhouette is unchanged. There is interval decrease in the right upper lung opacity consistent most likely with resolution of post biopsy hematoma. Mild vascular enlargement is present but no overt pulmonary edema is seen. Minimal right apical pneumothorax is more conspicuous on the current study.


SubjectID: 12029365, StudyID: 57246862, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pleural effusion // interval change

IMPRESSION: As compared to previous radiograph of 1 day earlier, a right pigtail pleural catheter remains in place with persistent small right pleural effusion and small right apical hydro pneumothorax. Subtle area of increasing opacity in the right infrahilar region may reflect atelectasis, aspiration, or developing infection. Short-term followup radiographs may be helpful in this regard.


SubjectID: 12029365, StudyID: 56668037, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with SClung ca s/p R sided chest tube // ptx?

IMPRESSION: Since the prior radiograph of ___, a right pigtail pleural catheter has been placed with decrease in size of right pleural effusion and development of a small right apical pneumothorax. Exam is otherwise remarkable for interval decrease in extent of pulmonary edema with no other relevant changes since the recent study   Keywords: decrease.


SubjectID: 12029365, StudyID: 52004953, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with chest tube placement // eval for evolution on PTX

IMPRESSION: As compared to previous study from several hr earlier, right pigtail pleural catheter has been replaced or repositioned, with associated decrease in size of right pleural effusion, and nearly resolved. Small right apical hydro pneumothorax demonstrates increased fluid component and decrease gas component but is overall similar in size. No other relevant changes   Keywords: no other relevant change.


SubjectID: 12029365, StudyID: 55647747, Comparison: 0.0

WET READ: ___ ___ ___ 7:46 PM 1. Slight improvement in now mild to moderate central pulmonary vascular congestion and interstitial edema. 2. Low lung volumes with asymmetric opacity overlying the right lower lobe, which may represent atelectasis although superimposed infection is difficult to exclude. 3. Small to moderate right pleural effusion. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ M with a h/o CAD, admitted with chest pain and dyspnea, with hypoxemic respiratory failure // concern for pulmonary edema versus pneumonia concern for pulmonary edema versus pneumonia

COMPARISON: Prior chest radiographs ___ through ___.

IMPRESSION: Previous mild pulmonary edema which was new on ___ has nearly resolved   Keywords: new. Lung volumes have improved, but there is still substantial consolidation in the right lower lobe, either atelectasis or pneumonia, accompanied by moderate right pleural effusion. Severe cardiomegaly and pulmonary vascular congestion remain   Keywords: remain. Transvenous right atrial pacer and right ventricular pacer defibrillator leads are in standard placements continuous from the left axillary generator.


SubjectID: 12029365, StudyID: 54330687, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with hypoxia // Eval for pulmonary edema

TECHNIQUE: Single AP view of the chest

COMPARISON: Multiple prior radiographs most recent on ___

FINDINGS: A left-sided pacer/ defibrillator and dual leads are in unchanged position. The heart is enlarged but stable in size from the prior examination on ___. Lung volumes are low. Bilateral pulmonary opacities are increased from the prior examination and asymmetrically involve the right lung. There is mild pulmonary vascular congestion There is elevation of the right hemidiaphragm, as before. There is no definite pleural effusion or pneumothorax. Persistent right apical opacity likely represents a small, resolving hematoma associated with prior chest tube placement, which is decreased in size from multiple prior exams.

IMPRESSION: Bilateral airspace opacities suggest pulmonary edema, which asymmetrically involves the right lung however concurrent infection should be considered in the appropriate clinical setting. Persistent small right pleural effusion.


SubjectID: 12029365, StudyID: 53487245, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with acute decompensated Heart failure, hypoxic resp failure due to heart failure and ?PNA // Assess status of previous RLL effusion and pulmonary edema, as well as presence of PNA

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, there is a minimal decrease in extent of the right pleural effusion and the associated parenchymal opacity. The left lung and the cardiac silhouette are unchanged. No new focal parenchymal opacities   Keywords: new.


SubjectID: 12039448, StudyID: 59825919, Comparison: 1.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with SOb and HF // interval

IMPRESSION: As compared to ___, cardiac silhouette remains enlarged and is accompanied by pulmonary vascular congestion   Keywords: remains. . Bilateral combined alveolar and interstitial pattern has slightly improved, and likely reflects pulmonary edema   Keywords: improve. A more confluent opacity in the right upper lobe has also slightly improved, and could reflect superimposed infection or a region of asymmetrical edema. Small pleural effusions has slightly decreased since the prior radiograph.


SubjectID: 12039448, StudyID: 52825198, Comparison: worse

FINAL REPORT

INDICATION: Concern for infection.

COMPARISON: Chest radiograph from ___.

TECHNIQUE: Frontal chest radiograph.

FINDINGS: The heart is mildly enlarged. Central pulmonary vascular congestion, with mild to moderate edema has worsened   Keywords: worse. Small bilateral pleural effusions are present. A left retrocardiac opacity remains unchanged, reflecting either atelectasis or a focal consolidation. There is no pneumothorax.


SubjectID: 12043836, StudyID: 59855567, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M ESRD on HD MWF, multiple failed transplants, MRSA endocarditis, mech MR with new 4+ MR (?clotted off or endocarditis). // interval change interval change

COMPARISON: Comparison to ___ at 21:28

FINDINGS: Portable semi-erect chest film ___ at 03:53 is submitted.

IMPRESSION: The right-sided chest tubes remain in place. There is stable scarring and volume loss within the right hemithorax with no obvious residual basilar right hydropneumothorax appreciated. No pulmonary edema. Streaky opacity at the left base likely reflects scarring or subsegmental atelectasis. Stable cardiac enlargement status post median sternotomy with valve replacement.


SubjectID: 12043836, StudyID: 58840934, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with recent VATS procedure. // r/o acute cardiopulmonary process

IMPRESSION: As compared to ___ chest radiograph, 3 chest tubes remain in place in the right hemi thorax with apparent interval increase in moderate size loculated right pleural effusion with associated multiple loculated hydro pneumothorax components. Additionally, confluent opacification in the right middle and lower lobes has slightly worsened. New left retrocardiac opacification is likely due to atelectasis or aspiration given rapid development. No other relevant changes   Keywords: no other relevant change.


SubjectID: 12043836, StudyID: 58588786, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p right VATS decortication // please evaluate for hemothorax, pneumothorax, chest tube position

IMPRESSION: As compared to ___ chest radiograph, 3 chest tubes have been placed in the right hemi thorax, and a right pigtail pleural catheter has been removed. Dominant apical component of patient's hydro pneumothorax has decreased in size and now contains more fluid and gas. Complex loculated hydro pneumothorax in the lower right hemi thorax is remarkable for decreased fluid component and increased relative proportion of gas. Right middle and lower lobes are slightly better aerated but continued to have substantial atelectasis and or consolidation present.


SubjectID: 12043836, StudyID: 54794983, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pleural effusion on left s/p 3 chest tubes and decortization vats ___, esrd, MVR with MV regurgitation // r/p left sided pleural effusion vs ptx, bleeding, pna vs pulm edema r/p left sided pleural effusion vs ptx, bleeding, pna vs pul

COMPARISON: Comparison to ___ at 03:26

FINDINGS: Portable AP upright chest film ___ at 21:31 is submitted.

IMPRESSION: Three right-sided chest tubes remain in place with decrease in the loculated basilar hydropneumothoraces and some interval improvement in aeration at the right base. There continues to be stable volume loss within the right hemithorax. The left lung remains well inflated with streaky opacity in the left costophrenic angle likely reflecting scarring or subsegmental atelectasis. No pneumothorax is appreciated. The heart is stably enlarged most likely reflecting cardiomegaly, although a pericardial effusion cannot be excluded. The patient is status post median sternotomy with valve replacement. No pulmonary edema or left effusion.


SubjectID: 12043836, StudyID: 51607590, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pleural effusion on left s/p 3 chest tubes and decortization vats ___, esrd, MVR with MV regurgitation // interval change interval change

COMPARISON: Comparison to ___ at 03:51

FINDINGS: Portable semi-erect chest film ___ at 04:20 is submitted.

IMPRESSION: Three right-sided chest tubes remain in place. There is persistent opacity in the right mid to lower lung with super areas of interspersed lucency more likely reflecting aerated lung rather than loculated pneumothorax. No obvious pneumothorax is seen. Left lung reveals residual linear opacities in the left costophrenic angle which could reflect scarring or subsegmental atelectasis but is otherwise clear. No pulmonary edema. Stable cardiac enlargement status post median sternotomy with valve replacement.


SubjectID: 12043836, StudyID: 59748251, Comparison: same

FINAL REPORT

INDICATION: ___-year-old male with lactic acidosis, severe mitral regurgitation, and tachypnea.

COMPARISON: ___.

TECHNIQUE: Single frontal chest radiograph was obtained portably with the patient in an upright position.

FINDINGS: Compared to prior exam, there has been no significant interval change   Keywords: no significant interval change. Moderate cardiomegaly and pulmonary vascular congestion persist. No focal consolidation is detected on this single view. There may be trace right pleural effusion. No pneumothorax is detected.

IMPRESSION: Stable chest radiograph.


SubjectID: 12043836, StudyID: 57333020, Comparison: None

FINAL REPORT

HISTORY: Lactic acidosis with concern for sepsis.

FINDINGS: In comparison with the study of ___, there is again huge enlargement of the cardiac silhouette. Relatively mild pulmonary vascular congestion, with discordancy raising the possibility of pericardial effusion or cardiomyopathy. Area of increased opacification at the right base could merely reflect crowding of vessels, though the possibility of developing consolidation would have to be considered in the appropriate clinical setting. The left hemidiaphragm is not as sharply seen, consistent with some volume loss in the left lower lung.


SubjectID: 12043836, StudyID: 52755908, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Questionable pneumothorax or pneumonia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Moderate cardiomegaly with signs of mild fluid overload. No larger pleural effusions. Moderate retrocardiac atelectasis. Normal hilar and mediastinal contours. No newly appeared focal parenchymal opacity suggesting pneumonia.


SubjectID: 12043836, StudyID: 59736298, Comparison: None

FINAL REPORT

HISTORY: ___-year-old male with end-stage renal disease, MRSA endocarditis, and refractory oropharyngeal bleeding, evaluate for interval change.

COMPARISON: ___, ___, and ___.

FINDINGS: Portable semi-upright chest radiograph demonstrates an endotracheal tube with its tip located 5 cm from the carina. An NG tube projects over the stomach, with its tip not seen. The lungs are clear with the exception of mild retrocardiac atelectasis. The pleural surfaces are normal. The cardiac silhouette remains markedly enlarged, the mediastinal contours are normal.

IMPRESSION: No acute chest abnormality. Standard position of support devices.


SubjectID: 12043836, StudyID: 53733669, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: Chest AP portable single view.

INDICATION: ___-year-old male patient with NG tube placement, check position.

FINDINGS: AP single view of the chest has been obtained with patient in semi-upright position. Comparison is made with the next preceding similar study obtained 12 hours earlier during the same day. The patient remains intubated, the ETT in unchanged position. During the interval, an NG tube has been placed seen to reach well below the diaphragm into the fundus of the stomach. No pneumothorax or any other placement-related complication can be identified. No new pulmonary infiltrates. Cardiomegaly with a relative prominence of main pulmonary artery segment on frontal view appears unchanged.


SubjectID: 12043836, StudyID: 59664199, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pneumothorax f/u after re connection pig tail // pig tail placement? evaluate for change from last CXR

COMPARISON: ___.

IMPRESSION: Substantially improved expansion of the right lung. Of the introduction of a pigtail catheter into the right pleural space. Small basal pneumothorax with minimal fluid in the pleural space persists. Parenchymal opacities at the right lung base are likely reflecting re-expansion pulmonary edema. No change in appearance of the enlarged cardiac silhouette and of the left lung.


SubjectID: 12043836, StudyID: 58610716, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pleural effusion, s/p ___ // please eval for pneumothorax

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Cardiomegaly is substantial. Replaced valves are in unchanged position. After thoracocentesis there is substantial interval decrease in right pleural effusion. The drainage catheter is in place. There is no evidence of pneumothorax.


SubjectID: 12043836, StudyID: 56577977, Comparison: None

WET READ: ___ ___ ___ 9:03 AM Right pigtail catheter is in similar position along the right lung base. Following pigtail repositioning, a moderate pneumothorax is seen with collapse of the right lower lobe. Similar cardiomegaly. The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 5:56 PM, 3 minutes after discovery of the findings.

WET READ VERSION #1 ___ ___ ___ 5:57 PM Right pigtail catheter is in similar position along the right lung base. Following pigtail repositioning, a moderate pneumothorax is seen with collapse of the right lower lobe. Similar cardiomegaly. The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 5:56 PM, 3 minutes after discovery of the findings. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p ___ with pigtail, now pigtail dislodged // please eval pigtail placement

COMPARISON: ___.

IMPRESSION: As compared to the previous image, a relatively extensive right pneumothorax has developed. A small amount of right pleural fluid persists. No change in appearance of the heart and of the left lung.


SubjectID: 12043836, StudyID: 52851457, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pleural effusion, s/p ___ // please eval for interval change

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the right pigtail catheter remains in unchanged position. Persistent 1 cm right apical pneumothorax. The extent of the pre-existing right pleural fluid has moderately increased. The parenchymal opacities at the right lung base are constant.


SubjectID: 12043836, StudyID: 59599059, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with chest tube. Evaluate chest tube placement.

TECHNIQUE: Single portable AP view of the chest.

COMPARISON: Chest radiographs of ___, ___, and ___.

FINDINGS: There has been little change in the large right pleural effusion. The 2 right-sided chest tubes are unchanged in position. No pneumothorax. The cardiac silhouette is continually enlarged. Intact median sternotomy wires.

IMPRESSION: No change in the large right pleural effusion or position of the 2 right-sided chest tubes. No evidence of pneumothorax.


SubjectID: 12043836, StudyID: 57850722, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CT // CT placement CT placement

IMPRESSION: In comparison with the study of ___, there is little overall change   Keywords: little overall change. Again there is a large right pleural effusion despite the presence of 2 chest tubes. Continued low lung volumes on the right with very large cardio mediastinal silhouette and mild elevation of pulmonary venous pressure.


SubjectID: 12043836, StudyID: 54314668, Comparison: 1.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with chest tube // chest tube

COMPARISON: CHEST X-RAY FROM ___ AT 14 55

FINDINGS: Again seen are 2 right-sided chest tubes. Allowing for differences in technique, no gross change is detected compared with ___ at 14:55. Again seen is the large right effusion, likely with underlying collapse and/or consolidation. The degree of opacification may be very slightly worse, but is likely accentuated by technical differences   Keywords: worse. No right-sided pneumothorax is detected. Mild vascular plethora in the upper zones is again noted   Keywords: again. There is minimal increased retrocardiac opacity, but the left hemi diaphragm remains readily visible. No gross left effusion. Marked cardiomegaly with sternotomy wires again noted, similar to the prior film. Left-sided central line again noted, with tip over proximal/mid SVC.

IMPRESSION: Equivocal minimal increased opacification in the right mid and lower zones. Otherwise, I doubt significant interval change.


SubjectID: 12043836, StudyID: 59325256, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with 2 R chest tubes, now draining sanguinous fluid w/ clot // acute process- PTX? change in effusion?

IMPRESSION: Since the prior study of 1 day earlier, pulmonary vascular congestion has improved and edema has nearly resolved   Keywords: resolve, improve. 2 right chest tubes remain in place with persistent moderate to large loculated right pleural effusion with adjacent atelectasis and or consolidation in the right mid and lower lung. No other relevant


SubjectID: 12043836, StudyID: 55571513, Comparison: None

WET READ: ___ ___ ___ 10:29 AM Two right pleural drains have been slightly withdrawn. The side ports of the chest tubes are excluded from view. It should be confirmed that the side ports are within the pleural space and not within the chest wall - clinically or by repeat radiograph which includes the right chest wall. Right pleural effusion appears unchanged and there appears to worsening opacity in the right mid lung. There is no pneumothorax. The findings were telephoned to ___ by ___ at 22:35, ___, ___ min after discovery.

WET READ VERSION #___ ___ ___ ___ 10:36 PM Two right pleural drains have been slightly withdrawn. The side ports of the chest tubes are excluded from view. It should be confirmed that the side ports are within the pleural space and not within the chest wall - clinically or by repeat radiograph which includes the right chest wall. Right pleural effusion appears unchanged and there appears to worsening opacity in the right mid lung. The findings were telephoned to by ___ at , ___, after discovery.

WET READ VERSION #___ ___ ___ ___ 10:51 PM Two right pleural drains have been slightly withdrawn. The side ports of the chest tubes are excluded from view. It should be confirmed that the side ports are within the pleural space and not within the chest wall - clinically or by repeat radiograph which includes the right chest wall. Right pleural effusion appears unchanged and there appears to worsening opacity in the right mid lung. There is no pneumothorax. The findings were telephoned to ___ by ___ at 22:35, ___, ___ min after discovery. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___ year old man with two chest tubes, pulled back 3 hours ago, please evaluate for positioning and PTX // r/o PTX, chest tube positioning

COMPARISON: Chest CT performed ___ as well as chest radiograph performed ___ at 11:27.

FINDINGS: Single portable AP chest radiograph was provided. The right hemithorax is incompletely imaged. A left sided central line is identified, its tip which projects over the made superior vena cava. Two right pleural drains have been slightly withdrawn. Side ports are excluded from the few. A large right pleural effusion is unchanged in size relative to prior examination. There is no left pleural effusion. There is no pneumothorax. Cardiomediastinal silhouette is stable. Patient is status post median sternotomy, tricuspid and mitral valve replacement. Imaged osseous structures and upper abdomen are without an acute abnormality.

IMPRESSION: Large right pleural effusion not significantly change relative to prior study. Two right pleural drains are identified though are incompletely imaged. Repeat radiograph or clinical correlation is advised to confirm placement of side port within the pleural space.


SubjectID: 12043836, StudyID: 52932583, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with h/o fungal empyema with two chest tubes being slowly retracted, CT were retracted today and put to water seal // evaluate chest tube positioning, r/o PTX evaluate chest tube positioning, r/o PTX

IMPRESSION: As compared to ___, the right pigtail catheter has been removed. The 2 right chest tubes are in unchanged position. Unchanged appearance of the combined pleural and parenchymal opacities on the right. No change in appearance of the cardiac silhouette and the left lung. In the interval, the patient has been extubated and the nasogastric tube was removed.


SubjectID: 12043836, StudyID: 52793169, Comparison: None

WET READ: ___ ___ ___ 8:21 PM Although very poorly seen there are likely two chest tubes projecting at the right base on the second image. Right pleural effusion remains unchanged in size. Severe cardiomegaly is unchanged. Left internal jugular central venous catheter is stable. There is no large pneumothorax. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with h/o fungal empyema with two chest tubes being slowly retracted, CT were retracted today and put to water seal // evaluate chest tube placement, r/o PTX evaluate chest tube placement, r/o PTX

IMPRESSION: As compared to the previous image, the 2 right-sided chest tubes have been removed. The extent of the pleural and parenchymal changes on the right are constant and have not changed. Moderate cardiomegaly persists. The appearance of the left heart border and of the left lung is constant.


SubjectID: 12043836, StudyID: 52374711, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with 2 R-sided chest tubes for fungal empyema needs repeat CXR to r/o PTX and evaluate side ports to make sure they are not up against chest wall (currently at dialysis for Tues AM) // chest tube positioning, r/o PTX, evidence of side port compressing against chest wall chest tube positioning, r/o PTX, evidence of side port compr

COMPARISON: ___

IMPRESSION: Cardiomegaly is unchanged. Left subclavian line tip is at the level of superior SVC. Chest tubes are in the same position and overall no substantial change since the prior study demonstrated. No pneumothorax.


SubjectID: 12043836, StudyID: 59240625, Comparison: None

FINAL REPORT

HISTORY: Cardiac arrest with intubation.

FINDINGS: In comparison with the study of ___, the monitoring and support devices remain in place. Huge enlargement of the cardiac silhouette with right pleural effusion and volume loss in the right lower lung are again seen. Retrocardiac opacification is consistent with volume loss in the left lower lobe. The discordancy between the cardiac silhouette and pulmonary vasculature raises the possibility of cardiomyopathy or pericardial effusion.


SubjectID: 12043836, StudyID: 55874186, Comparison: None

FINAL REPORT

HISTORY: Septic shock, to assess volume status.

FINDINGS: In comparison with the study of ___, the monitoring and support devices remain in place. There is again substantial enlargement of the cardiac silhouette with moderate pulmonary edema. The opacification at the right base, most likely representing pleural effusion and compressive atelectasis, is less prominent. This could reflect either decreased pleural fluid or merely a more erect position of the patient. The left lung is relatively clear with some mild retrocardiac atelectasis.


SubjectID: 12043836, StudyID: 54252903, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Cardiac arrest, evaluation for tubes and lines, rule out cardiopulmonary process.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the monitoring and support devices are in unchanged position. There is a slight decrease in extent of the right pleural effusion and a subsequent right atelectasis. On the left, there is improved ventilation of the retrocardiac lung areas. Otherwise, the image is unchanged, with cardiomegaly and moderate pulmonary edema   Keywords: unchanged. No pneumothorax.


SubjectID: 12043836, StudyID: 52563617, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: evaluation. Effusion.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The massive cardiomegaly and the right pleural effusion with subsequent collapse of the right lower lung parts are constant. Also constant is the relatively large left lower lobe atelectasis. The other lung areas show normal ventilation. No fluid overload. The monitoring and support devices are constant.


SubjectID: 12043836, StudyID: 59232682, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with right sided chest tubes for empyema and s/p decortication on ___.and decortization vats ___ // evaluate for interval change

TECHNIQUE: Portable semi-upright chest radiograph.

COMPARISON: Chest radiograph dated ___.

FINDINGS: The sternotomy wires appear intact and appropriately aligned. The patient is status post mitral and tricuspid valve replacement. There are 3 right-sided chest tubes, which appear unchanged in orientation in comparison to the prior chest radiograph. The loculated right pleural effusion appears unchanged in comparison to the prior chest radiograph. There are linear opacities at the left base, which reflect atelectasis. The left lung is otherwise clear. Heart size is stable. The mediastinal and hilar contours are stable. The pulmonary vasculature is normal. No pneumothorax is seen. There are no acute osseous abnormalities.

IMPRESSION: 1. Unchanged orientation of the 3 right-sided chest tubes without pneumothorax. 2. Unchanged appearance of loculated right pleural effusion.


SubjectID: 12043836, StudyID: 53793714, Comparison: None

WET READ: ___ ___ ___ 8:36 AM Stable appearance of the chest with 3 right-sided chest tubes. The anterior most chest tube is labeled with a paper clip, with the inferior most chest tube labeled with ___ ___. The most superior and posterior chest tube is unlabeled.

WET READ VERSION #1 ___ ___ ___ 8:34 PM Stable appearance of the chest with 3 right-sided chest tubes. The anterior most chest tube is labeled with a paper clip, with the inferior most chest tube labeled with ___ ___. The most superior and posterior chest tube is unlabeled. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___M s/p right VATS decortication // please take a lateral film, we've labeled two of the three chest tubes with a paperclip and ___ to ensure that we are removing the correct tube. thank you.

COMPARISON: ___, 04:10

IMPRESSION: As compared to the previous radiograph, 3 chest tubes are in unchanged position in the right hemi thorax. The postoperative opacities in the lateral basal aspect of the lung is stable. Unchanged appearance of the enlarged cardiac silhouette and of the left lung.


SubjectID: 12043836, StudyID: 52973834, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p right VATS decortication s/p removal of right anterior chest tube // please evaluate for pneumothorax

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, 1 of the 3 right-sided chest tubes has been removed. Minimal decrease in extent of the postoperative right basal lateral opacities. No right-sided pneumothorax. Moderate cardiomegaly persists. Unchanged normal appearance of the left lung.


SubjectID: 12043836, StudyID: 59116294, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with endocarditis, ESRD, plueral effusions // ? PNA, ? consolidation, ? inc pleural effusion

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the position of the 2 right-sided chest tubes is constant. Constant appearance of the postoperative right basal lateral parenchymal opacities. The sternal wires are in unchanged alignment. Moderate cardiomegaly persists. No pneumothorax.


SubjectID: 12043836, StudyID: 55951299, Comparison: None

FINAL REPORT

EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 1 EXAM

INDICATION: ___ year old man with CT // eval chest tube

TECHNIQUE: Portable semi-upright chest radiograph.

COMPARISON: Chest radiograph dated ___.

FINDINGS: There are 2 chest tubes on the right, which appear unchanged in comparison to the prior chest radiograph, without evidence of pneumothorax. The sternotomy wires appear intact and appropriately aligned. The patient is status post mitral valve and tricuspid valve replacement. The loculated right pleural effusion, with apical components, appears unchanged in comparison to the prior radiograph. There is a left retrocardiac consolidation, which is concerning for pneumonia. Heart size is stable. The mediastinal and hilar contours are stable. The pulmonary vasculature is normal. There are no acute osseous abnormalities.

IMPRESSION: 1. Right chest tubes in appropriate positioning, without evidence of pneumothorax. 2. Left retrocardiac consolidation concerning for pneumonia. 3. Unchanged loculated right pleural effusion.


SubjectID: 12043836, StudyID: 59063662, Comparison: None

FINAL REPORT

INDICATION: Evaluate right-sided chest tube

TECHNIQUE: Frontal chest radiograph.

COMPARISON: ___

FINDINGS: There is a small right-sided pneumothorax. A chest tube is noted at the right lung base. There is a small right-sided pleural effusion with associated parenchymal opacity which could reflect atelectasis. The heart is enlarged. The visualized left hemithorax is clear.


SubjectID: 12043836, StudyID: 53196291, Comparison: None

FINAL REPORT

INDICATION: Status post thoracentesis with right-sided chest tube

TECHNIQUE: Frontal chest radiograph

COMPARISON: ___

FINDINGS: There is a right sided basilar chest tube which appears coiled upon itself. A small pneumothorax is noted within the right lung medially new compared to the prior study. The degree of pleural fluid has decreased. There is a small effusion with associated atelectasis. The left hemithorax is clear.

IMPRESSION: 1. Right-sided chest tube appears coiled upon itself. Small right-sided pneumothorax.

NOTIFICATION: Findings discussed with Dr. ___ on ___ @ 9:33 am.


SubjectID: 12043836, StudyID: 52829839, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with ESRD, right pleural effusion s/p chest tube placement // eval position of chest tube and PTX

IMPRESSION: As compared to ___ radiograph, low lying right pleural catheter has changed in position. . Right pleural effusion has decreased in size with residual small effusion remaining and no definite pneumothorax. Mild interstitial edema it is again demonstrated as well as more confluent right lower lobe opacification possibly due to asymmetrical edema although infection is possible in the appropriate clinical setting   Keywords: again.


SubjectID: 12043836, StudyID: 52742558, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with large right effusion s/p pigtail placement, evaluate for pneumothorax.

COMPARISON: Chest radiograph from ___.

FINDINGS: AP view of the chest provided. There is interval placement of a right-sided pleural catheter. There is no pneumothorax. Right sided pleural effusion has minimally improved since prior study. Left lung base is clear. Massive cardiomegaly again seen. Patient is status post mitral and tricuspid valve replacements.

IMPRESSION: No pneumothorax.


SubjectID: 12043836, StudyID: 51213177, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with ongoing cough and poor air movement right lower/mid lung field. // rule out effusion or pneumonia

COMPARISON: Chest radiograph from ___.

FINDINGS: PA and lateral views of the chest provided. There is large right pleural effusion with compressive atelectasis. The left lung is clear. The heart is again seen to be severely enlarged. On lateral view, there may be a small fluid collection between the epicardial and pericardial fat pads. Pulmonary vasculature is normal. Median sternotomy wires and valvular repairs are seen.

IMPRESSION: 1. New large right pleural effusion. 2. Massive cardiomegaly without pulmonary edema. Differential includes pericardial effusion versus cardiomyopathy. Echocardiogram is recommended for further assessment.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 2:32 PM, 15 minutes after the images were reviewed.


SubjectID: 12043836, StudyID: 59025610, Comparison: None

WET READ: ___ ___ ___ 8:40 AM 1. Interval increase in size of right pneumothorax. 2. Interval increase in size of right pleural effusion and worsening right lung base consolidation. Wet read was discussed with Dr. ___ by Dr. ___ ___ telephone at 01:28 on ___, ___ min after discovery.

WET READ VERSION #1 ___ ___ ___ 1:30 AM 1. Interval increase in size of right pneumothorax. 2. Interval increase in size of right pleural effusion and worsening right lung base consolidation. Wet read was discussed with Dr. ___ by Dr. ___ ___ telephone at 01:28 on ___, ___ min after discovery. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hydropneumothorax, trapped lung p/w acute onset SOB // e/o pneumothorax or pulmonary edema

COMPARISON: ___.

IMPRESSION: Increase in extent of the right pneumothorax. Increase of the pleural fluid at the lung bases. And of the right basal consolidation. The left lung is unremarkable.


SubjectID: 12043836, StudyID: 54428651, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with new right sided chest pain // interval change in effusion

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Small to moderate right pleural effusion, moderate right pneumothorax are unchanged. Aeration of the right upper lung has mildly improved. Right basal opacities are unchanged   Keywords: unchanged. Left lung is grossly clear. Cardiomegaly is a stable. Right right basal pigtail catheter is in unchanged position. Sternal wires are aligned


SubjectID: 12043836, StudyID: 58620321, Comparison: None

WET READ: ___ ___ ___ 8:38 AM There has been interval placement of a left sided central venous catheter which now terminates in the upper SVC. The 2 right-sided chest tubes are in unchanged positions. Remaining intrathoracic findings are unchanged.

WET READ VERSION #1 ___ ___ ___ 12:35 AM There has been interval placement of a left sided central venous catheter which now terminates in the upper SVC. The 2 right-sided chest tubes are in unchanged positions. Remaining intrathoracic findings are unchanged. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with chest tube with new chest pain // ?interval change ?interval change

IMPRESSION: In comparison with the earlier study of this date, there has been interval placement of a left IJ catheter that extends into the upper SVC. The to right-sided chest tubes are unchanged, as is the appearance of the right hemithorax. Left lung remains essentially clear.


SubjectID: 12043836, StudyID: 58512647, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with ESRD onHD, MRSA endocarditis, s/p recent VATS for hemothoraxrecent, recent adjustment of chest tubes. // chest tube adjusted; please assess placement

TECHNIQUE: CHEST (PA AND LAT)

COMPARISON: ___

IMPRESSION: Right chest tubes are in place. No interval increase in pleural effusion. Demonstrated. The rest of the findings are unchanged


SubjectID: 12043836, StudyID: 56876485, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with chest tube // chest tube

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the 2 right-sided chest tubes are in unchanged position. There is a minimal decrease in extent of the known right pleural effusion. Unchanged alignment of the sternal wires, unchanged retrocardiac parenchymal collapse. No pulmonary edema.


SubjectID: 12043836, StudyID: 51009682, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with chest tubes for prior hemothorax; now s/p central line placement attempt. // s/p central line placement attempt; r/o PTX

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___ obtained at 11:51

IMPRESSION: Questionable small left apical pneumothorax versus skin fold is demonstrated. Note is made that the central venous line insertion attempt was on the right. Small amount of left pleural effusion is unchanged as well as the appearance of the right hemi thorax.

NOTIFICATION: Findings where discussed with Dr.___


SubjectID: 12043836, StudyID: 50942118, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CT // CT placement

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Right chest tube is in place (2 tubes). Cardiomediastinal silhouette is unchanged. Right basal consolidation and loculated pleural effusion on the right are unchanged as well. Overall no substantial change since the previous examination demonstrated


SubjectID: 12043836, StudyID: 50003428, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with recent hemithorax and R sided chest tubes and recent RIJ central line placement attempt, most recent CXR concerning for L PTX. Please assess at ___, 6 hrs following most recent CXR to evaluate for evolution. // please assess for L ptx @___ (or 6hr following most recent CXR, per rads rec) please assess for L ptx @___ (or 6hr following most recent

IMPRESSION: In comparison with the earlier study of this date, there is no evidence of left pneumothorax, indicating that the previous line reflected a skin fold. Otherwise, little overall change in the appearance of the heart and lungs except for possibly some increased atelectatic changes at the left base.


SubjectID: 12043836, StudyID: 52541148, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CT // CT

TECHNIQUE: Portable semi upright chest radiograph.

COMPARISON: Chest radiograph dated ___.

FINDINGS: There are 2 right-sided chest tubes, which appear unchanged in comparison to the prior chest radiograph, without evidence of pneumothorax. The sternotomy wires appear intact and appropriately aligned. Unchanged appearance of right loculated pleural effusion with compressive atelectasis. The left retrocardiac opacity persists. Heart size is stable. The mediastinal and hilar contours are stable. The pulmonary vasculature is normal. There are no acute osseous abnormalities.

IMPRESSION: 1. 2 right-sided chest tubes unchanged in positioning, without evidence of pneumothorax. 2. Unchanged right loculated pleural effusion with atelectasis. 3. Persistent left retrocardiac opacity, concerning for pneumonia.


SubjectID: 12043836, StudyID: 58247893, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with chest tube // effusion

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the position of the right chest tube is unchanged. Unchanged basal lateral pneumothorax without evidence of tension. Constant appearance of the left lung and of the cardiac silhouette. Unchanged normal alignment of the sternal wires.


SubjectID: 12043836, StudyID: 57095442, Comparison: None

WET READ: ___ ___ ___ 10:28 PM Interval removal of a right pigtail catheter. Mild interval increase in size of a small to moderate right apical pneumothorax. New moderate to large right pleural effusion. Dr. ___ discussed with Dr. ___ ___ the telephone on ___ at 17:45, 5 minutes after findings were made. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with right sided pleural effusion drain via chest tube that was removed today. // any complications of chest tube removal?

TECHNIQUE: AP chest radiograph.

COMPARISON: Chest radiograph dated ___.

FINDINGS: Status post right thorax pigtail catheter removal, there is mild interval increase in size of a small to moderate right apical pneumothorax. Also new is a right moderate to large pleural effusion. The trachea and mediastinum are midline. Median sternotomy wires are in good alignment and intact. A small left pleural effusion is present.

IMPRESSION: 1. Post right chest tube removal, there is mild interval increase in size of small to moderate right apical pneumothorax. 2. Increased right moderate to large pleural effusion.


SubjectID: 12043836, StudyID: 53760034, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with ESRD and rigt pleural effusion with chest tube // is effusion better please do at 5am

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the right pigtail catheter is in unchanged position. The extent of the lateral basal right pneumothorax has minimally increased. Partially collapsed right lower lung. Marked cardiomegaly persists. Unchanged appearance of the left lung   Keywords: unchanged appearance.


SubjectID: 12043836, StudyID: 58006558, Comparison: None

WET READ: ___ ___ 7:20 PM ETT appropriately positioned. Right effusion has decreased in size but there is still a moderate remaining effusion. Underlying consolidation of the right lower lobe cannot be excluded given presence of air-bronchograms.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post attempted thoracocentesis, evaluation of endotracheal tube.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is unchanged evidence of a relatively large right pleural effusion. The effusion, however, appears to be slightly less severe than on the previous image. There is no evidence of pneumothorax or other complication. The endotracheal tube is in unchanged position. Unchanged mild cardiomegaly, unchanged normal appearance of the left lung.


SubjectID: 12043836, StudyID: 55857992, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Rule out pneumothorax, evaluation.

COMPARISON: ___, 10:14 p.m.

FINDINGS: As compared to the previous radiograph, the monitoring and support devices are unchanged. The pleural effusion on the right has minimally decreased, with improved expansion of the right basal lung. Moderate cardiomegaly persists. No pneumothorax after attempted right thoracocentesis.


SubjectID: 12043836, StudyID: 53558243, Comparison: None

FINAL REPORT

INDICATION: Status post right pigtail placement.

TECHNIQUE: Single, AP, portable view of the chest with the patient in an upright position.

COMPARISON: Comparison is made to radiographs dated ___ at 7:32 a.m.

FINDINGS: As compared to the previous radiograph, the monitoring and support devices are unchanged. There has been interval placement of a right-sided pigtail catheter with interval resolution of the patient's right pleural effusion. Moderate cardiomegaly persists. The right upper lung and left lung are essentially clear.


SubjectID: 12043836, StudyID: 52865903, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Attempted right thoracocentesis.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Status post thoracocentesis on the right, no evidence of right pneumothorax. The right lung base is slightly better expanded than on the previous image. On the left, there is no relevant change   Keywords: no relevant change. Unchanged appearance of the cardiac silhouette.


SubjectID: 12043836, StudyID: 57921474, Comparison: None

FINAL REPORT

CHEST ON ___

HISTORY: Evaluate for pneumothorax.

FINDINGS: The heart is severely enlarged. There is volume loss/infiltrate in both lower lungs. There is a left pleural effusion. The patient is status post valve replacement. Left-sided PICC line with tip in the SVC is unchanged. There is mild pulmonary vascular redistribution. Mediastinal drains have been removed. There is a small left apical pneumothorax.


SubjectID: 12043836, StudyID: 55045316, Comparison: same

WET READ: ___ ___ 10:34 PM no evidence of pneumohtorax. ______________________________________________________________________________

FINAL REPORT

CHEST ON ___

HISTORY: Status post MVR, chest tube to waterseal.

FINDINGS: There has been interval removal of the ET tube. Mediastinal drains are still in place. Swan-Ganz catheter has been removed. There is dense consolidation in the left lower lobe. The heart size continues to be moderately enlarged. There is right lower lobe volume loss, which is increased compared to the prior. There continues to be some pulmonary vascular redistribution and alveolar infiltrate involving the upper lobes   Keywords: continue. Mitral valve replacement is again seen.

IMPRESSION: Increased volume loss/infiltrate in both lower lobes.


SubjectID: 12043836, StudyID: 53245782, Comparison: None

WET READ: ___ ___ ___ 6:05 PM Left-sided PICC now appears to be terminating in the left atrium, which may be due to patient position. Tip cannot be definitely visualized due to overlying leads. Pneumothorax is no longer visualized. Low lung volumes and bibasilar atelectasis, small left pleural effusion. D/w ___ at 6:05 p.m.. ______________________________________________________________________________

FINAL REPORT

CHEST ON ___

HISTORY: Evaluate left pneumothorax.

FINDINGS: Left-sided PICC now appears to be terminating in the left atrium, which may be due to patient position. Tip cannot be definitely visualized due to overlying leads.There is a moderate left pneumothorax which is increased in size compared to the film from earlier the same morning. This is most evident superolaterally. There is a small left effusion. The heart remains moderately enlarged.

IMPRESSION: 1. increased left pneumothorax 2. PICC line tip too low.


SubjectID: 12043836, StudyID: 57614714, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Sepsis, endotracheal tube placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the tube placement has not substantially changed. The tip of the tube still projects 4.4 cm above the carina. Unchanged moderate cardiomegaly, bilateral pleural effusions, right more than left, and subsequent areas of atelectasis at the right lung bases. No pneumothorax.


SubjectID: 12043836, StudyID: 55968259, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Sepsis, questionable pneumonia.

COMPARISON: ___.

FINDINGS: As compared to the previous image, the monitoring and support devices are constant. Constant moderate-to-severe cardiomegaly with mild fluid overload and a relatively important right pleural effusion. The effusion is associated with right areas of parenchymal atelectasis. No pneumothorax. No new changes.


SubjectID: 12043836, StudyID: 54278310, Comparison: worse

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with cardiac arrest, intubated. Evaluation for change.

COMPARISON: ___.

FINDINGS: ET tube ends 4 cm above the carina, NG tube is in the stomach. Right moderate layering pleural effusion has slightly increased, bibasilar consolidation are also unchanged. Moderate cardiomegaly is significant for age. There is also minimal increase in pulmonary vessel cephalization   Keywords: increase. There is no pneumothorax.

CONCLUSION: 1. Tubes and lines are in adequate position. 2. Right moderate layering pleural effusion has slightly increased. 3. Unchanged bibasilar consolidation. 4. Slight increase in minimal pulmonary vessel cephalization   Keywords: increase.


SubjectID: 12043836, StudyID: 53587441, Comparison: worse

FINAL REPORT

INDICATION: Severe sepsis, Gram-positive cocci bacteremia status post intubation. Please evaluate ET tube.

COMPARISON: ___ at 2:31 a.m.

FINDINGS: A new ET tube ends 3.6 cm above the carina. An OG tube ends in the lower esophagus with the side hole in the mid esophagus and would need to be advanced by approximately 15 cm to have the last side hole within the stomach. A large right pleural effusion has increased in size since 6 hours prior with new interstitial opacities consistent with pulmonary edema and no significant change in severe cardiomegaly   Keywords: new. No pneumothorax.

NOTIFICATION: A subsequent radiograph taken at 9:19 was performed prior to the study being read and providing team was notified after reading that radiograph.


SubjectID: 12043836, StudyID: 53275853, Comparison: worse

FINAL REPORT

INDICATION: OG tube adjustment.

COMPARISON: ___ at 9:19 a.m.

FINDINGS: ET tube ends 4.5 cm above the carina. An OG tube has tip within the stomach but sidehole above the GE junction. It would need to be advanced by approximately 6 cm to have the last sidehole in the stomach. Compared with two hours prior, pulmonary vascular congestion persists with worsening of the large right pleural effusion and associated atelectasis   Keywords: worse. Severe cardiomegaly is unchanged. No pneumothorax.

NOTIFICATION: Telephone notification to Dr. ___ by Dr. ___ at 12:05 p.m. on ___.


SubjectID: 12043836, StudyID: 52637506, Comparison: better

FINAL REPORT

INDICATION: Hypoxia.

COMPARISON: ___ at 8:10 a.m.

FINDINGS: ET tube ends 6.1 cm above the carina. An OG tube ends with the tip in the stomach but the side hole above the GE junction and would need to be advanced approximately 6 cm to have the last side hole within the stomach. Pulmonary edema has improved compared with one hour prior   Keywords: improve. A large right pleural effusion with associated atelectasis is not significantly changed. Severe cardiomegaly is stable. No pneumothorax.

NOTIFICATION: Telephone to Dr. ___ by Dr. ___ at 10:30 a.m. on ___.


SubjectID: 12043836, StudyID: 57293660, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with chest tube // r/o PTX

IMPRESSION: As compared to ___ chest radiograph, 2 chest tubes remain in place the right hemi thorax with slight decrease in size of a large multiloculated right pleural effusion with associated slight improvement an multifocal atelectasis/consolidation in the right lung. No other relevant changes   Keywords: no other relevant change.


SubjectID: 12043836, StudyID: 56631005, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with empyema, hypoxia // e/o of worsening empyema, effusion, lung collapse e/o of worsening empyema, effusion, lung collapse

IMPRESSION: All monitoring and support devices, notably the 2 right-sided chest tubes, are in unchanged correct position. The near total collapse of the right lung has partly resolved, with new ventilated areas at the right lung apex and the mid right lung zones. However, there continues to be a relatively extensive right pleural effusion, combines to areas of collapsed mid and lower right lung. The moderate cardiomegaly and the normal appearance of the left lung persists in unchanged manner.


SubjectID: 12043836, StudyID: 56209273, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with right pigtail catheter placement // tube placement tube placement

IMPRESSION: Insertion of an additional right-sided pigtail catheter in the pleural space. Slight decrease of the fluid accumulation on the right. No visible right pneumothorax. The previous to right chest tubes are in unchanged position. Moderate cardiomegaly. The monitoring and support devices are constant.


SubjectID: 12043836, StudyID: 55703147, Comparison: None

FINAL REPORT

INDICATION: ___ year old man s/p repair transvalvular leak // eval for ETT position s/p repair of MV leak

FINDINGS: As compared to radiograph from earlier today, the patient is now intubated with endotracheal tube 5 cm from the carina. Nasogastric tube with the first side port in the lower esophagus and needs to be advanced. Right-sided chest tubes and left internal jugular catheter in similar position. Essentially complete opacification of the right lung. The left lung remains relatively clear. Moderate cardiomegaly persists.

IMPRESSION: Complete opacification of the right lung with collapse superimposed multifocal opacities and moderate to large effusion.


SubjectID: 12043836, StudyID: 57281492, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old male with ESRD on HD, mechanical MV, recent prolonged admission for group A strep bacteremia c/b MV/TV endocarditis with perivalvular leak s/p repair, loculated pleural ___ empyema, fungemia, and C diff discharged to rehab 3 days ago presented to ER with chest pain during HD session today. // acute intra pulm process

IMPRESSION: As compared to the recent study of 1 day earlier, pulmonary vascular congestion and interstitial edema are new   Keywords: new. Large, multiloculated right pleural effusion has slightly increased in size with associated slight increase an adjacent parenchymal opacities in the right mid and lower lungs.


SubjectID: 12043836, StudyID: 54095352, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (AP AND LAT)

INDICATION: History: ___M with chest pain and shortness of breath

TECHNIQUE: Upright AP and lateral views of the chest

COMPARISON: Chest radiograph ___ and CT chest ___

FINDINGS: Patient is status post median sternotomy with mitral and tricuspid valve replacements. Moderate to severe cardiomegaly is re- demonstrated, unchanged. Mediastinal and hilar contours are similar with marked mediastinal lymphadenopathy again noted. There has been interval removal of the previously noted left subclavian central venous catheter. Moderate to large loculated right pleural effusion remains unchanged with continued right basilar opacification. Left lung is clear. No pulmonary edema or pneumothorax is seen. No acute osseous abnormality is detected.

IMPRESSION: No substantial interval change in appearance of moderate to large loculated right pleural effusion and right basilar opacification.


SubjectID: 12043836, StudyID: 56690693, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CT // chest tube

IMPRESSION: As compared to ___ chest radiograph, 2 chest tubes remain in place in the right hemi thorax with slight worsening of a large right pleural effusion and increasing adjacent parenchymal opacification involving a majority of the right lung, with relative sparing of the right apex. No other relevant changes since recent study   Keywords: no other relevant change.


SubjectID: 12043836, StudyID: 56129171, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Pulled orogastric tube, evaluation for position.

COMPARISON: ___, 9:07.

FINDINGS: As compared to the previous radiograph, the nasogastric tube has been pulled back. The tip projects over the middle third of the esophagus. The tube needs to be either withdrawn or repositioned. Better ventilated than before, with reduction in extent of the pre-existing basal parenchymal opacities. No pleural effusions.


SubjectID: 12043836, StudyID: 53646745, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Intubation, evaluation for endotracheal tube placement.

COMPARISON: ___, 9:19 p.m.

FINDINGS: As compared to the previous radiograph, the patient has been intubated. The tip of the endotracheal tube projects approximately 8 cm above the carina, and should be advanced by approximately 3 cm. The nasogastric tube has been advanced, the tip is now projecting over the proximal parts of the stomach, the sidehole is at the level of the gastroesophageal junction. No complications. Otherwise, unchanged radiograph   Keywords: unchanged radiograph.


SubjectID: 12043836, StudyID: 50553511, Comparison: None

FINAL REPORT

STUDY: AP chest, ___.

HISTORY: ___-year-old man with end-stage renal disease and endocarditis.

FINDINGS: Comparison is made to prior study from ___. There is an enteric tube with distal tip and sideport below the GE junction. The heart size is enlarged but stable. No focal consolidation, large pleural effusions or pulmonary edema is seen. There are no pneumothoraces.


SubjectID: 12043836, StudyID: 56107491, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with large right pleural effusion s/p new ___F CT placement with 1750ml initially. Prior CT DC'd. // ? PTX

COMPARISON: ___.

IMPRESSION: Unchanged position of the right pigtail catheter. The amount of pleural fluid has substantially decreased. However, there is a small basal lateral pneumothorax on the right, without evidence of tension. Unchanged appearance of the left lung and of the moderately enlarged cardiac silhouette.


SubjectID: 12043836, StudyID: 51928074, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with ESRD and right pleural effusionplease do CXR at 5am // is the effusion worse

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the known right pleural effusion is constant in extent and severity. Subsequent right basilar atelectasis is also unchanged. Moderate cardiomegaly. Unchanged alignment of the sternal wires. Unchanged appearance of the left lung parenchyma   Keywords: unchanged appearance.


SubjectID: 12043836, StudyID: 50168099, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with ESRD and right pleural effusion // is the right pleural effusion better ? please perform at 5am

TECHNIQUE: Portable upright chest radiograph

COMPARISON: ___

FINDINGS: Interval decrease in fluid at the right lung base since the prior studies. Pleural air indicative of pneumothorax is slightly larger than on the prior study. Right pleural catheter is unchanged. Heart size is stable. Left lung is clear.

IMPRESSION: 1. Interval decrease in right pleural effusion. 2. Continued right lung base consolidation. 3. Interval increase in right pneumothorax, still small.


SubjectID: 12043836, StudyID: 56015010, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with ESRD, mechanical heart valve and right sided pleural effusion // chest tube eval

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Cardiomegaly is substantial. Replaced valves are in unchanged position. Right pigtail catheter is in place. No appreciable change in the right basal consolidation and loculated air in the right apex demonstrated.


SubjectID: 12043836, StudyID: 54235269, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with ESRD, mechanical heart valve and right sided pleural effusion // eval of chest tube

TECHNIQUE: Portable semi-upright chest radiograph.

COMPARISON: Chest radiograph dated ___. .

FINDINGS: The sternotomy wires appear intact and in appropriate alignment. There is a right basilar chest tube, which appears unchanged in positioning. The patient is status post mitral valve replacement. There is a moderate right apical hydropneumothorax that is unchanged in size in comparison to the prior chest radiograph. There is a loculated moderate right pleural effusion with apical, fissural, and smaller basilar components, along with persistent small loculated hydropneumothoraces. Small left pleural effusion. There are are patchy opacities at the right base, which are unchanged. Mild pulmonary vascular congestion. Stable enlargement of the cardiac silhouette. There are no acute osseous abnormalities.

IMPRESSION: 1. Chest tube in appropriate positioning. 2. Unchanged moderate right hydropneumothorax with loculated right pleural effusion and compressive atelectasis.


SubjectID: 12043836, StudyID: 54631370, Comparison: worse

FINAL REPORT

INDICATION: Staph bacteremia. Evaluate for infiltrate, signs of viral pneumonia.

COMPARISON: ___.

IMPRESSION: Severely enlarged cardiac silhouette is not significantly changed from prior. However, there is increase in right pleural effusion and increase in moderate pulmonary edema. Linear opacity in the right mid lung is unchanged dating back to ___ compatible with atelectasis. No left pleural effusion or pneumothorax is present.

IMPRESSION: Stable severe cardiomegaly with new pulmonary edema and increasing right pleural effusion   Keywords: increasing, new. No evidence of pneumonia.


SubjectID: 12043836, StudyID: 52168650, Comparison: None

FINAL REPORT

HISTORY: Renal failure with cardiac arrest.

FINDINGS: In comparison with the study of ___, the monitoring and support devices remain in place. Continued substantial enlargement of the cardiac silhouette with only mild elevation in pulmonary venous pressure. This discordancy raises the possibility of cardiomyopathy or pericardial effusion. Mild atelectatic or fibrotic changes are seen in the right mid zone. On the left, there is substantial opacification in the retrocardiac region, consistent with volume loss in the lower lobe.


SubjectID: 12043836, StudyID: 55446838, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with ESRD with pleaural effusion on the right side // is the pleaural effusion worse? please peerform before 5am on ___

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Fluid component of a large right hydro pneumothorax has markedly increased in size. Right pigtail catheter is in unchanged position. Cardiomegaly is stable. The left lung is grossly clear. Sternal wires are aligned.


SubjectID: 12043836, StudyID: 55187188, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pleural effusion and chest tubeplease perform at 5am // pleural effusion change pleural effusion change

IMPRESSION: In comparison with the study ___ ___, there is little overall change   Keywords: little overall change. Again there is huge enlargement of the cardiac silhouette, which should raise the possibility of pericardial effusion. Extensive right pleural effusion with volume loss in the lower lungs is again seen. The left lung is essentially clear and there is no evidence of pulmonary vascular congestion. Is projected over the upper right abdomen.


SubjectID: 12043836, StudyID: 51291417, Comparison: same

FINAL REPORT

EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 1 EXAM

INDICATION: ___ year old man with chest tube in place // please evaluate for interval change and placement of chest tube

TECHNIQUE: Single frontal view of the chest

COMPARISON: Study performed 3 hours earlier

IMPRESSION: Right basal pigtail catheter is in unchanged position. There are no interval changes in the appearance of the chest   Keywords: no interval change. .


SubjectID: 12043836, StudyID: 50914289, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with pleural effusion and chest tube // interval change in pleural effusion

TECHNIQUE: Portable

COMPARISON: ___

FINDINGS: The right-sided pigtail catheter is in similar position. The right-sided moderate pleural effusion is stable with associated consolidation. The heart is markedly enlarged, with increase in size and a more globular appearance when compared to the prior. No interstitial edema. No pneumothorax.

IMPRESSION: Acute increase in size of cardiac shadow, could represent pericardial effusion or pericarditis in the appropriate clinical setting. Stable right moderate pleural effusion and consolidation.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 3:39 PM, 15 minutes after discovery of the findings.


SubjectID: 12043836, StudyID: 55430270, Comparison: None

WET READ: ___ ___ ___ 12:37 AM Small right apical pneumothorax, present on prior but more conspicuous as compared to the most recent prior study. right base opacity may be due to combination of pleural effusion and atelectasis underlying consolidation is not excluded. *** ED URGENT ATTENTION ***

WET READ VERSION #1 ___ ___ ___ 6:43 PM Small right apical pneumothorax, present on prior is but more conspicuous as compared to the most recent prior study. right base opacity may be due to combination of pleural effusion and atelectasis underlying consolidation is not excluded. *** ED URGENT ATTENTION *** ______________________________________________________________________________

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: History: ___M with pleural effusion and chest pain // eval for worsening effusion

TECHNIQUE: Chest: Frontal and Lateral

COMPARISON: ___

FINDINGS: Right pleural effusion with overlying atelectasis appears increased as compared to the prior study right base opacity may be due to pleural effusion and atelectasis underlying consolidation is not excluded. The cardiac silhouette remains enlarged. Patient is status post median sternotomy and cardiac valve replacement. There is concern for a small right apical pneumothorax, present on prior studies, but slightly more conspicuous than on the most recent prior.

IMPRESSION: Small right apical pneumothorax, present on prior but more conspicuous as compared to the most recent prior study. right base opacity may be due to combination of pleural effusion and atelectasis underlying consolidation is not excluded. Persistent enlargement of the cardiac silhouette.

NOTIFICATION: Small right apical pneumothorax discussed with Dr. ___ at 18:40 on ___ via telephone.


SubjectID: 12043836, StudyID: 54797530, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CT // chest tube

COMPARISON: Chest x-ray from ___ at 08:03

FINDINGS: Two right-sided chest tubes are present, similar in configuration to the prior film. The appearance of the right lung is similar, allowing for technical differences. Again seen is a large right effusion, with underlying collapse and/or consolidation. No pneumothorax is detected. The patient is status post sternotomy, with marked enlargement of the cardiomediastinal silhouette. As before, the right-sided heart border is obscured by the opacities at the right lung base, but no significant interval change is detected in cardiomediastinal size or morphology. The degree of retrocardiac opacity has improved. The left lung is otherwise grossly clear. There is minimal blunting of left costophrenic angle, unchanged. On the left, they areas upper zone redistribution, but no overt CHF. Vascular plethora in the right upper zone is likely secondary to compression of the right lung by the effusion.

IMPRESSION: Large right effusion with underlying collapse and/or consolidation. This together with other findings in the chest are essentially unchanged compared with ___. Possible slight interval improvement in left lower lobe collapse and/or consolidation. No pneumothorax detected.


SubjectID: 12043836, StudyID: 51856753, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with chest tube // Chest tube

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the 2 right-sided chest tubes are in unchanged position. The left central access line is also unchanged. Minimal increase in extent of the right pleural effusion. Otherwise no relevant change   Keywords: no relevant change.


SubjectID: 12043836, StudyID: 50736412, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with chest tubes // Chest tubes

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the 2 right-sided chest tubes are in unchanged position. The degree of pleural effusion has minimally decreased. The parenchymal opacities at the right lung bases are constant in appearance. Unchanged moderate cardiomegaly. Unchanged appearance of the left lung   Keywords: unchanged appearance.


SubjectID: 12043836, StudyID: 54793713, Comparison: same

FINAL REPORT

HISTORY: Self extubation. Evaluation for acute cardiopulmonary process.

COMPARISON: Multiple priors from ___ ___.

FINDINGS: The endotracheal tube is no longer present. The NG tube is in stable position, coursing below the diaphragm and terminating outside the field of view. Right pleural effusion and associated atelectasis is slightly improved from ___. Moderate cardiomegaly is unchanged. There is no pneumothorax.

IMPRESSION: Slight improvement of right pleural effusion. No other significant change   Keywords: no other significant change.


SubjectID: 12043836, StudyID: 52467233, Comparison: None

FINAL REPORT

CLINICAL

HISTORY: MRSA bacteremia. CHEST Since the previous chest x-ray, there has been some re-expansion of the left lower lobe. Atelectasis persists on the right side and small amount of fluid is probably present within the minor fissure. The position of the ET tubes remains satisfactory.

IMPRESSION: Re-expansion of left lower lobe, persistent atelectasis right side.


SubjectID: 12043836, StudyID: 50402322, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with chest tube and pneumothorax // interval change

TECHNIQUE: Portable AP chest radiograph.

COMPARISON: Chest radiograph ___

FINDINGS: There is persistent visualization of a moderate right pneumothorax and small to moderate right pleural effusion. A right-sided chest drain is in-situ, unchanged in position and appearance when compared to the prior study. There is a right basilar atelectasis. The left lung remains grossly clear. The heart is enlarged, stable compared to the prior study. Previous median sternotomy noted, the sternal wires are unchanged in appearance   Keywords: unchanged in appearance. Previous mitral valve replacement noted.

IMPRESSION: No significant interval change when compared to the prior study   Keywords: no significant interval change. Persistent visualization of the right apical pneumothorax.


SubjectID: 12043836, StudyID: 54236257, Comparison: None

WET READ: ___ ___ ___ 9:15 PM No evidence for acute change. Cardiomegaly and pulmonary arterial prominence again noted. ______________________________________________________________________________

FINAL REPORT

HISTORY: ESRD with possible of acute pulmonary edema.

FINDINGS: In comparison with study of ___, there is again substantial enlargement of the cardiac silhouette without definite vascular congestion, raising the possibility of cardiomyopathy or pericardial effusion. Hilar prominence consistent with lymphadenopathy is better seen on chest CT. There is suggestion of some increasing opacification at the right base, though without obliteration of the right heart border or hemidiaphragm. This could be a technical artifact, though in the appropriate clinical setting, a developing right lower lung consolidation could be considered.


SubjectID: 12043836, StudyID: 52233929, Comparison: None

FINAL REPORT

STUDY: PA AND LATERAL CHEST RADIOGRAPH.

INDICATION: ___-year-old male with history of severe pulmonary hypertension, new onset AFib, for evaluation.

TECHNIQUE: Two views of the chest were obtained.

COMPARISON: ___. REPORT: There is significant cardiomegaly noted. Prominent pulmonary hila are noted and there is some subcarinal splaying. Generalized pulmonary plethora is noted, although this is not as prominent as on the prior study. A few nonspecific interstitial lines are seen at the right lung base, again not as significant as on the prior study.

CONCLUSION: Findings of cardiomegaly, pulmonary arterial hypertension and pulmonary plethora suggest a significant cardiac shunt. There is no evidence of consolidation on this study. There is probably mild fluid overload. This, however, is not as pronounced as on prior studies from ___.


SubjectID: 12043836, StudyID: 52604679, Comparison: None

FINAL REPORT

INDICATION: MRSA endocarditis, pleural effusion and evaluate for pneumothorax status post right chest tube removal.

COMPARISONS: Chest radiograph from ___.

TECHNIQUE: Single portable chest radiograph was provided.

FINDINGS: Endotracheal and nasogastric tubes have been removed. The right chest tube has been removed. There is no pneumothorax. Bibasilar atelectasis is noted. Heart is significantly enlarged. There is no pleural effusion or focal consolidation. Valve replacements are noted. Median sternotomy wires are intact.

IMPRESSION: No evidence of pneumothorax. Bibasilar atelectasis and stable severe cardiomegaly.


SubjectID: 12043836, StudyID: 53366028, Comparison: worse

FINAL REPORT

HISTORY: ___-year-old male with end-stage renal disease on hemodialysis and severe mitral regurgitation and triscuspid regurgitation. Assess for pulmonary edema or pneumonia.

COMPARISON: Chest radiograph from ___ PORTABLE FRONTAL CHEST RADIOGRAPH: Pulmonary vascular congestion has increased since the prior examination, though remains mild. No large pleural effusion is identified. An unchanged linear opacity within the right mid-lung likely reflects parenchymal scarring. No confluent consolidation is identified. Mediastinal and hilar contours appear unchanged. Moderate cardiomegaly is stable.

IMPRESSION: New mild pulmonary vascular congestion   Keywords: new. No pneumonia.


SubjectID: 12043836, StudyID: 50847846, Comparison: None

WET READ: ___ ___ ___ 8:32 PM Stable right midlung opacity, likely atelectasis. Patchy opacities in the right lower ___, ___ represent aspiration. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___-year-old male with CHF and ESRD. New fever, evaluation for pneumonia.

COMPARISON: Comparison is made to radiographs of the chest from ___ and ___.

FINDINGS: A persistent region of atelectasis in the right mid lung is slightly more prominent today. Chronic enlargement of the heart and mild congestion of the central pulmonary vasculature are unchanged. There is no pneumothorax or appreciable pleural effusion. The left lung is grossly clear.

CONCLUSION: Right mid lung atelectasis, alternatively pneumonia, increased mildly. Chronic cardiomegaly and venous hypertension unchanged since the prior study. Left lung is grossly clear. A preliminary report was issued by Dr. ___ to Dr. ___ on ___. Subsequently, Dr. ___ was paged at 10:37 on ___ by Dr. ___ ___ the findings were subsequently discussed over the phone.


SubjectID: 12043836, StudyID: 52415797, Comparison: None

FINAL REPORT

STUDY: PA and lateral chest, ___. CLINICAL

HISTORY: ___-year-old man status post mitral valve replacement and PICC line.

FINDINGS: Comparison is made to the previous study from ___. There is a left-sided PICC, distal lead tip in the mid SVC. Heart size is enlarged but stable. There are small bilateral pleural effusions, best seen on the lateral view. Valve replacements are also seen. There are no signs for overt pulmonary edema or focal consolidation. No pneumothoraces are present.


SubjectID: 12043836, StudyID: 53022426, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with chest tubes s/p pull back today // CT

COMPARISON: ___.

IMPRESSION: The upper and the lower right-sided chest tube have been minimally pulled back. There is a mild decrease in extent of the right pleural effusion. The right parenchymal opacities are unchanged. Unchanged appearance of the cardiac silhouette and the left lung.


SubjectID: 12064623, StudyID: 58853206, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with idiopathic CHF, pulm HTN, asthma admitted with dyspnea and hypoxia. // ? interval change

TECHNIQUE: Chest PA and lateral

FINDINGS: Patient is status post median sternotomy, mitral valve replacement and left-sided defibrillator are unchanged. Moderate cardiomegaly. Ill-defined nodular and hazy opacities are seen throughout the right lung, are unchanged and can be asymmetric pulmonary edema   Keywords: unchanged or infection   Keywords: unchanged. There is a small left effusion. Pleural effusion or pneumothorax is identified.

IMPRESSION: Moderate cardiomegaly. Ill-defined nodular and hazy opacities are seen throughout the right lung, are unchanged and can be asymmetric pulmonary edema.


SubjectID: 12064623, StudyID: 57409080, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___F with shortness of breath, cough, wheezing.

TECHNIQUE: Upright AP and lateral views of the chest

COMPARISON: Chest CTA ___, chest radiograph ___

FINDINGS: Patient is status post median sternotomy and mitral valve replacement. Left-sided AICD/pacer device is noted with leads terminating in the right atrium and right ventricle. Moderate cardiomegaly is slightly increased in size compared to the previous study. Atherosclerotic calcifications are diffusely noted throughout the thoracic aorta. Ill-defined nodular and hazy opacities are seen throughout the right lung, and likely involving the left mid lung field, which may reflect multifocal pneumonia with asymmetric pulmonary edema a differential consideration. No pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities.

IMPRESSION: Findings concerning for multifocal pneumonia primarily involving the right lung, with markedly asymmetric pulmonary edema within the differential diagnosis. Followup radiographs after diuresis are recommended for further assessment.


SubjectID: 12064623, StudyID: 50042924, Comparison: 0.0

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with systolic CHF, pulm HTN, asthma admitted with dyspnea, hypoxia. CXR c/f multifocal PNA vs. asymmetrical pulm edema. ? interval change

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph of ___, ___.

FINDINGS: Patient is post median sternotomy, mitral replacement. Left-sided defibrillator, with leads in the right atrium and right ventricle, is unchanged. Previously seen ill-defined nodular and hazy opacities in the right lung have greatly improved since the radiograph from 2 days prior, suggesting these were due to pulmonary edema   Keywords: improve. However, persistent opacities in the right could be due to residual asymmetric edema or infection   Keywords: persistent.

IMPRESSION: 1. Significant improvement in asymmetric right lung opacities, suggesting they were due to pulmonary edema   Keywords: improve. 2. Persistent opacities in the right lung may be due to residual asymmetric edema or infection   Keywords: persistent.


SubjectID: 12078677, StudyID: 59009489, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man w/CHF and ___'s disease with recurrent aspiration // Eval for PNA vs aspiration pneumonitis vs pulmonary edema Eval for PNA vs aspiration pneumonitis vs pulmonary edema

IMPRESSION: In comparison with the study of ___, there is continued slow clearing of the bilateral pulmonary opacifications that most likely reflected pulmonary edema   Keywords: continue. However, some element of aspiration can certainly not be excluded in the appropriate clinical setting.


SubjectID: 12078677, StudyID: 55768775, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hypoxia and cough // Aspiration PNA vs pneumonitis vs pulm edema

TECHNIQUE: Portable chest

COMPARISON: ___.

FINDINGS: There has been interval partial clearing of the bilateral infiltrates which are now most apparent in the right mid lung and left lower lobe. There continues to be mild cardiomegaly and pulmonary vascular redistribution compatible fluid overload   Keywords: continue

IMPRESSION: Some improvement in the pulmonary status


SubjectID: 12078677, StudyID: 51685477, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p DCCV with ongoing O2 requirement // interval development; continues to be on O2

TECHNIQUE: Portable chest

COMPARISON: ___.

FINDINGS: There bilateral alveolar infiltrates lower lobe greater than upper lobe central greater than peripheral but increased slightly compared to the study from the prior day. Lung volumes are low there is a small right effusion there compressive changes at the bases

IMPRESSION: Slight progression of bilateral lower lobe infiltrates


SubjectID: 12078677, StudyID: 55549458, Comparison: None

FINAL REPORT

HISTORY: ___ disease complicated by aspiration pneumonia, shortness of breath, hypoxia, fevers.

TECHNIQUE: PA and lateral views of the chest.

COMPARISON: ___.

FINDINGS: The hepatic flexure is interposed between the liver and the diaphragm. Heart size is normal. Mediastinal and hilar contours are unchanged. There are low lung volumes. Streaky bibasilar opacities likely reflect atelectasis though aspiration or infection is difficult to exclude. There is mild pulmonary vascular congestion. No pleural effusion or pneumothorax is visualized. Diffuse demineralization of the osseous structures is re- demonstrated with a mild compression deformity noted at the thoracolumbar junction, unchanged.

IMPRESSION: Mild pulmonary vascular congestion and streaky opacities in the lung bases most likely reflective of atelectasis. Please note that aspiration or infection cannot be completely excluded.


SubjectID: 12078677, StudyID: 54186376, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with SOB // pulm edema?

COMPARISON: Chest CT from ___

FINDINGS: AP portable semi upright view of the chest. Low lung volumes as well as poor patient positioning limits assessment. Coarsened interstitial lung markings reflect known interstitial lung disease. A superimposed edema is difficult to exclude. However, there is increased focal opacity in the right upper lobe which is concerning for a superimposed pneumonia. Overall cardiomediastinal silhouette appears grossly unchanged with the heart size is difficult to reliably assessed. Gas-filled bowel loops are seen below the right and left hemidiaphragm. Bony structures appear grossly intact.

IMPRESSION: Diffuse interstitial opacity likely reflects known interstitial lung disease, difficult to exclude a superimposed edema. Focal right upper lobe opacities concerning for pneumonia.


SubjectID: 12081472, StudyID: 59172787, Comparison: same

FINAL REPORT

STUDY: Portable AP chest radiograph.

COMPARISON EXAM: Portable AP chest radiograph ___, ___.

INDICATION: ___-year-old with shortness of breath, rule out pneumonia.

FINDINGS: There is stomach distention causing slight elevation of the left hemidiaphragm. Heart size is mildly enlarged, but stable. There is a tortuous aorta with calcifications also stable. Hilar contours are stable. There is no pleural effusion or pneumothorax. The lungs are well expanded with no focal consolidation. There are stable severe bilateral shoulder degenerative changes as well as an unchanged appearance of a calcified granuloma in the right mid lung   Keywords: unchanged appearance.

IMPRESSION: No pneumonia.


SubjectID: 12081472, StudyID: 50438012, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with past medical history of asthma presenting with shortness of breath.

COMPARISONS: Multiple prior chest radiographs, most recently of ___.

FINDINGS: Frontal and lateral views of the chest were obtained. Mild cardiomegaly is similar to prior. Cardiomediastinal contours are stable. Opacity in the medial retrocardiac region is compatible with a hiatal hernia, which was present on ___ chest CT. The pulmonary vasculature is indistinct, compatible with mild pulmonary edema. No substantial pleural effusion, focal consolidation, or pneumothorax. No radiopaque foreign body. Bilateral shoulder degenerative changes are similar to prior. A calcified granuloma in the right mid lung is similar to prior. Wedge deformities of two thoracolumbar vertebral bodies are similar to prior.

IMPRESSION: Mild pulmonary edema. Small hiatal hernia.


SubjectID: 12081472, StudyID: 55042656, Comparison: worse

FINAL REPORT

HISTORY: Hyponatremia and shortness of breath

COMPARISON: ___.

FINDINGS: Two views were obtained of the chest. Compared with the previous examination of 1 day prior, lung volumes are slightly lower with increased interstitial abnormality and fullness of the vasculature most consistent with mild pulmonary edema   Keywords: increase. No pleural effusion or pneumothorax is seen. The heart is mildly enlarged with tortuous aortic contour. Degenerative disease is noted in the right greater than left glenoid humeral and acromioclavicular joints. Compression fractures in the mid and lower thoracic spine are unchanged from ___.

IMPRESSION: Mild pulmonary edema.


SubjectID: 12081472, StudyID: 54137781, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, evaluation for pulmonary edema.

COMPARISON: ___, 11:43 a.m.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Moderate cardiomegaly with tortuosity of the thoracic aorta. Known parenchymal calcifications and mild scarring but no evidence of acute or new pulmonary edema   Keywords: new. Massive degenerative changes in both shoulders.


SubjectID: 12081472, StudyID: 52119437, Comparison: same

FINAL REPORT

HISTORY: Altered mental status.

TECHNIQUE: Chest, frontal and lateral views.

COMPARISON: ___.

FINDINGS: There has been no significant change since the prior study   Keywords: no significant change. The cardiac and mediastinal silhouettes are stable, with the cardiac silhouette mildly enlarged and the aortic calcified and tortuous. No pleural effusion or pneumothorax is seen. No definite focal consolidation. Hilar contours are stable. Degenerative changes of bilateral shoulder and acromioclavicular joints are seen. There is also stable compression/anterior wedging deformity laterally to the vertebral bodies, 1 in the mid thoracic spine and 1 at the thoracolumbar junction.

IMPRESSION: No significant interval change   Keywords: no significant interval change. Stable enlargement of the cardiac silhouette.


SubjectID: 12081472, StudyID: 50481993, Comparison: same

FINAL REPORT

TYPE OF

EXAMINATION: Chest PA and lateral.

INDICATION: ___-year-old female patient with shortness of breath, evaluate for CHF.

FINDINGS: PA and lateral chest views were obtained with patient in upright position. Analysis is performed in direct comparison with the next preceding similar study of ___. Mild-to-moderate cardiac enlargement is present but not different in size in comparison to the previous study. Unchanged appearance of the mildly widened and elongated but heavily wall calcified thoracic aorta   Keywords: unchanged appearance. No suspicion for new aneurysmatic formations. The pulmonary vasculature is not congested and the lateral and posterior pleural sinuses remain free from any fluid accumulation. Lateral view demonstrates again accentuated kyphotic curvature in the demineralized thoracic spine with at least two wedge compressed vertebral bodies, similar as seen on previous examinations.

IMPRESSION: Stable chest findings, mild-to-moderate cardiac enlargement in elderly patient, but no evidence of acute pulmonary congestion or pulmonary edema. No acute new parenchymal infiltrates.


SubjectID: 12104056, StudyID: 57819780, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with as above // s/p myomectomy w/hypoxia-r/o effusion

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the endotracheal tube and the Swan-___ catheter remain in situ. Unchanged moderate cardiomegaly with mild pulmonary edema   Keywords: unchanged. Unchanged bilateral areas of basilar atelectasis. In addition, the pre-existing right basal lateral parenchymal opacity. Unchanged position of the pacemaker wires.


SubjectID: 12104056, StudyID: 55970778, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with s/p myomectomy // hypoxia

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The monitoring and support devices are in constant position. Constant appearance of the parenchymal opacities. No new opacities   Keywords: new. No pneumothorax.


SubjectID: 12104056, StudyID: 55681384, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with s/p myomectomy // hypoxia

COMPARISON: ___, 06:21

IMPRESSION: As compared to the previous image, no relevant change is seen   Keywords: no relevant change. The monitoring and support devices are constant position. Constant extent and severity of the known pre-existing bilateral parenchymal opacities. Moderate cardiomegaly persists. The presence of a small to moderate right pleural effusion cannot be excluded.


SubjectID: 12104056, StudyID: 54995699, Comparison: None

WET READ: ___ ___ ___ 8:28 AM Low lung volumes and increasing right basilar opacity which may reflect atelectasis versus infection. Probable small bilateral pleural effusions. Unchanged tiny right apical pneumothorax.

WET READ VERSION #1 ___ ___ ___ 7:24 PM Low lung volumes and increasing right basilar opacity which may reflect atelectasis versus infection. Probable small bilateral pleural effusions. Unchanged tiny right apical pneumothorax. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p myomectomy // eval effusions vs pneumo

COMPARISON: ___

IMPRESSION: The pre-existing millimetric right apical pneumothorax is no longer clearly identified. The lung volumes have decreased. Areas of atelectasis are present at both the left and the right lung base. Moderate cardiomegaly. Signs of mild pulmonary edema. No larger pleural effusions. The monitoring and support devices, including the Swan-Ganz catheter, are in unchanged normal position.


SubjectID: 12104056, StudyID: 54874924, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with myomectomy // r/o ptx, s/p ct d/c

TECHNIQUE: Portable semi-upright chest radiograph.

COMPARISON: Chest radiograph dated ___.

FINDINGS: There is a pacemaker overlying the left chest with leads that appear intact in the right atrium and right ventricle. There is a PA catheter, which is unchanged in comparison to the prior chest radiograph. The sternotomy wires appear intact appropriately aligned. There is a small unchanged right apical pneumothorax. Moderate vascular congestion, which has increased in comparison to the prior   Keywords: increase radiograph   Keywords: increase. Bibasilar atelectasis. The lungs are otherwise clear. Heart size is stable. The mediastinal and hilar contours are stable. No pleural effusion is seen. There are no acute osseous abnormalities.

IMPRESSION: 1. PA catheter in appropriate positioning. 2. Moderate vascular congestion, which has increased in comparison to the prior. 3. Small unchanged right apical pneumothorax.


SubjectID: 12104056, StudyID: 51016140, Comparison: None

WET READ: ___ ___ ___ 8:43 AM Interval placement of an ET tube terminating 1.9 cm above the carina.

WET READ VERSION #1 ___ ___ ___ 8:28 PM Interval placement of an ET tube terminating 1.9 cm above the carina. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p myomectomy // eval for ETT placement s/p reintubation

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the patient has been intubated. The tip of the endotracheal tube projects 2 cm above the level of the carina. No complications, notably no pneumothorax. The other monitoring and support devices are unchanged. Unchanged extent and severity of a known right basal parenchymal opacity as well as of a retrocardiac atelectasis. Signs of mild pulmonary edema persist.


SubjectID: 12104056, StudyID: 57458335, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p myomectomy // eval for infiltrate

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Swan-Ganz catheter tip is at the level of the right ventricular outflow tract. Pacemaker leads and a right atrium and right ventricle. Cardiomediastinal silhouette is unchanged but there is interval improvement of pulmonary edema   Keywords: improve. Bilateral pleural effusions are present. There is no pneumothorax.


SubjectID: 12104056, StudyID: 52523839, Comparison: 1.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p mymomectomy with increased secretions // eval for infiltrate

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: Moderate cardiomegaly is a stable. Swan-Ganz catheter tip is in the left main pulmonary artery. ET tube is in standard position. Enteric tube is out of view below the diaphragm. Moderate pulmonary edema is unchanged   Keywords: unchanged. Improved aeration of the lower lobes. There is no pneumothorax. Pacer leads are in standard position. Sternal wires are aligned.

IMPRESSION: Swan-Ganz catheter tip in the left main pulmonary artery. Improved aeration of the lower lobes Stable pulmonary edema   Keywords: improve


SubjectID: 12104056, StudyID: 50785178, Comparison: 0.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p myomectomy // follow up edema

IMPRESSION: As compared to recent study of 1 day earlier, Swan-Ganz catheter has been slightly repositioned with tip in the expected location of the main pulmonary artery. Exam is otherwise remarkable for decrease in extent of pulmonary edema, and marked improved aeration in the left lower lobe   Keywords: improve, decrease. No other relevant changes since recent study   Keywords: no other relevant change.


SubjectID: 12106117, StudyID: 58407370, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pericardial effusion, tamponade, and volume overload // interval change

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the cardiac silhouette continues to be substantially enlarged and signs of mild to moderate pulmonary edema still present   Keywords: still. The atelectatic changes in the right lung have minimally decreased, reflecting improved ventilation. The probably atelectatic opacity at the left lung base is constant in appearance. No new parenchymal opacities   Keywords: new. No larger pleural effusions.


SubjectID: 12106117, StudyID: 56646345, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pericardial effusion and pulm edema // Improved pulm edema?

COMPARISON: ___.

IMPRESSION: As compared to the previous image there is a minimally increased in extent and severity of pre-existing areas of atelectasis at the left lung basis and in the right midlung. The size of the cardiac silhouette constant continues to be substantially enlarged. Signs of mild to moderate pulmonary edema are still present   Keywords: still. No other new opacities   Keywords: new. No evidence of larger pleural effusions.


SubjectID: 12106117, StudyID: 51886766, Comparison: worse

FINAL REPORT

INDICATION: ___ year old man with pericardial effusion s/p drainage, hypoxia and hypercarbia.

TECHNIQUE: Portable chest radiograph.

COMPARISON: Chest radiographs from ___ through ___.

FINDINGS: The patient is status post drainage of a pericardial effusion with a chest tube in place. Lung volumes remain low and there has been interval increase in vascular markings since prior, suggesting vascular congestion   Keywords: increase. Additionally, there has been increased retrocardiac opacification and obscuration of the left hemidiaphragm which likely represents a component of pleural fluid and atelectasis. Heart borders are difficult to identify, but the heart remains enlarged. There is no pneumothorax.

IMPRESSION: Increased vascular congestion since prior   Keywords: increase. Persistent cardiomegaly.


SubjectID: 12110985, StudyID: 57134864, Comparison: same

WET READ: ___ ___ ___ 10:23 PM Right IJ CVL with tip in the mid svc. Otherwise, no change from prior study on the same day with diffuse bilateral pulmonary nodules suggestive of metastatic disease. ______________________________________________________________________________

FINAL REPORT

AP CHEST, 9:34 P.M., ___

HISTORY: Right IJ line central venous placement.

IMPRESSION: AP chest compared to ___: Tip of the new right internal jugular line projects over the low SVC. No mediastinal widening or pleural effusion. Widespread pulmonary metastases and possible mild edema are unchanged since earlier   Keywords: unchanged. The heart size is normal. Pleural effusion, minimal if any.


SubjectID: 12110985, StudyID: 52775712, Comparison: same

FINAL REPORT

CHEST, TWO VIEWS: ___.

HISTORY: ___-year-old male with dyspnea, history of CHF and metastatic melanoma.

FINDINGS: Frontal and lateral views of the chest are compared to previous exam from ___ and film from ___. There are innumerable bilateral nodular opacities throughout the lungs bilaterally suspicious for significant interval progression of metastatic disease. There is blunting of the posterior costophrenic angles which could potentially be due to small effusions. Cardiomediastinal silhouette is unchanged. Osseous and soft tissue structures are also unchanged.

IMPRESSION: Extensive bilateral nodular opacities in lungs suspicious for progression of metastatic disease. No definite pulmonary edema or new confluent consolidation, although subtle changes may be missed due to extensive burden of metastatic disease   Keywords: new.


SubjectID: 12118886, StudyID: 59801658, Comparison: worse

WET READ: ___ ___ 7:48 AM 1. Nasogastric tube ends in the stomach, with the last side for below the GE junction. 2. Bibasilar opacities remain concerning for pneumonia or aspiration. 3. Mild to moderate pulmonary edema.

WET READ VERSION #1 ___ ___ 10:08 PM 1. Nasogastric tube ends in the stomach, with the last side for below the GE junction. 2. Bibasilar opacities remain concerning for pneumonia or aspiration. 3. Mild to moderate pulmonary edema. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cirrhosis, encephalopathy, sepsis // NGT placement

IMPRESSION: As compared to previous radiograph of several hr earlier, a nasogastric tube has been placed, terminating within the stomach. Within the chest, pulmonary vascular congestion has slightly worsened   Keywords: worse. The recently reported bibasilar opacities are rapidly improving, favoring atelectasis or aspiration over infectious pneumonia.


SubjectID: 12118886, StudyID: 57606849, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with hypotension, hypoxic. ? infiltrate

TECHNIQUE: AP upright portable chest radiograph

COMPARISON: Chest radiograph from ___.

FINDINGS: Lung volumes are low limiting evaluation. The previously noted right IJ central venous catheter and the endogastric tube have been removed. The heart remains moderately enlarged. There are persistent opacities in the lower lungs which raise potential concern for pneumonia or aspiration. There is hilar prominence which could represent hilar congestion versus lymph node enlargement. There may be a small left pleural effusion. No pneumothorax.

IMPRESSION: Probable lower lung pneumonia versus aspiration. Small left effusion. Cardiomegaly. Mild hilar congestion. Followup to resolution.


SubjectID: 12118886, StudyID: 56733963, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cirrhosis now with sepsis, ?pneumonia // evaluate for progression of infiltrates

IMPRESSION: Allowing for differences in technique, there has not been a substantial change in the appearance of the chest since the recent radiograph of 1 day earlier.


SubjectID: 12118886, StudyID: 50105039, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with HE, septic shock, with new NGT placement this morning // please evaluate for NGT placement

IMPRESSION: Nasogastric tube courses below the diaphragm beyond the field of view of the radiograph. Within the image portion of the chest, there has been no relevant change in appearance since the recent study performed a few hr earlier   Keywords: no relevant change.


SubjectID: 12118886, StudyID: 59642308, Comparison: worse

FINAL REPORT

EXAMINATION: Portable AP chest radiograph

INDICATION: ___ year old man with UGIB // Intubated. Assess lungs.

COMPARISON: Chest radiograph dated ___.

FINDINGS: The patient is rotated. The right internal jugular venous catheter tip ends in the mid SVC. ET tube tip that the upper margin of the clavicles is no less than 7 cm from the carina with the chin in neutral or mild flexion. It could be advanced 2 cm for more secure seating. . Lung volumes remain low. Pulmonary vessels are prominent. Pulmonary edema has progressed and is moderate   Keywords: progressed. Small left pleural effusion is overall unchanged. No right effusion. The heart is mild-to-moderately enlarged, unchanged. Respiratory tubing projects over the left upper hemithorax, limiting evaluation. No pneumothorax.

IMPRESSION: Progressive heart failure or volume overload. ET tube 2 cm above optimal position.


SubjectID: 12118886, StudyID: 57421584, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with new NG tube placed // NG tube placement

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: NG tube tip passes below the diaphragm. Terminating in the stomach. Right internal jugular line tip is at the level of cavoatrial junction. Cardiomediastinal silhouette is unchanged. That retrocardiac consolidation is extensive. Minimal right basal opacity is noted. Overall the findings are similar to ___


SubjectID: 12118886, StudyID: 56758066, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___-year-old man with CHF presents with increased dry weight, shortness of breath. Evaluate for pulmonary edema.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph from ___.

FINDINGS: There is bibasilar atelectasis without focal consolidation. Scattered calcified granulomas are noted in the left lung. The heart is mildly enlarged. The hilar contours are stable. There is mild pulmonary vascular congestion without overt edema. There is no pleural effusion or pneumothorax.

IMPRESSION: Mild pulmonary vascular congestion without overt edema. Mild cardiomegaly.


SubjectID: 12118886, StudyID: 55227264, Comparison: worse

FINAL REPORT

EXAMINATION: Portable AP chest radiograph

INDICATION: ___ year old man with gi bleed and new intubation.

COMPARISON: Chest radiograph dated ___.

FINDINGS: The ETT tip ends approximately 6 cm from the carina with the neck extended. The newly placed right internal jugular venous catheter ends in the lower SVC. Lung volumes are low. Slight increased opacity in the right infrahilar region may suggest aspiration or atelectasis in the appropriate clinical setting. Interval increasm in interstitial edema. Mild to moderate cardiomegaly is overall unchanged. Blunting of the left costophrenic angle obscuring of the left hemidiaphragm is new, compatible with pleural effusion. Blunting of the lateral aspect of the descending thoracic aorta slight increase retrocardiac opacity is new and may suggest atelectasis. No pneumomediastinum or pneumothorax

IMPRESSION: 1. ETT in standard placement. 2. Interval increase in interstitial edema   Keywords: increase. Small left pleural effusion.


SubjectID: 12118886, StudyID: 52445893, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cirrhosis, gi bleed and now fevers // ngt placement and assess for pna

COMPARISON: ___ AT 328 ET TUBE TIP

FINDINGS: ET tube tip approximately 6.5 cm above the carina at the level of the mid clavicular heads. NG tube extends beneath the diaphragm, off the film. Right IJ central line tip is in the distal most SVC, adjacent to the SVC/RA junction. No pneumothorax is detected. There is prominence of the cardiomediastinal silhouette unchanged. There is upper zone redistribution and diffuse vascular blurring, consistent with CHF. There is increased retrocardiac density, consistent with left lower lobe collapse and/or consolidation, with a small left pleural effusion. There is atelectasis at the right lung base, with equivocal small effusion. Compared with 1 day earlier, there has been slight interval clearing at the left lung base laterally. Otherwise, I doubt significant interval change.

IMPRESSION: 1. NG tube extends beneath the diaphragm, off the film. 2. Left lower lobe collapse and/or consolidation. The possibility of a left base pneumonic infiltrate cannot be excluded, but the degree of opacification is slightly improved compared 1 day earlier. 3. Minimal patchy opacity at the right base likely represents atelectasis and is similar to 1 day earlier.


SubjectID: 12118886, StudyID: 55924902, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with GIB // NGT in place?

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: NG tube tip is in the stomach. Right internal jugular line tip is at the level of lower SVC. Cardiomediastinal silhouette is unchanged as well as bibasal consolidations and bilateral pleural effusion.


SubjectID: 12118886, StudyID: 55903514, Comparison: same

FINAL REPORT

EXAMINATION: Portable AP chest radiograph

INDICATION: ___ year old man with concern for volume overload. Evaluate for pulmonary edema.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph dated ___.

FINDINGS: Enteric tube traverses the diaphragm with tip not seen. The right internal jugular venous catheter ends in the low SVC, unchanged. Lung volumes are low, unchanged. Moderate cardiomegaly persists and is overall unchanged. Prominence of pulmonary vessels is also overall unchanged. Moderate to mild pulmonary edema is probably also grossly unchanged when accounting for redistribution   Keywords: unchanged. Small left pleural effusion is overall similar. Pleura effusion of the right, if any, is minimal. No pneumothorax.

IMPRESSION: Mild-to-moderate heart failure and/or volume overload, overall unchanged   Keywords: unchanged.


SubjectID: 12122921, StudyID: 58932373, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with critical AS s/p TAVR // ?pulm edema ?pulm edema

IMPRESSION: In comparison with the study of ___, there has been placement of a core valve as well as right IJ temporary pacer with its tip in the apex of the right ventricle. Continued enlargement of cardiac silhouette with substantial bilateral pleural effusions and compressive basilar atelectasis as well as pulmonary edema. What appears to be an endotracheal tube has its tip approximately 5.7 cm above the carina.


SubjectID: 12122921, StudyID: 55958095, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p TAVR on ___, CHF. // volume overload, infiltrates

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Severe cardiomegaly is stable. Pacer lead is in standard position the tip is in the right ventricle. Large right and moderate left pleural effusion with adjacent atelectasis are unchanged. Pulmonary edema has resolved   Keywords: resolve. Aortic stent is in place. There is no evident pneumothorax.


SubjectID: 12122921, StudyID: 58613199, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Shortness of breath, questionable pneumonia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Moderate cardiomegaly. New retrocardiac atelectasis. No larger pleural effusions. Focal parenchymal opacity at the bases of the right upper lobe is unchanged. Mild pulmonary edema is present.


SubjectID: 12122921, StudyID: 53963682, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with cough.

COMPARISON: ___.

TECHNIQUE: PA and lateral chest radiograph.

FINDINGS: There are patchy ill-defined opacities above the minor fissure in the right lung and in the right lung base, as well as multiple patchy retrocardiac opacities in the left lung base. Small bilateral pleural effusions are better assessed in the lateral view. Moderate cardiomegaly is present. There is no pneumothorax.

IMPRESSION: Multifocal parenchymal opacities compatible with pneumonia. Follow up ___ weeks after treatment is recommended to document resolution.


SubjectID: 12122921, StudyID: 51981093, Comparison: better

WET READ: ___ ___ 10:21 PM Slightly improved mild pulmonary edema with otherwise unchanged exam. ______________________________________________________________________________

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph of one day earlier.

FINDINGS: Stable cardiomegaly accompanied by improving pulmonary vascular congestion and decreasing pulmonary edema   Keywords: improving, decreasing. Small pleural effusions are present, but there is no visible pneumothorax.


SubjectID: 12122921, StudyID: 56210762, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___-year-old man, status-post drainage of left-sided pleural effusion and removal of chest tube; evaluate for pneumothorax.

COMPARISON: Chest radiograph dated ___.

FINDINGS: Interval removal of the left-sided pigtail catheter. No pneumothorax or associated sub-cutaneous emphysema. Improvement in the left pleural effusion, now small-to-moderate in size. Stable, small right pleural effusion with adjacent basilar atelectasis. Stable tracking of the effusions in the fissures. Stable cardiomegaly. The mediastinal contours are normal. No new focal consolidation or pulmonary edema   Keywords: new. No acute osseous abnormality. No intra-abdominal sub-diaphragmatic free air.

IMPRESSION: 1. No pneumothorax following removal of the left pigtail catheter. 2. Interval improvement in the, now small-to-moderate left pleural effusion. 3. Stable small right pleural effusion.


SubjectID: 12122921, StudyID: 53908133, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with pleural effusion // pleural effusion, interval change

IMPRESSION: Left pleural catheter is in place with a persistent small left pleural effusion and adjacent left lower lobe atelectasis and or consolidation. A small to moderate right pleural effusion is similar to the prior study, but adjacent right basilar lung opacification has improved.


SubjectID: 12122921, StudyID: 55606841, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___-year-old man with a known pleural effusion, status-post left pigtail catheter placement.

COMPARISON: CT of the chest dated ___.

FINDINGS: Large bilateral pleural effusions, greater on the left compared to the right, with adjacent bilateral atelectasis. Interval placement of a left pigtail catheter which appears to be in the area of the left pleural effusion. Apparent mediastinal widening is secondary to lack of full inspiration. The heart size cannot be fully assessed. There is no pneumothorax or pulmonary edema. No acute osseous abnormality.

IMPRESSION: 1. Large left pleural effusion, now being drained by a left pigtail catheter. 2. Moderate right pleural effusion. 3. Bibasilar atelectasis.


SubjectID: 12152816, StudyID: 58885266, Comparison: -1.0

FINAL REPORT

TYPE OF

EXAMINATION: CHEST, PA AND LATERAL.

INDICATION: ___-year-old male patient with cardiac amyloid and pleural effusion, evaluate size of pleural effusion.

FINDINGS: PA and lateral chest views were obtained with patient in upright position. Comparison is made with the next preceding AP single view chest examination of ___. Cardiac enlargement as before. Unchanged appearance of thoracic aorta, thus only mildly widened and elongated without evidence of local contour abnormalities. The pulmonary vasculature shows a mild upper zone redistribution pattern and some perivascular haze on the bases. On previous examination identified pleural effusion obliterating the right lateral pleural sinus has increased slightly. There are some crowded pulmonary vessels on the right base, but no conclusive evidence for infiltrates is present. The left-sided retrocardiac pulmonary density persists and as before, is indicative of a sizeable atelectasis in the left lower lobe. The lateral view discloses that also some small amount of pleural effusion reaches into the posterior left-sided pleural space. Previously identified calcification in right-sided sixth anterior rib remains unchanged.

IMPRESSION: Bilateral pleural effusions, slightly increasing and suggestive of CHF   Keywords: increasing. Left-sided retrocardiac atelectasis persists and possibility of infective course is likely. No other interval changes are seen   Keywords: no other interval change.


SubjectID: 12152816, StudyID: 58558468, Comparison: better

FINAL REPORT

AP CHEST, 10:52 A.M. ON ___

HISTORY: ___-year-old man after CPR.

IMPRESSION: AP chest compared to 7:47 a.m.: ET tube is in standard placement, but the diameter of the tube, 10 mm, is small relative to the tracheal diameter, 27 mm. Clinical evaluation recommended. Moderate bilateral pleural effusions obscure much of the lungs in this supine view. I suspect pulmonary edema has improved slightly, but I cannot be sure   Keywords: improve. There is still substantial atelectasis at the lung bases, and the heart remains mildly to moderately enlarge. New left internal jugular line ends in the midline, probably in the left brachiocephalic vein. An upper elementary tube passes into the stomach and out of view. No pneumothorax.


SubjectID: 12152816, StudyID: 57441659, Comparison: worse

FINAL REPORT

AP CHEST, 7:47 A.M., ___.

HISTORY: ___-year-old man after a PEA arrest.

IMPRESSION: AP chest compared to ___: Moderately severe pulmonary edema is new, exaggerated by an increase in substantial bilateral pleural effusion, large on the left, moderate on the right   Keywords: new, increase. Moderate cardiomegaly has worsened compared to ___. ET tube in standard placement. Enteric tube passes into the stomach and out of view. No pneumothorax. Dr. ___ was paged at 11:15 when these findings were recognized.


SubjectID: 12175593, StudyID: 54713656, Comparison: None

FINAL REPORT

AP CHEST 10:44 A.M. ___

HISTORY: Right pleural effusion, after thoracentesis of 700 cc. Question pneumothorax or residual effusion and re-expansion of the right lung.

IMPRESSION: AP chest compared to ___ and ___: No pneumothorax, after removal of a portion of the still moderate right pleural effusion. Lungs are clear. Moderate cardiomegaly is longstanding. Transvenous right atrial and right ventricular pacer leads are unchanged in standard positions. Patient has had mitral valve replacement via median sternotomy.


SubjectID: 12175593, StudyID: 54181630, Comparison: same

FINAL REPORT

INDICATION: ___-year-old male with pleural effusion.

COMPARISON: PA and lateral chest radiograph, ___.

TECHNIQUE: PA and lateral chest radiograph.

FINDINGS: There has been interval replacement of the mitral and aortic valves with corresponding sternotomy closed with plates and screws for which there are no obvious hardware complications. Moderate right subpulmonic effusion and right-sided layering effusion is seen. Left side is clear. There is no pneumothorax. Cardiomediastinal silhouette is stable and demonstrates an enlarged heart and mildly tortuous aorta.

IMPRESSION: 1) Interval increase in right-sided pleural effusion. 2) Stable cardiomegaly with no evidence of heart failure   Keywords: stable.


SubjectID: 12185775, StudyID: 59751598, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___ chest radiograph.

FINDINGS: Swan-Ganz catheter has been advanced beyond the right hilum, and should be withdrawn for standard positioning, as discussed by telephone with Dr. ___ at 9:45 a.m. on ___. New airspace opacity distal to the catheter tip could potentially represent pulmonary hemorrhage, but other etiologies such as atelectasis or aspiration are also possible. Improving atelectasis in left lower lobe and persistent small left pleural effusion. Incidental calcified granulomas within the left upper lobe.


SubjectID: 12185775, StudyID: 58095298, Comparison: better

FINAL REPORT

PORTABLE CHEST

COMPARISON: Chest radiograph, ___.

FINDINGS: Endotracheal tube and nasogastric tube remain in standard position. Swan-Ganz catheter has been slightly withdrawn, with tip terminating in the central right hilar region. Left sided catheter has been removed, with no visible pneumothorax. Cardiac silhouette remains mildly enlarged, but previously reported mild edema has nearly resolved   Keywords: resolve. Bibasilar retrocardiac atelectasis is present with some improvement on the left, and small left pleural effusion is unchanged.


SubjectID: 12185775, StudyID: 53930112, Comparison: None

FINAL REPORT

INDICATION: Hypoxia. Evaluate for interval change.

COMPARISONS: Chest radiograph, ___. Chest radiograph, ___. Chest radiograph, ___.

FINDINGS: A right internal jugular central line ends in the upper SVC. The Swan-Ganz catheter has been removed. A new consolidation at the right base is concerning for possible pneumonia, aspiration, or less likely infarction. Small bilateral pleural effusions are stable. Calcified granulomas in the left mid lung zone are unchanged.

IMPRESSION: 1. New right basilar consolidation is most concerning for pneumonia or aspiration. Less likely, it may be infarction. 2. Stable small bilateral pleural effusions. 3. Mild enlargement of the cardiac silhouette is unchanged. Results were discussed with ___ at 11:20 on ___ via telephone by Dr. ___.


SubjectID: 12185775, StudyID: 50127750, Comparison: None

FINAL REPORT

AP CHEST, 7:53 A.M. ON ___

HISTORY: Question right lower lobe pneumonia.

IMPRESSION: AP chest compared to ___: Small-to-moderate left pleural effusion has increased slightly over the past several days. Moderate enlargement of the cardiac silhouette accompanied by mediastinal vascular engorgement is also slightly more pronounced. Pulmonary vasculature is engorged but there is no edema. Consolidation has been present without appreciable change in the left lower lobe since at least ___. Mediastinum widened at the thoracic inlet by a combination of tortuous vessels and mediastinal fat deposition. Right jugular introducer ends just above the junction with left brachiocephalic vein.


SubjectID: 12185775, StudyID: 59700205, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Respiratory failure, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to a previous radiograph, the tube is still relatively high and could be advanced by 1 to 2 cm. Unchanged bilateral pleural effusions, unchanged moderate pulmonary edema and mild cardiomegaly   Keywords: unchanged. The nasogastric tube shows normal course.


SubjectID: 12185775, StudyID: 57463116, Comparison: same

WET READ: ___ ___ 8:13 PM Swan Ganz cath and ngt in std position. Minimally improved right and unchanged left pleural effusions with adjacent atelectasis, although underlying infectious process can't be excluded in the correct clinical setting. stable to slightly improved pulmonary edema. Mild cardiomegaly. ______________________________________________________________________________

FINAL REPORT

AP CHEST, 6:56 P.M., ___

HISTORY: Diuresis of pulmonary edema.

IMPRESSION: AP chest compared to ___ and ___, 9:25 a.m.: Tip of the endotracheal tube is at the upper margin of the clavicles, 6 cm from the carina. It could be advanced 2 cm for more secured seating. Severe cardiomegaly is worse. Mild interstitial edema persists   Keywords: persists. Severe opacification of the left lower lung could be atelectasis and pleural effusion but raises concern for pneumonia. Pleural effusion, at least moderate on the right, is unchanged. No pneumothorax. Swan-Ganz catheter ends in the right pulmonary artery and a nasogastric tube passes below the diaphragm and out of view. No pneumothorax.


SubjectID: 12185775, StudyID: 57164346, Comparison: better

FINAL REPORT

AP CHEST, 7:59 A.M. ON ___.

HISTORY: Patient intubated, question interval change.

IMPRESSION: AP chest compared to ___, 6:56 p.m.: Previous mild pulmonary edema has cleared from the right lung, improving on the left   Keywords: improving. Small left pleural effusion has increased. No appreciable right pleural effusion. Moderate cardiomegaly has improved. Tip of the endotracheal tube is no less than 4.5 cm above the carina, in standard placement. Swan-Ganz catheter ends in the right descending pulmonary artery and care should be taken that it not advance any further when it is not in the wedge position. Nasogastric tube passes into the distal stomach and out of view. No pneumothorax.


SubjectID: 12185775, StudyID: 51309585, Comparison: worse

WET READ: ___ ___ 11:01 PM Worsening pulmonary edema with increased opacification at the right lung base and right retrocardiac region likely worsening pleural effusion with collapsed right lower lobe/atelectastes vs worsening edema. Underlying infection can't be excluded. Trachea mildly deviated to right which may be positional or related to right lower lobe collapse. Milder opacification at left lung base may represent worsening edema vs effusion vs atelectasis. d/w dr. ___ at 10:57pm on ___ via tel. ______________________________________________________________________________

FINAL REPORT

AP CHEST, 10:23 P.M., ___

HISTORY: Worsening hypoxia and tachypnea. Rales.

IMPRESSION: AP chest compared to ___ through ___: Moderately severe pulmonary edema has worsened again   Keywords: worse. The relatively greater opacification at the right lung base seen previously was due to a combination of edema, atelectasis and right pleural effusion, so it is not necessary to invoke possible pneumonia to explain the current radiographic findings. Moderate-to-severe cardiomegaly is chronic. Pulmonary vascular engorgement and distention of mediastinal veins have worsened   Keywords: worse. No pneumothorax. Large calcified granulomas longstanding in the upper lungs.


SubjectID: 12185775, StudyID: 50491354, Comparison: better

FINAL REPORT

PORTABLE AP CHEST ON ___ AT 7:57 CLINICAL

INDICATION: A ___-year-old with respiratory failure, evaluate for interval change. Comparison is made to the patient's prior study of ___ at 7:59. Portable semi-erect chest film on ___ at 7:37 is submitted.

IMPRESSION: 1. Right internal jugular Swan-Ganz catheter with its tip in the right pulmonary artery, unchanged. Endotracheal tube has its tip at the thoracic inlet in satisfactory position. Nasogastric tube is seen coursing below the diaphragm. There is blunting of left costophrenic angle with some retrocardiac opacity likely reflecting a small effusion with patchy compressive atelectasis. Pneumonia cannot be entirely excluded. Improving with residual minimal interstitial edema   Keywords: improving. Left upper and mid calcified nodules likely reflect granulomata. No pneumothorax. Overall, cardiac and mediastinal contours are stable.


SubjectID: 12185775, StudyID: 59668999, Comparison: None

FINAL REPORT

CHEST ON ___

HISTORY: Repositioned PICC line.

FINDINGS: The PICC line tip is in the mid SVC. There is bilateral lower lobe infiltrates, left greater than right; bilateral pleural effusions, left greater than right; dense retrocardiac opacity and mild pulmonary vascular redistribution and alveolar infiltrate most marked on the right. Compared to the prior study, there has been some progression of the lower lobe infiltrates. The overall impression is that of CHF but an underlying infectious infiltrate cannot be excluded.


SubjectID: 12185775, StudyID: 56143620, Comparison: same

FINAL REPORT

HISTORY: Pulmonary edema with new desaturation.

FINDINGS: In comparison with the study of ___, there is little overall change   Keywords: little overall change. Continued enlargement of the cardiac silhouette with pulmonary vascular congestion and bilateral pleural effusions with compressive atelectasis   Keywords: continue. Central catheter remains in place.


SubjectID: 12185775, StudyID: 59200846, Comparison: better

FINAL REPORT

PA AND LATERAL CHEST X-RAY OF ___

COMPARISON: ___ chest x-ray.

FINDINGS: Cardiac silhouette remains enlarged. Pulmonary vascular congestion has slightly improved and is more substantially improved compared to ___   Keywords: improve. Left retrocardiac atelectasis has slightly decreased in extent, and a small left pleural effusion is also slightly smaller compared to the prior study. Small right pleural effusion is not changed, and a minor area of opacity at the right base appears similar to the recent study but improvement compared to earlier radiographs. Calcified granulomas in left upper lobe are unchanged. No new areas of consolidation are evident to suggest an acute pneumonia.

IMPRESSION: No new areas of consolidation to suggest a source of infection.


SubjectID: 12185775, StudyID: 54211038, Comparison: None

FINAL REPORT

INDICATION: ___-year-old woman with symptoms suspicious for flash pulmonary edema.

COMPARISON: PA and lateral chest radiographs ___.

TECHNIQUE: Portable AP semi-erect chest radiograph.

FINDINGS: New endotracheal tube is seen appropriately positioned terminating no less than 2.5 cm above the carina. There are low lung volumes bilaterally with moderate pulmonary edema . Small quantity of bilateral pleural effusion is seen. Cardiomediastinal silhouette is somewhat obscured but is stable and within normal limits.

IMPRESSION: Appropriately placed ET tube. Moderate pulmonary edema. These findings were reported to Dr. ___ at 4:55 p.m. via phone by ___.


SubjectID: 12185775, StudyID: 58100629, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with flash pulm edema // Please eval interval change Please eval interval change

IMPRESSION: In comparison with the study of ___, the monitoring and support devices are unchanged. There is again prominence of the cardiac silhouette with some indistinctness and pulmonary vessels consistent with elevated pulmonary venous pressure   Keywords: again. Calcified granulomas are again noted in the left mid lung.


SubjectID: 12185775, StudyID: 57024984, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F h/o CKD ___ diabetic nephropathy s/p DDRT in ___ p/w abdominal pain x1d, N/V, CT concerning for R-sided ?ischemic colitis vs. typhlitis now desating/sob. Assess for pulmonary edema.

TECHNIQUE: Single portable AP view of the chest.

COMPARISON: Chest radiographs from ___, ___, and ___.

FINDINGS: Right upper and lower lobe opacities are new since the prior day, with indistinctness of the pulmonary vessels, suggesting pulmonary edema   Keywords: new. However, concurrent pneumonia cannot be excluded, in the correct clinical setting. The right PICC line terminates in the lower SVC, and the ET tube terminates 4.5 cm above the carina. Unchanged calcified pulmonary granulomas in the left lung. No pneumothorax. Stable cardiomediastinal borders.

IMPRESSION: New right upper and lower lobe opacities with indistinctness of the pulmonary vessels suggests pulmonary edema   Keywords: new. However, in the correct clinical setting, concurrent pneumonia cannot be excluded.

NOTIFICATION: The above findings were communicated via telephone by Dr. ___ to Dr. ___ at 16:21 on ___, ___ min after discovery.


SubjectID: 12185775, StudyID: 56494283, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with suspected flash edema, heart failure. Now diuresing. // eval for resolving edema

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Severe cardiomegaly and widened mediastinum are unchanged. Pulmonary edema has markedly improved   Keywords: improve. Retrocardiac opacities have improved consistent with improving atelectasis and small left effusion. There is no pneumothorax. Lines and tubes are in standard position. calcified granulomas in the left upper lobe are again noted.


SubjectID: 12185775, StudyID: 53768980, Comparison: -1.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with L subclavian SVC pulled back 2.5cm // Please eval line placement. Thank you!

TECHNIQUE: Single frontal view of the chest

COMPARISON: Study performed 12 hr earlier

IMPRESSION: Left subclavian catheter tip is in the upper SVC. Mild to moderate pulmonary edema has increased   Keywords: increase. No other interval change from prior study   Keywords: no other interval change.


SubjectID: 12185775, StudyID: 50729749, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with DKA, Intubated for pulmonary edema // ? improvement

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: ET tube tip is 4.8 cm above the Carina. NG tube tip is in the stomach. Left central venous line tip is at the level of mid SVC. Heart size and mediastinum are enlarged. Pulmonary edema has substantially improved since the prior study   Keywords: improve.


SubjectID: 12185775, StudyID: 57648356, Comparison: better

FINAL REPORT

HISTORY: CAD, CHF, DM, renal transplant, question worsening pulmonary infiltrates. CHEST, SINGLE AP PORTABLE VIEW: Lordotic positioning. There has been interval removal of ET and NG tubes. There is cardiomegaly and upper zone redistribution with mild diffuse vascular blurring, suggesting CHF with interstitial edema. There is atelectasis at the left base, improved compared with ___ -- the left hemidiaphragm is now visible. Minimal blunting of the left costophrenic angle. Calcified granulomas of the left upper zone again noted.

IMPRESSION: CHF with interstitial edema and bibasilar atelectasis, improved compared with ___   Keywords: improve.


SubjectID: 12185775, StudyID: 55958316, Comparison: better

FINAL REPORT

AP CHEST, 3:36 A.M., ___

HISTORY: Recent pulmonary edema. Question improvement in volume overload.

IMPRESSION: AP chest compared to ___, 5:26 a.m. Severe cardiomegaly and mediastinal and hilar vascular engorgement persists but there has been very significant improvement in previous pulmonary edema, now only minimal, persisting at the base of the right lung   Keywords: improve. Small right pleural effusion is likely. No pneumothorax.


SubjectID: 12185775, StudyID: 55494760, Comparison: None

FINAL REPORT

INDICATION: Intubation. No comparison studies available. FRONTAL CHEST RADIOGRAPH: The heart is moderately enlarged. The aorta is mildly calcified and tortuous. The central pulmonary vessels are engorged and hazy, accompanied by patchy interstitial opacities, most dense at the left base. An ET tube terminates 4.7 cm above the carina. An orogastric tube terminates within the stomach. There is no pneumothorax or large effusion.

IMPRESSION: 1. Extensive bilateral patchy pulmonary opacities. In the setting of central vascular congestion, this is most likely severe pulmonary edema, but pneumonia cannot be excluded, particularly at the left base. 2. ET tube terminating 4.7 cm above the carina. Orogastric tube within the stomach.


SubjectID: 12185775, StudyID: 50953777, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: Chest PA and lateral.

INDICATION: ___-year-old female patient with end-stage renal disease, status post renal allograft, who presented with flash pulmonary edema. Concern regarding development on a pneumonia given worsening cough.

FINDINGS: PA and lateral chest views were obtained with patient in upright position. Analysis is performed in direct comparison with the next preceding portable chest examination of ___. Heart size is unchanged. Previously described moderate pulmonary congestive pattern with some upper zone re-distribution has normalized. Presently no evidence of pulmonary interstitial alveolar edema and the lateral as well as posterior pleural sinuses are free from any fluid accumulation. No pneumothorax in the apical area. No acute infiltrates. Lateral and posterior pleural sinuses are free. A previously described old calcified granuloma in the left upper lobe area is unchanged.

IMPRESSION: No evidence of new acute pulmonary infiltrates.


SubjectID: 12185775, StudyID: 56043671, Comparison: None

WET READ: ___ ___ ___ 4:54 PM Right PICC terminating in the proximal right atrium should be retracted 2 cm to place in the low SVC. The findings were discussed by Dr. ___ with Dr. ___ ___ telephone on ___ at 4:45 PM, during discovery of the findings. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: PORTABLE CHEST RADIOGRAPH

INDICATION: ___-year-old male with shortnes of breath, PICC placed at outside institution

TECHNIQUE: Upright AP view of the chest

COMPARISON: ___.

FINDINGS: A right PICC has been placed with the tip terminating in the proximal right atrium, which should be retracted 2 cm to place in the low SVC. The inspiratory lung volumes are decreased. There is mild right basilar atelectasis. Calcified pulmonary granulomas are unchanged. There is no focal consolidation concerning for pneumonia, significant pleural effusion or pneumothorax. The pulmonary vasculature is not engorged. The cardiomediastinal and hilar contours are stable. No acute osseous abnormality is detected.

IMPRESSION: Right PICC terminating in the proximal right atrium should be retracted 2 cm to place in the low SVC.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ ___ telephone on ___ at 4:45 PM, during discovery of the findings.


SubjectID: 12185775, StudyID: 56614076, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Reactive airways disease, pulmonary edema, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is a minimal decrease in extent of a pre-existing small right pleural effusion. Interstitial markings, on the other hand, are slightly increased, potentially reflecting increased interstitial fluid contents   Keywords: increase. Unchanged ___ of the cardiac silhouette. Unchanged basal areas of atelectasis, unchanged right venous introduction sheath. Also unchanged are left lung calcified granulomas. Overall, the findings indicate a mild increase in pulmonary edema   Keywords: increase.


SubjectID: 12185775, StudyID: 51682896, Comparison: 1.0

FINAL REPORT

PA AND LATERAL CHEST

COMPARISON: Radiograph of earlier the same date.

FINDINGS: Cardiac silhouette remains enlarged, accompanied by pulmonary vascular congestion   Keywords: remains. Interstitial edema has improved in the interval   Keywords: improve. Bibasilar atelectasis is again demonstrated, with improvement on the left. Bilateral small pleural effusions are also evident as well as multiple calcified granulomas in the left lung.


SubjectID: 12185775, StudyID: 53923012, Comparison: better

FINAL REPORT

INDICATION: Evaluation of patient with history of kidney transplant and heart failure for interval change.

COMPARISON: Chest radiograph from ___.

FINDINGS: Again visualized is a stable right lower lobe opacity consistent with small to moderate right pleural effusion. Improved asymmetric edema is noted on the left   Keywords: improve   Keywords: improve. There is no evidence of new consolidation or pneumothorax. Cardiomediastinal silhouette remains stable. Osseous structures remain normal.

IMPRESSION: 1. Stable small to moderal right pleural effusion. 2. Improved asymmetric edema is noted on the left.


SubjectID: 12185775, StudyID: 53850178, Comparison: better

FINAL REPORT

AP CHEST 7:41 A.M. ___

HISTORY: Diastolic CHF and flash pulmonary edema.

IMPRESSION: AP chest compared to ___: Mild pulmonary edema and mediastinal and pulmonary vascular engorgement have improved since ___   Keywords: improve. Small right pleural effusion has decreased. Lobar collapse has not recurred. Mild-to-moderate cardiomegaly is unchanged. No pneumothorax.


SubjectID: 12185775, StudyID: 53053450, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: CHF, questionable pulmonary edema.

COMPARISON: ___, 8:19 a.m.

FINDINGS: As compared to the previous radiograph, the pre-existing opacities at the right lung base have improved. The left lung base is unchanged. Overall, the signs indicative of pulmonary edema have slightly decreased in severity but they are still clearly present   Keywords: decrease. Unchanged moderate cardiomegaly and left calcified lung granulomas.


SubjectID: 12206478, StudyID: 59416604, Comparison: None

FINAL REPORT

PORTABLE AP RADIOGRAPH OF THE CHEST CLINICAL

INDICATION: ___-year-old male with placement of right internal jugular central venous line.

TECHNIQUE: Single portable AP radiograph of the chest was obtained.

COMPARISON: ___.

FINDINGS: There has been interval placement of a right-sided central venous catheter with tip terminating in the distal SVC. No pneumothorax is seen. Redemonstration of focal opacity within the right lower lung is again noted and consistent with infection versus aspiration. The heart is normal in size. Aortic arch vascular calcifications are noted. Biapical pleural thickening is present. There is mild degenerative change about bilateral glenohumeral joints.

IMPRESSION: 1. Status post right central venous line placed without evidence of pneumothorax. 2. Stable opacity within the right lower lung consistent with infection versus aspiration.


SubjectID: 12206478, StudyID: 59196182, Comparison: None

WET READ: ___ ___ ___ 5:04 PM Ncreased opacity in right lower lung consistent with acute infectious process ______________________________________________________________________________

FINAL REPORT

AP RADIOGRAPH OF THE CHEST CLINICAL

INDICATION: ___-year-old male with sepsis and cough.

TECHNIQUE: Single AP radiograph of the chest was obtained.

COMPARISON: None.

FINDINGS: There is focal opacity within the right lower lung. Lung volumes are decreased. No pleural effusion or pneumothorax is seen. The heart is normal in size. Aortic arch vascular calcifications are seen. Biapical pleural thickening is noted. Mild degenerative change is present within bilateral glenohumeral joints.

IMPRESSION: Increased opacity within the right lower lung, consistent with acute infectious process vs. aspiration.


SubjectID: 12218235, StudyID: 58363934, Comparison: None

FINAL REPORT

PORTABLE CHEST: ___.

HISTORY: ___-year-old male with new left IJ line.

FINDINGS: Single portable view of the chest is compared to previous exam from earlier the same day at 2:12 p.m. There is a new left IJ central venous catheter with tip likely in the upper SVC, although exact delineation of the tip is limited given overlying cardiac leads. It does not appear to terminate below the level of the RA-SVC junction. There is no visualized pneumothorax. Appearance of the lungs and cardiomediastinal silhouette is otherwise unchanged.

IMPRESSION: New left IJ line. No visualized pneumothorax.


SubjectID: 12218235, StudyID: 50252892, Comparison: None

FINAL REPORT

PORTABLE CHEST: ___

HISTORY: ___-year-old male with hypotension.

FINDINGS: Single portable view of the chest was compared to previous exam from ___. Triple-lead pacing device is again seen. Low lung volumes are again noted and there is obscuration of the left lung secondary to pacing device. There is no large confluent consolidation. Faint opacity at the right lung base may be due to atelectasis. Cardiomediastinal silhouette is stable. Surgical clips in the right upper quadrant suggest prior cholecystectomy. Osseous and soft tissue structures are otherwise unremarkable.

IMPRESSION: Limited portable exam with poor inspiratory effort. No large confluent consolidation.


SubjectID: 12233384, StudyID: 55868656, Comparison: None

FINAL REPORT

HISTORY: ___-year-old man status post transbronchial biopsy. Evaluate for pneumothorax.

COMPARISON: Prior radiographs of the chest dated ___ through ___, and intraoperative fluoroscopic spot views dated ___.

FINDINGS: Portable semi-upright radiograph of the chest demonstrates low lung volumes which results in bronchovascular crowding. There is an area of increased opacification at the left base, likely representing a combination of pleural effusion and adjacent atelectasis. The right lung is essentially clear. There is an area of increased opacification in the left mid lung zone, an area of presumed lung biopsy. There is a small left-sided apical pneumothorax. Cardiomediastinal and hilar contours are unchanged.

IMPRESSION: Small left-sided apical pneumothorax. COMMENTS: These findings were discussed with Dr. ___ by Dr. ___ ___ telephone at 3:39 p.m. on ___, two minutes after the findings were discovered.


SubjectID: 12238304, StudyID: 58330387, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with acute onset dyspnea // please evaluate interval change

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the lung volumes have slightly increased. The ventilation of the lung parenchyma appears improved. A retrocardiac atelectasis, however, persists. There is unchanged mild cardiomegaly but no evidence of overt pulmonary edema. No pneumothorax. No larger pleural effusions.


SubjectID: 12238304, StudyID: 51407396, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with heart failure. // Please evaluate for acute process and interval change.

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Mild remnant atelectasis in the retrocardiac lung regions. No pulmonary edema. No pneumonia, no larger pleural effusions. Better visualized than on the previous image is a high-grade degenerative change at the level of the right shoulder.


SubjectID: 12238304, StudyID: 52458084, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman POD5 TAVR LLL effusion // evaluate LLL effusion

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: There is a moderate size left pleural effusion with associated retrocardiac opacity. Effusions decrease compared to the study from the prior day. There is a small right effusion with volume loss the right lower lobe. There continues to be moment minimal pulmonary vascular redistribution   Keywords: continue. The right IJ line tip is in the right atrium. The patient is status post valve replacement. Degenerative changes are again seen in the right humeral head.

IMPRESSION: Decreased left effusion.


SubjectID: 12238304, StudyID: 50464162, Comparison: None

FINAL REPORT

PORTABLE UPRIGHT CHEST, ___.

COMPARISON: ___ radiograph.

FINDINGS: Interval increase in opacification of the left hemithorax with only a small amount of residual aerated lung in the left upper lobe. This appears to be due to a combination of partial left lung collapse and enlarging left pleural effusion which appears partially loculated. These findings were communicated by phone with Dr. ___ ___:30 a.m. on ___ at time of discovery. Small right pleural effusion and adjacent basilar atelectasis are unchanged.


SubjectID: 12245786, StudyID: 57451074, Comparison: 0.0

FINAL REPORT

HISTORY: Shortness of breath.

COMPARISON: Chest radiograph from ___.

FINDINGS: There is little interval change in comparison prior study from ___   Keywords: little interval change. Again noted is mild pulmonary vascular congestion   Keywords: again. Moderate cardiomegaly is stable. Mild right basilar opacities are again noted and appear relatively improved in comparison to the prior study. Otherwise, the lungs are without a new focal consolidation, effusion, or pneumothorax. Atherosclerotic calcifications are again noted at the aortic arch.

IMPRESSION: Moderate cardiomegaly and mild pulmonary edema appear unchanged   Keywords: unchanged. Bibasilar opacities have improved in comparison to the prior study from ___   Keywords: improve.


SubjectID: 12245786, StudyID: 53089796, Comparison: better

FINAL REPORT

STUDY: PA and lateral chest ___. CLINICAL

HISTORY: ___-year-old man with decreased temperature and shortness of breath.

FINDINGS: Comparison is made to prior study from ___. Heart size is enlarged but stable. There is some tortuosity of the thoracic aorta. There has been improvement of the pulmonary interstitial edema since the previous study   Keywords: improve. No focal consolidations are seen. There is some atelectasis at the right base. There are no pneumothoraces.


SubjectID: 12248852, StudyID: 56201167, Comparison: None

FINAL REPORT

EXAM: CHEST, FRONTAL AND LATERAL VIEWS. CLINICAL INFORMATION: Orthopnea, shortness of breath, cough.

COMPARISON: ___ earlier the same date at 12:58.

FINDINGS: There are small bilateral pleural effusions. Prominence of the central vasculature is also seen. The cardiac silhouette is top normal to mildly enlarge. The combination of the above raises concern for CHF. There is also subtle opacity in the retrocardiac region which may relate to prominent vasculature, but in the appropriate clinical setting, underlying consolidation cannot be excluded.


SubjectID: 12248852, StudyID: 54931364, Comparison: worse

WET READ: ___ ___ ___ 7:14 PM Markedly diminished lung volumes compared to yesterday. Mild pulmonary edema may have worsened from yesterday but at least some of the increased diffuse opacity is related to the lower lung volumes. Retrocardiac opacity appears increased, at least in part due to a left pleural effusion.

WET READ VERSION #1

WET READ VERSION #2 ___ ___ ___ 7:13 PM Markedly diminished lung volumes compared to yesterday. Mild pulmonary edema may have worsened from yesterday but at least some of the increased diffuse opacity is related to the lower lung volumes. Retrocardiac opacity appears increased, which may reflect atelectasis or pneumonia in the appropriate clinical setting. ______________________________________________________________________________

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with shortness of breath, ejection fraction of 35%, fluid overload?

COMPARISON: ___ through ___.

FINDINGS: The lung volumes are lower; moderate interstitial edema is new   Keywords: new. Possible small overlying pleural effusion. There is no pneumothorax. Cardiac contour is top normal.

CONCLUSION: New moderate interstitial edema   Keywords: new.


SubjectID: 12250544, StudyID: 55598529, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with recent TAVR, length of stay positive, wish to assess interval change in lung fields // interval change in pulmonary edema, other pathology

TECHNIQUE: Portable AP film was obtained

COMPARISON: ___

FINDINGS: The entire lung fields not included there remains extensive retrocardiac opacity in the left base. There is mild pulmonary edema and atelectasis. The patient has had a aortic repair.

IMPRESSION: Improvement in pulmonary edema   Keywords: improve. No additional finding incomplete imaging of the left lung


SubjectID: 12250544, StudyID: 53630751, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with severe AS s/p TAVR, intubated, right IJ temp pacing wire. // Please evaluate ET tube placement, temp pacing wires

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: There is interval placement of the transcatheter aortic valve which appears to be in expected position. Permanent pacemaker lead terminates in the expected location of the right ventricle. NG tube tip is in the stomach. ET tube tip is 3 cm above the carinal There is substantial pulmonary edema. There is no pneumothorax. Left pleural effusion is most likely present associated with atelectasis.


SubjectID: 12251429, StudyID: 59448933, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with acute dyspnea, tachypnea // Assess for worsening volume overload

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The lung volumes remain low and there is evidence of mild to moderate pulmonary edema. Moderate cardiomegaly. No pleural effusions. Minimal atelectasis at the right lung bases. No pneumothorax. The Dobbhoff catheter is in unchanged position.


SubjectID: 12251429, StudyID: 58828724, Comparison: worse

FINAL REPORT

INDICATION: ___ year old woman with end stage liver disease requiring tube feeds, new Dobbhoff tube placement.

TECHNIQUE: Portable chest radiograph.

COMPARISON: Chest radiographs from ___ through ___

FINDINGS: AP portable view of the chest shows a Dobbhoff tube ending in the stomach. Lung volumes are slightly lower. There has been interval increase of vascular congestion and mild to moderate pulmonary edema   Keywords: increase. There are no large pleural effusions. There is no pneumothorax. Cardiomediastinal silhouette is unchanged.

IMPRESSION: Dobbhoff tube ends in the stomach. Mild to moderate pulmonary edema.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 9:45 AM, 20 minutes after discovery of the findings.


SubjectID: 12251429, StudyID: 53120612, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with R tunneled line placement.

TECHNIQUE: Portable chest radiograph.

COMPARISON: Chest radiographs from ___ through ___.

FINDINGS: A portable view of the chest shows a new tunneled catheter ending at the inferior cavoatrial junction. There is a question of a small right apical pneumothorax. Lung volumes are low with mild to moderate pulmonary edema. Moderate cardiomegaly is unchanged. There is no definite pleural effusion. A Dobbhoff ends in the stomach.

IMPRESSION: Right tunneled catheter ends at the inferior cavoatrial junction. Possible tiny right apical pneumothorax.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 4:31 PM, 15 minutes after discovery of the findings.


SubjectID: 12251429, StudyID: 58004243, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with cirrhosis and renal failure // NG tube placement

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the Dobbhoff catheter was repositioned. The course of the catheter is unremarkable, the tip of the catheter projects over the middle parts of the stomach. Unchanged right mm slices catheter. Mild to moderate signs of fluid overload. Tips in situ. Otherwise unchanged appearance of the upper abdomen   Keywords: unchanged appearance.


SubjectID: 12251429, StudyID: 57855396, Comparison: None

FINAL REPORT

INDICATION: Cirrhosis and renal failure. NG tube placement.

COMPARISON: ___.

FINDINGS: Portable frontal radiograph of the chest demonstrates a weighted feeding tube with tip in the stomach. A right subclavian catheter ends in the right atrium. A TIPS stent is in unchanged position in the right upper quadrant. Stable mild enlargement of the cardiac silhouette with mild pulmonary edema. No large pleural effusion or pneumothorax.


SubjectID: 12251429, StudyID: 51953863, Comparison: same

FINAL REPORT

INDICATION: HCV/NASH cirrhosis complicated by a diuretic refractory ascites admitted to the MICU with hypercarbic respiratory arrest post extubation after her elective TIPS. Now with dyspnea. Evaluate worsening edema versus pneumonia.

COMPARISON: ___.

FINDINGS: Portable frontal radiograph of the chest demonstrates an enteric tube passing below the diaphragm with the tip out of view at the inferior aspect of the image. A right subclavian catheter is in unchanged position ending in the right atrium. Mild enlargement of the cardiac silhouette with mild pulmonary edema is unchanged   Keywords: unchanged. No pleural effusion or pneumothorax. Old posterior right rib fracture is again noted.


SubjectID: 12251429, StudyID: 53960229, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST FILM ___ AT 853 CLINICAL

INDICATION: ___-year-old with chronic cough, evaluation for infection or other cause. Comparison is made to the patient's prior study of ___. PA and lateral views of the chest ___ at 853 are submitted.

IMPRESSION: 1. Overall cardiac and mediastinal contours are stable. Lung volumes remain somewhat diminished, and there is a slight elevation of the left hemidiaphragm of uncertain significance. A nodular opacity in the right hemithorax involving the right seventh posterolateral rib likely represents callus formation related to a remote fracture. No focal airspace consolidation is seen to suggest pneumonia. No pleural effusions, pulmonary edema or pneumothorax. Degenerative changes in the mid thoracic spine. No acute bony abnormality appreciated. Clips in the right upper quadrant consistent with prior cholecystectomy. Narrowing of the right acromiohumeral distance suggests prior rotator cuff injury.


SubjectID: 12251429, StudyID: 53019034, Comparison: None

FINAL REPORT

HISTORY: Ascites, cirrhosis, cough, adrenal insufficiency.

TECHNIQUE: PA and lateral views of the chest.

COMPARISON: ___.

FINDINGS: Heart size is normal. The aorta remains tortuous with mild atherosclerotic calcifications. The pulmonary vasculature normal. Hilar contours are unremarkable. Lungs are clear. No pleural effusion or pneumothorax is seen. There are mild multilevel degenerative changes in the thoracic spine. Clips from prior cholecystectomy are seen in the right upper quadrant. Remote right posterior rib fracture is seen.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 12254325, StudyID: 59210484, Comparison: same

FINAL REPORT

EXAMINATION: Portable AP chest radiograph

INDICATION: ___ year old man with heart failure exacerbation // Any evidence of pulmonary edema?

COMPARISON: Chest radiographs dated ___ and ___.

FINDINGS: Lung volumes are slow but improved. Moderate-to-severe cardiomegaly persists. Blunting of the costophrenic angles, worse on the right, suggests persistent layering small pleural effusions. Pulmonary vascular congestion but no pulmonary edema.

IMPRESSION: Slightly improved lung volumes; otherwise no significant interval change   Keywords: no significant interval change. No pulmonary edema.


SubjectID: 12254325, StudyID: 54356283, Comparison: same

FINAL REPORT

EXAMINATION: Portable AP chest radiograph

INDICATION: ___ year old man with decompensated CHF // eval for interval change in pulm edema

COMPARISON: Chest radiograph dated ___ and ___.

FINDINGS: The patient is rotated. Probably overall not a significant interval change when accounting for differences in patient position and imaging technique. Slightly hazy opacification of the lower lungs bilaterally is likely secondary to dependent small pleural effusions on this semi erect film. Moderate to severe cardiomegaly persists and is overall unchanged. Pulmonary vascular congestion is probably also overall unchanged   Keywords: unchanged. Pulmonary edema is minimal if any, and likely dependent if present. No pneumothorax.

IMPRESSION: No significant interval change   Keywords: no significant interval change.


SubjectID: 12263025, StudyID: 52437258, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with ESRD now with hypoxia. Evidence of effusion/flash edema.

TECHNIQUE: AP portable chest radiograph

COMPARISON: Chest radiographs from ___, ___, ___. Chest CT from ___.

FINDINGS: Compared to prior, the lung volumes have decreased, accentuating the heart size and interstitial markings. Mild perihilar opacities and more conspicuous upper pulmonary vasculature may indicate mild pulmonary edema. Bibasilar atelectasis is likely, right worse than left. Small right pleural effusion is also likely. The heart is enlarged.

IMPRESSION: 1. Bibasilar atelectasis, right worse than left with small right pleural effusion. 2. Mild pulmonary edema.


SubjectID: 12263025, StudyID: 52002319, Comparison: None

FINAL REPORT

INDICATION: History: ___F with chest pain // please evaluate for acute intrathoracic process

TECHNIQUE: Portable semi-upright AP chest

COMPARISON: Chest radiographs ___ through ___

FINDINGS: The patient is rightward rotated limiting evaluation. The lungs are normally expanded and clear. Heart size is likely within normal limits. There is no pleural effusion or pneumothorax. Mild atelectasis in the right base is slightly improved. Atelectasis at the left base is minimal.

IMPRESSION: No acute cardiopulmonary abnormality.Mild bibasilar atelectasis.


SubjectID: 12270337, StudyID: 56525748, Comparison: None

FINAL REPORT

HISTORY: Shortness of breath.

FINDINGS: In comparison with the earlier study of this date, there is still vague opacification posteriorly that could represent an early consolidation. Remainder of the study is unchanged.


SubjectID: 12270337, StudyID: 54436978, Comparison: None

FINAL REPORT

INDICATION: ___-year-old woman with asthma and dyspnea. Evaluate for pneumonia.

COMPARISON: ___.

FINDINGS: Frontal and lateral views of the chest were obtained. The lungs are mildly hyperexpanded. Slightly increased density over the inferior spine on the lateral view without correlate on the frontal view may represent atelectasis, but early or developing infection cannot be excluded. No pleural effusion or pneumothorax. Heart size is normal. Mediastinal silhouette and hilar contours are normal.

IMPRESSION: Mildly increased opacity projecting over the spine on the lateral view may represent early or developing infection in the appropriate clinical setting.


SubjectID: 12279260, StudyID: 59786531, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with HTN, HLD and recent HCAP s/p treatment that finished ___ as well as recent ruptured appendix s/p antibiotics that finished ___, admitted for ? pneumonia/SIRS now transferred to the ICU with hypoxic respiratory failure and new atrial fibrillation with RVR // eval for interval change eval for interval change

IMPRESSION: In comparison with the study ___, there is little overall change   Keywords: little overall change. Again there is enlargement of the cardiac silhouette with evidence of pulmonary vascular congestion. Opacification at the left base is consistent with volume loss in the left lower lobe and pleural effusion. Granulomatous changes are again noted.


SubjectID: 12279260, StudyID: 59443153, Comparison: None

WET READ: ___ ___ ___ 11:32 PM Slightly increased pulmonary congestion compared to the prior study, but no overt edema or evidence of pneumonia. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with dyspnea, tachycardia, oxygen desaturation // Evaluate for pneumonia, pulmonary edema

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: The patient has been extubated. There is substantial cardiomegaly, unchanged. The NG tube has been discontinued. There is mild improvement of perihilar vascular opacities but still present left lower lobe retrocardiac consolidation. There is no pneumothorax.


SubjectID: 12279260, StudyID: 58069510, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hypoxic respiratory failure // Evaluate for interval change

TECHNIQUE: CHEST (PORTABLE AP)

FINDINGS: Heart size is enlarged, unchanged. Mediastinum is stable. Pleural calcifications, a left upper lobe calcified granulomas and mild vascular congestion is are unchanged   Keywords: unchanged   Keywords: unchanged

IMPRESSION: Heart size is enlarged, unchanged. Mediastinum is stable. Pleural calcifications, a left upper lobe calcified granulomas and mild vascular congestion is are unchanged


SubjectID: 12279260, StudyID: 56197960, Comparison: same

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old man with HCAP/aspiration PNA s/p dobhoff placement // Dobhoff placement

TECHNIQUE: Portable chest radiograph

COMPARISON: Chest x-ray ___

FINDINGS: Since the prior radiograph, there has been interval placement of a Dobbhoff tube that terminates in a branch of the right bronchial tree. There are no other significant changes   Keywords: no other significant change. Left retrocardiac opacity is likely due to pleural effusion with adjacent atelectasis, but there may also be residual consolidation from recent pneumonia. No pneumothorax. Stable cardiomegaly.

IMPRESSION: Interval placement of a Dobbhoff tube that terminates in a branch of the right bronchial tree.

NOTIFICATION: At the time that this radiograph was read, the malpositioned dobhoff tube had already been repositioned. Please see subsequent CXR report.


SubjectID: 12279260, StudyID: 52295627, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with respiratory failure // eval of interval change

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: ET tube tip is 6.4 cm above the carinal. The NG tube tip is in the stomach. Heart size and mediastinum are stable in appearance. There is progression of the left retrocardiac opacity concerning for interval development of left lower lobe atelectasis. There is also right basal opacity that is concerning for aspiration. Mild vascular congestion is present. There is no change in the evidence of left upper and right upper lung prior granulomatous exposure   Keywords: no change. Small amount of pleural effusion is present. Calcified pleural plaques are noted in the right lower pleura


SubjectID: 12279260, StudyID: 51003583, Comparison: same

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old man with HCAP/aspiration s/p dobhoff placement // Assess dobhoff placement

TECHNIQUE: Portable chest radiograph

COMPARISON: Chest x-ray ___ at 08:31

FINDINGS: Since the prior radiograph performed approximately ___ min earlier, the Dobbhoff tube has been repositioned and now terminates in the stomach. Otherwise, there are no significant changes   Keywords: no significant change. Persistent mild interstitial edema   Keywords: persistent. There is opacification of the left lung base, attributable to a small to moderate pleural effusion as well as adjacent atelectasis. No pneumothorax. Stable cardiomegaly.

IMPRESSION: 1. The Dobbhoff tube has been repositioned, and now terminates in the stomach. 2. Mild interstitial edema.


SubjectID: 12279260, StudyID: 57385955, Comparison: None

FINAL REPORT

INDICATION: History of fever, cough. Please evaluate for pneumonia.

COMPARISONS: Chest radiograph from ___.

TECHNIQUE: AP and lateral radiographs of the chest.

FINDINGS: Moderate cardiomegaly has been stable compared to exams dated back to at least ___. There has been mild interval increase in retrocardiac opacity compared to the most recent prior exam from ___. Small bilateral pleural effusions are persistent. Mild vascular plethora noted. Plate-like atelectasis is seen at the mid right lung. Calcified granulomas, as well as a calcified left hilar node, are redemonstrated. There is no evidence of a pneumothorax. The visualized osseous structures are grossly unremarkable.

IMPRESSION: 1. Interval increase in consolidation in the retrocardiac region is concerning for pneumonia. 2. Persistent small bilateral pleural effusions.


SubjectID: 12279260, StudyID: 50734530, Comparison: same

FINAL REPORT

HISTORY: Respiratory failure, getting intubated, check tube position. CHEST, SINGLE AP PORTABLE VIEW

COMPARISON: Chest x-rays from ___ at 23:44 p.m. Compared with the prior film, the patient has been intubated. The ET tube tip lies at the lower edge of the midclavicular heads, approximately 5.6 cm above the carina. Enlarged cardiac silhouette is again noted. There is upper zone redistribution and diffuse vascular blurring, consistent with CHF and interstitial edema. There is increased retrocardiac density, consistent with left lower lobe collapse and/or consolidation, though this appears slightly improved compared with the prior film. Bibasilar atelectasis is present. No gross effusion is detected on either side, though the extreme right costophrenic angle is excluded from the film. Incidental note is made of bilateral left greater than right apical pleural thickening and calcification along the right hemidiaphragm. Calcified left hilar node and calcified left granuloma are noted. Additional calcified granuloma may be present in the right upper zone as well. A rounded density overlies the right upper quadrant of the abdomen -- ? large calcified gallstone. (This is in keeping with a finding on the ___ abdominal CT.)

IMPRESSION: 1. ET tube tip at lower edge of midclavicular heads, approximately 5.6 cm above the carina. 2. Cardiomegaly and CHF, similar to the prior study   Keywords: similar. 3. Left lower lobe collapse and/or consolidation, slightly improved.


SubjectID: 12279260, StudyID: 59317536, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (AP AND LAT)

INDICATION: History: ___M with weakness, fever // Eval for PNA

TECHNIQUE: Chest AP and lateral

COMPARISON: ___

FINDINGS: Heart size is normal. Calcified left hilar lymph node and calcified nodule in the left mid lung field are unchanged, compatible with prior granulomatous disease. Aortic knob calcifications are present. The mediastinal and hilar contours are otherwise unremarkable. Pulmonary vasculature is not engorged. Right basilar and left lateral pleural calcifications are present suggestive of prior asbestos exposure. No focal consolidation, pleural effusion or pneumothorax is seen. Patchy opacities in the lung bases likely reflect atelectasis. There are mild degenerative changes in the thoracic spine.

IMPRESSION: Mild atelectasis at the lung bases. No focal consolidation to suggest pneumonia.


SubjectID: 12279260, StudyID: 52981651, Comparison: None

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: ___M here w/perforated appendicitis also with cough // any cardiopulmonary process

TECHNIQUE: Chest Frontal and Lateral

COMPARISON: ___

FINDINGS: Calcified a rounded nodular opacities projecting over the left mid lung are most consistent with calcified granuloma is, also seen on prior study. Left hilar calcified lymph node also suggest prior granulomatous disease. There may be punctate right-sided calcified granulomas as well. The cardiac and mediastinal silhouettes are stable. Right diaphragmatic pleural linear calcifications are better appreciated on the prior study. No pneumothorax is seen. Mild right basilar atelectasis. Slight blunting of the left costophrenic angle may be due to overlying soft tissue however a very trace pleural effusion is not excluded.

IMPRESSION: Bibasilar atelectasis without definite focal consolidation. Slight blunting of the left costophrenic angle, trace effusion not excluded.


SubjectID: 12279260, StudyID: 57913593, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with worsening hypoxia, tachypnea. // evaluate for pulmonary edema

TECHNIQUE: Single frontal view of the chest

COMPARISON: Study performed 9 hours earlier

IMPRESSION: Dobhoff tube has been removed. Worsening right lower lobe opacities are worrisome for aspiration. . No other interval change from prior study   Keywords: no other interval change.


SubjectID: 12279260, StudyID: 56498696, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with aspiration risk. // Dobhoff placement

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Dobhoff tube tip isin the mid esophagus. No other interval change from prior study   Keywords: no other interval change.


SubjectID: 12279260, StudyID: 51926111, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with chronic aspiration and CHF with desat overnight // Assess for aspiration/new infiltrate vs. pulm edema

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: As compared to the prior study there has been interval progression of pulmonary edema, still interstitial, moderate associated with large bilateral pleural effusions   Keywords: progression. Cardiomegaly is substantial. NG tube tip has been removed.


SubjectID: 12279260, StudyID: 51768656, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with aspiration PNA and afib w/ RVR c/b CHF. // Dobhoff tube placement

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: The last image demonstrates Dobbhoff tube being in the stomach. Heart size and mediastinum are stable. Left pleural effusion is moderate to large. Small right pleural effusion is most likely present. There is interval improvement of vascular congestion   Keywords: improve. Left basal atelectasis is unchanged.


SubjectID: 12279260, StudyID: 51573328, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with new intubation // Please confirm ET tube placement

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___ at 09:00

IMPRESSION: ET tube is in standard position. Improved opacities in the right mid lung are a combination of improving atelectasis, and redistribution of pleural effusion. There is improved aeration of the upper lobes. No other interval change from prior study   Keywords: no other interval change.


SubjectID: 12279787, StudyID: 59373560, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (AP AND LAT)

INDICATION: History: ___M with shortness of breath

TECHNIQUE: Upright AP and lateral views of the chest

COMPARISON: ___

FINDINGS: Lung volumes are low. Heart size is mildly enlarged, unchanged. Mediastinal contour is similar. Crowding of the bronchovascular structures is demonstrated with mild prominence of pulmonary vascular markings in the left lung, potentially suggestive of asymmetric mild pulmonary vascular congestion. Consolidative opacity in the left lung base is new in the interval. Patchy opacity in the right lung base is also noted. Small bilateral pleural effusions have developed. No pneumothorax is present. Cervical spinal fusion hardware is incompletely assessed. Mild to moderate multilevel degenerative changes are noted in the imaged thoracic spine. Elevation of the right hemidiaphragm is similar.

IMPRESSION: 1. New consolidative opacity in the left lung base, potentially atelectasis though infection or aspiration remain in the differential. 2. Small bilateral pleural effusions and right basilar atelectasis. 3. Mild asymmetric pulmonary vascular congestion.


SubjectID: 12279787, StudyID: 57330794, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with CHF, ?pneumonia vs. atelectasis on previous CXR // Please eval for interval change in L basilar pneumonia vs atelectasis

TECHNIQUE: Chest PA and lateral

COMPARISON: ___ 17:53

FINDINGS: The left linear opacities at left lung base are stable from ___ are most likely atelectasis. There is also right basilar atelectasis. There is mild pulmonary edema in the left lung which is unchanged   Keywords: unchanged. Small bilateral pleural effusions are unchanged. No pneumothorax or focal consolidation. Cardiac borders are indeterminate.There is right basilar atelectasis which is unchanged from ___.

IMPRESSION: Bibasilar atelectasis. No focal consolidation.


SubjectID: 12288757, StudyID: 59843337, Comparison: better

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___ radiograph.

FINDINGS: The patient is status post recent median sternotomy and mitral valve surgery. Stable marked cardiomegaly and slight decrease in postoperative widening of the mediastinum compared to the recent radiograph. Interval improvement in extent of pulmonary vascular congestion and perihilar edema   Keywords: improve. Persistent bibasilar atelectasis with improving bilateral pleural effusions, now small to moderate on the right and small on the left. No visible pneumothorax.


SubjectID: 12288757, StudyID: 52788011, Comparison: worse

FINAL REPORT

PORTABLE UPRIGHT CHEST, ___.

COMPARISON: ___ radiograph.

FINDINGS: Interval removal of indwelling support and monitoring devices with residual right internal jugular vascular sheath in place and no visible pneumothorax. Stable postoperative widening of cardiomediastinal contours, accompanied by worsening pulmonary vascular congestion, mild-to-moderate pulmonary edema, and enlarging moderate right pleural effusion   Keywords: worse. Bibasilar atelectasis is noted as well as a small left pleural effusion.


SubjectID: 12288757, StudyID: 57850401, Comparison: None

FINAL REPORT

HISTORY: Shortness of breath, to assess for CHF.

FINDINGS: In comparison with the study of ___, the right IJ catheter has been removed. There are low lung volumes with continued enlargement of the cardiac silhouette. The pulmonary vessels are difficult to assess on this study. Again there are substantial pleural effusions with bibasilar atelectatic changes in a patient with intact midline sternal wires after CABG procedure.


SubjectID: 12288757, StudyID: 50707773, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with NG tube placement // evaluate NG placement

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the patient has received a nasogastric tube. The tip of the tube is probably located in the 2 of the known and not included on the image. Moderate cardiomegaly and moderate pulmonary edema persist. No pneumothorax. Unchanged position of the left PICC line.


SubjectID: 12288757, StudyID: 50565562, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with SOB, incrasing white count, history of COPD and recent treatment for HCAP // Please evaluate for possible recrudescence of pneumonia

COMPARISON: ___

IMPRESSION: The lung volumes are normal. Status post sternotomy and valve replacement. Minimal fluid overload but no overt pulmonary edema. No evidence of pneumonia. The left PICC line has been slightly pulled back, the tip is now located at the level of the junction between brachiocephalic vein and superior vena cava.


SubjectID: 12294892, StudyID: 55341256, Comparison: None

WET READ: ___ ___ ___ 9:40 AM S/p Bi-V left pacemaker placement. No evidence of a pneumothorax.

WET READ VERSION #1 ___ ___ ___ 10:11 PM S/p Bi-V left pacemaker placement. No evidence of a pneumothorax. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___ year old man with CMP s/p biventricular pacemaker via left axillary vein. Evaluate for pneumothorax.

TECHNIQUE: Upright portable AP chest.

COMPARISON: Chest radiographs from ___, ___, ___.

FINDINGS: There has been interval placement of biventricular pacemaker with leads in expected location. However, the relationship with the ventricular walls cannot be appreciated in one view. Lung volumes are low, accentuating the cardiomediastinal silhouette and interstitial opacities. However, the heart is mildly enlarged.Mediastinal and hilar contours are unremarkable. There is no evidence for pulmonary edema, pulmonary consolidation, pleural effusion, or pneumothorax.Right-sided Port-A-Cath likely terminates in the low SVC.

IMPRESSION: No pneumothorax. Status post biventricular pacemaker with the leads in expected location.


SubjectID: 12294892, StudyID: 55079014, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with CMP s/p biventricular pacemaker via left axillary vein. Evaluate lead position, pneumothorax.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph from ___ at 19:19.

FINDINGS: Compare with a radiograph performed 14 hours prior, there is no appreciable change. Left-sided biventricular pacemaker appear unchanged in position. Heart size is within normal limits.Mediastinal and hilar contours are unremarkable. There is no evidence for pulmonary edema, pulmonary consolidation, pleural effusion, or pneumothorax.Cervical fixation screws and plates are seen. Right-sided Port-A-Cath is unchanged in position.

IMPRESSION: No pneumothorax.


SubjectID: 12305811, StudyID: 59791522, Comparison: better

FINAL REPORT

HISTORY: ___-year-old man with severe several community-acquired pneumonia. Evaluate for interval change.

TECHNIQUE: Portable AP single view chest x-ray in similar position.

COMPARISON: Exam is compared to chest x-ray of ___.

FINDINGS: The NG and ET tube have been removed. The right jugular catheter has been withdrawn few centimeter, but still ending in the upper SVC. Left axillary pacemaker is unchanged with leads following a standard course. Persistent consolidation of the right upper lobe and left lower lobe is for known pneumonia. There is an improvement of the right base opacification, mainly for reduced vascular congestion   Keywords: improve. Heart size is still moderately enlarged. There is no pneumothorax. Small pleural effusion on the left base.

IMPRESSION: Mild improvement of the right base ventilation, mainly for reduced pulmonary edema. NG and ET tube have been removed.


SubjectID: 12305811, StudyID: 57290094, Comparison: worse

FINAL REPORT

HISTORY: Sepsis, to assess for change.

FINDINGS: In comparison with the study of ___, the monitoring and support devices are essentially unchanged. The bilateral pulmonary opacifications have increased   Keywords: increase. Much of this could reflect pulmonary vascular congestion. Especially in view of the clinical history, multifocal pneumonia in the right mid and left lower zones should be seriously considered.


SubjectID: 12305811, StudyID: 52094908, Comparison: worse

FINAL REPORT

AP CHEST, 4:19 A.M., ___

HISTORY: An ___-year-old man with pneumonia after cardiac arrest.

IMPRESSION: AP chest compared to ___: Mild-to-moderate pulmonary edema has worsened, most easily appreciated in the perihilar left and right lower lungs   Keywords: worse. The large area of persistent consolidation in the right upper lobe and superior segment of the right lower lobe has not improved. Moderate-to-severe cardiomegaly is stable. Mediastinal vascular veins are not dilated. ET tube and upper enteric drainage tubes and transvenous right and left ventricular pacer leads are in standard placements. Small pleural effusions are presumed. There is no pneumothorax.


SubjectID: 12307889, StudyID: 57726280, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with of CAD s/p CABG s/p stents, CHF, HTN, early Alz dementia, HTN, HLD with hypoxia and new chest pain. // PNA vs. mediastinal widening.

TECHNIQUE: Plain film

COMPARISON: ___

FINDINGS: Portable upright study shows no interval widening or suspicious change and contours of the upper mediastinum. Taking into account AP technique, cardiac size is unchanged and no central pulmonary vascular congestion or focal parenchymal lung consolidation is seen   Keywords: unchanged. Small bilateral pleural effusions remain with slight increase on the right.

IMPRESSION: No suspicious change in mediastinal contours. Slight interval increase in small right pleural effusion.


SubjectID: 12307889, StudyID: 53460868, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH FROM ___

HISTORY: Dyspnea and upper back pain, rule out acute process.

TECHNIQUE: Frontal and lateral chest radiographs were obtained.

COMPARISON: None available.

FINDINGS: The patient is status post median sternotomy and likely CABG. The cardiac and mediastinal silhouette is unremarkable. The chest is hyperinflated. There are small bilateral pleural effusions as well as vague right lower lobe opacity, probably due to atelectasis. A mild interstitial abnormality mostly involves the lowre lungs and may be due to slight congestion or airway inflation. Mild bilateral pleural thickening is greater on the right left, possibly fluid, extrapleural fat or fibrous tissue.

IMPRESSION: Small suspected bilateral pleural effusions. Right basilar opacity, probably atelectasis. Mild non-specific interstitial abnormality.


SubjectID: 12326925, StudyID: 53212164, Comparison: None

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: ___ year old man with pleural effusion // evaluate pleural effusion

TECHNIQUE: Chest: Frontal and Lateral

COMPARISON: Chest radiographs from ___ and chest CT from ___.

FINDINGS: Compared to prior, there is new moderate left basal atelectasis with associated leftward shift due to volume a loss and small left pleural effusion. The evaluation of left heart border is difficult, but the heart size is likely normal. Mediastinal and hilar contours are unremarkable. The right lung is clear. There is no pneumothorax.

IMPRESSION: Interval development of small left pleural effusion and moderate left basilar atelectasis since ___.


SubjectID: 12326925, StudyID: 52210251, Comparison: None

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: ___ year old man with pleural effusion s/p L thoracentesis. Evaluate for PTX.

TECHNIQUE: Chest: Frontal and Lateral

COMPARISON: Chest radiographs from ___ at 09:12.

FINDINGS: There has been interval decrease in amount of left pleural effusion. There is residual left basal atelectasis, though improved compared to prior. There is no significant change in the right lung or the cardiomediastinal silhouette. There is no pneumothorax.

IMPRESSION: Interval decrease in left pleural effusion and atelectasis. No pneumothorax.


SubjectID: 12330397, StudyID: 59286227, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

TECHNIQUE: Single erect portable chest view was read in comparison with prior chest radiographs through ___ with the most recent from ___.

FINDINGS: Mild-to-moderate cardiomegaly, pulmonary interstitial edema and small bilateral pleural effusions suggestive of congestive heart failure changes is unchanged since ___   Keywords: unchanged. Concurrently associated pneumonia, however, cannot be ruled out, required attention on followup radiographs. Increased retrocardiac density reflects left lower lung atelectasis. Mediastinal and hilar contours have been stable. Aorta is generally tortuous but without evidence of aneurysmal widening.

IMPRESSION: Congestive heart failure changes and bilateral lower lung atelectasis unchanged since ___   Keywords: unchanged. Any element of concurrent pneumonia cannot be ruled out, should be followed up on the radiographs.


SubjectID: 12330397, StudyID: 58002831, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Shortness of breath felt to be secondary to right lower lobe pneumonia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there are newly appeared bilateral increases in interstitial markings   Keywords: increase, new. These are associated with increasing bilateral pleural effusions, fluid markings of the interlobar fissures, peribronchial cuffing, and Kerley B lines. Overall, the picture corresponds to moderate interstitial lung edema. The edematous changes are masking the pre-described right lower lobe pneumonia. Unchanged tortuosity of the thoracic aorta without evidence of aneurysmatic widening. At the time of dictation, the referring physician, ___. ___, was paged for notification (8:15 a.m., ___).


SubjectID: 12330397, StudyID: 56675244, Comparison: worse

FINAL REPORT

INDICATION: ___F with shortness of breath // acute process?

TECHNIQUE: Frontal lateral views the chest.

COMPARISON: ___.

FINDINGS: Increased interstitial markings are worse when compared to the prior   Keywords: worse, increase. There is slightly more dense opacity at the right lung base compared to prior. Severe cardiac enlargement is again noted. Densely calcified, tortuous thoracic aorta is unchanged. Left chest wall dual lead pacing device is in stable position. No acute osseous abnormalities.

IMPRESSION: Interstitial markings appear worse from prior suggesting component of interstitial edema   Keywords: worse. Right basilar opacity, potentially atelectasis given lower lung volumes although infection could be considered in the proper clinical setting.


SubjectID: 12330397, StudyID: 55229911, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___F with dyspnea consistent with CHF exacerbation, possible underlying pneumonia, evaluate.

TECHNIQUE: PA and lateral chest radiograph.

COMPARISON: Chest x-ray ___ at 15:10.

FINDINGS: Again seen is a left chest cardiac device with associated dual leads in grossly appropriate location. There is a tortuous and calcified thoracic aorta. Marked cardiac enlargement is stable. In comparison to prior radiograph, there is an improved inspiratory effort. Prominence of the interstitial markings is consistent with persistent pulmonary vascular congestion   Keywords: persistent. There is no overt pulmonary edema. The right lower lung is now clear. There is no focal lung consolidation elsewhere. There is no pneumothorax or pleural effusion.

IMPRESSION: 1. Stable moderate-to-severe cardiomegaly and pulmonary vascular congestion   Keywords: stable. 2. No focal lung consolidation.


SubjectID: 12350449, StudyID: 59684740, Comparison: None

FINAL REPORT

CLINICAL

HISTORY: ___-year-old woman with vomiting and dehydration. Evaluate for pneumonia.

COMPARISON: ___, ___ and ___.

FINDINGS: Frontal AP and lateral views of the chest were obtained. The lungs are hyperinflated, unchanged from the prior study. Mild atelectasis at the left lung base is noted. There is no focal consolidation, pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are stable with aortic knob calcifications and a mildly tortuous aorta. A small bulge in the descending thoracic aorta is unchanged since at least ___ and may represent a small anuerysm or focal dissection. Mild compression deformity in the mid thoracic spine is unchanged since ___. The patient is status post right mastectomy.

IMPRESSION: No pneumonia, effusion, or edema.


SubjectID: 12351481, StudyID: 59852608, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old male with congestive heart failure and COPD, presents with hypoxia and shortness of breath. Question fluid overload.

COMPARISON: ___.

FINDINGS: Single frontal view of the chest demonstrates interval increase of bilateral fluffy perihilar and infrahilar opacities as well as obscured and prominent cardiac silhouette, compatible with moderate congestive heart failure   Keywords: increase. There is persistent opacity involving the cardiophrenic angles. Supervening pneumonia and or aspiration cannot be excluded in the appropriate clinical setting. Small effusions cannot be excluded. There is no pneumothorax. Atherosclerotic calcifications are seen in the aortic arch.

IMPRESSION: 1. Findings compatible with moderate congestive heart failure, with interval worsening since ___   Keywords: worse. 2. Supervening lower lobe infection and/or aspiration cannot be excluded in the appropriate clinical setting.


SubjectID: 12351481, StudyID: 55446650, Comparison: better

FINAL REPORT

HISTORY: COPD with acute shortness of breath, likely CHF.

FINDINGS: In comparison with the study of ___, there is continued enlargement of the cardiac silhouette with decreasing pulmonary vascular congestion   Keywords: decreasing. Confluent lower lobe opacities are consistent with regions of pneumonia, especially at the right base. The endotracheal and nasogastric tubes have been removed.


SubjectID: 12351481, StudyID: 54158559, Comparison: -1.0

FINAL REPORT

INDICATION: ___-year-old male with new ET tube placement.

COMPARISON: ___.

FINDINGS: Single frontal view of the chest demonstrates interval intubation with ET tube terminating 3.5 cm above the carina. An enteric tube extends inferiorly out of view into the stomach. There is persistent perihilar vascular congestion with more confluent bilateral lower lobe opacities, which could represent congestive heart failure with pulmonary edema, although supervening infection or aspiration cannot be excluded   Keywords: persistent. Small pleural effusions may be present. Incidental note is made of bilateral glenohumeral degenerative disease.

IMPRESSION: 1. New ET tube in appropriate position without pneumothorax. 2. Slight interval worsenining of pulmonary edema and more confluent lower lobe opacities, raising question of supervening infection, particularly in the right lower lobe   Keywords: worse. Suggest follow-up to resolution following treatment to exclude underlying mass in the right lower lobe.


SubjectID: 12351481, StudyID: 59759024, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (AP AND LAT)

INDICATION: History: ___M with lethargy, hypoxia, low grade fever // pneumonia?

TECHNIQUE: Upright AP and lateral views of the chest

COMPARISON: Chest radiograph ___

FINDINGS: Heart size is mildly enlarged, unchanged. Mediastinal contour similar with tortuosity of the thoracic aorta again noted. Perihilar haziness with vascular indistinctness and increased interstitial opacities are compatible with moderate interstitial pulmonary edema, worse in the interval   Keywords: worse, increase. Small bilateral pleural effusions persist, not substantially changed. More focal patchy opacities in the lung bases may reflect areas of infection or aspiration. No pneumothorax is present. Degenerative changes are noted within both acromioclavicular joints as well as within the thoracic spine.

IMPRESSION: Worsening moderate interstitial pulmonary edema with similar appearance of small bilateral pleural effusions   Keywords: worse. More focal bibasilar airspace opacities could reflect infection or aspiration.


SubjectID: 12351481, StudyID: 54925075, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with HFpEF, COPD, asthma presented with lethargy being treated for HCAP now with increasing dyspnea and malaise. // Increasing dyspnea, history of CHF, question of volume overload or worsening pulmonary infilatrate Increasing dyspnea, history of CHF, question of volume overload or worsening pulmonary infilatrate

IMPRESSION: In comparison with the study ___ ___, there is little overall change   Keywords: little overall change. Again there is enlargement of the cardiac silhouette with pulmonary edema and bilateral pleural effusions with compressive basilar atelectasis. In the appropriate clinical setting, it again would be difficult to exclude superimposed pneumonia, especially in the absence of a lateral view.


SubjectID: 12351481, StudyID: 54730386, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF, COPD, hx frequent pneumonia presents w/ dyspnea, lethargy, r/o CHF, pneumonia, ?aspiration pneumonitis // Comparison to yesterday and prior CXR, correlation to clinical improvement Comparison to yesterday and prior CXR, correlation to clinical improvement

IMPRESSION: In comparison with the study ___ ___, there is little overall change   Keywords: little overall change. Again there is enlargement of the cardiac silhouette with pulmonary edema with bilateral pleural effusions and compressive basilar atelectasis. Given the clinical history an extensive pulmonary changes, it would be impossible to exclude superimposed pneumonia, especially in the absence of a lateral view.


SubjectID: 12351481, StudyID: 59741878, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with COPD and d CHF with cough and SOB c/w PNA // assess for infiltrate, interval change, effusion assess for infiltrate, interval change, effusion

IMPRESSION: In comparison with the study of ___, there is little overall change   Keywords: little overall change. Again there are bilateral pleural effusions, larger on the left and small to moderate on the right. Area of increased opacification is again seen in the left mid zone, worrisome for superimposed pneumonia. The prominence of pulmonary vascularity seen on the previous study is not definitely appreciated at this time, consistent with some improving pulmonary vascular congestion   Keywords: improving.


SubjectID: 12351481, StudyID: 58567256, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with sob // ?pna

TECHNIQUE: Portable AP Chest radiograph.

COMPARISON: Multiple prior exams most recently chest radiograph from ___

FINDINGS: There is a moderate-to-large left pleural effusion has increased since the previous exam. Again seen is a small right pleural effusion. There is new parenchymal opacity within the left upper lung zones concerning for pneumonia. Hazy opacity at the right lung base may represent layering pleural fluid however infection cannot be entirely excluded. The cardio mediastinal silhouette is unchanged. The aorta is tortuous.

IMPRESSION: 1. Moderate to large left pleural effusion increased since the prior exam. 2. New parenchymal opacity in the left upper lung zone concerning for pneumonia. Followup imaging after treatment is recommended. 3. Small right pleural effusion. Right lower lobe infection cannot be excluded.


SubjectID: 12351481, StudyID: 59363712, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with hypoxic // ? pna

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: There has been interval increase and moderate bilateral pleural effusions with overlying atelectasis. There has also been increasing and bilateral perihilar opacities was likely reflecting pulmonary edema, however, underlying infectious process is not excluded   Keywords: increasing. Cardiac silhouette is not accurately assessed due to the bibasilar opacities although grossly not larger than on the prior study. Mediastinal contours are unremarkable.

IMPRESSION: Interval increase in moderate bilateral pleural effusions with overlying atelectasis, underlying consolidation not excluded. Interval increase in perihilar opacities concerning for pulmonary edema although infectious process not excluded   Keywords: increase. Constellation of findings may be due to CHF in the appropriate clinical setting.


SubjectID: 12351481, StudyID: 59062293, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p thoracentesis oon ___ //

COMPARISON: Chest radiograph from ___.

FINDINGS: AP vie of the chest provided. Compared to prior study, there is interval increase in the amount of left pleural effusion. There is also new left basilar atelectasis, with slight ipsilateral mediastinal shift. Small amount of pleural effusion is seen on the right. Left-sided pleural drainage catheter is in unchanged position. There is no pneumothorax.

IMPRESSION: Increased left pleural effusion compared to prior study from 1 day ago.


SubjectID: 12351481, StudyID: 57594563, Comparison: None

FINAL REPORT

INDICATION: ___ year old man s/p thoracentesis // please assess for pneumothorax

TECHNIQUE: Portable frontal view of the chest.

COMPARISON: Multiple prior chest radiographs, the most recent of ___.

FINDINGS: A left chest tube has been placed and a small to moderate left pleural effusion has decreased in size compared to the chest radiograph performed 1 day prior. There is a small right pleural effusion. The previously seen right lower lobe opacity has improved. No pneumothorax is identified. The cardiac and mediastinal contours are stable.

IMPRESSION: Interval placement of a left chest tube and decrease in size of a small to moderate left pleural effusion. Improving right lower lobe opacity.


SubjectID: 12351481, StudyID: 51837677, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pleural effusion, worsening work of breathing, labored breathing worse than prior // r/o increase size pleural effusion

IMPRESSION: As compared to the recent radiograph from ___, but a moderate left and small right pleural effusion appear similar. Heterogeneous opacities persist in the left mid and right lower lung regions. More confluent opacity in left retrocardiac region is likely a combination of pleural effusion and adjacent atelectasis or consolidation.


SubjectID: 12351481, StudyID: 58314013, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with h/o MRSA PNA now admitted with fever and shortness of breath. // Please evaluate for PNA Please evaluate for PNA

IMPRESSION: Comparison to ___. The massive bilateral parenchymal opacities, documented on several previous chest x-rays, are stable in extent and severity   Keywords: stable. Neither the frontal nor the lateral radiograph reveals any presence of pleural effusions. Borderline size of the heart.


SubjectID: 12351481, StudyID: 55606199, Comparison: 0.0

WET READ: ___ ___ 10:29 PM Bilateral patchy opacities are not significantly changed from ___   Keywords: not significantly changed. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: Chest radiograph.

INDICATION: ___M with fever sob // eval for PNA

TECHNIQUE: Single AP view

COMPARISON: Chest radiograph ___

FINDINGS: Bilateral patchy opacities worse in the midlung zone   Keywords: worse. Lung based opacity are not significantly changed from ___, most confluent in the retrocardiac region. The cardiomediastinal silhouette is unchanged. No evidence of pneumothorax.

IMPRESSION: Bilateral patchy opacities are not significantly changed from ___.


SubjectID: 12351481, StudyID: 56930084, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with R PICC malpositioned // R PICC repo attempt, puleed back 1cm and ___ ___ ___

TECHNIQUE: Single portable. AP semi upright view of the chest.

COMPARISON: Multiple prior chest radiographs, most recently ___

FINDINGS: In comparison to the most recent radiograph, there is interval repositioning of the right PICC which now terminates in the upper SVC. Extensive heterogeneous bilateral lower lung consolidations persist. Small bilateral pleural effusions are unchanged. No pneumothorax.

IMPRESSION: 1. Interval repositioning of the right PICC, terminating in the upper SVC. 2. Persistent extensive heterogeneous bilateral lower lung consolidations. 3. Unchanged small bilateral pleural effusions.


SubjectID: 12351481, StudyID: 52257247, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with aspiration PNA, COPD, now w/ worsening hypoxia // hypoxia hypoxia

IMPRESSION: In comparison with the study of ___, there is continued substantial enlargement of the cardiac silhouette with pulmonary vascular congestion. The bilateral pleural effusions have increased, as has the substantial volume loss in the left lower lobe.


SubjectID: 12351481, StudyID: 56714692, Comparison: better

FINAL REPORT

INDICATION: History of COPD, congestive heart failure, and recent pneumonia presenting with dyspnea. Evaluate for pneumonia.

TECHNIQUE: AP and lateral views of the chest.

COMPARISON: Chest radiograph from ___. Chest radiograph from ___. CT of the chest from ___.

FINDINGS: Since the prior radiograph at the end of ___, there is been an interval increase in the size of the small right pleural effusion which is layering laterally and into the fissure. An opacity at the right base has also increased, and may represent pneumonia or rounded atelectasis. The moderate left pleural effusion and left basilar atelectasis are not significantly changed. The spiculated lesion seen on the prior CT in the left upper lobe is not appreciated on today's radiograph. The previously identified vascular congestion has improved   Keywords: improve. There is no pneumothorax. Mild enlargement of the cardiac silhouette is unchanged. The mediastinal contours are normal.

IMPRESSION: 1. Right pleural effusion and right basilar opacity have increased since the end of ___. The opacity may represent pneumonia. Alternatively, this could represent rounded atelectasis adjacent to the effusion. Clinical correlation is recommended. 2. Unchanged left pleural effusion and left basilar atelectasis. 3. Interval improvement in the vascular congestion since the radiograph from two days ago   Keywords: improve.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 11:28 AM, 2 minutes after discovery of the findings.


SubjectID: 12351481, StudyID: 51497101, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___M with dyspnea // acute process?

COMPARISON: Chest radiograph from ___ and CT chest from ___.

FINDINGS: PA and lateral views of the chest provided. Persistent bilateral pleural effusions are seen, moderate to large on the left and small on the right, unchanged with associated compressive lower lobe atelectasis. Scattered opacities in the left upper lung and right lower lung remain concerning for pneumonia. Mild edema difficult to exclude. Heart size cannot be assessed. No pneumothorax. Bony structures intact.

IMPRESSION: No significant change with bilateral pleural effusions and scattered opacities concerning for pneumonia. Probable mild edema.


SubjectID: 12351481, StudyID: 55709195, Comparison: None

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPHS

INDICATION: Dyspnea.

TECHNIQUE: Chest, AP upright and lateral.

COMPARISON: Radiographs from ___ and CT from ___.

FINDINGS: There is a a perhaps very mildly decreased moderate to large left-sided pleural effusion with presumed atelectasis of parts of the lingula and left lower lobe, noting mild leftward shift suggesting volume loss. Small pleural effusion or pleural thickening on the right appears unchanged with opacities at the right lung base suggestive of chronic unchanged round atelectasis. Irregular pulmonary architecture suggest emphysema.

IMPRESSION: Persistent pleural effusions. Emphysema. Heterogeneous opacity seen on the prior chest CT in the left upper lobe is not well assessed, difficult to see on radiographs, so it is not possibly to exclude whether is may persist. Short-term follow-up chest CT is recommended to reassess. Findings and recommendations discussed with Dr. ___ at 12:30 am on ___ by telephone.


SubjectID: 12351481, StudyID: 53945638, Comparison: worse

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___-year-old man with recent pneumonia with worsening confusion and weakness, evaluate for pneumonia

TECHNIQUE: AP and lateral view

COMPARISON: Chest radiograph ___ and ___.

FINDINGS: Compared to prior, there has been worsening bibasilar opacities   Keywords: worse. Small pleural effusions are again seen, worse on the left. Cardiomediastinal silhouette is unchanged. There is no pneumothorax.

IMPRESSION: Worsening bibasilar opacities, findings concerning for worsening infection and/or aspiration. Small bilateral pleural effusions, increased on the left.


SubjectID: 12351481, StudyID: 51957440, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (AP AND LAT)

INDICATION: ___M with sob. recent admit // eval for pna

COMPARISON: Prior study dated ___. Chest CT from ___.

FINDINGS: AP upright and lateral views of the chest provided. Persistent perihilar and lower lung opacities are noted with slight improvement compared with prior recent exam could reflect persistent pneumonia. Small pleural effusions are also present. No pneumothorax. Heart size is unchanged. Mild edema difficult to exclude. Patient is known to have severe emphysema. Bony structures are intact.

IMPRESSION: Persistent lower lung and perihilar opacities remain concerning for pneumonia with slight improvement from prior recent exam. Small bilateral pleural effusions. Recommend followup to resolution.


SubjectID: 12351481, StudyID: 53187849, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p chest tube with increased O2 req and tachypnea // acute process, interval change acute process, interval change

IMPRESSION: As compared to the previous image, the right pigtail catheter has been removed from the pleural space. The small lateral and basal pneumothorax persists at the site of tube insertion. The lung volumes have slightly decreased, increasing the areas of atelectasis. Moderate cardiomegaly. Mild pulmonary edema is unchanged   Keywords: unchanged.


SubjectID: 12351481, StudyID: 51069432, Comparison: None

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: History: ___M with productive cough // cough

TECHNIQUE: Chest: Frontal and Lateral

COMPARISON: ___

FINDINGS: There is persistent partial left lower lobe collapse. Left perihilar opacity is similar. There has been interval increase and opacity along the lateral right mid to lower lung suggesting a moderate to large pleural effusion, which may be partially loculated. Medial right base opacity may be due to atelectasis, infection, or aspiration. There is likely component of underlying a mild to moderate pulmonary edema. The cardiac and mediastinal silhouettes are grossly stable.

IMPRESSION: Increased opacity along the lateral right mid to lower hemi thorax most likely moderate to large pleural effusion which may be partially loculated. Medial right base opacity may be due to atelectasis, infection, or aspiration. Also likely underlying mild to moderate pulmonary edema. Persistent left lower lobe volume loss.


SubjectID: 12363835, StudyID: 58917920, Comparison: worse

FINAL REPORT

HISTORY: Shortness of breath, history of CHF off Lasix.

TECHNIQUE: Frontal and lateral views of the chest.

COMPARISON: Earlier today, ___ at 12:15.

FINDINGS: The cardiac and mediastinal silhouettes are stable. The cardiac silhouette remains enlarged. The aortic knob is calcified. There is moderate pulmonary edema, increased since the prior study   Keywords: increase. There is persistent blunting of the right costophrenic angle which may be due to a small pleural effusion. No pneumothorax is seen.

IMPRESSION: Moderate pulmonary edema appears increased since the prior study 2 hours prior   Keywords: increase.


SubjectID: 12363835, StudyID: 53376507, Comparison: better

FINAL REPORT

INDICATION: Shortness of breath.

COMPARISON: ___ chest radiograph. PA AND LATERAL CHEST RADIOGRAPHS: The cardiomediastinal and hilar contours are stable, with moderate cardiomegaly. Mild pulmonary edema has improved since the prior study. Small right pleural effusion is stable. No consolidation or pneumothorax is seen.

IMPRESSION: Stable cardiomegaly. Improved mild pulmonary edema   Keywords: improve.


SubjectID: 12363835, StudyID: 54303351, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF, s/p thoracentesis and chest tube. Slight reaccumulation of fluid. // interval change in pleural effusion

IMPRESSION: Since ___, a moderate sized right pleural effusion has slightly increased in size. Moderate right pneumothorax with apical and basilar components is unchanged, and the remainder of exam is unchanged as well.


SubjectID: 12363835, StudyID: 51086318, Comparison: 1.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with right pleural effusion s/p thoracentesis and chest tube placement and removed. With increase in pleural effusion today. // worsening of right pleural effusion

IMPRESSION: As compared to ___, moderate right pneumothorax with apical and basilar components is similar. Moderate right pleural effusion has slightly increased in size, however. Persistent pulmonary vascular congestion but slight improvement in interstitial edema   Keywords: improve. No other relevant changes since recent exam   Keywords: no other relevant change.


SubjectID: 12376118, StudyID: 59827811, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with hypoxia // ?pna, pulm edema

COMPARISON: ___.

FINDINGS: AP portable upright view of the chest. Lung volumes are markedly low limiting assessment. An AICD is again seen with leads extending to the expected region of the right arm and right ventricle. Cardiomegaly appears grossly unchanged. A rounded calcified density projecting over the left chest wall likely represents a calcified breast implant. Subtle opacity at the right lung base appear slightly more conspicuous than on prior, may represent atelectasis, though pneumonia cannot be excluded in the correct clinical context. Bronchovascular crowding likely accounts for perihilar opacities as these appear unchanged from prior   Keywords: unchanged. No large effusion or pneumothorax is seen. Mediastinal contour is stable with calcified thoracic aorta. Imaged osseous structures appear intact.

IMPRESSION: Subtle opacity at the right lung base, more conspicuous than on prior, question atelectasis versus pneumonia.


SubjectID: 12376118, StudyID: 57679145, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with respiratory failure // eval for interval change

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen, except for a small right pleural effusion that might have developed in the interval. Moderate cardiomegaly and retrocardiac atelectasis persists. No overt pulmonary edema. Low lung volumes. Unchanged course and position of the pacemaker leads.


SubjectID: 12376118, StudyID: 56029007, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with respiratory failure of unclear etiology, HCAP vs aspiration vs CHF // Eval for clinical change

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, there is unchanged low position of the endotracheal tube, that needs to be corrected. The tube needs to be withdrawn by about 2 cm, to avoid Ms. ___ of the right main bronchus. The course of the nasogastric tube is unchanged. Unchanged very low lung volumes. Retrocardiac and right basilar atelectasis as well as unchanged mild to moderate pulmonary edema   Keywords: unchanged.


SubjectID: 12376118, StudyID: 53928084, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with HCAP s/p adjustment of ET tube // check ET tube placement

COMPARISON: ___, 04:04

IMPRESSION: As compared to the previous radiograph, the endotracheal tube has been pulled back. The tube now projects approximately 2.5 cm above the carinal. The lung volumes remain low. Moderate cardiomegaly and mild fluid overload persist. No larger pleural effusions. Retrocardiac atelectasis is unchanged.


SubjectID: 12376118, StudyID: 53719075, Comparison: None

WET READ: ___ ___ ___ 12:46 AM Low lying endotracheal tube, terminates at the carina, heading into the proximal right mainstem bronchus. Recommend withdrawal by approximately 3 cm. *** ED URGENT ATTENTION *** ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with acute hypoxia pls eeval aspir // History: ___F with acute hypoxia pls eeval aspir

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___ at 14:28

FINDINGS: Endotracheal tube terminates at the car I mass heading to the proximal right mainstem bronchus, withdrawal by approximately 3 cm is recommended. Anterior tube is seen coursing below the diaphragm, inferior aspect not included on the image. There are low lung volumes. Bilateral perihilar opacities are worrisome for pulmonary edema. . More confluent right basilar opacity is seen, underlying pneumonia is not excluded. Calcified left ventricular aneurysm again noted.

IMPRESSION: Low lying endotracheal tube, terminating at the carina , very proximal right mainstem bronchus. Recommend withdrawal by approximately 3 cm. Discussed with Dr. ___ on ___ after the conclusion of the study. \\ . Bilateral perihilar opacities are worrisome for pulmonary edema. . More confluent right basilar opacity is seen, underlying pneumonia is not excluded


SubjectID: 12376118, StudyID: 59779005, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman extubated for respiratory failure of unclear exact cause, aspiration vs HCAP vs flash pulmonary edema // Eval for edema, consolidation

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The lung volumes remain low. Moderate cardiomegaly. Small right pleural effusion, moderate retrocardiac atelectasis and mild pulmonary edema. The pacemaker leads are in correct position. The tip of the endotracheal tube is within 1.5 cm of the carinal and could be pulled back by approximately 1 cm. The course of the nasogastric tube is unchanged.


SubjectID: 12376118, StudyID: 55960716, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with pneumonia, intubated. // Any interval change in pulm edema?

TECHNIQUE: Portable AP radiograph of the chest.

COMPARISON: ___ and dating back to ___.

FINDINGS: An endotracheal tube terminates in the lower trachea. Lung volumes are low. A left pectoral dual lead AICD is in place. A nasogastric tube enters the stomach, tip not visualized. A calcified left ventricular aneurysm is re-demonstrated. Marked cardiomegaly despite the projection is unchanged. There is no pneumothorax. Mild pulmonary edema is unchanged   Keywords: unchanged. There are likely stable small bilateral pleural effusions. Retrocardiac airspace opacification may be due to infection or atelectasis.

IMPRESSION: Mild CHF with mild pulmonary edema and stable small bilateral pleural effusions   Keywords: stable. Stable retrocardiac opacification which may be due to infection or atelectasis.


SubjectID: 12376118, StudyID: 59465142, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with leukocytosis // Pneumonia?

COMPARISON: Radiographs from ___

IMPRESSION: Pacemaker wires are identified. Heart size is enlarged but unchanged. There are calcifications of the thoracic aorta as well as a rounded calcification projecting over the left ventricle likely due to calcified ventricular aneurysm. There are very low lung volumes. There are bilateral pleural effusions. Atelectasis at the lung bases are identified. There are no pneumothoraces.


SubjectID: 12376118, StudyID: 53966832, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with sCHF, AF who presented with VT and acute on chronic CHF exacerbation // eval for interval change

COMPARISON: Radiographs from ___

IMPRESSION: The tip of the right-sided PICC line is in the cavoatrial junction. There is a left-sided pacemaker. There are calcifications of the thoracic aorta and of the left ventricle from known ventricular aneurysm. There is unchanged cardiomegaly. There is improved aeration of the right lung. There is atelectasis at the left base. There is minimal prominence of the pulmonary interstitial markings. There are no pneumothoraces.


SubjectID: 12376118, StudyID: 59435259, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hypotension, here for ___ exacerbation // eval for PNA

COMPARISON: ___.

IMPRESSION: No relevant change as compared to the previous examination   Keywords: no relevant change. Mild to moderate fluid overload. Low lung volumes. Bilateral areas of atelectasis. Moderate cardiomegaly. No new focal parenchymal opacities   Keywords: new.


SubjectID: 12376118, StudyID: 56320731, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF // assess for pulmonary edema and interval change assess for pulmonary edema and interval change

IMPRESSION: In comparison with the study of ___, there again are extremely low lung volumes that accentuate the transverse diameter of the heart. There may be mild elevation of pulmonary venous pressure. Calcified lesion at the left base is consistent with known ventricular aneurysm. The dual-channel pacer and right subclavian catheter remain in place. No definite acute focal pneumonia.


SubjectID: 12376118, StudyID: 58470422, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with ETT // eval for ETT placement after interval withdrawal of ETT by 2cm

COMPARISON: Radiographs performed one hour earlier.

IMPRESSION: Since the previous study, the endotracheal tube has been pulled back and is now 3.3 cm above the carina. The rest of the lines and tubes appear unchanged. There is again seen a calcified left ventricular aneurysm. There are bilateral effusions, a left retrocardiac opacity and mild pulmonary edema, stable   Keywords: stable.


SubjectID: 12376118, StudyID: 53286323, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with respiratory failure, intubated. NGT placed. // Is NG tube in appropriate position?

COMPARISON: Radiographs from ___.

IMPRESSION: There is a nasogastric tube whose tip and side port are below the GE junction appropriately sited. Curvilinear calcification projects over the right heart border, unchanged. The endotracheal tube tip is low, 1 cm above the carina and this could be pulled back 3-4 cm for more optimal placement. There are low lung volumes. There is cardiomegaly. There are unchanged bilateral pleural effusions. There is mild pulmonary edema.


SubjectID: 12376118, StudyID: 53030115, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with PNA, likely underlying OSA/obesity hypoventilation persistent respiratory failure // eval for change eval for change

IMPRESSION: In comparison with the study of ___, the monitoring and support devices are essentially unchanged. Calcified left ventricular aneurysm is again seen. In the degree of pulmonary vascular congestion may be slightly less than on the previous study. Bilateral layering effusions again seen, more prominent on the right, with compressive atelectatic changes as well.


SubjectID: 12376118, StudyID: 51118030, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with new ETT // eval for ETT placement

COMPARISON: Radiographs from ___.

IMPRESSION: The tip of the endotracheal tube is entering the right mainstem bronchus and needs to be pulled back 3-4 cm. There is stable cardiomegaly. There is a calcified left ventricular aneurysm. Aortic calcifications are also seen. There remains bilateral pleural effusions and a left retrocardiac opacity. Mild pulmonary interstitial edema is seen, stable   Keywords: stable.


SubjectID: 12376118, StudyID: 58102835, Comparison: worse

FINAL REPORT

HISTORY: ___-year-old female with desaturation.

COMPARISON: Multiple prior chest radiographs, most recently ___.

FINDINGS: Single frontal view of the chest was obtained. Lung volumes remain very low. Increased left lung base opacity may represent either edema or pneumonia   Keywords: increase. No pneumothorax. Round calcification overlying the left heart is consistent with a left ventricular aneurysm. Heart size and cardiomediastinal contours are stable.

IMPRESSION: Increased left lung base opacity, consistent with edema or pneumonia   Keywords: increase. Findings were communicated via phone call by ___ to ___ on ___ at 17:06.


SubjectID: 12376118, StudyID: 57524988, Comparison: None

FINAL REPORT

CHEST ON ___

HISTORY: Hypoxemia, question interval change. REFERENCE EXAM: ___.

FINDINGS: The leads from the dual-lead pacer are unchanged. The calcification from the left ventricular aneurysm is again visualized. There is increased hazy opacity projecting over the left lung, compatible with an effusion layering posteriorly and superimposed alveolar infiltrate. This has worsened compared to the prior exam. There continues to be right lower lobe volume loss, right effusion.

IMPRESSION: Worsened appearance to the left lung.


SubjectID: 12376118, StudyID: 55014066, Comparison: None

FINAL REPORT

HISTORY: Pneumonia. RSV.

COMPARISON: ___.

FINDINGS: There are bilateral pleural effusions with volume loss in both lower lungs. There is pulmonary vascular redistribution. Compared to the study from the prior day. There is improved aeration in the left upper lung. The dual lead pacemaker and a right IJ line are unchanged.


SubjectID: 12379354, StudyID: 58642377, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old male with past medical history of diabetes type 2, hypertension, new onset of CHF and bradycardia status post pacer, now with hypoxia. Evaluate mediastinal widening as complication of procedure. Question pulmonary edema.

COMPARISON: Prior chest radiograph from ___ at 7:48.

TECHNIQUE: Portable erect AP chest radiograph.

FINDINGS: As compared to prior chest radiograph from the same day, there has been interval placement of a left sided pacemaker. There is persistent enlargement of the cardiac silhouette with elevated pulmonary venous pressures. Pulmonary edema has worsened   Keywords: worse. Bilateral pleural effusions persist.

IMPRESSION: Interval worsening of pulmonary edema with bilateral pleural effusions   Keywords: worse.


SubjectID: 12379354, StudyID: 58331967, Comparison: same

FINAL REPORT

HISTORY: CHF with worsening leukocytosis.

FINDINGS: In comparison with the study of ___, there is little overall change   Keywords: little overall change. Again there is enlargement of the cardiac silhouette with elevated pulmonary venous pressure and bilateral pleural effusions. In the appropriate clinical setting, supervening pneumonia would be difficult to exclude.


SubjectID: 12379354, StudyID: 50509495, Comparison: same

FINAL REPORT

INDICATION: ___-year-old male with past medical history of diabetes type 2, hypertension, 120-pack-year history of smoking and with questionable history of hyperlipidemia and previous MI who was transferred to ___ from ___ ___, found to have new onset CHF and found to be bradycardic now status post pacer. Question worsening pulmonary edema, consolidation.

COMPARISON: Prior chest radiograph from ___.

FINDINGS: As compared to prior chest radiograph from ___, cardiac silhouette remains enlarged. Pulmonary edema remains unchanged   Keywords: unchanged, remains. There are substantial bilateral pleural effusions with associated compressive atelectasis. No new focal consolidation.

IMPRESSION: Unchanged pulmonary edema and substantial bilateral pleural effusions with compressive atelectasis   Keywords: unchanged.


SubjectID: 12427592, StudyID: 53007460, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___-year-old man with fever, productive cough, and ronchi at the left base; eval for PNA at LLB.

COMPARISON: Chest radiograph dated ___.

FINDINGS: Multiple, bilateral focal consolidations, several of which are new in synapse the prior exam on ___. Stable moderate pulmonary edema   Keywords: stable. Stable small bilateral pleural effusions. No pneumothorax. Stable mild cardiomegaly. No interval change in the cardiomediastinal silhouette. No acute osseous abnormality. Sternotomy wires and cardiac valves are intact and unchanged in position.

IMPRESSION: Progressive multi-focal pneumonia. Stable pulmonary edema and small bilateral effusions   Keywords: stable.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___, ___ referring provider, on the telephone on ___ at 3:54 PM, 2 minuted after discovery of the findings.


SubjectID: 12427592, StudyID: 51486984, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___-year-old man with history of CHF and multi focal pneumonia, now presenting with worsening shortness of breath; evaluate for pulmonary edema.

COMPARISON: Chest radiograph dated ___.

FINDINGS: The patient is not in full inspiration. Overall, no significant change compared to the prior exam   Keywords: no significant change. Overall stable multi-focal bilateral opacities, without clear evidence of new focal opacities   Keywords: new. Stable small bilateral effusions with some tracking in the major fissures. Stable moderate pulmonary edema   Keywords: stable. Stable cardiomegaly and mediastinal contours. No pneumothorax. The sternotomy wires and cardiac valve devices appear intact and unchanged in position. No acute osseous abnormality.

IMPRESSION: No significant change compared to the prior exam   Keywords: no significant change. Stable multi-focal bilateral opacities, small bilateral effusions, and moderate pulmonary edema   Keywords: stable.


SubjectID: 12427592, StudyID: 50819505, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with shortness of breath, cough, fever

TECHNIQUE: Portable upright AP view of the chest

COMPARISON: ___

FINDINGS: The patient is status post median sternotomy and CABG. Heart size is mildly enlarged but unchanged. The mediastinal and hilar contours are relatively stable. There is mild pulmonary edema. Patchy opacities in the lung bases may be a reflection of dependent pulmonary edema, though atelectasis is not excluded. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities.

IMPRESSION: Mild pulmonary edema. Patchy opacities in the lung bases may reflect dependent pulmonary edema or atelectasis. ___, MD ___=___ CC: DR. ___


SubjectID: 12433158, StudyID: 59113950, Comparison: worse

FINAL REPORT

INDICATION: History: ___F with extensive cardiac history now w new dyspnea on exertion x3d // New dyspnea on exertion x3d, concern for cardiopulmonary change

TECHNIQUE: PA and lateral views of the chest

COMPARISON: ___

FINDINGS: Moderate cardiomegaly is unchanged. Pacemaker leads are stable in position. Calcifications are present in the aortic arch as before. The lungs are notable for nonspecific streaky bibasilar opacities, new compared to the prior examination   Keywords: new. There is no pleural effusion or pneumothorax.

IMPRESSION: New streaky bibasilar opacities are nonspecific and may represent atelectasis, aspiration, or less likely pneumonia.


SubjectID: 12433158, StudyID: 50950773, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with CHF with 3 days of fatigue and malaise and crackles at bases L>R // please evaluate for pneumonia and/or CHF PLEASE EVAL FOR PNA, ? CHF 3 DAYS OF FATIGUE MALAISE AND CRACKLES AT L>R BASE

IMPRESSION: In comparison with the study of ___, there is continued mild enlargement of the cardiac silhouette without vascular congestion, pleural effusion, or acute focal pneumonia. Dual-channel pacer remains in good position with leads in the right atrium and apex of the right ventricle. Atelectatic changes are seen at the left base.


SubjectID: 12440939, StudyID: 57120621, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ y/o M w/ sub-aortic stenosis and suspected secondary CHF, AI, Strep Galloliticus (Strep Bovis Biotype 2) bacteremia in ___, and recent admission for acute on chronic diastolic heart failure p/w failure to thrive found to be profoundly anemic with acute kidney injury unexplained transaminitis, all of which are now resolved, awaiting guardianship // r/o acute process vs pulmonary edema r/o acute process vs pulmonary edema

IMPRESSION: In comparison with the study of ___, there is again substantial enlargement of the cardiac silhouette without appreciable vascular congestion. This suggests cardiomyopathy or possibly pericardial effusion. Opacification at the left base obscuring the hemidiaphragm is consistent with volume loss in the left lower lobe and possible small pleural effusion.


SubjectID: 12440939, StudyID: 56188658, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___-year-old man with a possible left apical pneumothorax seen on the recent chest x-ray.

COMPARISON: Portable chest radiograph from the same day, ___ at 00:17 h.

FINDINGS: No left apical pneumothorax. Overall unchanged appearance of the lungs and heart   Keywords: unchanged appearance. Stable left lower lung focal consolidation and/or atelectasis. Stable reduced left lung volume. Possible small left pleural effusion, unchanged. Stable cardiomegaly without pulmonary edema   Keywords: stable. RIJ unchanged in position.

IMPRESSION: No left apical pneumothorax.


SubjectID: 12440939, StudyID: 52956125, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with swan cath placement // line placement

IMPRESSION: Since ___, a Swan-Ganz catheter is been placed via a left sided approach, terminating in the right interlobar pulmonary artery. There is no left pneumothorax, but note is made of a possible tiny right apical pneumothorax. Since the recent radiograph, the Cardiac silhouette has slightly decreased in size and a nonspecific opacity in the left retrocardiac region has partially cleared.


SubjectID: 12440939, StudyID: 50927944, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with PA line and CHF // ?PA line placement/worsening pulm edema

IMPRESSION: As compared to ___ radiograph, Swan-Ganz catheter the terminates in the the junction of the distal right pulmonary artery and interlobar pulmonary artery. Cardiomegaly is accompanied by pulmonary vascular congestion and minimal interstitial edema. Small right pleural effusion is new. Adjacent right lower lobe opacity favors atelectasis over infectious consolidation.


SubjectID: 12440965, StudyID: 59532855, Comparison: None

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old man with cough and altered mental status. Evaluate pneumonia.

FINDINGS: Comparison is made to the previous study from ___. There is again seen a right-sided central venous catheter whose distal lead tip is poorly seen but is at least to the level of the mid SVC. Cardiac silhouette is within normal limits. There are calcifications in thoracic aorta. There is minimal atelectasis at the lung bases. There are no signs for pulmonary edema or focal consolidation.


SubjectID: 12440965, StudyID: 58645598, Comparison: None

FINAL REPORT

STUDY: AP chest performed on ___. CLINICAL

HISTORY: ___-year-old man with PICC line placement.

FINDINGS: There has been placement of a right-sided PICC line with the distal lead tip at the mid SVC. No pneumothoraces are identified. There is some mild blunting of the left CP angle suggestive of small pleural effusion or atelectasis. Calcification of the thoracic aorta is present.


SubjectID: 12440965, StudyID: 59159989, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF, COPD, worsening dyspnea // eval for PNA, pulm edema eval for PNA, pulm edema

COMPARISON: Chest radiographs ___ through ___.

IMPRESSION: Lung volumes, appreciably lower perhaps because of increasing mild pulmonary edema exaggerate moderate cardiomegaly   Keywords: increasing. Small bilateral pleural effusions are larger. No pneumothorax.


SubjectID: 12440965, StudyID: 51600780, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF, COPD, worsening dyspnea // eval for PNA, pulm edema eval for PNA, pulm edema

COMPARISON: Comparison to ___ at 17:25

FINDINGS: Portable semi-erect chest radiograph ___ at 13:37 is submitted.

IMPRESSION: There is perihilar and interstitial edema which has worsened since ___   Keywords: worse. There is a layering left effusion and some patchy left basilar opacity likely reflecting compressive atelectasis. The heart remains enlarged. Mediastinal contours are stable. Calcification of the aorta consistent with atherosclerosis. No obvious pneumothorax.


SubjectID: 12440965, StudyID: 59073318, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with afib with RVR // eval for pulm edema

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: The lung volumes are relatively low. There is moderate pulmonary edema. Blunting of the right costophrenic angle suggests a small pleural effusion. Difficult to exclude small left pleural effusion. The cardiac silhouette is mildly enlarged. The aorta is calcified and tortuous.

IMPRESSION: Pulmonary edema and small bilateral pleural effusions.


SubjectID: 12440965, StudyID: 58232619, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man failed s s now with new NGT // NGT placement NGT placement

IMPRESSION: Compared to prior chest radiographs since one ___, most recently ___. Mild pulmonary edema, right lower lobe atelectasis have worsened   Keywords: worse. Small bilateral pleural effusions and moderate cardiomegaly are unchanged. Esophageal drainage tube ends in the mid esophagus and would need to be advanced at least 15 cm to move all the side ports into the stomach.


SubjectID: 12446471, StudyID: 55905326, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with new wheezing s/p getting amiodarone on ___. h/o dementia, atrial fibrillation, chronic systolic heart failure, MR/AR/TR, and hypertension, presenting with jaundice, transferred to the ___ medical ICU for concern for cholangitis as well as atrial fibrillation with rapid ventricular rate. // Any acute change to explain new wheezing? Any acute change to explain new wheezing?

IMPRESSION: Comparison to ___. Unchanged mild cardiomegaly and mild pulmonary edema   Keywords: unchanged. Minimal increase in extent of a pre-existing right pleural effusion that extends into the fissure. Unchanged moderate retrocardiac atelectasis without evidence of pneumonia. The right internal jugular vein catheter is in stable position.


SubjectID: 12446471, StudyID: 52873243, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with heart failure. // evaluate for interval change. evaluate for interval change.

IMPRESSION: Comparison to ___. Unchanged bilateral mild to moderate pleural effusions. Unchanged mild to moderate cardiomegaly and mild to moderate pulmonary edema. Retrocardiac and left basilar atelectasis are stable. No new focal parenchymal opacities correct position of the right internal jugular vein catheter.


SubjectID: 12456824, StudyID: 58745583, Comparison: worse

FINAL REPORT

INDICATION: ___ year old man with COPD exacerbation and pulmonary edema // Interval change, possible pneumonia

COMPARISON: ___

FINDINGS: The lungs are hyperinflated, suggesting chronic obstructive pulmonary disease. There is moderate pulmonary edema, increased since the prior exam   Keywords: increase. There is increasing fluid along the right major fissure, causing hazy opacity over the right lower lobe. The cardiac silhouette is mildly enlarged. Moderate right and small left pleural effusions. No pneumothorax.

IMPRESSION: Increasing moderate pulmonary edema with accompanying pleural effusions right greater than left   Keywords: increasing.


SubjectID: 12456824, StudyID: 54198333, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with SOB // Eval for pulmonart edema/pna

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: The lungs are hyperinflated, suggesting chronic obstructive pulmonary disease. There is blunting of the left costophrenic angle suggesting a small pleural effusion. There may be a trace right pleural effusion. There is moderate pulmonary edema. Difficult to exclude underlying infectious process. The cardiac silhouette is mildly enlarged. The aorta is unfolded.

IMPRESSION: Left greater than right small pleural effusions. Pulmonary edema. Mild cardiomegaly. Underlying infection difficult to exclude in the appropriate clinical setting.


SubjectID: 12456824, StudyID: 52539123, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with COPD CHF admitted w afib and hypoxia. Now s/p diuresis and looking to see if infiltrates still persist // reassess for infiltrate post diuresis

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Small to moderate bilateral effusions have increased. There are bibasilar atelectasis. The lungs appear hyperinflated, suggesting COPD. Moderate pulmonary edema is stable   Keywords: stable. Cardiomediastinal contours are unchanged. There is no pneumothorax.


SubjectID: 12456824, StudyID: 50050827, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with trouble breathing // fluid overloaded fluid overloaded

IMPRESSION: In comparison with the study of ___, the cardiac silhouette is within normal limits. Hyperexpansion of the lungs is consistent with chronic pulmonary disease. There is again prominence of interstitial markings, some of which represents elevation of pulmonary venous pressure, while there may be some component of chronic interstitial lung disease   Keywords: again. Poor definition of the hemidiaphragms is consistent with small pleural effusions an basilar atelectasis bilaterally. There is an area of increased opacification in the left upper zone, also seen previously, that could represent a focus of consolidation. The area of possible increased opacification the upper zone on the right is not definitely seen on the current study, though it could be hidden be hind the first rib.


SubjectID: 12458552, StudyID: 58460650, Comparison: same

FINAL REPORT

HISTORY: Pain on inspiration. Recent robotic VATS wedge resections of the right lung.

COMPARISON: Comparison is made to chest radiographs from ___ at ___.

FINDINGS: PA and lateral views of the chest demonstrates a persistent small right apical hydropneumothorax, with increased fluid in the apical pleural space since the prior study. Blunting of the right costophrenic angle is persistent, representing a small right pleural effusion is unchanged since the prior study, as has the left subsegmental basilar atelectasis. Opacity within the medial right upper lung field is unchanged, likely related to prior surgery. No new focal opacities are identified   Keywords: new. The cardiomediastinal silhouette is stable in appearance. There is no evidence of pulmonary edema.

IMPRESSION: Small right hydropneumothorax with increased fluid in the right apex, and small right basilar pleural effusion. Otherwise, no significant change the prior study   Keywords: no significant change.


SubjectID: 12458552, StudyID: 53641499, Comparison: same

WET READ: ___ ___ 8:02 PM Lower lung volumes, otherwise no significant change in the small right apcial hydropneumothorax and small right basilar pleural effusion. Left lung remains clear. No change in the cardiomediastinal silhouette.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

HISTORY: Kidney transplant status post VATS with chest pain.

COMPARISON: ___

FINDINGS: Lower lung volumes, otherwise no significant change in the small right apcial hydropneumothorax and small right basilar pleural effusion. Left lung remains clear. No change in the cardiomediastinal silhouette.

IMPRESSION: No significant change   Keywords: no significant change.


SubjectID: 12458552, StudyID: 58022201, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Skin lesion on previous chest x-ray, evaluation with skin marker.

COMPARISON: ___, 6:32 a.m.

FINDINGS: As compared to the previous radiograph, the patient has received a skin marker. The skin marker is not at the position of the suspicious lesion. Please re-do radiograph with skin marker as indicated in the report from ___, 6:32.


SubjectID: 12458552, StudyID: 55404277, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with renal transplant presents with nausea and vomiting. Question aspiration.

COMPARISON: ___.

FINDINGS: Frontal and lateral views of the chest demonstrate normal cardiomediastinal silhouette. Slight unfolding of the thoracic aorta is noted. The lungs are clear, but appear mildly hyperexpanded, raising question of emphysema. There is no pneumothorax, vascular congestion, or pleural effusion. A 22 mm rounded density overlying the third right anterior rib was present on ___, but not identifiable ___ ___.

IMPRESSION: 1. No radiographic evidence of acute cardiopulmonary process. 2. 22 mm rounded density over the third right anterior rib and interspace is a skin or lung nodule or pleural calcification. Recommend correlation with physical exam for such a lesion at this location. If present, suggest repeat radiograph with skin marker on the lesion. If no lesion is found on exam, consider shallow oblique views for further assessment. Findings reported to Dr. ___ at 7:50 a.m. by phone on ___.


SubjectID: 12458842, StudyID: 58474022, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p ct pull. Eval for ptx.

TECHNIQUE: Single portable AP view of the chest.

COMPARISON: Chest radiograph from ___ and ___.

FINDINGS: Compared with the most recent radiograph, there has been interval removal of although monitoring and support devices in this post CABG patient, including the mediastinal drains, and anterior chest tube, endotracheal tube, NG tube, and Swan-Ganz catheter. The right IJ introducer sheath is still present. As expected, lung volumes have decreased, causing apparent increase in the size of the cardiac silhouette and bibasilar atelectasis. There is no new large pleural effusion or pneumothorax. Patient is status post valve replacement and median sternotomy with intact wires.

IMPRESSION: 1. No evidence of pneumothorax. No new large pleural effusion. 2. Expected post extubation changes as above.


SubjectID: 12458842, StudyID: 55224428, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with mitral regurgitation // r/o inf, eff

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the signs indicative of fluid overload have completely resolved   Keywords: resolve. Moderate cardiomegaly and elongation of the descending aorta persist. No pleural effusions. No pneumonia, no pulmonary edema.


SubjectID: 12468016, StudyID: 59377456, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ with COPD and CHF triggered for hypoxia // eval for interval change eval for interval change

COMPARISON: ___

IMPRESSION: Heart size and mediastinum are unchanged in appearance. Lungs are overall clear with interval improvement of the right basal opacity. No new abnormality is demonstrated.


SubjectID: 12468016, StudyID: 59328979, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with Gold Stage IV COPD, CHF, volume overload // assess pulm edema

TECHNIQUE: AP and lateral views the chest.

COMPARISON: ___.

FINDINGS: Exam is limited secondary to patient body habitus. Right greater than left basilar opacities are likely attributable to atelectasis. There is no overt pulmonary edema. Cardiomediastinal silhouette is stable, prominence of the hila bilaterally suggest pulmonary hypertension. Cardiac silhouette is enlarged but likely accentuated by AP technique and probable at least mild underlying cardiomegaly.

IMPRESSION: Limited exam without definite acute cardiopulmonary process.


SubjectID: 12468016, StudyID: 59052887, Comparison: None

FINAL REPORT

INDICATION: Evaluate left internal jugular placement.

COMPARISON: Chest radiographs from ___, ___, ___.

FINDINGS: A portable semi-erect frontal chest radiograph demonstrates a left internal jugular catheter which terminates at the origin of the SVC. There is increasing opacity of the left hemi thorax with minimal aeration of the left upper lobe and leftward shift of the mediastinum, compatible with increasing left lung collapse. No right focal consolidation or pleural effusion is appreciated. No pneumothorax is visualized.

IMPRESSION: 1. Left internal jugular catheter terminating at the origin of the SVC. 2. Increasing collapse of the left lung, with minimal aeration of the left upper lobe.

NOTIFICATION: The findings were discussed with ___, M.D. by ___, M.D. on the telephone on ___ at 11:54 AM, 5 minutes after discovery of the findings.


SubjectID: 12468016, StudyID: 57432300, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with lung collapse // interval change interval change

IMPRESSION: Comparison to ___. As compared to the previous image, the previously collapsed left lung is now substantially better ventilated. Only around the left hilus and in the retrocardiac lung regions and atelectasis persists. The mediastinum has returned to its normal position. The right lung is stable, with a small right basal atelectasis.


SubjectID: 12468016, StudyID: 58842728, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with PMHx notable for Crohn's disease (not on treatment as non-compliant), COPD (gold stage IV, on 3.5L NC at baseline), recurrent C. diff, HTN, HLD, history of DVTs on A/C, and dCHF, who presents with abdominal pain and BRBPR from rehab, course c/b aspiration PNA, with NG tube pulled out // eval for NG

IMPRESSION: Radiograph centered at the thoracoabdominal junction was obtained for assessment of a nasogastric tube, which courses below the diaphragm. Due to image artifact, the distal tip of the nasogastric tube is not confidently visualized. Repeat radiograph of the upper abdomen may be helpful in this regard.


SubjectID: 12468016, StudyID: 52480455, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with PMHx notable for Crohn's disease (not on treatment as non-compliant), COPD (gold stage IV, on 3.5L NC at baseline), recurrent C. diff, HTN, HLD, history of DVTs on A/C, and dCHF, who presents with abdominal pain and BRBPR from rehab, course c/b aspiration PNA, with NG tube pulled out // eval for NG tube placement

IMPRESSION: Radiograph was obtained centered at the thoracoabdominal junction first full assessment of nasogastric tube. The nasogastric tube terminates in the stomach with the side port just beyond the expected location of the GE junction. In the imaged portion of the lower chest, worsening atelectasis is present in the left retrocardiac region with a persistent small left pleural effusion.


SubjectID: 12468016, StudyID: 58185338, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with COPD and respiratory failure. // eval for interval change

TECHNIQUE: Portable chest

COMPARISON: ___.

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change.


SubjectID: 12468016, StudyID: 58034120, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with IBD, COPD on O2 and CHF now with new hypotension // Please evaluate for new edema/infiltrate Please evaluate for new edema/infiltrate

IMPRESSION: In comparison with the study of ___, there again is enlargement of the cardiac silhouette with mild basilar atelectatic changes. There may be minimal residual elevation in pulmonary venous pressure. No acute focal pneumonia.


SubjectID: 12468016, StudyID: 58060639, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with dCHF and LGIB s/p resuscitation // Eval for interval change

COMPARISON: The comparison is made with prior studies including ___.

IMPRESSION: There is a right central line, the tip is in the mid SVC. There is no pneumothorax. There is patchy atelectasis in both lung bases. There is a small left pleural effusion. There is no CHF.


SubjectID: 12468016, StudyID: 55170334, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with LGIB // Eval for placement of subclavian

COMPARISON: The comparison is made with prior studies including ___.

IMPRESSION: There is a new right central line, the tip is in the mid SVC. There is no pneumothorax. There is linear atelectasis in both lung bases. There is a small left pleural effusion. There is no CHF.


SubjectID: 12468016, StudyID: 57872385, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___ year old man with aspiration event ___ and LLL changes // ___ year old man with aspiration event ___ and LLL changes

TECHNIQUE: Portable AP chest Re

COMPARISON: Prior chest radiographs from ___, ___, ___. A chest with and without contrast from ___

FINDINGS: Persistence of substantial opacities in the left lower lung base, likely due to a combination of aspiration and compressive atelectasis, better assessed on CT Chest from ___. Moderate atelectatic changes are seen in the right lower lung base. The heart size is unchanged. No new focal consolidations are seen. No pneumothorax or pulmonary edema.

IMPRESSION: 1. Persistence of substantial opacities in the left lower lung base are likely due to combination aspiration and compressive atelectasis, better assessed on CT Chest from ___.


SubjectID: 12468016, StudyID: 56268843, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with new NGT // positioning positioning

IMPRESSION: In comparison with the earlier study of this date, there has been placement of a nasogastric tube that extends to the mid body of the stomach. The side-port is not clearly seen, though it it appears to be distal to the esophagogastric junction. The tube could be pushed forward about 5-10 cm for more optimal position. Opacification persists in the retrocardiac region   Keywords: persists. Again this could represent atelectasis or, in the appropriate clinical setting superimposed aspiration.


SubjectID: 12468016, StudyID: 55256530, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hypoxia, eval for pulmonary edema // ___ year old man with hypoxia, eval for pulmonary edema ___ year old man with hypoxia, eval for pulmonary edema

IMPRESSION: Left internal jugular line tip is at the level of mid SVC. There is additional elevation of left hemidiaphragm with associated atelectasis as well as right basal opacity, findings concerning for interval development of pulmonary edema   Keywords: development.


SubjectID: 12468016, StudyID: 54927950, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___ year old man with SOB. // worsening pulmonary edema?

TECHNIQUE: Portable AP chest is

COMPARISON: Prior chest radiographs from ___, ___, ___, ___

FINDINGS: A reticular opacification is seen in the left apex, which could be an area of aspiration. Mild vascular congestion is possible, however, there is no overt pulmonary edema. Increased right lower lobe basilar opacities likely indicate increased atelectasis. There is increased linear atelectasis in the left lung base. The heart size is unchanged. The left hemidiaphragm is chronically elevated, possibly from stomach distension. The previously seen right subclavian catheter has been removed.

IMPRESSION: 1. A reticular opacification is seen in the left apex, which could be an area of aspiration. 2. Increased bibasilar atelectasis since ___.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ ___ on the telephoneon ___ at 10:34 AM, 5 minutes after discovery of the findings.


SubjectID: 12468016, StudyID: 51036606, Comparison: None

FINAL REPORT

INDICATION: History: ___M with sob, hx of chf and copd, pls eval for edema vs pna.

TECHNIQUE: AP and lateral radiographs of the chest

COMPARISON: Radiograph from ___

FINDINGS: The heart size is normal. The hilar and mediastinal contours are normal. Bibasilar linear opacities are most compatible with atelectasis, worse at the cardiophrenic angle. Trace right pleural effusion. There is no pneumothorax. The visualized osseous structures are unremarkable.

IMPRESSION: Subtle opacity right lung base is likely atelectasis, however a small consolidation cannot be excluded.


SubjectID: 12468016, StudyID: 50696752, Comparison: None

FINAL REPORT

INDICATION: ___M with DOE/SOB, inc ___ edema. // r/o PNA/pulm edema

TECHNIQUE: Frontal and lateral views of the chest.

COMPARISON: ___.

FINDINGS: The lungs are hyperinflated. Linear left basilar opacities most likely atelectasis. There is no confluent consolidation or effusion. The cardiomediastinal silhouette is stable. No acute osseous abnormalities identified.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 12478288, StudyID: 59819227, Comparison: 0.0

FINAL REPORT

HISTORY: Rales, shortness of breath.

TECHNIQUE: Upright AP view of the chest.

COMPARISON: Chest CT and chest radiograph performed earlier the same day.

FINDINGS: The study is somewhat limited due to patient rotation. Patchy ill-defined opacities in the lung bases appear slightly progressed when compared to the prior study   Keywords: progressed. This could reflect atelectasis as a result of slightly reduced lung volumes compared to the prior study. Additionally, more focal patchy opacity in the right lung base again may reflect asymmetric pulmonary edema or infection   Keywords: again. There are continued small bilateral pleural effusions as well as a loculated right apicolateral pleural effusion. Remainder of the exam is unchanged moderate cardiomegaly. No evidence of pneumothorax. The patient is status post median sternotomy, CABG, pacemaker placement, and left axillary lymph node dissection.

IMPRESSION: Slightly decreased lung volumes compared to the prior study with patchy ill-defined bibasilar airspace opacities likely reflecting atelectasis. More focal opacity in the right lung base could reflect asymmetric pulmonary edema or infection. Remainder of the exam is unchanged.


SubjectID: 12478288, StudyID: 57623119, Comparison: None

FINAL REPORT

HISTORY: Back pain, undergoing treatment for breast pain.

TECHNIQUE: Upright AP and lateral views of the chest.

COMPARISON: ___ chest radiograph.

FINDINGS: The patient is status post median sternotomy CABG. Right-sided dual chamber pacemaker is noted with leads terminating in the right atrium and right ventricle, unchanged. There is mild to moderate cardiomegaly which is stable. The aorta is mildly tortuous and diffusely calcified. Small bilateral pleural effusions are noted with fluid identified within the fissures. Smoothly lobulated opacity overlying the right apex is compatible with a loculated pleural effusion which has slightly increased when compared to the prior study. Ill-defined streaky opacity within the right lung base appears slightly worsened in the interval, which could reflect asymmetric pulmonary edema though infection in the right lung base is not completely excluded. The left lung is grossly clear. There is diffuse demineralization of the osseous structures with compression deformities in the mid thoracic spine again demonstrated. Clips in the left axilla are again noted.

IMPRESSION: Small bilateral pleural effusions with slight interval increase in loculated pleural fluid about the right lung apex. Patchy opacity within the right lung base may reflect asymmetric pulmonary edema though infection cannot be excluded.


SubjectID: 12478288, StudyID: 50078791, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with dyspnea and loculated pleural effusion.

COMPARISON: Comparison is made with chest radiograph from ___ and ___.

FINDINGS: Two frontal images of the chest demonstrate some interval improvement in the right lower lobe opacity. The right upper lobe collection of loculated pleural fluid appears to have increased in size since the previous imaging. Again seen is cardiomegaly. There is no pneumothorax or pleural effusion. Multiple surgical clips are noted in the left axillary region.

IMPRESSION: Increasing right upper lobe collection of loculated pleural fluid. Improving right lower lobe opacity.


SubjectID: 12478288, StudyID: 59679890, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Stroke, evaluation for effusion and pneumonia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is minimally increased opacity at the left lateral lung bases, likely atelectatic in origin. The known bilateral subpleural opacities along with pre-existing rib changes, are constant in extent and severity. Also constant in extent is a known right apical area of severe pleural thickening. The lung volumes remain low. There is status post CABG, moderate size of the cardiac silhouette. Right pectoral pacemaker, clips after left axillary lymph node resection.


SubjectID: 12478288, StudyID: 56024885, Comparison: same

FINAL REPORT

HISTORY: CAD with stroke and hypoxia.

FINDINGS: In comparison with the study of ___, there is little overall change   Keywords: little overall change. Again there is enlargement of the cardiac silhouette without definite vascular congestion. Opacification along the right lateral chest wall is again seen, as is an apparent loculated collection of pleural fluid at the upper zone laterally. Continued cardiomegaly in a patient with a dual-channel pacemaker device in place and intact midline wires following CABG. Surgical clips in the left axillary region are again seen.

IMPRESSION: Little change   Keywords: little change.


SubjectID: 12478288, StudyID: 58499442, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST OF ___

COMPARISON: ___ radiograph.

FINDINGS: The patient is status post median sternotomy and coronary bypass surgery. Cardiomediastinal contours are stable in appearance. Pulmonary vasculature is within normal limits. Smoothly marginated right-sided lateral pleural opacification is again demonstrated, and has slightly decreased in extent apicolaterally. On the lateral radiograph, pleural opacity, presumably fluid is also present within the fissures on the lateral view. Within the right lung, heterogeneous opacities are present throughout the right lower lobe, projecting over the thoracic spine on the lateral view. A previously present opacity in the right upper lung has resolved. Bones are diffusely demineralized, and compression deformities are again visualized in the mid thoracic spine. Permanent pacemaker in standard position. Previous left axillary lymph node dissection.

IMPRESSION: 1. Slight decrease in extent of right-sided pleural opacity, presumably representing loculated pleural fluid, although a component of chronic pleural thickening is also possible 2. Clearing of right upper lobe opacity, but persistent opacities in the right lower lobe. Findings could potentially be due to an aspiration pneumonia given clinical suspicion for pneumonia.


SubjectID: 12478288, StudyID: 50847530, Comparison: None

FINAL REPORT

CHEST, TWO VIEWS: ___

HISTORY: ___-year-old female with weakness.

FINDINGS: AP and lateral views of the chest. No prior. The lungs are slightly hyperinflated with flattening of the diaphragms. There is blunting of posterior costophrenic angles compatible with effusions. There is also increased opacity which is pleural-based in the right hemithorax, potentially due to pleural thickening or loculated effusion. Clear delineation of any underlying parenchymal abnormalities is limited secondary to this opacity. The left lung is grossly clear. Cardiac silhouette is within normal limits for technique. Postoperative changes with median sternotomy and mediastinal clips are noted. Dual-lead pacing device is seen with tips in the right atrium and right ventricle. Multiple old bilateral rib fractures are identified. Surgical clips project over the left axilla. IVC filter seen within the mid abdomen. Compression deformities of the lower thoracic spine are noted.

IMPRESSION: 1. Increased opacity which appears pleural-based in the right suggestive of possible effusion which may be loculated or pleural thickening. This may obscure changes in the underlying parenchyma. Correlation with old films would be of use should they become available. 2. Compression deformity in mid thoracic spine, the acuityl of which is uncertain.


SubjectID: 12478288, StudyID: 54460075, Comparison: None

FINAL REPORT

HISTORY: Generator change in pacer, to assess for lead migration.

FINDINGS: In comparison with the study of ___, there is little change in the appearance of the heart and lungs except for somewhat better degree of inspiration. Specifically, there is no change in the appearance of the pacer leads.


SubjectID: 12478288, StudyID: 51453709, Comparison: None

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Cough. Reportedly, a recent pneumonia seen on radiographs.

COMPARISONS: ___ and ___.

TECHNIQUE: Chest, PA and lateral.

FINDINGS: There is increased volume loss in the right upper lung with a similar right lateral pleural thickening. The overall appearance suggests a loculated pleural effusion in the right hemithorax. Likewise, there is a persistent lenticular collection along the left upper hemithorax as well as thickening along fissures. This is again most likely to represent a loculated pleural effusion. Compared to the prior study, more dense opacification is suspected in the left lower lobe within the retrocardiac region that may reflect a superimposed process, although, aside from the fact that it is new since ___, acuity is uncertain. Considerable background opacification appears fairly chronic within both lungs bilaterally. There are also increasing, but small free-flowing components of pleural effusion suspected bilaterally based on the lateral view. The patient is status post sternotomy and coronary artery bypass graft surgery. A pacemaker/ICD device with two leads appears unchanged with leads again terminating in the right atrium and ventricle. The bones appear demineralized with multiple similar compression deformities and bony demineralization.

IMPRESSION: Persistent opacities largely reflecting, most likely loculated pleural effusions. Background reticulation at the lung base is suspicious for pulmonary fibrosis. Focal increased opacification is noted in the left lower lobe, possibly pneumonia in the appropriate clinical setting, although other etiologies including worsening interstitial lung disease could be considered.


SubjectID: 12488897, StudyID: 59827007, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Respiratory failure, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Low lung volumes with extensive areas of atelectasis and lateral pleural effusions. Moderate cardiomegaly with signs of mild fluid overload. Unchanged monitoring and support devices.


SubjectID: 12488897, StudyID: 54233504, Comparison: None

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old man with respiratory failure, intubated and basilar opacities. Evaluate for interval change.

FINDINGS: Comparison is made to previous study from ___ at 4:25 a.m. The lines and tubes are all stable in position. There are again seen low lung volumes with crowding of the pulmonary vascular markings. There are bilateral pleural effusions and a left retrocardiac opacity. There is likely an element of fluid overload. These findings are all unchanged.


SubjectID: 12488897, StudyID: 51529818, Comparison: None

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old man with respiratory failure, intubated.

FINDINGS: Comparison is made to previous study from ___ at 4:17 a.m. The endotracheal tube, feeding tube, and right IJ central venous line are in unchanged position. There is again seen low lung volume with crowding of the pulmonary vascular markings at the lung bases and subsegmental atelectasis at the bases. The nasogastric tube tip and side port are within the body of the stomach.


SubjectID: 12488897, StudyID: 51075050, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Cirrhosis, respiratory distress, evaluation for interval change.

COMPARISON: ___, 8:10 a.m.

FINDINGS: As compared to the previous radiograph, the right costophrenic sinus is now visualized. There is a mild-to-moderate right pleural effusion at persisting low lung volumes. Bilateral areas of atelectasis are better visualized than on the previous film. Unchanged moderate cardiomegaly, position of the nasogastric tube, the endotracheal tube and the right internal jugular vein catheter.


SubjectID: 12488897, StudyID: 59491904, Comparison: None

FINAL REPORT

CHEST, TWO VIEWS: ___.

HISTORY: ___-year-old male with cough, question infiltrate.

FINDINGS: Frontal and lateral views of the chest were compared to previous exam from one day prior. Again, lung volumes are low. That being said, there is no focal consolidation identified. There is no effusion or pneumothorax. Cardiomediastinal silhouette is normal. Osseous and soft tissue structures are unremarkable.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 12488897, StudyID: 54069573, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Wheezing and shortness of breath, to evaluate for pneumonia.

TECHNIQUE: PA and lateral chest views were reviewed in comparison with prior chest radiograph from ___. Both lungs are clear. There are no lung opacities concerning for pneumonia. Heart size, mediastinal and hilar contours are normal. There is no pleural abnormality.

IMPRESSION: No pneumonia.


SubjectID: 12488897, StudyID: 59044729, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Cirrhosis, shortness of breath, evaluation for infection.

COMPARISON: ___.

FINDINGS: Compared to the previous radiograph, lung volumes are still low. The size of the cardiac silhouette is at the upper range of normal. Newly occurred mildly widened pulmonary vessels, potentially suggesting mild fluid overload. Pleural effusions, no evidence of pneumonia. At the time of observation and dictation, 11:16 a.m., on ___, the referring physician, ___. ___, was paged for notification. The finding was subsequently discussed over the telephone.


SubjectID: 12488897, StudyID: 55100750, Comparison: None

FINAL REPORT

PORTABLE AP CHEST FROM ___ AT 4:25 CLINICAL

INDICATION: ___-year-old with respiratory failure, now intubated, assess for interval change. Comparison is made to the patient's prior study of ___ at 22:54. Portable semi-erect chest film ___ at 4:30 a.m. is submitted.

IMPRESSION: 1. Right internal jugular line has its tip in the mid to distal SVC. A nasogastric tube is seen coursing below the diaphragm with the tip not identified. Endotracheal tube continues to have its tip approximately 3.5 cm above the carina. Lung volumes remain markedly low with increasing opacity at the left base and a stable patchy opacity at the right base. There are likely layering effusions, left greater than right. The findings most likely reflect bibasilar patchy atelectasis, although pneumonia cannot be entirely excluded. Vascular crowding is seen, likely related to low lung volumes with no overt pulmonary edema. No pneumothorax is appreciated. Overall, cardiac and mediastinal contours are difficult to assess given the markedly low lung volumes.


SubjectID: 12507642, StudyID: 58769690, Comparison: better

FINAL REPORT

AP CHEST, 11:31 P.M, ___

HISTORY: ___-year-old woman with multiple MIs and CVA, AFib. Left leg pain after fall. AP chest compared to ___ and ___.

FINDINGS: Severe cardiomegaly is chronic. Pulmonary vascular redistribution has improved since ___ and mild pulmonary edema present previously has resolved   Keywords: resolve, improve. Lungs clear.


SubjectID: 12507642, StudyID: 56603965, Comparison: None

FINAL REPORT

HISTORY: Aortic stenosis and atrial fibrillation, to look for pulmonary congestion as reason to start diuresis.

FINDINGS: In comparison with study of ___, the pulmonary vascularity is essentially within normal limits. Substantial enlargement of the cardiac silhouette persists in a patient with intact midline sternal wires following CABG. Lateral view shows that there are bilateral pleural effusions.


SubjectID: 12515935, StudyID: 58001735, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Intubation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Tip of the endotracheal tube projects 3 cm above the carina. The transparency of the lung parenchyma has increased, likely reflecting improved ventilation. Unchanged retrocardiac atelectasis. The course of the nasogastric tube is constant. Unchanged left pectoral pacemaker.


SubjectID: 12515935, StudyID: 57051222, Comparison: worse

FINAL REPORT

HISTORY: Intubation for airway protection.

FINDINGS: In comparison with the study of ___, the monitoring and support devices are essentially unchanged. There is continued enlargement of the cardiac silhouette with pacer devices in place. Retrocardiac opacification with obliteration of the hemidiaphragms consistent with volume loss in the left lower lobe and pleural effusion. At the right base, there is some patchy area of increased opacification. It is unclear whether this could represent some asymmetric pulmonary edema or a developing consolidation, especially since the upper part of the right heart border is not sharply seen   Keywords: developing.


SubjectID: 12515935, StudyID: 52685029, Comparison: None

FINAL REPORT

INDICATION: ___-year-old woman with severe cardiomyopathy and ICD.

TECHNIQUE: Frontal and lateral radiographs of the chest were obtained.

COMPARISON: Chest radiograph from ___.

FINDINGS: There is severe cardiomegaly and moderate vascular congestion, but no pulmonary edema. ICD/Pacemaker leads end in the right atrium and right ventricle and coronary sinus, unchanged from ___.


SubjectID: 12515935, StudyID: 52648152, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Ventricular fibrillation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is an increased in general lung density, likely to reflect pulmonary edema after cardiac failure. Presence of a small pleural effusion cannot be excluded. There is evidence of retrocardiac atelectasis. The patient has been intubated, the endotracheal tube projects 3 cm above the carina with its tip. There is no evidence of pneumothorax or other complication.


SubjectID: 12525991, StudyID: 59750114, Comparison: None

WET READ: ___ ___ ___ 9:07 PM Tip of a new intra-aortic balloon pump terminates 2.5 cm below the superior aspect of the aortic knob. Otherwise, unchanged exam. _________________________________________________________________________________

FINAL REPORT

HISTORY: New lines.

COMPARISON: 526.

FINDINGS: The tip of the new intra-aortic balloon pump terminates 2.5 cm below the superior aspect of the aortic knob. There is a femoral Swan-Ganz catheter with tip in the right descending pulmonary artery. The heart continues to be severely enlarged. There is mild pulmonary vascular redistribution but no overt pulmonary edema. Dual lead pacemaker appears unchanged.


SubjectID: 12525991, StudyID: 58708555, Comparison: same

FINAL REPORT

HISTORY: Injured balloon pump.

COMPARISON: ___.

FINDINGS: Compared to the prior exam there is no significant interval change   Keywords: no significant interval change.


SubjectID: 12525991, StudyID: 57636540, Comparison: same

FINAL REPORT

HISTORY: IABP position.

FINDINGS: In comparison with study of ___, the tip of the IABP measures approximately 4.1 cm below the transverse arch of the aorta and about 8 mm above the carina. It should probably be advanced about 1.5-2 cm cranially. Otherwise, little change   Keywords: little change.


SubjectID: 12525991, StudyID: 50876413, Comparison: None

FINAL REPORT

HISTORY: Acute on chronic heart failure.

COMPARISON: ___.

FINDINGS: The right subclavian line with tip in the mid SVC is unchanged. The right IJ Swan-Ganz catheter is been removed. The dual lead pacemaker has leads in similar location as prior. There continues to be moderate cardiomegaly. There is no focal infiltrate. There is a tiny right effusion. There is mild pulmonary vascular redistribution.

IMPRESSION: moderate cardiomegaly but no overt CHF.


SubjectID: 12525991, StudyID: 58369144, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Intra-aortic balloon pump, evaluation for location.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the aortic balloon pump is in unchanged position, with the tip projecting 3 cm below the upper aspect of the aortic knob. No other relevant changes   Keywords: no other relevant change. Mild fluid overload and cardiomegaly, Swan-Ganz catheter, inserted over the inferior vena cava. No pleural effusions. No pneumothorax. Unchanged left pectoral pacemaker.


SubjectID: 12525991, StudyID: 54014632, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Postoperative bleeding, evaluation for hematothorax.

COMPARISON: ___, 3:48 p.m.

FINDINGS: As compared to the previous radiograph, the aortic balloon pump has been removed. The other monitoring and support devices, including the cardiac pump, are unchanged. Unchanged mild fluid overload, moderate-to-severe cardiomegaly as well as substantial basal areas of atelectasis   Keywords: unchanged. No new parenchymal opacity. No pneumothorax. No larger pleural effusion.


SubjectID: 12525991, StudyID: 51860854, Comparison: None

FINAL REPORT

HISTORY: LVAD placement. Evaluate for effusion.

COMPARISON: ___.

TECHNIQUE: Portable frontal chest radiograph, single view.

FINDINGS: Compared to a prior examination, there is slightly increased layering right pleural effusion. There is otherwise no significant interval change including mild fluid overload, severe cardiomegaly, bibasilar atelectasis as well as unchanged positioning of numerous monitoring support devices including the LVAD. There is no pneumothorax.

IMPRESSION: Slightly increasing layering right pleural effusion, otherwise no significant change.


SubjectID: 12525991, StudyID: 58194505, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post left thoracocentesis, evaluation for pulmonary edema.

COMPARISON: ___.

FINDINGS: Compared to the previous radiograph, there is a decrease in extent of the left pleural effusion, with improved ventilation in the retrocardiac lung areas and at the left lung bases. A minimal pleural effusion on the left remains visible. Unchanged normal appearance of the right lung. Unchanged appearance of the monitoring and support devices, the cardiac support and the pacemaker.


SubjectID: 12525991, StudyID: 57454804, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___.

FINDINGS: Feeding tube terminates within the stomach. Appearance of the chest is otherwise not appreciably changed since the recent radiograph performed two days earlier.


SubjectID: 12525991, StudyID: 54926214, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Respiratory failure, status post left thoracocentesis, followup.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the left pleural effusion has minimally increased. Also increased is the amount of left retrocardiac atelectasis. After left thoracocentesis yesterday there is no evidence of left pneumothorax. Otherwise, unchanged radiograph   Keywords: unchanged radiograph.


SubjectID: 12525991, StudyID: 53882890, Comparison: None

FINAL REPORT

HISTORY: Left effusions status post thoracentesis.

FINDINGS: In comparison with study of ___, there is little overall change and no evidence of appreciable reaccumulation of pleural fluid. Pacemaker device and intestinal tube remain in place. Substantial enlargement of the cardiac silhouette persists with relatively normal pulmonary vessels, raising the possibility of cardiomyopathy or pericardial effusion.


SubjectID: 12525991, StudyID: 57847502, Comparison: None

FINAL REPORT

HISTORY: Dobbhoff placement.

FINDINGS: In comparison with the study of ___, there has been placement of a Dobbhoff tube with the opaque distal portion just beyond the level of the esophagogastric junction. Substantial opacification at the left base persists, with the degree of pleural effusion appearing to be somewhat more prominent. Otherwise, little change in the appearance of the heart and lungs with substantial enlargement of the cardiac silhouette.


SubjectID: 12525991, StudyID: 57318730, Comparison: None

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with nonischemic dilated cardiomyopathy, fraction ejection of ___%, now LVAD as bridge to transplant. Dobbhoff tube placement.

COMPARISON: ___.

FINDINGS: Dobbhoff tube is lying more distally than the previous exam in the gastric body. The LVAD is in unchanged position. There is no sign of pulmonary edema. Right-sided PICC line ends in mid SVC. Left pleural effusion and basilar atelectasis are unchanged. There is no sign of pulmonary edema. The heart is significantly enlarged, but unchanged.

CONCLUSION: Dobbhoff tube is slightly more distal than the previous exam in the body of the stomach. The remaining of the exam is unchanged.


SubjectID: 12525991, StudyID: 52695520, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old man with left-sided pleural effusion.

FINDINGS: Comparison is made to the prior radiographs from ___. LVAD is unchanged in position. There is an AICD with lead tips in the right atrium and right ventricle, unchanged. There is a right-sided central venous line with distal lead tip in the mid SVC, unchanged. There remains cardiomegaly and a left-sided pleural effusion and left retrocardiac opacity. This is stable. There are no pneumothoraces. There is a feeding tube whose distal tip is within the body of the stomach. No pneumothoraces are seen.


SubjectID: 12525991, StudyID: 57657155, Comparison: None

FINAL REPORT

INDICATION: Status post chest tube removal.

COMPARISON: Chest radiograph ___, ___, ___, ___.

FINDINGS: There has been interval removal of left chest tube and mid sternal drain. ICD defibrillator is present with leads in stable position terminating in the right atrium and right ventricle. There is stable positioning of the Swan-Ganz catheter. There is persistent severe cardiomegaly, stable in the postoperative period. There is no pleural effusion or pneumothorax. There is no focal consolidation concerning for pneumonia. There is mild interstitial edema.

IMPRESSION: No pneumothorax.


SubjectID: 12525991, StudyID: 56115925, Comparison: same

FINAL REPORT

INDICATION: Assess for interval change.

COMPARISON: Chest radiographs ___, ___.

FINDINGS: Again seen is an ICD defibrillator with leads in stable position. The Swan-Ganz catheter is again seen in stable position. There has been interval placement of an enteric tube with tip off the film, but sideholes near the GE junction. The ventricular assist device is not entirely captured on the current stidy. Again seen is persistent severe cardiomegaly, stable in the post-operative period. There is no pleural effusion or pneumothorax. There is no focal consolidation concerning for pneumonia. Mild interstitial pulmonary edema is unchanged   Keywords: unchanged.

IMPRESSION: 1. Interval placement of enteric tube with sideholes near the GE junction. Tube should be advanced to ensure location of sideholes in the stomach. 2. Incomplete visualization of the ventricular assist device. 3. No other changes   Keywords: no other change.


SubjectID: 12525991, StudyID: 52198896, Comparison: better

FINAL REPORT

INDICATION: Shortness of breath, query effusion.

COMPARISON: Chest radiograph, ___ to ___, ___.

FINDINGS: The cardiomediastinal and hilar contours remain stable with moderate cardiomegaly. A left axillary pacemaker defibrillator is again seen with tips terminating in the right atrium and right ventricle. A Swan-Ganz catheter is present in unchanged position. There has been interval removal of the enteric tube. There is a small left pleural effusion, and a possible small right pleural effusion, although the right costophrenic angle is not completely captured on the current study. There has been improvement in the mild interstitial pulmonary edema   Keywords: improve.

IMPRESSION: Improvement in pulmonary edema with a small left pleural effusion and possible right pleural effusion   Keywords: improve.


SubjectID: 12525991, StudyID: 51155555, Comparison: better

WET READ: ___ ___ 8:18 PM No signficant change since prior. Stable mild pulmonary edema. Support devices unchanged.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

PORTABLE CHEST ___

COMPARISON: ___.

FINDINGS: Indwelling support and monitoring devices are unchanged in position. Stable marked cardiomegaly, but improvement in degree of pulmonary edema and apparent decrease in size of right pleural effusion   Keywords: decrease, improve. Small left pleural effusion is similar, but adjacent left retrocardiac opacity has slightly improved. Right retrocardiac opacity is unchanged. No visible pneumothorax.


SubjectID: 12525991, StudyID: 56362930, Comparison: None

FINAL REPORT

HISTORY: To assess for effusions.

FINDINGS: In comparison with the study of ___, the Swan-Ganz catheter has been removed and a right jugular catheter remains in place. Continued enlargement of the cardiac silhouette without appreciable pulmonary vascular congestion. Dual-channel pacer-defibrillator is again seen with the leads terminating in the right atrium and apex of the right ventricle. There is some increased opacification at the left base consistent with worsening pleural effusion and substantial volume loss in the left lower lobe. The right lung is essentially clear.


SubjectID: 12525991, StudyID: 51629409, Comparison: None

FINAL REPORT

PORTABLE CHEST ___ ___

COMPARISON: ___ radiograph.

FINDINGS: Cardiac silhouette remains enlarged and reflects both cardiomegaly and pericardial effusion on recent CT. ICD pacing device remains in place as well as a left ventricular assist device. Right internal jugular vascular sheath has been removed with no visible pneumothorax. Moderate left pleural effusion has slightly increased in size and is associated with adjacent atelectasis in the left lower lobe.


SubjectID: 12525991, StudyID: 53388402, Comparison: None

FINAL REPORT

INDICATION: Shortness of breath. Evaluate for increasing left effusion and atelectasis.

COMPARISON: Chest radiograph, ___ though ___.

FINDINGS: A left anterior chest pacemaker defibrillator is again seen with tips terminating in the right atrium and right ventricle in unchanged positions. Again seen is a right PICC line with tip terminating in the upper to mid SVC and a left ventricular assist device in stable position. The cardiomediastinal and hilar contours are stable with moderate cardiomegaly involving the right atrium, the left atrium, and the left ventricle. A left base consolidation, likely representing a combination of atelectasis and partly loculated pleural effusion, is essentially stable compared to the most recent prior study. There is no right pleural effusion. There is no pneumothorax. There is no new focal consolidation concerning for pneumonia.

IMPRESSION: No significant change in partly loculated left pleural effusion with associated atelectasis.


SubjectID: 12525991, StudyID: 51835843, Comparison: None

FINAL REPORT

PORTABLE CHEST ___ ___

COMPARISON: Radiograph of one day earlier.

FINDINGS: Indwelling support and monitoring devices are unchanged in position, including a left ventricular assist device and ICD pacer. Stable marked enlargement of cardiac silhouette in keeping with a combination of enlarged heart and pericardial effusion on recent CT. Moderate partially loculated left pleural effusion appears slightly smaller, with associated slight decrease in left lower lobe atelectasis.


SubjectID: 12525991, StudyID: 50851107, Comparison: None

WET READ: ___ ___ ___ 9:47 PM New 2 lead pacemaker with no acute cardiopulmonary process otherwise identified. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: ICD lead placement to rule out pneumothorax.

TECHNIQUE: Single upright portable chest view was read in comparison with prior radiograph from ___.

IMPRESSION: Dual lead from a new left pectraol ICD device course through the left transvenous approach and end at expected locations of right atrium and right ventricle respectively. There is no pneumothorax or pleural effusion. Mild-to-moderate enlarged heart is unchanged since at least ___. Lungs are clear.


SubjectID: 12547073, StudyID: 58844983, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman s/o RLL wedge resection, right chest tube removed, assess interval change.

COMPARISON: Prior exam is dated ___ at 10:20. Chest CT from ___.

FINDINGS: PA and lateral views of the chest provided. There has been interval removal of the right chest tube. Patient is undergone prior right lower lobe wedge resection. Skin ___ along the right lateral chest wall noted. Midline sternotomy wires and a prosthetic cardiac valve are again noted. There is no pneumothorax. Blunting of the right CP angle with thickening along the right lateral pleura could represent loculated effusion. There is scattered poorly defined opacity within the right lung which has been seen on prior exams and is concerning for infection vs atelectasis. There is mild left basilar atelectasis and possible tiny left pleural effusion. The heart size is difficult to assess but appears grossly unchanged. The mediastinal contour appears stable. The bony structures appear grossly intact.

IMPRESSION: 1. Interval removal of right chest tube without pneumothorax. Probable loculated right pleural effusion with extensive opacity in the right lung concerning for pneumonia vs atelectasis. 2. Probable atelectasis and small effusion at the left lung base.


SubjectID: 12547073, StudyID: 58504633, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with RLL nodule // check for leak check for leak

IMPRESSION: In comparison with the earlier study of this date, there again are postoperative changes on the right. The chest tube is in place and there is no evidence of pneumothorax. Some indistinctness of pulmonary vessels suggests elevated pulmonary venous pressure. Continued opacification at the left base consistent with atelectasis and effusion.


SubjectID: 12547073, StudyID: 55720265, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman s/p Right Vats wedge with post op bleeding // R/O PTX with CT clamped for 3 hours, please do around 9:30 am R/O PTX with CT clamped for 3 hours, please do around 9:30 a

IMPRESSION: In comparison with the study of ___, the right chest tube has been clamped and there is no evidence of pneumothorax. Little interval change in the appearance of the heart and lungs.


SubjectID: 12547073, StudyID: 55452351, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman s/p R VATS wedge bx // check interval change check interval change

IMPRESSION: In comparison with the study of ___, there is little overall change   Keywords: little overall change. Continued enlargement of the cardiac silhouette with elevation of pulmonary venous pressure. Postoperative changes are seen on the right with continued blunting of the costophrenic angle and opacification along the right lateral chest wall. In the appropriate clinical setting, superimposed pneumonia would have to be considered. Mild left basilar atelectatic changes are again seen.


SubjectID: 12547073, StudyID: 50667823, Comparison: None

FINAL REPORT

PORTABLE CHEST ___

COMPARISON: ___ radiograph.

FINDINGS: Right chest tube remains in place, with a tiny right apical pneumothorax as well as a possible basilar component of pneumothorax. Heterogeneous opacities in the right mid and lower lung regions have minimally improved, and a loculated right pleural effusion is unchanged. On the left, there has been slight improvement in left retrocardiac atelectasis with persistent adjacent small left pleural effusion.


SubjectID: 12547073, StudyID: 53910524, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with chest tube removed // s/p chest tube removal s/p chest tube removal

IMPRESSION: In comparison with the study of earlier in this date, 1 of the right chest tubes has been removed. No evidence of pneumothorax. Otherwise little change   Keywords: little change.


SubjectID: 12547073, StudyID: 52150510, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with s/p R wedge resection // interval change interval change

IMPRESSION: In comparison with the study of ___, the endotracheal tube has been removed. Again there are 2 right chest tubes but no evidence of pneumothorax. The subcutaneous gas has essentially cleared. Continued enlargement of the cardiac silhouette with elevation of pulmonary venous pressure, bilateral pleural effusions, and compressive atelectasis at the bases.


SubjectID: 12547073, StudyID: 58299491, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p takeback R thoracotomy for hemoptysis // post op eval post op eval

IMPRESSION: In comparison with the study of earlier in this date, there has been a substantial increase in subcutaneous gas along the right lateral chest wall extending into the neck. This information was conveyed to Dr.___. Right chest tube remains in place without definite pneumothorax. Indistinctness of pulmonary markings suggests some over-hydration or vascular congestion. Endotracheal tube tip lies approximately 2 cm above the carina. Bibasilar opacifications are consistent with pleural effusion and compressive atelectasis.


SubjectID: 12547073, StudyID: 55541540, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p VATS R LL wedge // post op eval post op eval

IMPRESSION: In comparison with the study of ___, there is been a vats procedure with right lower lobe wedge resection. Right chest tube is in place and there is no evidence of pneumothorax. Postoperative changes are seen on the right. Basilar opacification bilaterally is consistent with pleural effusion and compressive atelectasis.


SubjectID: 12547073, StudyID: 55118322, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p takeback R thoracotomy for hemoptysis // interval eval interval eval

IMPRESSION: In comparison with the study of to ___, the 2 chest tubes remain in the right hemithorax without evidence of pneumothorax. There has been some decrease in the subcutaneous gas along the right lateral chest wall and extending into the neck. Bilateral increased basilar opacification is again consistent with some combination of pleural fluid and compressive atelectasis. Endotracheal tube is essentially unchanged.


SubjectID: 12547073, StudyID: 52965793, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ F h/o COPD p/w peripheral RLL nodule s/p R VATS and wedge ___ // interval eval ? bleed interval eval ? bleed

IMPRESSION: In comparison with the earlier study of this day, the right chest tube remains in place and there is no pneumothorax. There is some increasing opacification at the right base with continued opacification at the left base, consistent with pleural fluid and compressive atelectasis on both sides. The degree of subcutaneous gas at the right base appears to have increased.


SubjectID: 12548159, StudyID: 59548661, Comparison: worse

WET READ: ___ ___ 10:04 PM Moderate pulmonary edema.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

INDICATION: ___-year-old with respiratory distress.

TECHNIQUE: Single frontal radiograph of the chest was obtained.

COMPARISON: Chest radiograph from ___.

FINDINGS: There is moderate cardiomegaly and mild pulmonary edema as well as bilateral small pleural effusions. The mediastinum and hila are normal. No focal consolidation.

IMPRESSION: Mild-to-moderate pulmonary edema, progressed since ___   Keywords: progressed.


SubjectID: 12548159, StudyID: 56957928, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH: Comparison: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Mild fluid overload. Cardiomegaly, extensive right pleural effusion with subsequent right middle and lower lung consolidations, likely to represent atelectasis, pneumonia, or a combination of both. Unchanged right PICC line. No pneumothorax.


SubjectID: 12567919, StudyID: 59943520, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with CHF, hypoxia s/p diuresis // interval change

COMPARISON: Radiographs from ___

IMPRESSION: Heart size is upper limits of normal. There are low lung volumes. There are no focal consolidations, pleural effusion, or pulmonary edema. There are no pneumothoraces.


SubjectID: 12567919, StudyID: 55993023, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (AP AND LAT)

INDICATION: ___F with ?chf // eval for chf

COMPARISON: ___

FINDINGS: AP upright and lateral views of the chest provided. Cardiomegaly again noted with cephalization and hilar engorgement. No large effusion or pneumothorax. No convincing signs of pneumonia. Bony structures appear unchanged.

IMPRESSION: Mild edema, cardiomegaly unchanged   Keywords: unchanged.


SubjectID: 12567919, StudyID: 57319576, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with altered mental status, fever, recent admission

TECHNIQUE: Single AP view of the chest was obtained.

COMPARISON: AP view of the chest dated ___, AP and lateral views of the chest dated ___

FINDINGS: Lung volumes are low. The heart remains mildly enlarged. The mediastinal and hilar contours are unremarkable. No definite consolidation, pleural effusion, or pneumothorax is noted. No acute osseous abnormality is detected.

IMPRESSION: No acute intrathoracic findings.


SubjectID: 12567919, StudyID: 50456807, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with diastolic CHF, history of Hodgkins lymphoma, presenting with fever, cough, septic shock. // please assess for retrocardiac opacity or other evidence of infiltrate please assess for retrocardiac opacity or other evidence of infiltrate

COMPARISON: ___

IMPRESSION: Cardiomegaly is moderate. Mediastinum is unremarkable. Mild interstitial edema is present. No focal consolidations noted.


SubjectID: 12567919, StudyID: 53891298, Comparison: None

FINAL REPORT

INDICATION: ___F with confusion, hypoxia and LLL ronchi // eval for pna

TECHNIQUE: Single portable view of the chest.

COMPARISON: ___.

FINDINGS: Relatively low lung volumes are noted. There is no focal consolidation, large effusion or vascular congestion. Cardiomediastinal silhouette is stable. No acute osseous abnormalities.

IMPRESSION: No visualized acute cardiopulmonary process.


SubjectID: 12567919, StudyID: 52851728, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with influenza pneumonia // ?infiltrates

COMPARISON: Radiographs from ___

IMPRESSION: Heart size is prominent but stable. No focal consolidation is seen however there is some mild prominence of the interstitial markings. There are no pneumothoraces.


SubjectID: 12577612, StudyID: 58348267, Comparison: None

FINAL REPORT

PATIENT

HISTORY: ___ years old man with DOE/CP craakle ___ - JVD, trace of edema, congestive heart failure.

TECHNIQUE: Chest x-ray in two projections.

COMPARISON: Exam is compared to chest x-ray of ___.

FINDINGS: Left lower lobe reticular and cystic opacities have increased and are suspicious for new inflammatory infective process superimposed to mild basilar fibrosis and bronchiectasis. Heart size is stable and mildly enlarged. The patient had sternotomy for cardiac surgery. The right pectoral pacemaker is unchanged and standard position with wires following the expected course. There is no pleural effusion or pneumothorax.

IMPRESSION: New left lobe consolidation with persistent bibasilar reticular and cystic changes suggestive of pneumonia superimposed to fibrosis. Findings were paged to Dr ___ ___ at 6:20 pm by Dr ___


SubjectID: 12577612, StudyID: 54460868, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Dyspnea on exertion, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the bilateral reticular opacities at the lung bases, left more than right, are overall unchanged. No new parenchymal opacities   Keywords: new. Unchanged appearance of the cardiac silhouette. No pneumothorax. Status post CABG and pacemaker placement. As communicated in yesterday's report, the findings are suggestive of pneumonia superimposed on fibrosis. No pulmonary edema.


SubjectID: 12577612, StudyID: 55499248, Comparison: None

WET READ: ___ ___ ___ 11:13 AM The left pleural effusion is not significantly changed since study performed 1 day prior. Likely small right pleural effusion is also present. There is persistent bibasilar reticular opacities, which could reflect worsening of chronic interstitial lung disease versus superimposed infection.

WET READ VERSION #1 ___ ___ 11:16 PM The left pleural effusion is not significantly changed since study performed 1 day prior. Likely small right pleural effusion is also present. There is persistent bibasilar reticular opacities, which could reflect worsening of chronic interstitial lung disease versus superimposed infection. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___ year old man with effusion, appears larger on stress MIBI // Assess for effusion progression

TECHNIQUE: PA and lateral

FINDINGS: Triple lead right-sided pacer device is stable in position. The patient is status post median sternotomy and CABG. The cardiac and mediastinal silhouettes are stable. When compared to the most recent prior examination stable bilateral pleural effusions with basal opacities, are superimposed on background lower lobe predominant fibrosis. There is mild vascular congestion PE

IMPRESSION: Basal predominant fibrosis with superimposed small bilateral pleural effusions. The superimposed basal airspace opacities can represent dependent edema due to congestive heart failure or infection in the appropriate clinical setting.


SubjectID: 12577612, StudyID: 51161208, Comparison: None

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: History: ___M with chest pain // PNA?

TECHNIQUE: Chest: Frontal and Lateral

COMPARISON: ___

FINDINGS: Triple lead right-sided pacer device is stable in position. The patient is status post median sternotomy and CABG. The cardiac and mediastinal silhouettes are stable. There is significant increase in bibasilar reticular opacities which could be due to chronic lung disease however, superimposed infection is difficult to entirely excluded in the appropriate clinical setting. Blunting of the left costophrenic angle is seen and there may be a trace pleural effusion versus pleural thickening.

IMPRESSION: Interval increase in bibasilar reticular opacities which may be due to worsening of chronic interstitial lung disease, but superimposed infection may be present.


SubjectID: 12591968, StudyID: 54385304, Comparison: None

FINAL REPORT

HISTORY: CHF, to assess for pneumonia.

FINDINGS: No previous images. There is enlargement of the cardiac silhouette with evidence of substantial elevation of pulmonary venous pressure. Although no definite consolidation is appreciated, this would be difficult to detect in view of the pulmonary vascular congestion. In addition, the area behind the heart would require a lateral view for proper evaluation.


SubjectID: 12591968, StudyID: 50160048, Comparison: better

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with CHF, treated for pneumonia at outside hospital, afebrile. Volume status ? infiltrate ?

COMPARISON: ___.

FINDINGS: Moderate pulmonary edema has completely resolved   Keywords: resolve   Keywords: resolve. Left lower lobe atelectasis is also better. Mild cardiomegaly is unchanged. Pleural effusion is small if any. There is no pneumothorax.

CONCLUSION: Moderate pulmonary edema has completely resolved. There is no evidence of new consolidation.


SubjectID: 12595991, StudyID: 59402852, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with open abd, intubated // interval assessment interval assessment

IMPRESSION: In comparison with the study ___ ___, there has been placement of an endotracheal tube with its tip approximately 4.6 cm above the carina. Nasogastric tube extends to the lower body of the stomach. Continued low lung volumes. There is increase in the size and indistinctness of pulmonary vessels, consistent with elevated pulmonary venous pressure possibly related to over-hydration   Keywords: increase. The 3-channel pacer device remains in place. The left IJ catheter again crosses the midline to extend to the right subclavian or internal jugular system.


SubjectID: 12595991, StudyID: 58585557, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with hypotension and dyspnea // infiltrate, edema

TECHNIQUE: Portable chest x-ray.

COMPARISON: Chest radiographs dated ___ through ___.

FINDINGS: Portable semi-upright radiograph of the chest demonstrates low lung volumes with resultant bronchovascular crowding. Bibasilar consolidations may represent atelectasis or pneumonia in the appropriate clinical setting. The cardiomediastinal and hilar contours are unchanged. There is a new lucency beneath the right hemidiaphragm concerning for intra-abdominal free air. Right-sided PICC line and to the mid SVC. Unchanged position of the AICD. No pneumothorax.

IMPRESSION: 1. Bibasilar consolidations may represent atelectasis or pneumonia in the appropriate clinical setting. 2. New lucency beneath the right hemidiaphragm is concerning for intra-abdominal free air. Clinical correlation recommended. Additional evaluation could be performed with repeat upright radiograph or left lateral decubitus radiograph.

NOTIFICATION: These findings were discussed with Dr. ___ By Dr. ___ ___ telephone at 10:29 on ___, 10 minutes after discovery.


SubjectID: 12595991, StudyID: 55463602, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with open abdomen, oliguric renal failure // presence of interval change

TECHNIQUE: Portable chest x-ray.

COMPARISON: Chest radiographs dated ___ through ___.

FINDINGS: Portable semi-upright radiograph of the chest demonstrates low lung volumes with resultant bronchovascular crowding. Clearing of the right base is consistent with decrease in size of the pleural effusion and improved aeration. Persistent retrocardiac opacity corresponds to atelectasis and probable left pleural effusion. There is moderate pulmonary edema. Cardiomediastinal and hilar contours are unchanged. Monitoring and support devices are in the appropriate position.

IMPRESSION: 1. Moderate pulmonary edema. 2. Stable retrocardiac opacity, consistent with small pleural effusion and atelectasis.


SubjectID: 12595991, StudyID: 50749866, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with open abdomen // interval progression

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: Moderate to severe cardiomegaly is stable. Pacer leads are in standard position. ET tube is in standard position. Left IJ catheter tip is in the mid SVC . Right PICC is in unchanged position. NG tube tip is out of view below the diaphragm. Vascular congestion has improved   Keywords: improve. Bibasilar atelectasis have improved. Bilateral effusions right greater than left are unchanged

IMPRESSION: Improved pulmonary edema   Keywords: improve.


SubjectID: 12604446, StudyID: 59375739, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluation for pleural effusions.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Areas of atelectasis at both lung bases. The ventilation of the right upper lobe has improved. The pleural effusions are seen on the lateral radiograph only and are limited to the posterior aspects of the costophrenic sinuses. The size of the cardiac silhouette is unchanged. Unchanged alignment of the sternal wires.


SubjectID: 12604446, StudyID: 53386432, Comparison: better

FINAL REPORT

HISTORY: ___-year-old male status post mitral valve repair and chest tube removal. Question pneumothorax.

COMPARISON: ___

FINDINGS: Compared to two days prior, there is significant improvement of pulmonary edema and near complete resolution of a right pleural effusion   Keywords: improve. There is persistent subsegmental atelectasis in the right upper lobe and increased retrocardiac opacity, consistent with left basilar atelectasis. Postsurgical cardiomediastinal silhouette is stable. A replacement mitral valve is in place. Median sternotomy and sternotomy wires are intact. The Swan-Ganz catheter and intra-aortic balloon pump has been removed.

IMPRESSION: 1. Improved pulmonary edema and decrease right pleural effusion   Keywords: improve, decrease. 2. Stable subsegmental atelectasis in the right upper lung and slightly increased left basilar atelectasis.


SubjectID: 12604446, StudyID: 59246897, Comparison: better

FINAL REPORT

PORTABLE CHEST X-RAY OF ___

COMPARISON: ___.

FINDINGS: Swan-Ganz catheter has been placed via a femoral approach, with initial abrupt angulation within the right atrium, subsequently coursing into the right pulmonary artery with distal tip directed horizontally at the right hilum, likely at the junction of the right main and interlobar pulmonary arteries. Intra-aortic balloon pump is present, with radiodense tip terminating at the level of the aorticopulmonary window. Cardiomediastinal contours are within normal limits. Improving perihilar edema with residual predominantly interstitial edema remaining, as well as probable small bilateral pleural effusions   Keywords: improving.


SubjectID: 12604446, StudyID: 54249072, Comparison: better

FINAL REPORT

INDICATION: Hypertension and acute mitral regurgitation, status post intra-aortic balloon pump.

TECHNIQUE: Portable frontal chest radiograph.

COMPARISON: ___.

FINDINGS: Cardiomediastinal silhouette and hilar contours are stable. Intra-aortic balloon pump is in appropriate position 2.5 cm caudal to the aortic knob. A right femoral approach Swan-Ganz catheter is in place with tip pointing slightly cranially, in a right upper lobar pulmonary artery. There is continued improvement of pulmonary edema   Keywords: improve. There is no large effusion or pneumothorax.

IMPRESSION: 1. Swan-Ganz catheter in a right upper lobar pulmonary artery and withdrawal of the catheter by 3 cm is recommended. IABP in appropriate position. 2. Continued improvement of edema   Keywords: improve. Results were discussed over the telephone with Deb, CCU nurse, by ___ at 9:42 a.m. on ___ at the time of discovery.


SubjectID: 12604683, StudyID: 59296315, Comparison: None

FINAL REPORT

INDICATION: ___F with sob

COMPARISON: Chest radiograph dated ___

FINDINGS: AP upright and lateral chest radiograph demonstrates right upper lobe airspace opacities suggestive of pneumonia. Cardiomediastinal and hilar contours are stable in appearance and within normal limits. Obscuration of the left heart border is less conspicuous. There is no pleural effusion or pneumothorax. No acute osseous abnormalities detected.

IMPRESSION: Airspace opacities within the right upper lobe suggestive of pneumonia.


SubjectID: 12604683, StudyID: 56045390, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with pneumonia and chf // evaluate for any evolution of the pna and pulm venous congestion. please perform chest xray in the morning before 8 am evaluate for any evolution of the pna and pulm venous conges

IMPRESSION: In comparison with the study of ___, what appears to have been pulmonary vascular congestion has substantially improved   Keywords: improve. Diffuse prominence of coarse markings throughout both lungs could well merely reflect severe chronic pulmonary disease. No definite acute focal pneumonia at this time.


SubjectID: 12604683, StudyID: 52581231, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Shortness of breath.

COMPARISONS: ___.

TECHNIQUE: Chest, portable AP upright.

FINDINGS: There is a moderate left-sided pleural effusion with associated opacity, probably due to atelectasis. Similar but less striking findings are present on the right with a small effusion. There is new prominence of the pulmonary vascularity, which appears mildly distended and indistinct suggesting mild vascular congestion   Keywords: new. The heart is again mildly enlarged. The aortic arch is calcified.

IMPRESSION: Findings suggesting mild pulmonary edema with pleural effusions.


SubjectID: 12606113, StudyID: 59664041, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___-year-old man with ESRD on HD, now SOB. Evaluate for pulmonary edema. Per OMR, the patient has a history of recurrent lung cancer and history of left lower lobectomy.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph dated ___. Reference is made to the FDG PET-CT dated ___.

FINDINGS: The heart is mildly enlarged. There is hilar congestion and mild interstitial edema. The aorta is slightly unfolded and calcified. Blunting of the left CP angle could be related to pleural thickening though a small effusion difficult to exclude. There is mild right basal atelectasis. Chronic deformity of the left ribs noted. No acute osseous abnormality.

IMPRESSION: Cardiomegaly with hilar congestion and mild interstitial edema. Possible tiny left pleural effusion. Right basal platelike atelectasis.


SubjectID: 12606113, StudyID: 59129783, Comparison: None

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old man with cardiac arrest // PTX?

TECHNIQUE: Portable AP chest

COMPARISON: ___ PA and lateral chest radiographs

FINDINGS: Lateral left lung and bilateral costophrenic angles are excluded from the field of view. Despite this limitation, there is new lucency over the inferior and lateral right lung. No definite pneumothorax. Mild pulmonary edema in the right upper and left lung. Interval intubation with endotracheal tube terminating 6 cm above the carina. Heart size and cardiomediastinal hilar silhouettes are likely unchanged.

IMPRESSION: New lucency over the lower right lung is suspicious for pulmonary embolism, less likely anterior pneumothorax.

NOTIFICATION: The findings were discussed with Dr. ___ by ___, M.D. on the telephone on ___ at 5:08 PM, less than 5 minutes after discovery of the findings.


SubjectID: 12606113, StudyID: 55175960, Comparison: None

FINAL REPORT

HISTORY: Status post bronchoscopy and bilateral transbronchial biopsy. Check for pneumothorax post procedure.

COMPARISON: Chest radiograph from ___ in conjunction with chest CT from ___.

FINDINGS: Compared with recent CT, there is no significant change in the right lower lobe and left lower lingular nodules opacities. There is no pneumothorax. No focal consolidation or pleural effusion is present.

IMPRESSION: No change in the bilateral nodular opacities from recent CT scan with no evidence of pneumothorax after biopsy.


SubjectID: 12606113, StudyID: 54064469, Comparison: None

FINAL REPORT

HISTORY: Bilateral lung biopsy, to assess for pneumothorax.

FINDINGS: In comparison with the earlier study of this date, there again is no evidence of pneumothorax. Bibasilar opacifications persist consistent with previous nodules and perhaps some atelectatic changes.


SubjectID: 12606543, StudyID: 59703611, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: Chest AP portable single view.

INDICATION: ___-year-old female patient with new tracheostomy and Dobbhoff line placement. Evaluate.

FINDINGS: AP single view of the chest has been obtained with patient in supine position. Comparison is made with the next previous similar study obtained 10 hours earlier during the same day. The patient has now been extubated and a tracheostomy cannula has been placed. The position is unremarkable and no pneumothorax has developed. Previously identified right internal jugular approach central venous line remains in unchanged position. A Dobbhoff tube is identified and seen to reach well below the hiatus with the terminal portion reaching well into the fundus of the stomach. No new pulmonary abnormalities are seen.


SubjectID: 12606543, StudyID: 59679485, Comparison: same

WET READ: ___ ___ ___ 10:01 PM ET tube 7.2 cm from the carina - advancement by 3 cm recommended. NG within the stomach. Right IJ in low SVC. No pneumothorax. Stable moderate pulmonary edema and cardiomegaly. ET tube position communicated to ___ ICU RN by telephone - who stated tube had already been advanced (RN ___) @ 10pm on ___. ___ p_________________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

TECHNIQUE: Portable upright chest tube was read in comparison with prior chest radiographs through ___ with the most recent from ___.

FINDINGS: With the patient's neck in flexed position, the endotracheal tube ends high, 9-10 cm above the carina. Consider advancing the endotracheal tube by 3-4 cm for appropriate seating. Orogastric tube ends in the stomach and right internal jugular line terminates at cavoatrial junction, and are appropriate. Bilateral lung volumes remain low. Mediastinal and pulmonary vascular congestion is unchanged   Keywords: unchanged. Bilateral lower lung atelectasis, left side more than right, is similar. There is no pulmonary edema or pleural effusion. Dr. ___ discussed findings related to endotracheal tube position with ICU RN by telephone at 10:00 p.m. on ___.


SubjectID: 12606543, StudyID: 54651118, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

TECHNIQUE: Portable AP upright chest view was read in comparison with prior chest radiographs through ___ with the most recent from ___.

IMPRESSION: Endotracheal tube has been repositioned and now the tip ends approximately 4.3 cm above the carina and is appropriate. Orogastric tube ends into the stomach and the right internal jugular line terminates approximately at the level of the cavoatrial junction. Mildly enlarged heart size and mediastinal and vascular congestion are unchanged since prior radiograph from ___   Keywords: unchanged. Lung volumes remain low. There are no lung opacities concerning for pneumonia. There is no pleural effusion.


SubjectID: 12606543, StudyID: 52626846, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: COPD, intubation, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The position and course of the endotracheal tube and the nasogastric tube are constant. There is unchanged mild-to-moderate pulmonary edema and moderate cardiomegaly   Keywords: unchanged. Also, a rounded parenchymal opacity lateral to the left hilus is unchanged. No larger pleural effusions. No pneumothorax. No interval appearance of new parenchymal changes.


SubjectID: 12606543, StudyID: 58443098, Comparison: same

FINAL REPORT

INDICATION: Hypercarbic respiratory failure, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Cardiomegaly with mild-to-moderate pulmonary edema and bilateral areas of atelectasis. Status post intubation, the tube has been advanced and the tip now projects at the level of the sternoclavicular joints. The nasogastric tube and the right internal jugular vein catheter are unchanged. Minimal increase in density around the left perihilar areas, probably vascular, the area should receive attention on future followups.


SubjectID: 12606543, StudyID: 53341645, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: COPD, extubation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient is now extubated. The course of the nasogastric tube and the right internal jugular vein catheter are unchanged. Unchanged moderate cardiomegaly with mild pulmonary edema and basal areas of atelectasis as well as a potential minimal left pleural effusion   Keywords: unchanged. No newly appeared focal parenchymal opacities suggesting pneumonia.


SubjectID: 12606543, StudyID: 58430651, Comparison: worse

FINAL REPORT

INDICATION: ___ year old woman with dCHF and ___ with viral PNA // volume status; eval for pulmonary edema

TECHNIQUE: Chest PA and lateral

COMPARISON: ___

FINDINGS: Tracheostomy tube remains in satisfactory position. There is stable marked cardiac and mediastinal enlargement. There is increasing mild pulmonary edema   Keywords: increasing. There are likely layering small effusions, left greater than right. No pneumothorax.

IMPRESSION: Slight interval worsening of mild to moderate pulmonary edema   Keywords: worse


SubjectID: 12606543, StudyID: 52846213, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with chronic trach, PNA // interval change interval change

COMPARISON: Comparison to ___ at 04:32

FINDINGS: Portable AP upright chest radiograph ___ at 15:35 is submitted.

IMPRESSION: Tracheostomy tube remains in satisfactory position. There is stable marked cardiac and mediastinal enlargement. There is increasing moderate pulmonary edema   Keywords: increasing. There are likely ayering small effusions, left greater than right. No definite pneumonia is appreciated.


SubjectID: 12606543, StudyID: 58378313, Comparison: worse

FINAL REPORT

INDICATION: Patient with shortness of breath and hypoxia.

COMPARISONS: Chest radiograph of ___.

FINDINGS: Frontal portable view of the chest demonstrates low lung volumes, which accentuate bronchovascular markings. Moderate pulmonary edema appears progressed from prior exam   Keywords: progressed. Left costophrenic angle is obscured, suggestive of a small pleural effusion. Left hemidiaphragm is poorly visualized due to a lung base opacity. Hilar and mediastinal silhouettes are unchanged. Moderate cardiomegaly is slightly increased from the prior study. Partially imaged upper abdomen is unremarkable.

IMPRESSION: 1. In comparison to ___ exam, there is worsening congestive heart failure with moderate pulmonary edema, small left pleural effusion, and increased size of the cardiac silhouette   Keywords: increase, worse. 2. Left lung base opacity obscuring left hemidiaphragm likely represents atelectasis or infection in appropriate clinical setting.


SubjectID: 12606543, StudyID: 50374506, Comparison: same

PROVISIONAL

FINDINGS

IMPRESSION (PFI): ___ ___ 9:26 AM PFI: 1. Line and tubes in place. 2. Stable cardiomegaly and mediastinal widening with moderate pulmonary edema   Keywords: stable   Keywords: stable. ______________________________________________________________________________

FINAL REPORT

STUDY: Portable AP semi-upright chest radiograph.

COMPARISON: ___.

FINDINGS: The endotracheal tube tip seats 4 cm above the carina. The endogastric tube courses inferiorly and projects over the stomach. The right-sided IJ central venous catheter tip seats at the cavoatrial junction. The heart size continues to be enlarged, as are the mediastinal contours, but they are stable compared to prior study. There continues to be moderate pulmonary edema   Keywords: continue. There is no pneumothorax or large pleural effusion.

IMPRESSION: 1. Line and tubes in place. 2. Stable cardiomegaly and mediastinal widening with moderate pulmonary edema.


SubjectID: 12606543, StudyID: 57986846, Comparison: same

WET READ: ___ ___ ___ 8:59 PM Little change from ___ in moderate pulmonary edema allowing for differences in lung volumes and technique. No new opacity ______________________________________________________________________________

FINAL REPORT

PORTABLE AP CHEST ON ___ AT 17:49 CLINICAL

INDICATION: ___-year-old with hypoventilation, status post trach and increasing secretions, question interval change in edema or infiltrate. Comparison is made to the patient's prior study of ___. A single portable semi-erect chest film ___ at 17:49 is submitted.

IMPRESSION: 1. Tracheostomy tube remains in place and likely unchanged in position. There continues to be bilateral airspace disease which does not appear to be appreciably changed and most likely represents stable pulmonary edema, although bilateral pneumonia cannot be excluded   Keywords: stable. The cardiac and mediastinal contours remain enlarged despite portable technique, but are likely stable given differences in positioning. The lung volumes remain relatively low. No large pneumothorax or pleural effusions are appreciated.


SubjectID: 12606543, StudyID: 55469435, Comparison: better

FINAL REPORT

PORTABLE AP CHEST FILM, ___ AT 4:33 CLINICAL

INDICATION: ___-year-old with worsening hypoxemia, evaluate for interval change. Comparison is made to the patient's previous study dated ___ at 17:49. A single portable erect chest film ___ at 4:30 a.m. is submitted.

IMPRESSION: 1. Tracheostomy tube remains in place in satisfactory position. Overall, cardiac and mediastinal contours are stably enlarged. There is interval improvement in the mild-to-moderate pulmonary edema   Keywords: improve. No focal airspace consolidation is seen to suggest pneumonia. No pleural effusions or pneumothorax is seen.


SubjectID: 12606543, StudyID: 51888508, Comparison: same

FINAL REPORT

INDICATION: ___-year-old woman with hypoxemia and volume overload, evaluate for interval change.

COMPARISONS: Portable chest radiograph from ___.

FINDINGS: The patient is status post tracheostomy. Since the most recent prior radiograph, there is no significant interval change   Keywords: no significant interval change. Again seen is diffuse bilateral patchy opacities and engorgement of pulmonary vasculature consistent with pulmonary edema   Keywords: again. Moderate cardiomegaly is stable. There is no definite focal consolidation, pleural effusion or pneumothorax.

IMPRESSION: Stable moderate pulmonary vascular congestion and unchanged cardiomegaly   Keywords: stable, unchanged.


SubjectID: 12606543, StudyID: 57572716, Comparison: None

FINAL REPORT

HISTORY: COPD and pulmonary hypertension with morbid obesity presenting with poor tidal volumes.

FINDINGS: In comparison with the study of ___, the position of the tracheostomy tube and Dobbhoff tube is unchanged. Continued enlargement of the cardiac silhouette with worsening congestive failure.


SubjectID: 12606543, StudyID: 51811896, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female, status post tracheostomy five days ago, now with leak. Confirm tube position.

COMPARISON: Chest radiograph from ___. SEMI-ERECT PORTABLE FRONTAL CHEST RADIOGRAPH: A tracheostomy cannula is located within the upper trachea above the level of the clavicles. There is no pneumothorax. Interval removal of the Dobbhoff feeding tube and right internal jugular catheter is noted. There is unchanged mild pulmonary vascular congestion, though no large effusions. Cardiomediastinal and hilar contours are enlarged but appear unchanged from prior.

IMPRESSION: 1. Tracheostomy cannula above the level of the clavicles within the upper trachea but rotated and potentially malpositioned. 2. No acute cardiopulmonary process.


SubjectID: 12606543, StudyID: 56467349, Comparison: better

FINAL REPORT

AP CHEST 3:30 A.M. ___

HISTORY: Re-adjusted PICC line.

IMPRESSION: AP chest compared to ___ at 1:26 a.m.: PICC line has been withdrawn to the approximate level of the superior cavoatrial junction. Lung volumes are low exaggerating mild vascular congestion which is improved, and moderate cardiomegaly and mediastinal venous engorgement which has not   Keywords: improve. No pleural effusion. Tracheostomy tube in standard placement. Feeding tube passes below the diaphragm and out of view.


SubjectID: 12606543, StudyID: 52039276, Comparison: same

FINAL REPORT

INDICATION: History of COPD, right CHF, CKD, and recent respiratory failure with new left arm pain and abnormal VBG.

COMPARISONS: Chest radiograph, ___. CT torso, ___. Chest radiograph, ___.

FINDINGS: The tracheostomy tube is approximately 2 cm from the carina, and unchanged in position. A right PICC ends at the superior atriocaval junction. Mild vascular congestion is unchanged from the prior radiograph   Keywords: unchanged. There is stable enlargement of the cardiomediastinal silhouette. There is no pleural effusion or pneumothorax. There is no new consolidation. A feeding tube is seen in the stomach with the tip out of the field of view.

IMPRESSION: Stable mild vascular congestion and cardiomegaly   Keywords: stable. No significant change from prior radiographs   Keywords: no significant change.


SubjectID: 12606543, StudyID: 51236351, Comparison: worse

FINAL REPORT

AP CHEST, 1:26 A.M., ___

HISTORY: Hypercarbic respiratory failure, check PICC line placement.

IMPRESSION: AP chest compared to ___: PICC line still ends low in the right atrium, no less than 6 cm beyond the estimated location of the superior cavoatrial junction. Severe cardiomegaly has worsened, and pulmonary vascular congestion may have progressed as well   Keywords: worse, progressed. Tracheostomy tube in standard placement. Feeding tube passes below the diaphragm and out of view. No pneumothorax. Pleural effusions are small if any.


SubjectID: 12606543, StudyID: 55854332, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Shortness of breath and lethargy.

COMPARISONS: ___.

TECHNIQUE: Chest, AP upright portable.

FINDINGS: The patient is status post tracheostomy. The heart is mildly enlarged. There is a mild prominence of pulmonary vascularity and patchy opacification suggesting pulmonary congestion. There is no definite pleural effusion or pneumothorax.

IMPRESSION: Findings suggesting mild pulmonary vascular congestion in the appropriate clinical setting.


SubjectID: 12606543, StudyID: 54990644, Comparison: None

FINAL REPORT

INDICATION: Shortness of breath, question of infiltrate or pulmonary edema.

COMPARISON: Chest radiograph on ___.

FINDINGS: Tracheostomy tube is in appropriate position. Moderate cardiomegaly is again seen. There is no evidence of pulmonary vascular congestion and pulmonary interstitial edema. There is no focal consolidation. There is no large pleural effusion or pneumothorax. A left mid lung opacity may represent a mass.

IMPRESSION: Marked cardiomegaly and pulmonary interstitial edema. Left mid lung opacity may represent small mass. CT can be done for further assessment.


SubjectID: 12606543, StudyID: 53526182, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old female with pulmonary hypertension and worsening hypoxia. Evaluation for pulmonary edema.

COMPARISON: Comparison is made to radiograph of the chest from ___ at 00:08.

FINDINGS: Frontal radiograph of the chest demonstrates interval worsening of pulmonary edema since the prior study eight hours earlier   Keywords: worse. The left mid lung opacity is unchanged acutely and could be atelectasis or scarring, but appears to have grown over the past several months, and could therefore be a mass. There is no pneumothorax or large pleural effusion. Marked cardiomegaly is unchanged. A face mask rests over the tracheostomy.

CONCLUSION: Interval worsening of pulmonary interstitial edema   Keywords: worse. Left mid lung opacity and marked cardiomegaly unchanged. The above findings were communicated to Dr. ___ by Dr. ___ ___ telephone at 10:00, at the time the discovery was made.


SubjectID: 12606543, StudyID: 54433547, Comparison: same

FINAL REPORT

INDICATION: ___-year-old female with congestive heart failure. Question interval change.

COMPARISON: Multiple prior exams, most recently ___.

FINDINGS: Single frontal view of the chest demonstrates persistent low lung volumes, likely accentuating the cardiac contour and mildly prominent hilar vessels. Mild component of upper zone pulmonary edema is similar   Keywords: similar. A tiny left pleural effusion is unchanged. There is stable to slightly increased compressive atelectasis in the left lung base. There is no pneumothorax or confluent consolidation. There is no large pleural effusion. The tracheostomy tube is in standard position. The airway is midline.

IMPRESSION: No new acute cardiopulmonary finding. Persistently low lung volumes.


SubjectID: 12606543, StudyID: 53053706, Comparison: None

FINAL REPORT

HISTORY: Pulmonary hypertension and CHF.

FINDINGS: In comparison with the study of ___, there are mildly improved lung volumes. Continued substantial enlargement of the cardiac silhouette with relatively mild vascular congestion. The asymmetry raises the possibility of cardiomyopathy or even pericardial effusion. Bibasilar atelectatic changes are seen. No evidence of acute focal pneumonia or large pleural effusion. Tracheostomy tube is again in standard position.


SubjectID: 12606543, StudyID: 54367732, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Obesity, hypoventilation, evaluation for interval change.

COMPARISON: ___, 1:57 a.m.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Tracheostomy tube is unchanged. Moderate cardiomegaly with moderate pulmonary edema and likely left pleural effusion. Extensive retrocardiac atelectasis. No evidence of pneumonia.


SubjectID: 12606543, StudyID: 53321027, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: ___. CLINICAL

HISTORY: CHF, hypoxia, question CHF or pneumonia.

FINDINGS: Portable AP upright chest radiograph obtained. A tracheostomy tube is seen. As on prior study, cardiomegaly and pulmonary edema is re-demonstrated. There is no large pleural effusion or pneumothorax. Evaluation for subtle superimposed pneumonia is limited. Mediastinal contour is stably widened. Bony structures appear intact.

IMPRESSION: Overall stable exam with pulmonary edema, cardiomegaly   Keywords: stable.


SubjectID: 12606543, StudyID: 51793077, Comparison: same

FINAL REPORT

INDICATION: TAH and acute respiratory failure, assess for interval change.

COMPARISON: Chest radiograph on ___.

FINDINGS: One portable AP semi-erect view of the chest. A right internal jugular central venous catheter ends at the cavoatrial junction. NG tube ends in the stomach with last side port below the GE junction. Endotracheal tube ends 5 cm from the carina. Cardiomegaly is stable. Mediastinal and hilar contours are stable. Moderate pulmonary edema is unchanged   Keywords: unchanged   Keywords: unchanged.

IMPRESSION: 1. Moderate pulmonary edema is unchanged. 2. Moderate cardiomegaly is stable.


SubjectID: 12612379, StudyID: 55547914, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female patient with right pleural effusion status post right-sided thoracentesis. Study requested to rule out pneumothorax.

TECHNIQUE: AP portable chest radiograph.

COMPARISON: Prior chest radiograph from ___.

FINDINGS: The cardiac size is normal. The hilar and mediastinal contours are normal. There has been interval improvement of the right sided pleural effusion. Right middle lobe opacity is not as sharply seen on today's examination. There is no pneumothorax.

IMPRESSION: Significant improvement of right pleural effusion with no pneumothorax.


SubjectID: 12612379, StudyID: 58734376, Comparison: None

FINAL REPORT

HISTORY: Pleural effusion, evaluation.

FINDINGS: In comparison with study of ___, there is little overall change in the degree of right pleural effusion with compressive atelectasis at the base. Otherwise, little change in the post-treatment changes of the right middle lobe mass. No vascular congestion or acute focal pneumonia.


SubjectID: 12612379, StudyID: 57782645, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female patient with recurrent right effusion status post thoracentesis, 600 mL removal.

COMPARISON: Prior chest radiograph from ___, 12:05.

TECHNIQUE: Portable AP chest radiograph.

FINDINGS: As compared to prior chest radiograph from ___, there has been minimal improvement of the right-sided pleural effusion. There is atelectasis at the base of the right lung. There is no pneumothorax. Posttreatment changes of the right middle lobe mass are unchanged. No vascular congestion or acute focal consolidations are noted.

IMPRESSION: Minimal improvement of right-sided pleural effusion with no pneumothorax.


SubjectID: 12612379, StudyID: 58330263, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: Chest AP portable single view.

INDICATION: ___-year-old female patient with COPD, pneumonia, now status post thoracocentesis, evaluate for pneumothorax.

FINDINGS: AP single view of the chest has been obtained with patient in upright position. Comparison is made with the next preceding similar study dated ___. The right lung base, which on the next previous examination demonstrated increased evidence of pleural effusion, has cleared up partially, indicating successful removal of pleural effusion. Examination of the right apical area with magnification device does not disclose any evidence of a small pneumothorax in this area. Previously described pulmonary changes are grossly unaltered.


SubjectID: 12612379, StudyID: 52805548, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post thoracocentesis, evaluation for pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. No pneumothorax after thoracocentesis. Normal lung volumes. The pre-existing parenchymal opacities are constant in extent and distribution. Unchanged borderline size of the cardiac silhouette. No large effusions are not documented on today's image.


SubjectID: 12612379, StudyID: 51917341, Comparison: None

FINAL REPORT

INDICATION: History of COPD and one week of shortness of breath, cough, fever, left base crackles, worse than right. Evaluate for pneumonia.

COMPARISONS: Chest CT from ___. PA and lateral chest x-ray from ___ and ___.

TECHNIQUE: PA and lateral chest radiographs are provided.

FINDINGS: There is a new small-to-moderate right pleural effusion. There is no focal consolidation or pneumothorax. Bibasilar atelectasis and scarring in the right middle lobe from prior RFA are unchanged. Coarse right breast calcifications are unchanged. Lungs remain hyperinflated. Cardiomediastinal silhouette is unchanged. Osseous structures are unremarkable except for degenerative changes in the thoracic spine.

IMPRESSION: Small-to-moderate right pleural effusion, increased since ___; otherwise, no significant change.


SubjectID: 12612379, StudyID: 50021562, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Shortness of breath, evaluation for acute process.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. No visible pneumothorax after right thoracocentesis. Unchanged signs of moderate fluid overload, unchanged appearance of the cardiac silhouette. Unchanged left pleural effusion and retrocardiac atelectasis.


SubjectID: 12612379, StudyID: 57789430, Comparison: None

FINAL REPORT

INDICATION: Pleural effusions.

COMPARISON: Chest CT ___.

FINDINGS: The cardiomediastinal and hilar contours remain stable. Again seen is a small to moderate right pleural effusion, difficult to compare to the prior study but grossly stable. There is no left pleural effusion, and there is no pneumothorax. Again seen is a nodular opacity in the lateral segment of the right middle lobe, corresponding to post-treatment changes, stable compared with the prior study. There is no new focal consolidation concerning for pneumonia. Pulmonary vasculature is within normal limits.

IMPRESSION: Small to moderate right pleural effusion, grossly stable since the prior chest CT.


SubjectID: 12612379, StudyID: 57101309, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with acute shortness of breath and crackles on exam, had been admitted for COPD exacberation, evaluate for pulmonary edema.

TECHNIQUE: Portable chest radiograph.

COMPARISON: Chest radiographs from ___ through ___. Chest CT ___.

FINDINGS: Since prior, there has been increased blunting of the left and right costophrenic angles, consistent with small bilateral pleural effusions. Additionally, increased heart size and peribronchial cuffing suggests mild pulmonary edema. A new linear opacity in the right midlung is likely infectious. There is no pneumothorax.

IMPRESSION: 1. Increased heart size, bilateral small effusions, and peribronchial cuffing consistent with pulmonary edema. 2. New opacification in the right midlung is likely infectious.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 11:26 AM, 30 minutes after discovery of the findings.


SubjectID: 12612379, StudyID: 55565854, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: Prior chest radiograph from ___ as well as a chest CT from ___. CLINICAL

HISTORY: Known pleural effusions with worsening shortness of breath. Assess interval change.

FINDINGS: PA and lateral views of the chest were provided. There is interval mild increase in the bilateral pleural effusions with slight increase in bibasilar atelectasis. The right mid lung opacity is similar to prior exam and reflects post-treatment changes of a right middle lobe mass. There is no pneumothorax and there are no clear signs of pulmonary edema. The heart size cannot be assessed. Mediastinal contour is stable. Bony structures are intact.

IMPRESSION: Mild increase in bilateral pleural effusions with bibasilar atelectasis, also slightly progressed.


SubjectID: 12612379, StudyID: 53804404, Comparison: None

FINAL REPORT

HISTORY: Thoracentesis, to assess for pneumothorax.

FINDINGS: In comparison with the earlier study of this date, there are somewhat lower lung volumes. Left pleural fluid with adjacent atelectasis is again seen. No definite pneumothorax is appreciated.


SubjectID: 12625430, StudyID: 55891642, Comparison: None

FINAL REPORT

HISTORY: COPD exacerbation.

FINDINGS: In comparison with the prior study, the retrocardiac region is much clearer. Remaining opacification in this region most likely represents atelectatic change, which has also improved at the right base. No pulmonary vascular congestion.


SubjectID: 12625430, StudyID: 50434660, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: New intubation, evaluation for tube placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has been intubated. The tip of the endotracheal tube projects 5.3 cm above the carina, the tube could be advanced by approximately 1-2 cm as it is very cranial. Borderline size of the cardiac silhouette with signs of minimal fluid overload. No pleural effusions. No pneumonia. Atelectasis at the lung bases.


SubjectID: 12629893, StudyID: 59589501, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p cardiac arrest with falling Hct on heparin gtt. // interval change? effusion?

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, there is unchanged evidence of a right internal jugular vein catheter, of a nasogastric tube that projects over the proximal parts of the stomach and has been pulled back, as well as of a endotracheal tube that is positioned slightly to I. The pre-existing mild but widespread parenchymal opacities are unchanged in extent and severity   Keywords: unchanged. No larger pleural effusions. No pneumothorax.


SubjectID: 12629893, StudyID: 52311931, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with COPD, ILD, CAD, CHF now s/p cardiac arrest and intubated and sedated. // confirm OGT placement

TECHNIQUE: Portable AP Upright view of the chest

COMPARISON: ___

FINDINGS: Endotracheal tube terminates approximately 8 cm above the carina and should be further advanced for optimal placement. There is interval placement of an enteric tube projecting over the stomach, tip not imaged. Cardiomediastinal silhouette is unchanged. The small bilateral pleural effusions and adjacent atelectasis are noted. The lungs are otherwise clear.

IMPRESSION: 1. Endotracheal tube projects 8 cm above the carinal and remains too high; needs to be advanced further for optimal placement. 2. Interval placement an enteric tube projecting over the stomach, tip not imaged. 3. Bilateral small pleural effusions and mild bibasilar atelectasis.


SubjectID: 12629893, StudyID: 52248308, Comparison: same

FINAL REPORT

INDICATION: Shock and respiratory failure, status post cardiac arrest. Evaluate endotracheal tube placement.

COMPARISON: ___.

FINDINGS: The ET tube ends 5.3 cm from the carina. Right IJ ends in the mid SVC. Sternotomy wires and mediastinal clips are stable. Enteric tube ends in the stomach. No significant change in bilateral parenchymal opacities.

IMPRESSION: ET tube ends 5 cm from the carina. Bilateral parenchymal opacities are unchanged   Keywords: unchanged.


SubjectID: 12629893, StudyID: 53817696, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with end stage COPD and lung disease // eval for consolidation/infiltrate, congestion, R IJ placement, OG tube, ET tube placement

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The tubes and lines are unchanged. Unchanged appearance of the cardiac silhouette. Unchanged appearance of the lung parenchyma   Keywords: unchanged appearance.


SubjectID: 12629893, StudyID: 59195003, Comparison: worse

FINAL REPORT

AP CHEST, 12:36 A.M., ___

HISTORY: COPD and new hypoxia.

IMPRESSION: AP chest compared to ___ through ___ at 12:36 p.m. Prior chest CT scanning reveals that the patient has severe emphysema and mild pulmonary fibrosis. Would explain the heterogeneous distribution of acute pulmonary edema, worsened since ___   Keywords: worse. Heart size is top normal, unchanged. Pleural effusion small on the right. No pneumothorax.


SubjectID: 12629893, StudyID: 57093275, Comparison: None

FINAL REPORT

INDICATION: Shortness of breath.

COMPARISON: Chest radiograph ___. CTA chest ___.

FINDINGS: The lungs are hyperinflated. There are coarse bilateral interstitial markings, most predominant in the periphery and the bases. This is consistent with the patient's history of emphysema related fibrosis. The interstital changes limit the evaluation of the underlying parenchyma, but there is no definite evidence of consolidations, edema, pleural effusion, or pneumothorax. The patient is status post a median sternotomy. The sternal wires are intact. The cardiomediastinal silhouette is normal.

IMPRESSION: Chronic interstitial lung disease and emphysema. Evaluation of the underlying parenchyma is limited, but no acute cardiopulmonary process is present.


SubjectID: 12629893, StudyID: 58489584, Comparison: same

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: Patient with upper GI bleed, now intubated. Evaluate tube placement and for pulmonary edema.

FINDINGS: Comparison is made to previous study from ___ at 3:47 a.m. The endotracheal tube, enteric tube, and right-sided central venous line are unchanged in position. There is unchanged cardiomegaly. There is again seen coarsening of the bronchovascular markings which is unchanged and may represent some mild pulmonary edema   Keywords: unchanged. There is mild blunting of bilateral costophrenic angles suggestive of small pleural effusion. No pneumothoraces are seen. Overall, there has been no change   Keywords: no change.


SubjectID: 12629893, StudyID: 54663114, Comparison: None

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old man with several cardiac arrests. Placement of the endotracheal tube.

FINDINGS: Comparison is made to previous study from ___ at 7:47 a.m. There has been placement of an endotracheal tube whose distal tip is 6.7 cm above the carina. The heart size is within normal limits. There is an enteric tube whose sideport is just below the GE junction. There is a right IJ central line with distal lead tip in the distal SVC. There is again seen severe emphysema and changes likely related to pulmonary fibrosis particularly within the right lung. Mild blunting of the right costophrenic angle likely represents a small pleural effusion. There are no pneumothoraces. Overall, these findings appear stable.


SubjectID: 12629893, StudyID: 53842265, Comparison: better

FINAL REPORT

PORTABLE CHEST ___

COMPARISON: ___ ___ ___.

FINDINGS: Interval extubation. Decrease in extent of pulmonary edema as well as slight improvement in extent of bibasilar atelectasis   Keywords: improve, decrease. Small pleural effusions are present, but there is no visible pneumothorax.


SubjectID: 12629893, StudyID: 55285845, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with COPD on home O2 with ILD now s/p PEA arrest likely secondary to respiratory failure // interval change

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Mild cardiomegaly is stable. Moderate right effusion has minimally increased with increasing adjacent atelectasis. Known severe emphysema, associated interstitial abnormality and mild vascular congestion are stable   Keywords: stable. Sternal wires are aligned There is no pneumothorax . If any there is a small left effusion


SubjectID: 12629893, StudyID: 54733747, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___ Comparison with a study performed earlier today as well as one dated ___. CLINICAL

HISTORY: Hypoxia, assess CHF.

FINDINGS: Portable upright AP views of the chest were provided. Midline sternotomy wires and mediastinal clips again noted. Patient is known to have a background of emphysema though there is superimposed pulmonary edema. Trace bilateral pleural effusions are seen. Overall no change from prior study from approximately three hours earlier   Keywords: no change. Bony structures appear intact.

IMPRESSION: Findings compatible with congestive heart failure superimposed on a background of emphysema. No change from prior from three hours ago   Keywords: no change.


SubjectID: 12629893, StudyID: 51632471, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: ___. CLINICAL

HISTORY: Shortness of breath and chest pain.

FINDINGS: PA and lateral views of the chest were obtained. Midline sternotomy wires and mediastinal clips are again noted. There is a background of emphysema better appreciated on the prior radiographs. There has been interval development of pulmonary vascular congestion and mild pulmonary edema   Keywords: development. Trace bilateral pleural effusions are present. No pneumothorax. Cardiomediastinal silhouette is stable. Bony structures are intact.

IMPRESSION: Emphysema with superimposed pulmonary edema. Trace bilateral pleural effusions.


SubjectID: 12629893, StudyID: 51294575, Comparison: None

FINAL REPORT

INDICATION: ___ year old man s/p PEA arrest and intubated // intubated patient

TECHNIQUE: Portable chest x-ray.

COMPARISON: Chest radiographs dated ___ through ___.

FINDINGS: Portable semi-upright radiograph of the chest demonstrates hyperexpanded lungs with diffuse coarsened interstitial markings bilaterally, concerning for interstitial pulmonary fibrosis. Interval worsening of a right-sided pleural effusion with adjacent atelectasis. The cardiomediastinal and hilar contours are unchanged. The endotracheal tube ends 4.6 cm from the carina. Nasogastric tube courses into the stomach. No pneumothorax.

IMPRESSION: 1. Diffuse coarse interstitial markings bilaterally are concerning for interstitial pulmonary fibrosis. 2. Interval worsening of right-sided pleural effusion with adjacent atelectasis.


SubjectID: 12645992, StudyID: 56379734, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Previous pigtail placement, now pulled. Evaluation for pneumothorax.

COMPARISON: ___, 1:57 p.m.

FINDINGS: As compared to the previous radiograph, the right pigtail catheter has been pulled. There is no evidence of pneumothorax. No pleural effusion on the right. The left pleural effusion is unchanged in appearance. Moderate cardiomegaly, moderate retrocardiac atelectasis.


SubjectID: 12645992, StudyID: 54300494, Comparison: None

FINAL REPORT

HISTORY: History of CHF status post right thoracentesis with pleural pigtail catheter in place, here to evaluate for interval change.

COMPARISON: Chest radiograph dated ___ at 15:46. Technique: Portable upright AP radiograph of the chest.

FINDINGS: A left pectoral pacemaker with 2 leads terminating in the right atrium and right ventricle is unchanged. A right pleural pigtail catheter is unchanged in position between the right lateral ___ and 7th ribs. There is improved aeration of the right lung base and improved inspiratory effort compared to the most recent prior study. No residual right pleural fluid is noted. There is persistent blunting of the left costophrenic angle compatible with small left pleural effusion. No definitive evidence of pneumothorax is seen. The pulmonary vasculature is not engorged and there is no overt pulmonary edema. The cardio mediastinal silhouette is incompletely evaluate. The mediastinal and hilar contours are within normal limits with unchanged rightward deviation and kinking of the trachea in the upper mediastinum.

IMPRESSION: 1. Improved aeration of the right lung base with no residual right pleural effusion. 2. Persistent small left pleural effusion. 3. No definitive evidence of pneumothorax.


SubjectID: 12645992, StudyID: 51190430, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Pleural effusion, chronic heart failure, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is unchanged evidence of bilateral pleural effusions. The extent of the effusions, however, has slightly decreased. The subsequent areas of bilateral atelectasis are unchanged. The patient has no pneumothorax but the heart remains enlarged and there are signs of mild fluid overload. The left pectoral pacemaker is unchanged.


SubjectID: 12655574, StudyID: 59024097, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Hypotensive, confused and concern exists for possible pneumonia.

COMPARISONS: ___.

TECHNIQUE: Chest, portable AP upright.

FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged, allowing for small differences in technique. There are patchy new basilar opacities with hazy density in the right costophrenic sulcus and more streaky left basilar opacities   Keywords: new. These are more typical of atelectasis than pneumonia. There is no evidence for congestive heart failure.

IMPRESSION: Streaky and vague basilar opacities, more suggestive of atelectasis than pneumonia, but if pneumonia is a continuing potential clinical concern then short-term followup radiographs could be considered.


SubjectID: 12661994, StudyID: 59424586, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with CHF, moribid obesity, w/ hypoxic hypercarbic resp failure // interval change

COMPARISON: The comparison is made with prior studies including ___.

IMPRESSION: Endotracheal tube tip is 3 cm above the carina. Nasogastric tube tip is difficult to visualize due to technical factors. There is a central line on the right and the tip is in the SVC. There is no pneumothorax. There is cardiomegaly and pulmonary edema. There is elevation of the right hemidiaphragm and there is a right pleural effusion.


SubjectID: 12661994, StudyID: 58150802, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ yo m pmh CHF, morbid obesity 579 lb found down w/ no identification transferred by EMS to ___ found to have hypercarbic resp failure, electively inbubated, tachycardiac, prolonged QTc and EKG changes concerning for NSTEMI vs. PE, elevated liver enzymes and elevate today in the setting of positive cocaine on urine tox screen. // acute CP process acute CP process

IMPRESSION: Compared to prior chest radiographs since ___, most recently ___ through ___. Previous mild pulmonary edema and right lower lobe consolidation, presumably edema and atelectasis have nearly cleared. Severe cardiomegaly is chronic. Dilatation of pulmonary arteries and mediastinal veins is chronic. ET tube in standard placement. Right jugular line ends above the origin of the SVC. Nasogastric drainage tube ends in the lower esophagus and would need to be advanced at least 8 cm to move all side ports into the stomach.


SubjectID: 12661994, StudyID: 52702612, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with morbid obesity, septic shock // Assess for interval change

COMPARISON: The comparison is made with prior studies including ___.

IMPRESSION: Endotracheal tube tip is 5 cm above carina. Nasogastric tube tip is difficult to visualize due technical factors. There is a central line on the right which is unchanged. There is cardiomegaly but there is no CHF. There is atelectasis in the right lower lobe.


SubjectID: 12661994, StudyID: 51496317, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with pna, sepsis // ? effusion, consolidation, ptx

COMPARISON: The comparison is made with prior studies including ___.

IMPRESSION: Endotracheal tube tip is 5 cm above the carina. Right central line tip is in the proximal SVC. A new esophageal monitoring lead is seen in the midline with the tip 5 cm distal to the carina. There is a faint ___ medially to the left of the esophageal tube and the tip is difficult to see. This may terminate at approximately 1 cm beyond the carina, although it is possible that it is overlying the spine and difficult to visualize. This is not seen to extend into the stomach with certainty and this should be evaluated clinically. . There is persistent right lower lobe atelectasis. There is marked cardiomegaly which is unchanged. There is no CHF.

NOTIFICATION: Dr. ___ reported the findings to the patient's nurse, ___ and to the patient's respiratory therapist, ___, by telephone on ___ at 12:01 PM, 5 minutes after discovery of the findings.


SubjectID: 12661994, StudyID: 58533960, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with resp distress // daily chest xray

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change.


SubjectID: 12661994, StudyID: 58465381, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with acute resp failure // interval change

IMPRESSION: Since a recent study of 1 day earlier, cardiomegaly is accompanied by pulmonary vascular congestion and improving edema   Keywords: improving.


SubjectID: 12661994, StudyID: 55725376, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p cardiac arrest, deferred til 8am ___ instability // ? consolidation, ptx, effusion ? consolidation, ptx, effusion

IMPRESSION: In comparison with the study of ___, obliquity of the patient makes it extremely difficult to assess the heart and lungs. There is continued enlargement of the cardiac silhouette. Opacification at the right base could reflect some combination of volume loss in the lower lobe and pleural fluid. Monitoring and support devices are essentially unchanged.


SubjectID: 12661994, StudyID: 55622982, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hypercarbiac hypoxic resp failure and CHF // Placement of esophageal balloon Placement of esophageal balloon

IMPRESSION: Status post placement of an esophageal device. The other monitoring and support devices are constant. Severe cardiomegaly with retrocardiac and right basilar atelectasis as well as moderate pulmonary edema persists   Keywords: persists. No pneumothorax. No larger pleural effusions.


SubjectID: 12661994, StudyID: 56611517, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man with cardiomegaly and weight gain. Evaluate for pulmonary edema.

COMPARISON: Prior chest radiograph on ___.

TECHNIQUE: PA and lateral chest radiographs.

FINDINGS: There is moderate cardiomegaly. The hilar and mediastinal contours are within normal limits. There is a mild-to-moderate pulmonary edema. There is no pneumothorax.

IMPRESSION: Mild-to-moderate pulmonary edema.


SubjectID: 12661994, StudyID: 55008099, Comparison: None

FINAL REPORT

HISTORY: Pulmonary edema.

FINDINGS: In comparison with study of ___, there are continued low lung volumes with substantial enlargement of the cardiac silhouette and pulmonary edema. Bibasilar atelectatic changes are evident.


SubjectID: 12661994, StudyID: 53185820, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hypoxic respiratory failure, shock and obesity now s/p right CVL placement // Assess CVL placement Assess CVL placement

COMPARISON: ___ obtained at 03:07

IMPRESSION: Right internal jugular line terminates at the level of cavoatrial junction. Left internal jugular line terminates at the level of mid SVC. Right lower lung atelectasis demonstrated there is substantial internal progression of pulmonary edema   Keywords: progression. No pneumothorax.


SubjectID: 12661994, StudyID: 53028986, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hypercarbic hypoxic resp failure and sepsis // interval change vs. new effusions/cosolidations vs. ARDS interval change vs. new effusions/cosolidations vs. ARDS

IMPRESSION: Comparison to ___. No relevant change   Keywords: no relevant change. Moderate cardiomegaly. Mild pulmonary edema. Small atelectasis at the left lung base and larger right lower lobe parenchymal opacity. Minimal new opacity at the basis of the right upper lobe, along the right minor fissure. Monitoring and support devices are in stable position.


SubjectID: 12662051, StudyID: 57938767, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___M with CHF and progressive SOB // eval for CHF

TECHNIQUE: Chest PA and lateral

COMPARISON: ___

FINDINGS: There are multiple overlying monitoring devices obscuring evaluation of the heart and lungs. Heart size is enlarged, as before. Left chest wall port is again seen with catheter tip at the RA SVC junction. There is mild central vascular congestion. No interstitial edema, pneumonia, or pleural effusions. There is mild basilar atelectasis seen on the lateral view.

IMPRESSION: Cardiomegaly. No interstitial edema or pleural effusions.


SubjectID: 12662051, StudyID: 51044096, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with MV endocarditis // ___ year old man with MV endocarditis

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: The heart is severely enlarged and is slightly larger than on the prior study. There is hazy alveolar infiltrates in both lower lobes for increased compared to prior   Keywords: increase. The left CP angle is obscured and is likely a small left effusion. The left subclavian line is unchanged


SubjectID: 12662051, StudyID: 53247607, Comparison: None

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPH

INDICATION: Dyspnea. History of congestive heart failure with ejection fraction of 30%.

TECHNIQUE: Chest, AP upright portable.

COMPARISON: ___.

FINDINGS: The tip of a Port-A-Cath terminates at the cavoatrial junction. The heart appears mildly enlarged. The cardiac, mediastinal and hilar contours appear stable. There is no pleural effusion or pneumothorax. The lungs appear clear.

IMPRESSION: No evidence of acute cardiopulmonary disease.


SubjectID: 12662051, StudyID: 51792769, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with depressed EF, sCHF, right heart strain // CXR for lung scan today

COMPARISON: ___.

IMPRESSION: No relevant change as compared to the previous image   Keywords: no relevant change. Moderate cardiomegaly. No overt pulmonary edema. No pleural effusions. No pneumonia. Unchanged left subclavian catheter.


SubjectID: 12681303, StudyID: 53497441, Comparison: None

FINAL REPORT

HISTORY: Congestive heart failure, shortness of breath and oxygen desaturation.

TECHNIQUE: Upright AP and lateral views of the chest.

COMPARISON: ___.

FINDINGS: There is a persistent moderate size right pleural effusion with slight interval increase in size of a small left pleural effusion. Bibasilar airspace opacities likely reflect compressive atelectasis. The cardiac and mediastinal contours are unchanged, with calcification of the aortic knob again seen. There is mild pulmonary vascular congestion. The lungs remain hyperinflated. No pneumothorax is detected. There are no acute osseous abnormalities.

IMPRESSION: Similar size moderate right pleural effusion with interval increase in size of a small left pleural effusion. Bibasilar atelectasis with mild pulmonary vascular congestion.


SubjectID: 12700195, StudyID: 57085461, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (AP AND LAT)

INDICATION: ___F with fall, preop CXR

COMPARISON: ___

FINDINGS: AP semi upright and lateral views of the chest provided. Lungs are grossly clear. No large effusion or pneumothorax. Cardiomediastinal silhouette appears normal. No acute bony injury.

IMPRESSION: No acute findings in the chest.


SubjectID: 12700195, StudyID: 56363079, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p ORIF, now with new hypoxia post op. // Effusion, infiltrate?

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the patient now shows signs of mild pulmonary edema. Areas of atelectasis at both the left and the right lung bases are increasing in extent. No pleural effusions. Moderate cardiomegaly persists. No evidence of pneumonia.


SubjectID: 12704088, StudyID: 59893114, Comparison: worse

FINAL REPORT

INDICATION: ___F with sudden worsening SOB // CHF, PNA?

TECHNIQUE: Portable AP chest radiograph

COMPARISON: Radiograph dated same day, ___ at approximately 16:39

FINDINGS: Portable AP chest radiograph demonstrates stable cardiomediastinal silhouette. A right chest dual lead pacing device is noted, of leads which appear intact and in unchanged position. Relative to most recent examination, opacity within the right lung base appears more confluent. There has been progression of pulmonary vascular congestion   Keywords: progression. No new confluent consolidation identified on the left. There persists blunting of the right costophrenic angle consistent with a small pleural effusion. There is no pneumothorax.

IMPRESSION: Worsening vascular congestion with developing more confluent right lung base opacity, potentially due to blossoming infection or progressive atelectasis although asymmetric edema is possible   Keywords: worse, developing.


SubjectID: 12704088, StudyID: 51936871, Comparison: None

FINAL REPORT

INDICATION: ___F with DOE // CHF exacerbation?

TECHNIQUE: PA and lateral views of the chest.

COMPARISON: ___ chest x-ray and chest CT from ___.

FINDINGS: When compared to prior x-ray, there is more conspicuous opacity at the right lung base medially with a more rounded configuration on the frontal views. Increased less well the found surrounding opacity is also noted at the right lung base as well. There is a small right pleural effusion. Biapical scarring is again noted. The left lung is otherwise clear. There is pulmonary vascular congestion without overt edema. Cardiomediastinal silhouette is stable. No acute osseous abnormalities. Right chest wall dual lead pacing device is again noted. Mid thoracic compression deformity is unchanged from prior CT.

IMPRESSION: Progression of opacity at the right lung base potentially in part due to post obstructive atelectasis given known increasing infrahilar soft tissue on prior CT scan. Superimposed infection would be possible. More rounded nodule at the right lung base could represent a pulmonary nodule. Followup will be necessary.


SubjectID: 12704088, StudyID: 57610285, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___F hx of metastatic breast CA p/w dyspnea // r/o infiltrate, effusion

COMPARISON: ___, CT Chest dated ___.

FINDINGS: PA and lateral views of the chest provided. Asymmetric breast tissue with clips in the right breast again noted in this patient with h/o breast cancer. Since the prior exam, there is increased hazy opacity in the right perihilar region and left lung base which raises concern for pneumonia. Scarring in the apices with emphysema is again noted. No large pleural effusion is seen. No edema. Cardiomediastinal silhouette is grossly stable. Bony structures are intact.

IMPRESSION: Increased left perihilar and lower lung opacities concerning for pneumonia.


SubjectID: 12704088, StudyID: 52847918, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman s/p PPM // PTX, leads

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the patient has received a new left pectoral pacemaker. 1 lead projects over the coronary sinus and 1 over the right atrium. No evidence of complications, notably no pneumothorax. The pre-existing, relatively diffuse lung parenchymal opacities are constant in extent and distribution.


SubjectID: 12704088, StudyID: 57609966, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with breast cancer s/p resection and chemo now admitted with CHF ___ heart block and s/p Left sided pacemaker. Also being treated for CAP. // please eval for interval change

TECHNIQUE: PA and lateral view radiographs of the chest.

COMPARISON: Prior chest radiographs dating back to___ and prior chest CT dated ___..

FINDINGS: The diffuse interstitial opacities are worsening compared with the prior study of ___, likely representing progressive interstitial edema   Keywords: worse. A developing opacity at the left costophrenic angle was not present on the prior study of ___, and may be atelectasis, but superimposed infection cannot be ruled out. The attention is recommended on subsequent followup imaging. Surgical clips in the reconstructed right breast are unchanged. The dual chamber left chest wall pacemaker leads are in unchanged position.

IMPRESSION: 1. Increased diffuse interstitial opacities, which likely representing progressive interstitial edema   Keywords: increase. 2. Focal consolidation in the anteromedial segment of left lower lobe, which may represent pneumonia considering history of ongoing treatment of pneumonia. 1.


SubjectID: 12704088, StudyID: 54103825, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with R sided pleural effusion s/p tap // r/o PTX r/o PTX

COMPARISON: Comparison to ___ at 22:17

FINDINGS: Portable upright chest radiograph ___ at 16:26 is submitted.

IMPRESSION: A right-sided pacer remains in place with the leads intact and terminating over the right atrium and right ventricle, respectively. There has been interval decrease in size of a right pleural effusion status post thoracentesis with improved aeration at the right base and no definite pneumothorax identified. No pulmonary edema. Stable left apical opacity likely reflecting post radiation changes. No focal airspace consolidation to suggest pneumonia. Stable cardiac and mediastinal contours. Multiple surgical clips overlying the right lower hemi thorax consistent with prior mastectomy and reconstruction.


SubjectID: 12704088, StudyID: 53926607, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with right effusion s/p ___ with 500mL out // ? PTX ? PTX

IMPRESSION: In comparison with study of ___, there is decreasing opacification at the right base with increased sharpness of the hemidiaphragm. Cardiac silhouette remains at the upper limits of normal in size with mild elevation of pulmonary venous pressure. Specifically, there is no evidence of pneumothorax.


SubjectID: 12704088, StudyID: 50482235, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with history of metastatic breast cancer, recent bilateral pleural effusion. Evaluate for reaccumulation of pleural effusions.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiographs from ___, ___.

FINDINGS: Small nodular opacities in the right base is concerning for pneumonia. Small right pleural effusions is seen. The left lung is mostly clear. Heart and mediastinal vein are enlarged compared to prior. Right-sided pacemaker is unchanged in position with leads in standard position.

IMPRESSION: 1. Right lower lobe pneumonia with small right pleural effusion. Follow-up radiograph in 6 weeks following antibiotic therapy is recommended. 2. Enlarged cardiomediastinal silhouette, possibly due to volume overload, right heart failure or pericardial effusion.

RECOMMENDATION(S): Right lower lobe pneumonia with small right pleural effusion. Follow-up radiograph in 6 weeks following antibiotic therapy is recommended.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the ___ ___ at 6:07 PM, 20 minutes after discovery of the findings.


SubjectID: 12713791, StudyID: 59422200, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with shortness of breath // assess for improvement s/p diuresis versus pneumonia assess for improvement s/p diuresis versus pneumonia

IMPRESSION: In comparison with the earlier study of this date, there is continued enlargement of the cardiac silhouette. However, the pulmonary vascular congestion is less prominent. There are residual areas of opacification at the bases. Although this could reflect residual congestion and atelectatic changes, the possibility of superimposed pneumonia can certainly not be excluded.


SubjectID: 12713791, StudyID: 50255924, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with 1 day shortness of breath, history of tracheomalacia. Evaluate for consolidation

TECHNIQUE: Frontal chest radiographs were obtained with the patient in the upright position.

COMPARISON: None available.

FINDINGS: The heart is moderately enlarged, and there is mild pulmonary edema. Bilateral, right greater than left, opacities likely reflect multifocal pneumonia.

IMPRESSION: Bilateral pneumonia. Cardiomegaly with mild pulmonary edema.

NOTIFICATION: The findings were discussed by Dr. ___ with the ___ resident in person on ___ at 2:30 AM, following wet read request.


SubjectID: 12724735, StudyID: 59359794, Comparison: better

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___F with xfer, on BiPAP, pulm edema // Eval for acute process, resolution of pulm edema

TECHNIQUE: Chest portable upright radiograph

COMPARISON: Chest radiograph from ___, ___. CTA of the chest from, ___.

FINDINGS: Right dual lumen central venous catheter is unchanged in position with the tip projecting over the right atrium. Stable cardiomegaly. Decreased pulmonary edema and opacification of the right lung base with persistent bibasilar opacities, left greater than right   Keywords: decrease. No pneumothorax. No large pleural effusion. Metallic clips are seen overlying the left neck. Vascular calcifications are noted.

IMPRESSION: Decreased pulmonary edema and opacification of the right lung base with persistent bibasilar opacities which could represent atelectasis or infection   Keywords: decrease.


SubjectID: 12724735, StudyID: 59250420, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with dyspnea, hypoxia, CXR on admission showing pulm edema and possible PNA // Eval for progressive pneumonia and change in pulmonary edema Eval for progressive pneumonia and change in pulmonary edema

IMPRESSION: Comparison to ___. Stable moderate cardiomegaly with mild pulmonary edema   Keywords: stable. Hemodialysis catheter on the right is stable. No pneumonia, no pleural effusions.


SubjectID: 12724735, StudyID: 58517996, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with GPC bacteremia, low blood pressures // eval pneumonia

TECHNIQUE: Portable AP chest radiograph.

COMPARISON: Chest radiograph ___

FINDINGS: There is persistent cardiomegaly with prominence of the pulmonary vasculature consistent with pulmonary vascular congestion. A tunneled right internal jugular dialysis catheter is unchanged in position. No pneumothorax. No consolidation seen. There is deformity of the left lateral chest wall, stable when compared to the prior study. Small left-sided pleural effusion. Interval improvement in the linear opacities of the right lung base.


SubjectID: 12724735, StudyID: 51658953, Comparison: better

WET READ: ___ ___ ___ 7:59 PM Interval improvement in degree of mild pulmonary edema with small persistent bilateral effusions   Keywords: improve. Enlarged cardiac silhouette which could potentially be due to cardiomegaly although pericardial effusion could also have this appearance. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___F with ESRD, CHF, new a-fib, O2 requirement // Eval for acute process, attn to CHF

TECHNIQUE: Single portable view of the chest.

COMPARISON: ___.

FINDINGS: When compared to prior, there has been slight interval improvement in the degree of pulmonary edema   Keywords: improve. Blunting of the lateral costophrenic angles suggests small bilateral effusions, likely decreased from prior. Streaky retrocardiac and right basilar opacities are likely atelectasis. Moderate enlargement of the cardiac silhouette is similar compared to prior. Atherosclerotic calcifications are noted in the aorta. Right chest wall tunneled venous catheter is noted as well surgical clips of the upper mediastinum on the left. No acute osseous abnormalities.

IMPRESSION: Interval improvement in degree of mild pulmonary edema with small persistent bilateral effusions. Enlarged cardiac silhouette which could potentially be due to cardiomegaly although pericardial effusion could also have this appearance.


SubjectID: 12724735, StudyID: 58076029, Comparison: None

FINAL REPORT

INDICATION: History: ___F with s/p line // eval for line

TECHNIQUE: Portable semi-erect radiograph of the chest.

COMPARISON: Radiograph from ___

FINDINGS: Multiple prior radiographs dated back to ___. Moderate cardiomegaly has been stable compared to prior exams dated back to ___. Diffuse opacities are seen throughout the left hemi thorax, predominantly overlying the mid left lung. A left-sided IJ is seen, with the tip likely in the ipsilateral brachiocephalic/internal jugular vein junction. A right-sided hemodialysis catheter is seen, terminating in the right atrium, unchanged in position compared to the prior exam. There is no large pleural effusion, or pneumothorax.

IMPRESSION: Left-sided IJ line terminates likely in the left ipsilateral brachiocephalic vein/internal jugular vein junction. Diffuse opacities overlying the mid left lung, may be secondary to pneumonia.


SubjectID: 12724735, StudyID: 55936831, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF // eval for interval changes eval for interval changes

IMPRESSION: Right internal jugular line terminates most likely at the junction of the left jugular vein and brachycephalic vein. Cardiomegaly is unchanged, moderate. There is substantial improvement in the left perihilar opacities that might reflect resolution of asymmetric edema or aspiration   Keywords: improve. Right basal opacity has improved as well. Right central venous line tip terminates in the right atrium. There is no pneumothorax. There is no interval increase in pleural effusion.


SubjectID: 12724735, StudyID: 57141823, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: History: ___F with sob, hypoxia // eval effusions

TECHNIQUE: Portable chest radiograph

COMPARISON: Chest radiograph ___

FINDINGS: There are parenchymal opacities, most pronounced at the lung bases bilaterally, which most likely represents pulmonary edema. However, pneumonia or aspiration cannot be excluded. There are likely small pleural effusions bilaterally. There is upper zone redistribution. No pneumothorax. Heart size is mildly enlarged. Right-sided hemodialysis dual-lumen catheter terminates in the right atrium. Note is made of surgical clips in the left paratracheal region, near the left lung apex.

IMPRESSION: Parenchymal opacities predominantly at the lung bases along with probable pleural effusions most likely represents pulmonary edema. However, infection or aspiration cannot be excluded in the appropriate clinical setting. Small bilateral pleural effusions cannot be excluded.


SubjectID: 12724735, StudyID: 52606347, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ y.o F with ESRD, on HD, presenting with dyspnea, found to have pulmonary edema, now s/p 4L fluid removal // interval change of pulmonary edema

COMPARISON: Chest x-ray dated ___ at 06:26

FINDINGS: Again seen is a dual-lumen catheter with both lumens overlying the right atrium. There is moderate cardiomegaly, probably less pronounced and with better definition of the cardiomediastinal borders. There is upper zone redistribution, but there has been marked improvement in the CHF/ remain pulmonary edema findings   Keywords: improve. Mild residual vascular blurring a is present. Probable residual left base atelectasis, seen is increased retrocardiac density, but the left hemidiaphragm is now distinctly visible. No gross effusion. The right hemidiaphragm is elevated. No pneumothorax is identified. Clips noted over left thoracic inlet. Densely calcified tortuous splenic artery is again noted.

IMPRESSION: Marked interval improvement in the CHF findings   Keywords: improve. Now only minimal residual upper zone redistribution and slight vascular blurring.


SubjectID: 12724735, StudyID: 56052563, Comparison: same

FINAL ADDENDUM ADDENDUM Please ignore the previous report that belongs to different patient The report on this patient chest radiograph is as following Comparison: ___ The ET tube tip is approximately 3 cm above the carinal. NG tube tip is in the stomach. Cardiac silhouette appears to be substantially increased as compared to the previous examination, by more than 1 cm that might potentially represent different phases of inspiration but interval accumulation of pericardial effusion is a possibility. Patient continues to be in pulmonary edema, interstitial that appears to be progressed since the prior study. No pneumothorax is seen. Bilateral pleural effusions are present. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with h/o HTN, Alport's syndrome s/p 2 renal transplants with chronic graft failure, presenting in hypertensive urgency with respiratory distress. // interval change

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

FINDINGS: Since the prior study the has been insertion of pigtail catheter in the left pleural space at the mid aspect. As a consequence there has been interval substantial decrease in the amount of pleural effusion in particular at the basal aspect of the pleura. Currently the effusion continues to be loculated containing multiple foci of air, most likely trapped within the effusion. The prior study there has been interval elevation of the hemidiaphragm, slight potentially due to decrease in the amount of pleural fluid with subsequent slight right mediastinal shift. Left chest wall air is demonstrated along the tract of the catheter. No pneumothorax seen outside of the fluid collection. No appreciable pericardial effusion is seen. Minimal amount of right pleural fluid is demonstrated, increased since the prior study. Imaged portion of the upper abdomen demonstrate large cortical cyst in the left kidney as well as gallbladder sludge and foci of calcification in the right kidney. Airways are patent to the subsegmental level bilaterally except fall left lower lobe and lingula where atelectasis is noted most likely due to combination of effusion and elevated left hemidiaphragm. Except for minimal a right lower lung atelectasis right lung is clear. Off note is soft tissue lesion, 2.3 x 1.7 cm, pleural or extrapleural based, series 4, image 148, unchanged in appearance since previous CT obtained 2 days ago   Keywords: unchanged in appearance. No lytic or sclerotic lesions worrisome for infection or neoplasm demonstrated. Erosive changes at the manubrial sternal joint suggesting prior inflammation as previously. Septal thickening in the left upper lobe is minimal. Besides left lower lobe atelectasis no new findings demonstrated.

IMPRESSION: Interval decrease in size in loculated left pleural effusion after placement of the pigtail catheter. Multiple loculated bubbles of air. Subcutaneous air. Left lower lobe consolidation, most likely a combination of atelectasis or infection with no possibility to exclude underlying mass. Unchanged appearance of the right chest wall/pleural lesion   Keywords: unchanged appearance. Potentially as previously suggested 8 might be related to previous fracture of the left seventh rib but followup is required to exclude the possibility of neoplastic origin. No changes in the intra-abdominal findings demonstrated but there is higher elevation of left hemidiaphragm potentially due to drainage of pleural effusion with more pronounced right mediastinal shift.


SubjectID: 12724735, StudyID: 52899741, Comparison: better

WET READ: ___ ___ 5:43 PM Bibasilar consolidations, possibly pleural effusions with superimposed aspiration or infection. Pulmonary vascular congestion. NG tube with side hole port at the GE junction, advancement several cm is recommended.

WET READ VERSION #1 ___ ___ ___ 2:02 PM Bibasilar consolidations, likely aspiration or infection. Pulmonary vascular congestion. NG tube with side hole port at the GE junction, advancement several cm is recommended. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPH ___

INDICATION: ___F sp intubation // tube placement

TECHNIQUE: Single portable supine view of the chest was obtained.

COMPARISON: ___.

FINDINGS: An endotracheal tube terminates in appropriate position above the carina. A nasogastric tube courses through the esophagus and below the diaphragm, with side hole port at the level of the GE junction. Bibasilar consolidations are present, obscuring the bilateral hemidiaphragms. There is pulmonary vascular congestion, improved pulmonary edema compared to the most recent prior available chest radiograph from ___   Keywords: improve. There is no pneumothorax. Surgical clips seen at the neck inferiorly on the left.

IMPRESSION: 1. Bibasilar consolidations, possibly pleural effusions with superimposed aspiration or infection. 2. Pulmonary vascular congestion. 3. NG tube with side hole port at the GE junction, advancement several centimeters is recommended.


SubjectID: 12729521, StudyID: 56312141, Comparison: None

FINAL REPORT

HISTORY: Status post chest tube removal question pneumothorax.

COMPARISON: 526.

FINDINGS: The film is rotated limiting assessment of the right lower lobe. There continues to be right lower lobe dense consolidation with volume loss and ___ B-lines. there is pulmonary vascular redistribution. There is Volume loss/consolidation in the left lower lobe as well.

IMPRESSION: Compared to the prior study, the appearance of the right lung is worse, however some of this impression aofworsening appearance could be due to the rotation of the film


SubjectID: 12729521, StudyID: 54860044, Comparison: None

FINAL REPORT

HISTORY: Decreased breath sounds bilaterally.

COMPARISON: ___.

FINDINGS: The ET tube, Swan-Ganz catheter, left chest tube has been removed. Mediastinal drain is still in place. There is increased right lower lobe volume loss with right-sided effusion. There is pulmonary vascular redistribution.

IMPRESSION: Right lower lobe volume loss and effusion. An underlying infectious infiltrate can't be excluded.


SubjectID: 12729521, StudyID: 50982331, Comparison: None

FINAL REPORT

HISTORY: ___-year-old man status post AVR and CABG.

COMPARISON: ___.

TECHNIQUE: PA and lateral views of the chest.

FINDINGS: An ET tube terminates approximately 6.6 cm from the carina and can be re-positioned more inferiorly. A Swan-Ganz catheter is in appropriate position. A left-sided chest tube is present. The patient is now status post median sternotomy. Two mediastinal drains are seen. Widening of the upper mediastinum is likely due to vascular engorgement status post surgery. There is no pleural effusion or convincing evidence of infection.

IMPRESSION: Status post CABG.


SubjectID: 12740948, StudyID: 54786242, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man intubated // ?interval changes in tube placement ?interval changes

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The monitoring and support devices are constant, the tip of the endotracheal tube is too low, the tube should be pulled back by approximately 2 cm. The other monitoring and support devices are in correct position. Moderate cardiomegaly with small bilateral pleural effusions, subsequent areas of atelectasis as well as mild pulmonary edema. No evidence of pneumonia. No pneumothorax.


SubjectID: 12740948, StudyID: 54630904, Comparison: None

FINAL REPORT

EXAMINATION: ___

INDICATION: History of end-stage renal disease on hemodialysis with multiple prior intubations for CHF exacerbations intubated on arrival to the ED.

TECHNIQUE: Single frontal view of the chest.

COMPARISON: None

FINDINGS: Endotracheal tube tip terminates approximately 6 cm cranial to the carinal. NG tube tip terminates out of field of view, probably in the stomach. Heart size is moderately enlarged with mild unfolding of the thoracic aorta. Aortic knob calcifications are moderate. Prominent central pulmonary vascular congestion with bilateral perihilar predominant opacities, greater on the right compatible with severe pulmonary edema. Probable trace bilateral effusions. No pneumothorax.

IMPRESSION: 1. Severe pulmonary vascular congestion and interstitial pulmonary edema with probable trace effusions. 2. Pneumonia cannot be excluded in the appropriate clinical context. 3. Endotracheal tube tip terminates 6 cm cranial to the carina. No pneumothorax.


SubjectID: 12740948, StudyID: 54306009, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pulmonary edema, intubated // ET placement, interval change

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Right internal jugular line tip is at the level of mid SVC. NG tube tip is in the proximal stomach. Cardiomegaly appears to be than minimal increase since the prior study associated with bilateral pleural effusions and bibasal consolidations.


SubjectID: 12740948, StudyID: 53838385, Comparison: same

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: New right internal jugular central venous line.

TECHNIQUE: Single frontal view of the chest.

COMPARISON: ___ 06:22

FINDINGS: Compared to examination from 1 hour prior, a new right internal jugular approach central venous catheter tip terminates in the mid SVC. No associated pneumothorax. No other relevant change   Keywords: no other relevant change.

IMPRESSION: See above.


SubjectID: 12740948, StudyID: 50985539, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hypoxic respiratory failure s/p intubation // eval pulmonary parynchema, R IJ, ETT

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the monitoring and support devices are constant. The lung volumes have slightly increased, potentially reflecting improved ventilation. Decrease of pulmonary fluid overload   Keywords: decrease. Persisting atelectasis at the left lung bases. Unchanged moderate cardiomegaly.


SubjectID: 12749036, StudyID: 58423643, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with h/o prostate CA, CHF, CKD, a-fib with SOB // acute PNA vs pulm edema. acute PNA vs pulm edema.

IMPRESSION: Comparison ___. No relevant change   Keywords: no relevant change. The lung volumes are constant. Moderate cardiomegaly and bilateral areas of atelectasis persist. Moderate right and small left pleural effusion are not substantially changed. No new focal parenchymal opacities   Keywords: new. No pneumothorax. No overt pulmonary edema.


SubjectID: 12749036, StudyID: 51154333, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with ESRD and CHF presenting with edema and weight gain as well as altered mental status. // Please evaluate for pulmonary edema/pneumonia Please evaluate for pulmonary edema/pneumonia

IMPRESSION: Comparison to ___. Minimal increase in extent of a pre-existing left pleural effusion, a right pleural effusion is unchanged. Moderate cardiomegaly. Bilateral basal areas of atelectasis and mild pulmonary edema is present on the current image.


SubjectID: 12749036, StudyID: 56593530, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man with asthma, shortness of breath and vomiting, question infiltrate.

COMPARISON: PA and lateral chest radiograph from ___.

FINDINGS: There are bilateral pleural effusions which are minimally increased since the prior study on ___. There is no focal consolidation or pneumothorax. There is no evidence of pulmonary edema. The cardiomediastinal silhouette is unremarkable. There is abnormal contour of the right humeral head which may represent an old fracture.

IMPRESSION: 1. Slightly increasing bilateral pleural effusions since ___ without any clear cause. 2. Possible old right humeral fracture, recommend clinical correlation or dedicated films of the right shoulder.


SubjectID: 12749036, StudyID: 53587827, Comparison: worse

FINAL REPORT

INDICATION: Multiple medical problems presenting with lethargy, evaluate for pneumonia or cardiac failure.

COMPARISON: ___.

FINDINGS: Frontal view of the chest shows increase in pulmonary edema compared to prior   Keywords: increase. There are moderate bilateral pleural effusions, the left of which has increased since prior study. Cardiac size is enlarged. There is no pneumothorax. The mediastinal structures are normal. Degenerative changes are again seen in the acromioclavicular joints and glenohumeral joints.

IMPRESSION: Worsening pulmonary edema   Keywords: worse. These findings were discussed with Dr. ___ by Dr. ___ at 12 a.m. on ___, by telephone at the same time the finding was discovered.


SubjectID: 12759187, StudyID: 59887924, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p temp HD line and temp wire from bilateral IJs // Eval for interval change

TECHNIQUE: Portable AP chest radiograph.

COMPARISON: Chest radiograph ___

FINDINGS: A left internal jugular dialysis catheter terminates in the distal SVC. A right internal jugular temporary pacing wire is in appropriate position, the tip appears to be in the right ventricle. There is a persistent right pleural effusion. Hazy opacity throughout the right lung is likely due to layering of the pleural effusion, difficult to exclude underlying consolidation. There is moderate pulmonary vascular congestion, similar in appearance when compared to the prior study   Keywords: similar in appearance, similar.

IMPRESSION: The temporary pacing wire terminates in the expected location of the right ventricle. The left internal jugular catheter terminates in the distal SVC.


SubjectID: 12759187, StudyID: 57955728, Comparison: None

FINAL REPORT

INDICATION: ___ year old female with bradycardia. Evaluate for congestive heart failure or pneumonia.

TECHNIQUE: AP and lateral chest radiographs were obtained.

COMPARISON: Chest radiograph from ___.

FINDINGS: Lung volumes have decreased, and the heart continues to be severely enlarged. There is a moderate right pleural effusion with fluid tracking along the minor fissure. The low lung volumes cause crowding of the central bronchovascular structures, and there is central pulmonary vascular congestion. No pneumothorax is seen.

IMPRESSION: Cardiomegaly with moderate right pleural effusion and central pulmonary vascular congestion. Low lung volumes.


SubjectID: 12759187, StudyID: 52090031, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p temp HD line and cordis placement // Eval for line placement Eval for line placement

IMPRESSION: In comparison with the study of ___, there has been placement of a temporary hemodialysis line that extends to the level of the cavoatrial junction. No evidence of pneumothorax. The hazy opacification in the right hemithorax consistent with layering pleural effusion is much less prominent on the current study. This could reflect improved pleural effusion, though it may merely be a manifestation of a more upright position of the patient. Otherwise little change   Keywords: little change.


SubjectID: 12759187, StudyID: 58610898, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with new pacemaker placement // interval changes interval changes

COMPARISON: Prior chest radiographs ___ through ___.

IMPRESSION: Moderate cardiomegaly has improved. Minimal pulmonary edema remains, and pleural effusions are presumed, but small   Keywords: remains. Transvenous right ventricular pacer lead follows its expected course, from the left pectoral generator, unchanged. No pneumothorax.


SubjectID: 12759187, StudyID: 55931952, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with chest tube // interval changes interval changes

IMPRESSION: Comparison to ___. The external pacemaker and the hemodialysis catheter was removed. The pigtail catheter in the right pleural space is unchanged. Placement of a an left pectoral pacemaker. The single lead projects over the right ventricle. No complications, notably no pneumothorax. Moderate cardiomegaly persists. No pulmonary edema. No pleural effusions.


SubjectID: 12759187, StudyID: 58418421, Comparison: same

FINAL REPORT

CLINICAL

HISTORY: ___-year-old woman with CHF and wheezing. Evaluate for pneumonia or effusion.

COMPARISON: Multiple chest radiographs dating back to ___, most recently ___.

FINDINGS: A frontal upright view of the chest was obtained portably. The patient is rotated and the chin obscures the left apex. Lung volumes are slightly lower than on the prior study. There is mild bibasilar atelectasis. No focal consolidation and no large pleural effusion or pneumothorax. Mild interstitial pulmonary edema and moderate cardiomegaly are unchanged   Keywords: unchanged.

IMPRESSION: Bibasilar atelectasis. No pneumonia or large effusion.


SubjectID: 12759187, StudyID: 54937095, Comparison: worse

FINAL REPORT

INDICATION: Shortness of breath. Please evaluate for acute process.

COMPARISON: Comparison to multiple chest radiographs, most recently dated ___.

FINDINGS: Chest PA and lateral radiograph demonstrates unremarkable mediastinal and hilar contours. Double right-sided heart contour is suggestive of left atrial enlargement. Coarsened interstitium is noted throughout with increased bibasilar opacities, right greater than left, which suggest likely developing infectious process possibly on a background of minimal pulmonary edema   Keywords: increase, developing.

IMPRESSION: Bibasilar opacities, right greater than left, may indicate developing infectious process.


SubjectID: 12759187, StudyID: 50533940, Comparison: same

WET READ: ___ ___ ___ 1:04 AM ild interstitial edema. No confluent consolidation - ___ ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Worsening dyspnea, evidence of fluid overload.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Mild interstitial edema. Moderate cardiomegaly. No pleural effusions. No evidence of pneumonia.


SubjectID: 12759187, StudyID: 55972134, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F w/new chest tube placement // evaluate for pneumothorax, interval changes

TECHNIQUE: Single frontal view of the chest

COMPARISON: Portable chest x-ray ___

FINDINGS: Right moderate pleural effusion is stable. Moderate cardiomegaly is stable. Pulmonary vascular congestion is increased   Keywords: increase. The left IJ dialysis catheter terminates within low SVC. The right IJ catheter with temporary pacer terminates within the right ventricle. The right pigtail catheter is in the right lower thorax. There is no pneumothorax.

IMPRESSION: 1. Stable right moderate pleural effusion. 2. Increased pulmonary vascular congestion   Keywords: increase. 3. No pneumothorax.


SubjectID: 12759187, StudyID: 53083861, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with multiple comorbidities, worsening anemia, concern for ongoing blood loss. // Evidence of hemothorax Evidence of hemothorax

IMPRESSION: Comparison to ___. Interval increase of the pre-existing right pleural effusion. The effusion now causes a decrease in radiolucency of the entire right hemi thorax. A small left pleural effusion is new. Moderate cardiomegaly. No overt pulmonary edema. Bilateral areas of atelectasis but no evidence of pneumonia. Unchanged position of a left-sided hemodialysis catheter.


SubjectID: 12759241, StudyID: 56767164, Comparison: None

FINAL REPORT

HISTORY: Respiratory failure. Evaluate for pneumonia, effusion, pulmonary edema.

TECHNIQUE: Frontal and lateral chest radiographs were obtained.

COMPARISON: None available.

FINDINGS: Low lung volumes are seen with cephalization and interstitial markings consistent with pulmonary edema. Bibasilar opacities likely represent pleural effusions and associated atelectasis but infection cannot be fully excluded. Right middle lobe opacity could represent asymmetric edema or infection in the appropriate clinical setting. Degenerative changes and compression deformity is seen at the thoracolumbar junction.

IMPRESSION: Pulmonary edema with bilateral pleural effusions though a focal consolidation cannot be fully excluded, as above. Consider repeat imaging following diuresis.


SubjectID: 12788091, StudyID: 59861800, Comparison: None

WET READ: ___ ___ ___ 6:03 AM An enteric tube courses below the level of the diaphragm and off the inferior aspect of the film. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: Chest radiograph.

INDICATION: ___ year old man with osteomyelitis, mitral valve clot, bacteremia. Intubated, with NGT placed // confirm NTG position

TECHNIQUE: Single AP view

COMPARISON: Chest radiograph ___

FINDINGS: An enteric tube courses below the level of the diaphragm and off the inferior aspect of the film. An endotracheal tube ends the mid thoracic trachea. A right IJ line ends in the low SVC. Lung volumes are low, and there is mild atelectasis at the left lung base, worsened. No pneumothorax. No pulmonary edema.

IMPRESSION: An enteric tube courses below the level of the diaphragm, beyond the field of view.


SubjectID: 12788091, StudyID: 53367928, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with osteomyelitis, MSSA bacteremia // please evaluate for interval change

TECHNIQUE: Single AP radiograph of the chest.

COMPARISON: Chest radiograph dated ___.

FINDINGS: Lines and tubes are unchanged in positio. Low lung volumes with bibasilar opacities, likely representing atelectasis. No focal consolidations. The pulmonary vasculature is normal. There is a stable appearance of the cardiomediastinal silhouette. There may be a small left pleural effusion. There is no pneumothorax.

IMPRESSION: 1. Unchanged positions of lines and tubes. 2. Low lung volumes with bibasilar atelectasis, but no focal consolidations to suggest pneumonia. 3. Possible small left pleural effusion.


SubjectID: 12788091, StudyID: 51624120, Comparison: None

WET READ: ___ ___ ___ 9:07 AM The NG tube projects over the left upper quadrant in the region of the stomach. The ET tube and right internal jugular central venous catheter are in unchanged position. There is otherwise similar appearance of the chest with retrocardiac opacity. Opacities in the right lung have improved.

WET READ VERSION #1 ___ ___ ___ 11:44 PM The NG tube projects over the left upper quadrant in the region of the stomach. The ET tube and right internal jugular central venous catheter are in unchanged position. There is otherwise similar appearance of the chest with retrocardiac opacity. Opacities in the right lung have improved. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with replaced NGT // interval change, NGT location

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: Endotracheal tube terminates approximately 5.4 cm above the level of the carina. Enteric tube terminates left upper quadrant, in expected location of the stomach. Right internal jugular central venous catheter terminates in the low SVC. No pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. There are low lung volumes. Left mid lung subsegmental atelectasis is seen.

IMPRESSION: Endotracheal tube terminates approximately 5.4 cm above the level of the carina. Enteric tube terminates in the left upper quadrant, expected location of the stomach. Subsegmental left mid lung atelectasis.


SubjectID: 12793376, StudyID: 54959335, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___/F s/p R TKA POD4, with persistent hypoxia. Please r/o pneumonia. // Atalectasis vs infiltrate? Atalectasis vs infiltrate?

COMPARISON: Comparison to prior study dated ___ at 08:09

FINDINGS: Portable AP upright chest film ___ at 17:17 is submitted.

IMPRESSION: Lungs remain hyperinflated suggesting underlying emphysema. Streaky opacities at the bases more likely reflect scarring or subsegmental atelectasis rather than an acute infectious process. However, clinical correlation is advised. No evidence of pulmonary edema. Small left effusion, less apparent on the current study than on the prior. Overall cardiac and mediastinal contours are unchanged with the heart being mildly enlarged. Degenerative changes of both glenohumeral joints with no acute bony abnormality appreciated.


SubjectID: 12793376, StudyID: 53033902, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with elevated wbc // wbc ___.4 ? pna vs atelectasis wbc ___.4 ? pna vs atelectasis

COMPARISON: Comparison to ___ at 17:16

FINDINGS: Portable AP upright chest film ___ at 11:22 is submitted.

IMPRESSION: Heart remains enlarged. Mediastinal contours are likely unchanged given differences in patient rotation. There is improved aeration at the left base and residual streaky opacities at the right base which may reflect scarring or subsegmental atelectasis. No new airspace consolidation is seen. No pulmonary edema or pneumothorax. No large effusions. Degenerative changes of both glenohumeral joints.


SubjectID: 12801114, StudyID: 59219210, Comparison: None

FINAL REPORT

EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of CHF.

COMPARISON: None.

FINDINGS: Frontal and lateral views of the chest were obtained. Relatively low lung volumes. The patient is status post median sternotomy and cardiac valve replacement. There is some obscuration of the left hemidiaphragm, which may be due to a left pleural effusion with atelectasis. No large right pleural effusion is seen, although a small one would be difficult to exclude. There is prominence of the central pulmonary vasculature.


SubjectID: 12801114, StudyID: 54409180, Comparison: same

FINAL REPORT

INDICATION: ___-year-old woman with respiratory distress, history of CHF, evaluate for pulmonary edema.

COMPARISONS: PA and lateral chest radiograph from ___.

FINDINGS: Since the most recent prior radiograph, there has been no significant change   Keywords: no significant change. There is a retrocardiac opacity and obscuration of the left hemidiaphragm, likely from a combination of atelectasis as well as a small left pleural effusion. There is no right pleural effusion. There is engorgement of the central pulmonary vasculature. The heart size is mildly enlarged. Median sternotomy wires are intact. There is no focal consolidation or pneumothorax. The visualized bony structures show no acute skeletal abnormalities.

IMPRESSION: No signficant interval change. Stable left pleural effusion and lower lobe opaicty, probably atelectasis. Mild pulmonary edema.


SubjectID: 12806204, StudyID: 53208770, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: New coronary sinus lead, assessment of position.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is a new lead. The frontal and lateral radiographs suggest correct position in the coronary sinus. Lateral lucency along the left chest wall, potentially suggestive of a loculated lateral pneumothorax. No evidence of tension. At the time of dictation and observation, 10:58 a.m., on the ___, the referring physician ___. ___ was paged for notification. Unchanged moderate pleural thickening on the right. Unchanged mild cardiomegaly without overt pulmonary edema   Keywords: unchanged.


SubjectID: 12806204, StudyID: 51220112, Comparison: None

FINAL REPORT

HISTORY: Patient with small left-sided pneumothorax status post pacemaker, eval pneumothorax.

COMPARISON: ___.

FINDINGS: Frontal and lateral chest radiographs were obtained. A lucency along the left lateral chest wall is unchanged. There is no evidence of mediastinal shift or apical pneumothoraces. Small bilateral pleural effusions are stable. The lobulated pleural thickening on the right chest wall is unchanged in appearance. There is no focal consolidation or pulmonary edema. Heart size is stable.

IMPRESSION: Lucency along the left lateral chest wall is small and stable in size, and more likely reflects a skinfold rather than pneumothorax.


SubjectID: 12808249, StudyID: 59099976, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man R apical PTX s/p R VATS wedge; chest tube 4 hour clamp trial // interval change; 4 hour clamp trial; please perform at 16:30 pm

COMPARISON: ___, 13:47

IMPRESSION: For hr of the clamping of the chest tube, a small apical lateral right-sided pneumothorax has newly appeared. There is no evidence of tension. New partial atelectasis of the left lower lobe. The bilateral parenchymal opacities are constant in extent and severity. Unchanged appearance of the cardiac silhouette.


SubjectID: 12808249, StudyID: 56601776, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with R apical PTX // interval change, please evaluate

COMPARISON: ___, 20:27

IMPRESSION: Unchanged extent of a small right apical lateral pneumothorax. The right chest tube is in unchanged position. Unchanged extent of the bilateral parenchymal opacities   Keywords: unchanged.


SubjectID: 12808249, StudyID: 54404135, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pneumothorax s/p chest tube placement // Eval for interval change

COMPARISON: ___

IMPRESSION: As compared to the previous image, the right chest tube is in unchanged position. . The extent of the known right pneumothorax has decreased but the pneumothorax is still clearly visible, with a diameter of approximately 1 cm and a lateral parts of the right apex. No evidence of tension. Unchanged appearance of the extensive bilateral parenchymal opacities.


SubjectID: 12808249, StudyID: 54287929, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with R apical PTX s/p VATS wedge resection, chest tube clamp trial 4 hours // interval change, please evaluate; 4 hour clamp trial; please perform at 20:30pm

COMPARISON: ___, 16:00

IMPRESSION: As compared to the previous radiograph, the right apical lateral small pneumothorax has decreased in size but is still visualized. No evidence of tension. The right chest tube is in constant position. The bilateral opacities are unchanged, a pre-existing left lower lobe atelectasis is resolved in the interval.


SubjectID: 12808249, StudyID: 53359988, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pneumothorax and chest tube. // eval for ptx

COMPARISON: ___

IMPRESSION: Lower lung volumes. Right-sided chest tube. Extensive bilateral parenchymal opacities. On this current radiograph, there is no convincing evidence for the presence of a right pneumothorax.


SubjectID: 12808249, StudyID: 53317846, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with R apical PTX s/p chest tube removal // interval change; please evaluate; please perform at 14:00

COMPARISON: ___.

IMPRESSION: Of the removal of the right chest tube, a 1-2 mm right apical lateral pneumothorax is visualized. No evidence of tension. Unchanged appearance of the widespread bilateral parenchymal opacities. Unchanged size and shape of the cardiac silhouette.


SubjectID: 12808249, StudyID: 50587077, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with R apical PTX, 1 hour chest tube clamp trial // interval change, please evaluate- 1 hour clamp trial. Please perform at 13:30 pm

COMPARISON: ___, 11:06

IMPRESSION: As compared to the previous radiograph, the chest tube has been clamped. There is no evidence of changes, notably no pneumothorax. The known parenchymal opacities are constant in extent and severity.


SubjectID: 12808249, StudyID: 58642028, Comparison: better

FINAL REPORT

EXAMINATION: Portable AP Chest Radiograph

INDICATION: ___ year old man with organizing pneumonia here w/ pneumothorax. Evaluate chest tube placement.

COMPARISON: Multiple chest radiographs dated ___ to ___. CT chest dated ___.

FINDINGS: The newly placed pigtail catheter projects over the right lateral hemithorax with apparent improvement in the right pneumothorax, now not readily appreciable. Lung volumes are low. Bilateral diffuse patchy opacities, more prominent on the right, are more conspicuous and increased in number and size from at least ___, but somewhat similar dated ___. Day-to-day changes likely reflect edema, but persistent opacities likely reflect underlying infection and scarring, better seen on CT   Keywords: better. No definite pleural effusion. The heart is normal in size.

IMPRESSION: 1. Newly placed right pigtail projects over right lateral hemithorax with resolution of right pneumothorax. 2. Progressive bilateral extensive consolidations, likely combination of edema, severe scaring, and pneumonia.


SubjectID: 12808249, StudyID: 55870057, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with HL, recent VATS, r apical PTX s/p chest tube placement // Interval change in pneumothorax

IMPRESSION: As compared to ___ chest radiograph, there has been little change in the appearance of the chest except for slight decrease in extent of consolidation in the right supra hilar region. Other multifocal heterogeneous opacities are similar to the recent radiograph   Keywords: similar. Right pigtail pleural catheter remains in place, with slight decrease in right apical pneumothorax, now very small in size.


SubjectID: 12808249, StudyID: 51255300, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with R apical PTX s/p R VATS wedge resection ___, 4 hour chest tube to water seal film // interval change on water seal, please evaluate; please perform at 13:00 on ___

COMPARISON: ___, 05:03

IMPRESSION: As compared to the previous radiograph, there is minimally decreased extent and severity of the bilateral diffuse parenchymal opacities. These opacities, nonetheless, stay extensive. The position of the right chest tube is not substantially changed. Normal to borderline size of the cardiac silhouette. No pneumothorax. No pleural effusions.


SubjectID: 12808249, StudyID: 51125580, Comparison: same

FINAL REPORT

EXAMINATION: Portable AP chest radiograph

INDICATION: ___ year old man with HL, COP, VATS now new ptx s/p ct placement. Evaluate for interval change.

COMPARISON: Chest radiograph from earlier on the same day, dated ___ and 08:20.

FINDINGS: A pigtail catheter projects over the right mid upper hemithorax, overall unchanged. A small right apical lateral pneumothorax has increased in size compared the exam only earlier today. Otherwise, no significant interval change in heterogeneous extensive bilateral lung opacities. Appearance of the cardiomediastinal silhouette is also unchanged. Lung volumes are low and atelectasis bilaterally is also overall unchanged. No evidence of tension. No pleural effusion.

IMPRESSION: Interval increase in size of the now small right apical pneumothorax. No significant interval change otherwise   Keywords: no significant interval change.

NOTIFICATION: The findings were discussed by Dr. ___ with cardiothoracic teamon the telephone on ___ at 1:57 PM, after discovery of the findings.


SubjectID: 12808249, StudyID: 50150301, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with Hodgkins lymphoma, h/o POC. ON steroids // F/U xray. On rx for POC

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the patient has developed a 3 cm right apical lateral pneumothorax. There currently is no evidence of tension. Otherwise the chest radiograph is unchanged. Bilateral diffuse parenchymal opacities, right more than left. Borderline size of the cardiac silhouette. No pulmonary edema. Mild elongation of the descending aorta. At the time of dictation and observation, the referring nurse ___ was notified by page via the Hematology office. The findings were discussed with ___, the nurse coordinator, at the time of dictation and observation, 13:27, on the ___


SubjectID: 12808249, StudyID: 57554897, Comparison: better

WET READ: ___ ___ ___ 8:27 AM 1. Hypoinflated lungs with crowding of vasculature. 2. Interval increase in multifocal parenchymal opacities predominately within the left upper lobe, better characterized on CT chest dated ___. 3. New small left pleural effusion. 4. S/p right-sided vats with biopsy and chest tube placement. Ktalati ___ 11:39 PM d/w Dr. ___, ___ mins after observation.

WET READ VERSION #1 ___ ___ ___ 11:48 PM 1. Hypoinflated lungs with crowding of vasculature. 2. Interval increase in multifocal parenchymal opacities predominately within the left upper lobe, better characterized on CT chest dated ___. 3. New small left pleural effusion. 4. S/p right-sided vats with biopsy and chest tube placement. Ktalati ___ 11:39 PM d/w Dr. ___, ___ mins after observation. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with lymphoma and new effusions/infiltrates; s/p R VATS wedge biopsy // postop postop

IMPRESSION: In comparison with the study of ___, there again are diffuse bilateral pulmonary opacifications, better characterized on the CT of ___   Keywords: better. There is now a right chest tube in place after biopsy with no evidence of pneumothorax. Increased opacification at the left base is consistent with small effusion and atelectatic changes.


SubjectID: 12808249, StudyID: 55176259, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man s/p R VATS wedge biopsy x 2, now s/p chest tube removal // interval change, please evaluate interval change, please evaluate

IMPRESSION: In comparison with the study ___ ___, the right chest tube has been removed and there is no evidence of pneumothorax. The severe diffuse bilateral pulmonary opacification is are again seen consistent with the differential diagnosis detailed on the CT of ___   Keywords: again.


SubjectID: 12808249, StudyID: 55566897, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with bilaterla pulm infilitrates, pleural effusions s/p bilateral chest tubes // Assess for interval change; PLEASE DO BETWEEN 5 AND 6 AM

TECHNIQUE: Chest PA and lateral

COMPARISON: ___

FINDINGS: Lines and Tubes: Bilateral chest tubes project over the lower lateral chest wall. The pigtail of the right-sided chest tube projects outside the chest wall may be in the subcutaneous tissues. Lungs: Well inflated with unchanged bilateral diffuse coarse linear and patchy opacities   Keywords: unchanged. Pleura: There is no pleural effusion or pneumothorax Mediastinum: Unchanged cardiomegaly and mediastinal silhouette. Bony thorax: No interval change   Keywords: no interval change

IMPRESSION: Persistent bilateral diffuse coarse linear and patchy lung opacities compatible with unchanged pulmonary infiltrates   Keywords: unchanged, persistent. No pleural effusion or pneumothorax. Note position of right-sided chest tube projecting outside the chest wall, likely in the subcutaneous tissues.


SubjectID: 12808249, StudyID: 53924996, Comparison: None

FINAL REPORT

INDICATION: ___M with hx of lyphoma, on chemo today with sob and hypoxia // r/o infiltrate,effussion

EXAMINATION: CHEST (PORTABLE AP)

TECHNIQUE: Portable Chest radiograph, frontal view

COMPARISON: Chest radiograph ___, PET CT ___

FINDINGS: Compared to ___, there is new patchy opacity diffusely distributed in bilateral lungs with peripheral sparing. Differential includes pulmonary edema, ARDS and multifocal pneumonia. There is probable underlying fibrotic changes of the lung parenchyma. Blunting of the right costophrenic angle suggests at least small right effusion. No pneumothorax. Cardiomediastinal silhouette is within normal size.

IMPRESSION: Compared to ___, there is new patchy opacity diffusely distributed in bilateral lungs. Differential includes pulmonary edema, ARDS and multifocal pneumonia.


SubjectID: 12826857, StudyID: 53106716, Comparison: same

WET READ: ___ ___ ___ 8:35 AM Appropriate position of the endotracheal tube following intubation, terminating in the mid trachea. Otherwise, no significant change in appearance of the chest since the prior study from earlier today.

WET READ VERSION #1 ___ ___ 8:55 PM Appropriate position of the endotracheal tube following intubation, terminating in the mid trachea. Otherwise, no significant change in appearance of the chest since the prior study from earlier today. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___ year old man s/p intubation for GI bleed // confirm ETT placement

IMPRESSION: Interval intubation with endotracheal tube in standard position. No other relevant changes since recent radiograph from earlier the same date   Keywords: no other relevant change.


SubjectID: 12826857, StudyID: 53081771, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with line placement

TECHNIQUE: Portable upright AP view of the chest

COMPARISON: ___ at 13:09

FINDINGS: Right internal jugular central venous catheter tip terminates at the SVC/ right atrial junction. The patient is status post median sternotomy. The cardiac, mediastinal and hilar contours are unchanged. Minimal atelectasis is noted in the lung bases. No pneumothorax is identified. No large pleural effusion is present though the costophrenic angles are excluded from the field of view. No acute osseous abnormality is visualized.

IMPRESSION: Right internal jugular central venous catheter at the junction of the SVC and right atrium. No pneumothorax.


SubjectID: 12839549, StudyID: 54150790, Comparison: None

FINAL REPORT

HISTORY: ___-year-old male with elevated BNP, assess for congestive heart failure.

TECHNIQUE: PA and lateral views of the chest.

COMPARISON: ___. PROCEDURE:

FINDINGS: PA and lateral views of the chest were provided. Tiny bilateral pleural effusions are noted with mild interstitial edema. No frank alveolar edema is seen. There is no focal consolidation to suggest the presence of pneumonia. No pneumothorax. Heart size is stable and normal. Mediastinal contour is unremarkable. Bony structures are intact. No free air below the right hemidiaphragm seen.

IMPRESSION: Mild interstitial edema with small bilateral pleural effusions. Effusions.

NOTIFICATION:


SubjectID: 12839549, StudyID: 52033793, Comparison: better

FINAL REPORT

CHEST, TWO VIEWS

INDICATION: ___-year-old man with CHF. Please assess for change from ___. CHEST, TWO VIEWS: Comparison is made to prior examination of ___. The heart is normal in size. Mediastinal and hilar contours are unremarkable. The pulmonary vasculature is normal. The lungs are unremarkable. There is no evidence for interstitial or alveolar edema. The previously identified small pleural effusions have resolved.

IMPRESSION: Normal chest x-ray. The previously identified interstitial edema and pleural effusions have resolved   Keywords: resolve.


SubjectID: 12839549, StudyID: 53494661, Comparison: None

FINAL REPORT

CHEST, TWO VIEWS: ___.

HISTORY: ___-year-old man with fevers, rigors and cough. Question pneumonia.

FINDINGS: PA and lateral views of the chest. Comparison is made to previous exam from earlier the same day and from ___. The lungs are clear of focal consolidation, effusion or pulmonary vascular congestion. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 12847817, StudyID: 56524359, Comparison: None

FINAL REPORT

HISTORY: Central line attempt, to assess for pneumothorax.

FINDINGS: Following the procedure, there is no evidence of pneumothorax. There are lower lung volumes with evidence of bilateral pleural effusions, more prominent on the right with compressive atelectasis at the bases. Retrocardiac opacification is again consistent with volume loss in the left lower lobe.


SubjectID: 12847817, StudyID: 58905647, Comparison: None

FINAL REPORT

INDICATION: Chronic immunosuppression, now with nausea and dizziness. Recent history of productive cough.

TECHNIQUE: Single frontal radiograph of the chest.

COMPARISON: Multiple prior examinations, most recent dated ___.

FINDINGS: Lung volumes are somewhat low, however, no focal opacity to suggest pneumonia is seen. No pleural effusion, pulmonary edema or pneumothorax is present. A stent in the region of the left brachiocephalic vein is unchanged. Surgical chain suture is noted in the right lower lobe. A calcification seen projecting over the cardiac silhouette to the left of the aorta is not clearly localized on this single frontal radiograph, however, was not present on the examination of ___. The heart size is normal.

IMPRESSION: 1. No evidence of acute cardiopulmonary process. 2. Rounded calcification projecting over the cardiac silhouette not well localized on this single frontal radiograph. This could represent a calcified granuloma, however, was not present on the examination of ___. PA and lateral radiographs may be performed for further evaluation and localization.


SubjectID: 12847817, StudyID: 57631028, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST RADIOGRAPH DATED ___

COMPARISON: Chest x-ray ___.

FINDINGS: An approximately 6 mm diameter rounded opacity is again demonstrated in the left retrocardiac region, to the left of the descending aortic interface. It overlies the tenth left posterior rib level and is not definitively calcified but overlap with rib limits this assessment. Lungs are otherwise notable for surgical chain sutures in right mid lung. Cardiomediastinal contours are within normal limits. Left subclavian and brachiocephalic vascular stents remain in place. Minimal pleural thickening versus small effusion at lateral right costophrenic sulcus. No acute skeletal findings.

IMPRESSION: 6 mm diameter left lower lobe opacity is unchanged since recent chest radiograph, but is not fully characterized. Considering patient's immunosuppressed status and concern for acute infection, CT may be considered for more complete evaluation of this region if warranted clinically. This was discussed by telephone with the physician covering for Dr. ___ at pager ___ on ___ at 11:50 a.m.


SubjectID: 12847817, StudyID: 57348805, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Line placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, no additional line or monitoring devices visible on the current examination. The pre-existing Swan-Ganz catheter is in unchanged position. As on the previous report, it is noted that the the device needs to be pulled back by approximately 4 cm, as it is located too far in the right pulmonary system. Unchanged evidence of vascular stents and the right pleural effusion distributes in a different manner, but is overall unchanged in extent. The left lung appears unchanged.


SubjectID: 12847817, StudyID: 56973241, Comparison: same

FINAL REPORT

INDICATION: CHF. Reevaluation of Swan-Ganz position.

COMPARISON: Multiple priors from ___.

FINDINGS: Portable AP chest radiograph. The Swan-Ganz catheter has been withdrawn 2 cm, but still should be withdrawn an additional 2 cm. There is otherwise no significant interval change   Keywords: no significant interval change. Again noted is a vascular stent in the left subclavian artery and moderate bilateral pleural effusions, greater on the right. Mild interstitial edema has not significantly changed   Keywords: not significantly changed.


SubjectID: 12847817, StudyID: 54656023, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, Swan-Ganz catheter position.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has received a Swan-Ganz catheter. Catheter shows a normal course, the tip, however, is located too much distal in the right pulmonary artery and must be pulled back by approximately 4 cm. Otherwise, the radiograph is unchanged, low lung volumes, mild cardiomegaly, vascular stents in situ. Moderate to extensive right pleural effusion and mild left pleural effusion, both with evidence of atelectasis in the basal lung regions. No pneumothorax.


SubjectID: 12852433, StudyID: 52334317, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Intra-aortic balloon pump.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the intra-aortic balloon pump was moved upwards. Currently, the tip of the pump projects 4 cm below the upper margin of the aortic arch. At the time of image acquisition, the pump was inflated. Moderate cardiomegaly, diffuse bilateral parenchymal opacities reflecting pulmonary edema. Minimal pleural effusions.


SubjectID: 12852433, StudyID: 52143883, Comparison: better

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Intra-aortic balloon pump, severe aortic stenosis.

COMPARISON: ___.

FINDINGS: Intra-aortic balloon pump has been removed. The patient had prior sternotomy for CABG with moderate cardiomegaly. Severe bilateral pleural effusion is unchanged. Pulmonary edema has slightly improved and is now moderate   Keywords: improve. There is no pneumothorax. Bibasilar atelectasis is stable.

CONCLUSION: 1. Intra-aortic balloon pump has been removed. 2. Moderate pulmonary edema has slightly improved   Keywords: improve. 3. Bilateral severe pleural effusion is stable.


SubjectID: 12868814, StudyID: 59969985, Comparison: worse

FINAL REPORT

INDICATION: ___ year old woman with amlyoidosis, s/p CT placement on ___, removed ___. * please perform at 6 am * // interval change* please perform at 6 am *

TECHNIQUE: Portable

COMPARISON: ___

FINDINGS: There has been overall interval worsening, with bilateral pleural effusions have increased. The interstitial pulmonary edema has also increased   Keywords: increase. The visualized cardiomediastinal silhouette appears enlarged. No pneumothorax.

IMPRESSION: Interval worsening of the moderate pulmonary edema and bilateral pleural effusions, left greater than right   Keywords: worse.


SubjectID: 12868814, StudyID: 58575191, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with large right effusion s/p pigtail placement // ? PTX

IMPRESSION: As compared to ___ chest radiograph, cardiac silhouette has slightly decreased in size and pulmonary vascular congestion has improved   Keywords: improve, decrease. Right pigtail pleural catheter has been placed with decrease in size of right pleural effusion, with residual small effusion remaining and no visible pneumothorax. Moderate left pneumothorax is not appreciably changed, and bibasilar opacities are also a persistent finding.


SubjectID: 12868814, StudyID: 51422917, Comparison: None

WET READ: ___ ___ ___ 8:21 AM Right pigtail chest catheter. A tiny right apical pneumothorax is new and a moderate left pneumothorax is stable. The right pleural effusion has decreased compared to the prior radiograph performed 6 hours prior and the left pleural effusion is slightly increased. ___ discussed with ___ ___ ___.

WET READ VERSION #1 ___ ___ ___ 10:35 PM Right pigtail chest catheter. A tiny right apical pneumothorax is new and a moderate left pneumothorax is stable. The right pleural effusion has decreased compared to the prior radiograph performed 6 hours prior and the left pleural effusion is slightly increased. ___ discussed with ___ ___ ___. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with new pleuritic R sided chest pain 4hrs post-thoracentesis. // Is there a new pneumothorax? Is there a new pneumothorax?

IMPRESSION: In comparison with the study of earlier in this date, the right pigtail catheter remains in place and there is a tiny apical pneumothorax. The larger left apical pneumothorax is stable. The left pleural effusion appears slightly more prominent. The right hemidiaphragm is more sharply seen and there is less fluid in the minor fissure. Continued enlargement of the cardiac silhouette with some element of elevated pulmonary venous pressure.


SubjectID: 12868814, StudyID: 51120573, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with amyloid, s/p CT placement on the right // r/o pneumo, interval change** Please perform at 6am ** r/o pneumo, interval change** Please perform at 6am **

IMPRESSION: In comparison with the study of ___, there is little overall change   Keywords: little overall change. There may still be a very tiny right apical pneumothorax, of no clinical significance. Continued enlargement of cardiac silhouette with elevated pulmonary venous pressure and left effusion with volume loss in the lower lobe. The right hemidiaphragm is less well seen, suggesting either some re-accumulation of pleural fluid or a more supine position of the patient.


SubjectID: 12868814, StudyID: 56088572, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with right effusion s/p ___ (-1.1L) // r/o PTX

COMPARISON: Chest x-ray from ___ at ___

FINDINGS: There is a small right effusion, with thickening of the minor fissure and right base atelectasis. There is increased retrocardiac density consistent with left lower lobe collapse and/or consolidation and small left effusion, progressed compared with ___. There is upper zone redistribution and mild vascular plethora. No pneumothorax detected.

IMPRESSION: 1. No pneumothorax detected. 2. Small right effusion appears similar to ___. 3. New opacity in the retrocardiac region, consistent with new/worsening left lower lobe collapse and/or consolidation, together with a slight interval increase in a small left effusion. 4. Cardiomegaly and mild vascular plethora.


SubjectID: 12868814, StudyID: 53056655, Comparison: None

WET READ: ___ ___ ___ 1:03 PM 1. Mild pulmonary edema with small bilateral pleural effusions. 2. Right basilar opacity may represent asymmetric pulmonary edema or infectious process in the proper clinical setting. 3. No pneumothorax. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___F with chest pain, evaluate for pneumothorax.

TECHNIQUE: PA and lateral view radiographs of the chest.

COMPARISON: Prior chest radiographs dating back to ___.

FINDINGS: Pulmonary vascular congestion and pulmonary edema are mild. A small right pleural effusion was present on the prior study, with fluid now tracking into the minor fissure on the right. A small left pleural effusion is new. An opacity in the right base is new from the immediate prior study and may represent mildly asymmetric pulmonary edema, although an early infectious process could be considered in the proper clinical setting. There is no pneumothorax.

IMPRESSION: 1. Mild pulmonary edema with small bilateral pleural effusions. 2. Right basilar opacity may represent asymmetric pulmonary edema or infectious process in the proper clinical setting. 3. No pneumothorax.


SubjectID: 12875526, StudyID: 58573180, Comparison: worse

FINAL REPORT

HISTORY: New pacemaker lead.

FINDINGS: In comparison with the earlier study of this date, there has been placement of a dual-channel pacemaker device with leads extending to the region of the right atrium and apex of the right ventricle. The pulmonary vessels appear somewhat more hazy and engorged, suggesting some mild increase in pulmonary vascular congestion   Keywords: increase.


SubjectID: 12875526, StudyID: 54772599, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with fall, assess for acute process. Portable chest radiograph was obtained. The endotracheal tube is in the trachea, 1.9 cm above the carina, and should not be advanced any further. Nasogastric tube courses into the stomach. Lungs are low in volume which limits assessment; however, bilateral hazy opacification is compatible with moderate pulmonary edema and likely atelectasis without definite focal consolidation. No pleural effusion or pneumothorax is seen. The heart is at least mildly enlarged.

IMPRESSION: Moderate pulmonary edema.


SubjectID: 12875526, StudyID: 51627576, Comparison: better

FINAL REPORT

HISTORY: Intubation with tube placement.

FINDINGS: In comparison with the study of earlier in this date, the monitoring and support devices remain in place. The degree of pulmonary edema has slightly improved   Keywords: improve. Basilar atelectatic changes are again seen. Low lung volumes may account for some of the prominence of the transverse diameter of the heart.

IMPRESSION: Mild decrease in pulmonary vascular congestion   Keywords: decrease.


SubjectID: 12875526, StudyID: 57489576, Comparison: None

WET READ: ___ ___ ___ 8:32 PM Mild cardiomegaly and central venous congestion. Moderate R pleural effusion. New R lung opacities, most prominent in RUL and partially obscured by pacemaker. This is concerning for pneumonia, likely with superimposed pulmonary edema and tracking effusion.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

REASON FOR

EXAMINATION: Evaluation of the patient with pleural effusions after aortic valve replacement. Portable AP radiograph of the chest was reviewed in comparison to ___. Heart size and mediastinum are unchanged in appearance. Replaced aortic valve is in place. Right pleural effusion is moderate, unchanged. There is interval progression of right upper lobe opacity concerning for pneumonia. Mild interstitial pulmonary edema is demonstrated but cannot explain the entire problem in the right upper lobe.

IMPRESSION: New right upper lobe consolidation concerning for pneumonia.


SubjectID: 12875526, StudyID: 55108758, Comparison: same

FINAL REPORT

HISTORY: Aortic stenosis status post valve repair. Any change in size of pleural effusion?

TECHNIQUE: Portable AP chest.

COMPARISON: Chest radiograph ___.

FINDINGS: A right pacer has 2 leads terminating in the right atrium and right ventricle respectively. A moderate right pleural effusion is unchanged. The cardiomediastinal silhouette is unchanged with moderate cardiomegaly. A prosthetic aortic valve is again seen. There is mild vascular congestion. There is no pneumothorax.

IMPRESSION: Moderate right pleural effusion, moderate cardiomegaly, and mild vascular congestion are unchanged   Keywords: unchanged.


SubjectID: 12886834, StudyID: 59827971, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with weakness // ?evaluate subtle opacity since on portal, please schedule on ___ AM

TECHNIQUE: Chest PA and lateral

COMPARISON: Priors and ___ and ___

FINDINGS: Heart is top-normal in size. Cardiomediastinal and hilar contours are within normal limits. Minimal blunting of the right costophrenic angle could represent a trace pleural effusion pleural thickening. Increasing pulmonary opacities throughout the right lung, particularly at the right base suggest atelectasis or infection in the appropriate setting. There is mild pulmonary vascular congestion. No pneumothorax. As before, pleural plaques suggest prior asbestos exposure.

IMPRESSION: Increasing right lung opacities could represent asymmetric edema or pneumonia in the appropriate clinical setting   Keywords: increasing. Mild vascular congestion


SubjectID: 12886834, StudyID: 54523943, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with weakness // PNA?

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: Bilateral calcified pleural plaques are seen, suggesting prior asbestos exposure. There is slight blunting of the right costophrenic angle which could be due to a trace pleural effusion versus pleural thickening. Subtle opacity projecting over the right mid lung could be due pneumonia versus underlying pleural plaques, appears new/increased as compared to the prior study. Dedicated PA and lateral views when patient able could be helpful for further evaluation. No pneumothorax is seen. The cardiac silhouette is mildly enlarged. Mediastinal contours are unremarkable.

IMPRESSION: Bilateral pleural plaques suggest asbestos exposure. Subtle opacity projecting over the right mid lung could be due to pneumonia or underlying pleural plaque, appears new/increased compared to the prior study. Dedicated PA and lateral views when patient able could be helpful for further evaluation.


SubjectID: 12886834, StudyID: 52036061, Comparison: None

FINAL REPORT

INDICATION: ___M with chf // eval for fluid overload

TECHNIQUE: Frontal lateral views the chest.

COMPARISON: ___.

FINDINGS: Calcific densities projecting over the bilateral lungs suggest calcified pleural plaques. There is likely mild superimposed pulmonary vascular congestion. There is no large effusion. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities.

IMPRESSION: Pulmonary vascular congestion.


SubjectID: 12886834, StudyID: 50331157, Comparison: worse

FINAL REPORT

INDICATION: ___M with chf // eval for pna

TECHNIQUE: Single frontal view of the chest.

COMPARISON: ___ and ___

FINDINGS: Calcific densities project over the chest bilaterally suggesting calcified pleural plaques. The degree of opacification in the right mid lung however has progressed since prior as well as the degree of pulmonary vascular congestion   Keywords: progressed. There is a possible small right pleural effusion. Cardiomediastinal silhouette is stable. No acute osseous abnormalities.

IMPRESSION: Bilateral calcified pleural plaques with likely superimposed underlying parenchymal opacities particularly in the right mid lung which could be infection as well as component of pulmonary edema.


SubjectID: 12888412, StudyID: 58034587, Comparison: 1.0

FINAL REPORT

PORTABLE CHEST X-RAY, ___.

COMPARISON: ___ radiograph.

FINDINGS: Moderate-to-large left pleural effusion is slightly worse compared to the prior study and accompanied by adjacent atelectasis and/or consolidation in the left mid and lower lung regions. Persistent cardiomegaly accompanied by pulmonary vascular congestion   Keywords: persistent. Improved pulmonary edema with only minimal residual edema remaining   Keywords: improve.


SubjectID: 12888412, StudyID: 53109592, Comparison: worse

FINAL REPORT

HISTORY: ___-year-old female with lethargy and recent pneumonia.

COMPARISON: Multiple prior chest radiographs, most recently of ___.

FINDINGS: Frontal and lateral views of the chest were obtained. Enlarging left lower lobe opacity without shift of the mediastinum is consistent with pleural effusion and atelectasis. The right lung is essentially clear with minimal right lower lobe atelectasis. Mild pulmonary edema has slightly worsened   Keywords: worse. No pneumothorax. Mild to moderate cardiomegaly is unchanged. A compression deformity of a lower thoracic spine vertebral body is unchanged.

IMPRESSION: 1. Left lower lobe opacity, slightly increased since ___, is consistent with an enlarging pleural effusion with adjacent atelectasis. 2. Slightly worsened pulmonary edema   Keywords: worse.


SubjectID: 12888412, StudyID: 52238770, Comparison: better

FINAL REPORT

HISTORY: Female with CHF, presents with fever and somnolence. Assess for worsening pulmonary process.

COMPARISON: Chest radiograph, ___, ___.

TECHNIQUE: Supine frontal chest radiograph.

FINDINGS: Moderate stable retrocardiac opacity with left pleural effusion, atelectasis, and likely pneumonia. Low lung volumes are unchanged. No pneumothorax or right pleural effusion. Minimal improvement in pulmonary edema   Keywords: improve with mildly enlarged heart, mediastinum vein dilatation, air bronchograms and cephalization   Keywords: improve. No bony abnormality.

IMPRESSION: 1. Moderate left lower lobe atelectasis, left pleural effusion, and likely left lower lobe pneumonia. 2. Minimal improvement in pulmonary edema. Results were conveyed via telephone to ___ by Dr.___ on ___ at 10:55AM within 10 minutes of observation of findings.


SubjectID: 12888412, StudyID: 50851100, Comparison: None

FINAL REPORT

PORTABLE CHEST ON ___ AT 9:08 CLINICAL

INDICATION: ___-year-old with CHF, now with AMS, tachypnea. Rule out pneumonia/pulmonary edema. Comparison is made to the patient's previous study of ___ at 8:58. A portable AP chest film ___ at 9:08 is submitted. The patient's mandible does obscure the lung apices, but this is the best possible images that could be obtained.

IMPRESSION: 1. Lung volumes remain low and there is persistent airspace opacity at the left base likely with an associated layering effusion suggestive of either atelectasis, aspiration or pneumonia. There has been interval appearance of perihilar edema as well as mild interstitial edema. Overall, the heart remains enlarged. No large pneumothorax is appreciated.


SubjectID: 12896316, StudyID: 50919711, Comparison: None

WET READ: ___ ___ ___ 10:13 PM Small bilateral pleural effusions, mild cardiomegaly, and interstitial edema, all likely reflecting volume overload. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___-year-old woman with shortness of breath, evaluate for CHF versus pneumonia.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest x-ray from ___

FINDINGS: There are small bilateral pleural effusions with bibasilar atelectasis. There is moderate pulmonary vascular congestion and mild interstitial edema. The cardiac silhouette is mildly enlarged. No pneumothorax is seen. Degenerative changes are seen at the right acromioclavicular joint and throughout the thoracic spine.

IMPRESSION: Small bilateral pleural effusions, mild cardiomegaly, and interstitial edema, all likely reflecting volume overload.


SubjectID: 12896316, StudyID: 50763061, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with HTN urgency // Eval for interval change Eval for interval change

COMPARISON: Comparison to ___ at 20:40

FINDINGS: Portable AP chest radiograph ___ at 08:15 is submitted.

IMPRESSION: Interval resolution of perihilar vascular congestion and mild interstitial edema. The heart remains enlarged. Smaller bilateral pleural effusions. Improved aeration at the lung bases consistent with resolving atelectasis. No pneumothorax.


SubjectID: 12902262, StudyID: 55868791, Comparison: None

FINAL REPORT

INDICATION: ___F with tachypnea, hypoxia // evaluate for acute process

COMPARISON: ___ and ___.

FINDINGS: Portable AP chest radiograph. The patient is rotated to the right. This causes the cardiomediastinal silhouette to obscure the right lung base. A repeat radiograph with better positioning would help exclude an underlying consolidation. There is mild edema and possibly small effusions. There is no pneumothorax. The heart is moderately enlarged.


SubjectID: 12902262, StudyID: 54191394, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with dyspnea and increased O2 requirement // abrupt SOB. potential flash pul edema

EXAMINATION: CHEST (PORTABLE AP)

TECHNIQUE: Portable Chest radiograph, frontal view

COMPARISON: Chest radiograph ___

FINDINGS: Bibasilar opacities are similar compared to ___   Keywords: similar. There are small to moderate bilateral pleural effusions. There is no pulmonary edema. Cardiomegaly is unchanged. Central retrocardiac opacity is consistent with history of hiatal hernia.

IMPRESSION: No notable interval change. No pulmonary edema.


SubjectID: 12902262, StudyID: 53106989, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with dyspnea, tachypnea // repeat eval for pneumonia

COMPARISON: ___, 17:18

FINDINGS: AP portable upright view of the chest. Since the prior exam, there is apparent progression of pulmonary edema   Keywords: progression. Interval increase in lower lung opacities raises concern for pneumonia versus aspiration. Cardiomegaly is unchanged with subtle retrocardiac opacity which is consistent with known hiatal hernia. No pneumothorax.

IMPRESSION: Apparent worsening of pulmonary edema   Keywords: worse. Difficult to exclude a superimposed pneumonia or aspiration at the lung bases.


SubjectID: 12902262, StudyID: 52301401, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with dCHF, pulmonary hypertension, dyspnea. // Please assess for edema, interval change.

EXAMINATION: CHEST (PORTABLE AP)

TECHNIQUE: Portable Chest radiograph, frontal view

COMPARISON: Chest radiograph ___. Chest radiograph ___

FINDINGS: There is acute consolidation of left lower lobe which could be due to atelectasis but pneumonia cannot be ruled out. There is bilateral small to moderate pleural effusions. Moderate to severe cardiomegaly is unchanged. Hiatal hernia is again noted.

IMPRESSION: Acute left lower lobe collapse can be due to atelectasis but pneumonia cannot be ruled out.


SubjectID: 12902262, StudyID: 54272866, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with ?retrocardiac opacity on chest x-ray, hypoxemia, motion artifact // pneumonia? mass? edema?

FINDINGS: Cardiomegaly is accompanied by pulmonary vascular congestion. Again demonstrated is a hiatal hernia. New patchy and linear right basilar opacity is most likely due to atelectasis. Questionable area of abnormal increased opacity in the right paramediastinal region may be due to superimposition of structures, but attention to this region on the standard PA and lateral chest radiograph prior to discharge is recommended to exclude a pneumonia or mass.

COMPARISON: ___ chest radiograph.


SubjectID: 12902262, StudyID: 52061559, Comparison: None

FINAL REPORT

INDICATION: History: ___F with multiple falls // R/O CHF, pneumonia

TECHNIQUE: Chest PA and lateral views. The lateral view is suboptimal due to overlying motion artifact.

COMPARISON: None. Please note that comparison to old films can be helpful to detect subtle interval change.

FINDINGS: There is moderate cardiac enlargement which may reflect cardiomegaly or a pericardial effusion. There is pulmonary vascular congestion with no overt pulmonary edema. Thehilar and mediastinal contours difficult to assess given marked patient rotation on the current study. There is likely a hiatal hernia. There may be a focal opacity in the retrocardiac region; however evaluation is limited due to patient rotation and motion artifact. Followup imaging may be prudent. No large effusions are seen. No pneumothorax is appreciated. No acute bony abnormality.

IMPRESSION: 1. Limited examination due to marked patient rotation and overlying motion artifact on the lateral view. Cardiac enlargement which may reflect cardiomegaly or pericardial effusion. Probable hiatal hernia. No definite pneumonia or pulmonary edema. Followup imaging would be prudent. .

NOTIFICATION: ___ d/w Dr. ___ by Dr. ___ at 5:___p on the day of the exam by phone.


SubjectID: 12931038, StudyID: 59846994, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with sCHF. // Please eval interval change Please eval interval change

IMPRESSION: In comparison with the study of ___, the patient has taken a better inspiration. Continued substantial enlargement of the cardiac silhouette with relatively mild and is decreasing elevation of pulmonary venous pressure. The area of increased opacification at the right base has effectively cleared.


SubjectID: 12931038, StudyID: 53391179, Comparison: None

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old man with decompensated heart failure // ? pulmonary edema

TECHNIQUE: Portable chest radiograph

COMPARISON: None available.

FINDINGS: Lung volumes are low. There is opacification of the right lung base, which may be due to asymmetrical pulmonary edema, but pneumonia should be considered in the appropriate clinical setting. There is no pulmonary edema or pneumothorax. Heart size is mildly enlarged.

IMPRESSION: Right lung base opacity which may be due to asymmetrical pulmonary edema, but pneumonia should be considered in the appropriate clinical setting.


SubjectID: 12948123, StudyID: 59576204, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with hypertension and shortness of breath.

COMPARISON: None available.

FINDINGS: Portable single AP chest radiograph was obtained. Although suboptimal technique, the heart appears enlarged obscuration of the left hemidiaphragm may reflect atelectasis though a focal infectious consolidation cannot be excluded. Obscuration of bilateral costophrenic angles is consistent with bilateral pleural effusions. Vascular congestion is noted as well as cephalization of vessels. Hilar and mediastinal contours are otherwise unremarkable. Osseous structures demonstrates no acute abnormality.

IMPRESSION: Mild pulmonary edema


SubjectID: 12948123, StudyID: 58658455, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with asthma, clinical concern for PNA given fever and respiratory failure // evaluate for presumed PNA - febrile, hypercarbic resp failure

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The lung volumes are low. Moderate cardiomegaly with mild fluid overload but no overt pulmonary edema. Minimal bilateral basilar atelectasis. No larger pleural effusions. No pneumonia.


SubjectID: 12948123, StudyID: 52853727, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hypoxic respiratory distress // evaluate for interval change

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the lung volumes are unchanged an low. Moderate cardiomegaly. Signs of mild pulmonary edema. No pleural effusions. Minimal retrocardiac atelectasis.


SubjectID: 12948123, StudyID: 51830504, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with hypoxia and fluid overload, no convincing PNA previously but febrile, pls re-eval for pna // re-eval for pulmonary edema vs. pneumonia

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Mild fluid overload. Moderate cardiomegaly. Minimal bilateral areas of atelectasis. No pneumonia.


SubjectID: 12948123, StudyID: 57824351, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF exacerbation // pulmonary edema, pleural effusion?

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, a pre-existing opacities at the lung bases have completely cleared. Slightly increased lung volumes reflect improved ventilation. Moderate cardiomegaly persists. Right internal jugular vein catheter is in unchanged position.


SubjectID: 12948123, StudyID: 56276108, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with diastolic heart failure and hypercarbic respiratory distress // pulmonary edema

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___ obtained 21:09

IMPRESSION: Right central venous line tip is in the right atrium and its tip is approximately 2 cm below the cavoatrial junction. Cardiomegaly is severe, unchanged. Mild interstitial opacities are noted, unchanged no evidence of pulmonary edema is present   Keywords: unchanged


SubjectID: 12948123, StudyID: 55021299, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF, ?mediastinal widening/aortic dissection

TECHNIQUE: Upright AP view of the chest

COMPARISON: ___ at 12:23

FINDINGS: Cardiac silhouette size is mildly enlarged. The mediastinal contours are unremarkable. Previous pattern of pulmonary edema has improved with only mild pulmonary vascular congestion remaining   Keywords: improve. Aeration of the lung bases is incorrect streaky opacities, potentially atelectasis. A small right pleural effusion is noted. No pneumothorax is identified. No acute osseous abnormality is seen.

IMPRESSION: 1. Interval improvement in pulmonary edema with only mild pulmonary vascular congestion and small right pleural effusion currently   Keywords: improve. 2. Improved aeration of the lung bases with streaky bibasilar opacities, potentially atelectasis.


SubjectID: 12948123, StudyID: 51399174, Comparison: worse

FINAL REPORT

INDICATION: ___M with resp distress // ?ptx, pna

TECHNIQUE: Semi-erect portable view of the chest.

COMPARISON: Chest radiograph ___, ___.

FINDINGS: Severe cardiomegaly, increased since the prior exam. Additionally, the mediastinum appears significantly widened compared to the prior exam, which was taken with a similar technique and patient positioning. Moderate pulmonary edema is also present. There is a moderate right pleural effusion, which is new. A small left pleural effusion is likely present. Right upper and right lower lobe opacities are new.

IMPRESSION: Widened mediastinum with increased cardiomegaly, moderate pulmonary edema, a new right pleural effusion and multifocal opacities in the right lung   Keywords: increase, new. Chest CT is recommended for further evaluation.

RECOMMENDATION(S): The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 3:26 PM, 15 minutes after discovery of the findings.


SubjectID: 12950787, StudyID: 55042702, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with increased respiratory effort in setting of known mucus plug // assess for interval change

FINDINGS: As compared to ___, the left basal atelectasis has likely slightly decreased. The small right-sided effusion and right middle/lower lobe atelectasis have not significantly changed. No interstitial edema. No pneumothorax.

IMPRESSION: Right effusion, and middle/lower lobe atelectasis are stable. Slight decrease in left atelectasis.


SubjectID: 12950787, StudyID: 51722961, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with increased supplemental oxygen support. 5LNC w/ sats ___%. // r/o acute process

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph ___

FINDINGS: Since ___, the base of the aerated right lung has elevated, changed configuration obscuring much of the right heart border. Even thought the mediastinum is midline the findings are best explained by collapse of the right middle and lower lobes. A left retrocardiac opacity obscures the margin of the descending thoracic aorta and the medial diaphragmatic interface, most likely due to atelectasis of the basal segments of the left lower lobe. Bilateral small pleural effusions are possible. There is no pneumothorax. Cardiomediastinal and hilar structures are normal.

IMPRESSION: Probable collapse of the right lung middle and lower lobes and probable basilar atelectasis of the left lung, new since ___. Small bilateral pleural effusions are possible, but not clinically significant, that is, not responsible for the severe atelectasis.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 2:04 PM, 5 minutes after discovery of the findings.


SubjectID: 12952223, StudyID: 59762556, Comparison: None

FINAL REPORT

HISTORY: Chest tube placement.

FINDINGS: In comparison with the study of ___, there has been placement of a right basilar chest tube with clearing of almost all of the pleural effusion. No evidence of pneumothorax. The remainder of the study is essentially unchanged.


SubjectID: 12952223, StudyID: 58055058, Comparison: same

WET READ: ___ ___ ___ 7:42 PM ETT ends 2.8cm above carina. NGT follows expected course although tip is not seen. R IJ probably ends in region of cavoatrial junction. R effusion is unchanged to slightly decreased from 3:12pm. probably small left effusion. Bibasilar atelectasis and pulmonary edema are similar. ______________________________________________________________________________

FINAL REPORT

HISTORY: Cardiac surgery with reintubation after respiratory distress.

FINDINGS: In comparison with the earlier study of this date, the endotracheal tube tip lies approximately 2.8 cm above the carina. Nasogastric tube extends to at least the mid body of the stomach, where it crosses the inferior margin of the image. Right IJ catheter extends to about the level of the cavoatrial junction. Change in appearance of the right pleural effusion may reflect differences in patient position. Bilateral atelectasis and pulmonary edema are essentially unchanged   Keywords: unchanged.


SubjectID: 12952223, StudyID: 57273961, Comparison: None

WET READ: ___ ___ 9:54 PM Limited study due to the low lung volumes. Moderate right pleural effusion with adjacent atelectasis appears slightly increased. Small left pleural effusion likely present. Increased left basilar atelectasis, pneumonia must be excluded in the proper clinical setting. Right IJ tip may be in the right atrium but difficult to assess due to low lung volumes. A repeat radiograph is recommended when possible. ______________________________________________________________________________

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman status post aortic valve replacement. Evaluate for pleural effusions.

FINDINGS: There is a right IJ central venous line with distal lead tip at the cavoatrial junction, stable. There are extensive large pleural effusions, right side worse than left. Atelectasis at the left lung base and poor inspiratory effort is again visualized. No pneumothoraces are seen. There is mild underlying pulmonary edema.


SubjectID: 12952223, StudyID: 50802157, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman status post aortic valve replacement and with pleural effusions.

FINDINGS: Comparison is made to previous study from five hours earlier. Bilateral pleural effusions are again seen, right side worse than left. There is cardiomegaly. There is mild-to-moderate pulmonary edema with prominence of pulmonary interstitial markings. There is a right IJ catheter with distal lead tip in the right atrium. This could be pulled back 4 cm for more optimal placement. There is calcification adjacent to the soft tissues of the right shoulder which can be seen with calcific tendinitis or tumoral calcinosis.


SubjectID: 12952223, StudyID: 58565744, Comparison: worse

FINAL REPORT

HISTORY: AVR and pulmonary edema.

FINDINGS: In comparison with the study of ___, there again is enlargement of the cardiac silhouette with pulmonary edema and bilateral pleural effusions with compressive atelectasis, worse on the right   Keywords: worse. IJ catheter remains in place.


SubjectID: 12952223, StudyID: 58509428, Comparison: same

FINAL REPORT

HISTORY: Cardiac surgery, to assess for effusion.

FINDINGS: In comparison with the study of ___, there are continued low lung volumes. Bilateral pleural effusions with compressive atelectasis at the bases persist. Mild pulmonary vascular congestion is again seen   Keywords: again. Right IJ catheter remains in place.


SubjectID: 12952223, StudyID: 54537743, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: Chest AP portable single view.

INDICATION: ___-year-old female patient with shortness of breath.

FINDINGS: AP single view of the chest has been obtained with patient in upright position. Comparison is made with the next preceding similar study of ___. The findings on the portable AP single chest view remains the same. Thus, bilateral pleural effusions exist and the pulmonary vasculature remains congested similar as it was on all three postoperative and follow up examinations. As on the next previous study, the patient is extubated. Right internal jugular approach central venous line remains in unchanged position.


SubjectID: 12952223, StudyID: 58485731, Comparison: better

FINAL REPORT

PORTABLE AP CHEST FILM, ___ AT 10:51 CLINICAL

INDICATION: ___-year-old with Dobbhoff tube, check position. Comparison to ___ at 07:44. A portable AP upright chest film, ___ at 10:51 is submitted.

IMPRESSION: 1. The Dobbhoff feeding tube is seen coursing down into the stomach and then courses back up into the upper esophagus where the tip is positioned. Removal with an attempt at repositioning of the Dobbhoff feeding tube would be advised at this time. The endotracheal tube remains in place and the tip is difficult to identify as this is the location where the Dobbhoff feeding tube appears to be coiled within the esophagus. However, it is likely unchanged in position. There has been median sternotomy. Stable postoperative cardiac and mediastinal contours. There are layering effusions bilaterally with some associated patchy airspace disease, which most likely represents compressive atelectasis. Overall, there has been interval improvement in the pulmonary edema   Keywords: improve. No pneumothorax is seen. Results of this examination were conveyed directly to the patient's nurse, ___, on ___ at 11:55 a.m. The patient's nurse stated that the feeding tube has already been withdrawn and a new feeding tube has been put in place.


SubjectID: 12952223, StudyID: 53389484, Comparison: None

FINAL REPORT

PORTABLE AP CHEST FILM ___ AT 11:51 CLINICAL

INDICATION: ___-year-old with PICC line and repositioned Dobbhoff feeding tube. Comparison is made to the patient's prior study of ___ at 10:51. Portable semi-erect chest film ___ at 11:51 is submitted.

IMPRESSION: 1. Endotracheal tube has its tip 3.6 cm above the carina. There has been interval repositioning of the Dobbhoff feeding tube which now has its tip projected over the stomach. In addition, there has been interval placement of right subclavian PICC line, which has its tip in the right atrium. Pullback of approximately 4 cm would be advised in order to position the tip in the mid to distal SVC. The patient is status post median sternotomy with stable postoperative cardiac and mediastinal contours. There continued to be patchy opacities at both bases with some layering pleural fluid, likely suggestive of compressive atelectasis rather than bilateral pneumonia. Clinical correlation is advised. No pneumothorax is seen. Calcification of the aorta is consistent with atherosclerosis. The IV nurse, ___, was notified of the need for repositioning on ___ by phone at 1:10 p.m.


SubjectID: 12952223, StudyID: 51183783, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post aortic valve replacement, questionable right-sided pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the right hemothorax that pre-existed has slightly decreased in extent but is still visible. The pneumothorax is limited to the apicolateral parts of the right hemithorax. There is no evidence of tension. Unchanged moderate cardiomegaly with bilateral pleural effusions and areas of atelectasis. Mild fluid overload. Status post CABG.


SubjectID: 12952223, StudyID: 51080537, Comparison: same

WET READ: ___ ___ ___ 8:39 PM Dobhoff ends in the stomach. ______________________________________________________________________________

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman with new DHT, evaluate placement.

FINDINGS: Comparison is made to prior study from ___ at 11:51 a.m. There is a Dobhoff tube whose distal tip is below the gastroesophageal junction. There is endotracheal tube whose tip is 3 cm above the carina. There is a right-sided central venous catheter with the distal lead tip in the mid SVC. There are bilateral pleural effusions and left retrocardiac opacity, which is stable. There is also some pulmonary vascular congestion which is unchanged   Keywords: unchanged.


SubjectID: 12952223, StudyID: 57876776, Comparison: same

WET READ: ___ ___ ___ 7:10 PM No significant interval change since the prior study. Bilateral small-moderate pleural effusions, with bibasal atelectasis and mild edema. R IJ CVL tip in the right atrium. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Low oxygen saturation, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Low lung volumes with bilateral pleural effusions and relatively extensive areas of bilateral basal atelectasis. Mild fluid overload might be present. No newly appeared focal parenchymal opacities   Keywords: new. The right internal jugular vein catheter and the sternal wires are in constant position.


SubjectID: 12952223, StudyID: 57259586, Comparison: 0.0

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Urosepsis, chronic heart failure, pulmonary edema. Evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is improvement of ventilation, as reflected by decrease in extent of the parenchymal opacities   Keywords: decrease. At the lung bases, the opacities, however, are still evident   Keywords: still. Moderate cardiomegaly, mild fluid overload, no pneumothorax.


SubjectID: 12952223, StudyID: 56581630, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Urosepsis, chronic heart failure, evaluation for endotracheal tube position.

COMPARISON: ___, 5:50 a.m.

FINDINGS: As compared to the previous radiograph, the endotracheal tube has been slightly pulled back. It now projects roughly 3 cm above the carina. The lung parenchyma has minimally increased in transparency, potentially reflecting improved ventilation or higher respiratory pressures. Small bilateral pleural effusions are likely. Unchanged evidence of mild fluid overload and cardiomegaly   Keywords: unchanged.


SubjectID: 12952223, StudyID: 54870443, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Respiratory failure, evaluation for endotracheal tube position.

COMPARISON: ___, 2:23 a.m.

FINDINGS: As compared to the previous radiograph, the patient has received an endotracheal tube. The tip of the tube projects 1 cm above the carina and should be pulled back by approximately 1-2 cm. There is no evidence of complications. The patient has also received a nasogastric tube, the course of the tube is unremarkable, the tip of the tube projects over the middle parts of the stomach. Unchanged appearance of the lung parenchyma, the heart and the chest wall.


SubjectID: 12952223, StudyID: 54586308, Comparison: better

FINAL REPORT

INDICATION: Hypoxia.

COMPARISON: ___. SUPINE AP VIEW OF THE CHEST: Low lung volumes are present. The patient is status post median sternotomy and aortic valve replacement. Cardiac silhouette size is mildly enlarged. Thoracic aorta remains calcified. There continues to be mild pulmonary vascular congestion. Persistent streaky opacities at the lung bases appear slightly improved compared to the prior study, and likely reflect atelectasis. There are adjacent small bilateral pleural effusions, though the size of the effusions appearing slightly improved compared to the most recent prior study. No pneumothorax is identified. There are no acute osseous abnormalities.

IMPRESSION: Slight interval improvement in mild pulmonary vascular congestion, small bilateral pleural effusions, and bibasilar airspace opacities likely reflecting atelectasis   Keywords: improve. Please note that infection at the lung bases cannot be completely excluded.


SubjectID: 12952223, StudyID: 54128066, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old woman with tachypnea.

COMPARISONS: ___ to ___.

FINDINGS: Moderate pulmonary edema has progressed since yesterday   Keywords: progressed. Bibasilar atelectasis is unchanged. Mild cardimegally is similar. Median sternotomy wires are intact and mediastinal clips are in expected positions.

IMPRESSION: Progression of moderate pulmonary edema   Keywords: progression.


SubjectID: 12952223, StudyID: 56354797, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post AVR, pulmonary edema.

TECHNIQUE: PA and lateral chest views were reviewed in comparison with prior chest radiograph from ___.

FINDINGS: Bilateral lung volumes are lower. Since yesterday, mild-to-moderately severe pulmonary edema has significantly improved   Keywords: improve. However, moderate right pleural effusion associated with right lower lung atelectasis and left lower lung atelectasis and small left pleural effusions are unchanged. The lung effusions and atelectasis obscuring the mediastinal border, thus assessment of the cardiomediastinum was limited.

IMPRESSION: Over last 24 hours, mild pulmonary edema has significantly improved, moderate right and small left pleural effusion as well as bilateral lower lung atelectasis are unchanged   Keywords: improve.


SubjectID: 12952223, StudyID: 52149367, Comparison: -1.0

FINAL REPORT

TYPE OF

EXAMINATION: Chest AP portable single view.

INDICATION: ___-year-old female patient status post aortic valve replacement, pulmonary edema.

FINDINGS: AP single view of the chest has been obtained with patient in sitting semi-upright position. Comparison is made with the next preceding similar study of ___. As before, the patient is status post sternotomy, aortic valve replacement and bypass surgery. Cardiomegaly as before. A right internal jugular approach central venous line remains in unchanged position and terminates in a location compatible with the upper portion of the right atrium. The diaphragmatic contours are bilaterally obscured and the lateral pleural sinuses are blunted. This is indicative of increasing pleural effusion in comparison with the previous portable postoperative chest examination. Pulmonary vasculature remains congested with considerable perivascular haze   Keywords: remains. No pneumothorax is seen. The comparison is extended to multiple previous postoperative examinations, signs of pleural effusion and pulmonary congestion existed already earlier. On the preoperative chest examination of ___, significant cardiomegaly existed already at that time. The pleural spaces are practically free.

IMPRESSION: Continuing postoperative CHF with bilateral pleural effusion apparently increasing slightly during latest examination interval   Keywords: increasing. Dr. ___ ___ was informed via page.


SubjectID: 12952223, StudyID: 53302552, Comparison: None

FINAL REPORT

HISTORY: AVR.

FINDINGS: In comparison with study of ___, there is extremely poor inspiration on the frontal view. Opacification at the bases most likely reflects pleural fluid and atelectasis. The pulmonary vascularity is difficult to assess, though there probably is some elevated pulmonary venous pressure.


SubjectID: 12952223, StudyID: 52774948, Comparison: same

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___ study.

FINDINGS: The patient is status post median sternotomy and coronary bypass surgery. Heart remains enlarged, and is accompanied by pulmonary vascular congestion   Keywords: remains. Interval improved aeration at both lung bases with improving atelectasis and decreasing pleural effusions. No new areas of consolidation within either lung.


SubjectID: 12952223, StudyID: 50380203, Comparison: worse

FINAL REPORT

INDICATION: Aortic valve replacement, followup of effusions and atelectasis.

COMPARISONS: ___.

FINDINGS: Portable AP chest radiograph demonstrates worsening bilateral pleural effusions and associated atelectasis, greater on the right. There is also worsening pulmonary vascular congestion   Keywords: worse. There is no pneumothorax. Right internal jugular catheter probably terminates in the right atrium.

IMPRESSION: Worsening pulmonary edema and bilateral pleural effusions   Keywords: worse. Results were relayed to ___, PA-C by phone at approximately 6:00 p.m. on ___.


SubjectID: 12952223, StudyID: 50551136, Comparison: None

FINAL REPORT

PORTABLE CHEST X-RAY

COMPARISON: ___ radiograph.

FINDINGS: Cardiac silhouette is enlarged and accompanied by pulmonary vascular congestion. Persistent moderate right and small left pleural effusions with adjacent basilar lung opacities, which probably reflect atelectasis, although coexisting pneumonia is possible in the appropriate clinical setting.


SubjectID: 12960546, StudyID: 54977072, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male status post dual-chamber pacer placement requiring assessment for lead position.

COMPARISON: Comparison is made with chest radiograph from ___ and chest CT from ___.

FINDINGS: Pacer is in left anterior axillary position with intact leads along the expected course to the right atrium and right ventricle. There is no pneumothorax or other related complication. There is mild pulmonary edema and bibasilar atelectasis. There are persistent small-to-moderate bilateral pleural effusions. Cardiomediastinal silhouette is unchanged.

IMPRESSION: Pacer leads in appropriate position. Mild pulmonary edema with bilateral pleural effusions.


SubjectID: 12960546, StudyID: 50239274, Comparison: worse

WET READ: ___ ___ ___ 10:35 PM bilateral pleural effusions are unchanged. subtle opacification of right lung compared to left is unchanged compared to CT and may be due to very mild asymmetric edema. no new opcity. ______________________________________________________________________________

FINAL REPORT

PA AND LATERAL CHEST X-RAY

INDICATION: Patient with productive cough, aortic stenosis, heart failure, rule out pneumonia.

COMPARISON: No prior chest x-ray. Chest CT of ___.

FINDINGS: Increased interstitial marking and pulmonary vessels cephalization is compatible with mild interstitial edema   Keywords: increase. Bilateral pleural effusions are small and improved since prior CT. Cardiac contour is mildly enlarged with a heavily calcified mitral valve annuls. There is no pneumothorax.

CONCLUSION: 1. Interstitial pulmonary edema is mild. 2. Bilateral pleural effusions are small and improved since prior chest CT.


SubjectID: 12960546, StudyID: 54103949, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior study from ___. CLINICAL

HISTORY: Edema, question failure.

FINDINGS: AP portable upright frontal and lateral views of the chest provided. Dual-lead pacer is unchanged. There is pulmonary edema re-demonstrated with bilateral small to moderate pleural effusions, right greater than left. No pneumothorax is seen. The heart size appears grossly stable. A vascular stent is again noted within the region of the ascending aorta. The imaged osseous structures are intact. DISH-related changes of the T-spine noted.

IMPRESSION: Findings compatible with congestive heart failure with pulmonary edema and bilateral pleural effusions, moderate on the right. Basilar atelectasis also present.


SubjectID: 12960546, StudyID: 53612811, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old man with volume overload, now with decreased breath sounds on the right side.

FINDINGS: Comparison is made to the previous study from ___. There is a dual-lead left-sided pacemaker with lead tips in right atrium and right ventricle. There has been increase in the right-sided pleural effusion which is now moderate in size. A small left-sided pleural effusion and left retrocardiac opacity are also seen. There is mild pulmonary edema. There are no pneumothoraces identified.


SubjectID: 12961917, StudyID: 59657415, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with NSCLC, RLL pneumonia, SBO. NGT just placed // NGT placement NGT placement

COMPARISON: Chest radiographs since ___ most recently ___ and ___.

IMPRESSION: Right lower lobe pneumonia and moderate right pleural effusion have increased progressively since ___ and ___. Postoperative right apical pleural fluid loculation and other findings are better evaluated Chest CT scans on ___ today. Small left pleural effusion and larger today than it was on ___. Left upper lobe pulmonary vasculature mildly engorged. No pulmonary edema. Heart size stable, partially obscured by the consolidation in the right lung. Esophageal drainage tube ends in the stomach and left central venous infusion catheter ends in the low SVC. No pneumothorax.


SubjectID: 12961917, StudyID: 56192296, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with metastatic lung cancer admitted with SBO, GNR bacteremia and RP bleed. Developed sudden onset severe chest pain after manipulating NGT // Eval NGT position. Eval source of CP

COMPARISON: Radiographs from ___

IMPRESSION: The nasogastric tube has migrated slightly more proximally with the sideport just at the GE junction. This could be advanced a few cm for more optimal placement. The left-sided Port-A-Cath is unchanged in position. There remains contrast material within the colon. There is unchanged mild cardiomegaly. There are bilateral pleural effusions, right greater than left. Right upper lobe opacity may represent loculated fluid. There remains mild prominence of the pulmonary interstitial markings   Keywords: remains. There are no pneumothoraces.


SubjectID: 12961917, StudyID: 53924070, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with stage IV NSCLC with dyspnea on exertion // pulmonary edema. Other acute change pulmonary edema. Other acute change

COMPARISON: ___

IMPRESSION: Heart size and mediastinal contours including widening of the right upper mediastinum are similar to previous examination. Bilateral pleural effusions appear to be minimally increased. Vascular congestion is present but no overt pulmonary edema is present. No pneumothorax.


SubjectID: 12961917, StudyID: 57633354, Comparison: None

FINAL REPORT

EXAM: Chest, single frontal view. CLINICAL INFORMATION: Non-small cell lung CA with recurrent malignant right pleural effusion, status post thoracoscopy.

COMPARISON: ___.

FINDINGS: Right-sided chest tubes are again seen. There is persistent elevation of the right hemidiaphragm. Right upper chest region of loculated gas is again seen, grossly stable in extent. There has been interval increase in adjacent right upper lung opacity which may be due to underlying pleural effusion and consolidation with possible component of collapse without shift of the mediastinum. The left lung is grossly clear aside from minor basilar atelectasis. The cardiac and mediastinal silhouettes are stable with the right aspect difficult to fully assess due to the right-sided opacities. Extensive subcutaneous emphysema is again seen tracking along the right chest wall and into the right neck.

IMPRESSION: 1. Loculated pneumothorax again seen along the right upper chest, stable to possibly minimally increased. There has been interval increase in adjacent right upper chest opacification which may be due to a combination of pleural fluid and consolidation with possible component of lung collapse without mediastinal shift, underlying malignancy not excluded. Elevation of the right hemidiaphragm may be due to volume loss with possible subpulmonic effusion.


SubjectID: 12961917, StudyID: 57017261, Comparison: same

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph of one day earlier.

FINDINGS: As compared to the recent study, there has been little interval change in the appearance of the chest except for slight improved aeration at both lung bases   Keywords: little interval change.


SubjectID: 12961917, StudyID: 50844645, Comparison: None

FINAL REPORT

HISTORY: Pleural effusion with Pleurx and chest tube placement.

FINDINGS: In comparison with study of ___, there has been placement of a right chest tube and Pleurx tube with some residual pleural effusion. There is a large area of loculated gas in the right upper zone, consistent with a loculated pneumothorax. Extensive opacification along the right lateral chest wall is consistent with subcutaneous emphysema. The left lung is essentially clear.


SubjectID: 12961917, StudyID: 57201049, Comparison: None

FINAL REPORT

HISTORY: Effusion with worsening shortness of breath.

FINDINGS: In comparison with the study of ___, there is little change in the substantial subpulmonic pleural effusion on the right. No evidence of pneumothorax, pulmonary vascular congestion, or acute focal pneumonia.


SubjectID: 12961917, StudyID: 54351996, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Right malignant effusion, status post thoracocentesis.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has undergone a right thoracocentesis. The extent of the pre-existing pleural effusion has substantially decreased. There is no right pneumothorax. Elevation of the right hilar structures, as well as partial right upper lobe atelectasis, better documented on a CT examination from ___. Normal appearance of the cardiac silhouette and of the left lung.


SubjectID: 12961917, StudyID: 54487652, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph of one day earlier.

FINDINGS: One of two right-sided pleural tubes has been removed in the interval, with no substantial change in appearance of loculated hydropneumothoraces at the right lung apex. However, dependent pleural fluid at the costophrenic sulcus has increased and is now moderate in size. Adjacent right basilar opacity has also worsened and may reflect atelectasis and/or infectious consolidation. Scattered linear opacities in the right mid and lower lung regions appear unchanged. Overall improved aeration of the left lung with persistent small left pleural effusion and near resolution of left basilar atelectasis.


SubjectID: 12972442, StudyID: 55311384, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old woman with respiratory distress, desaturating to the 70s, likely flash pulmonary edema. Please assess fluid status.

COMPARISONS: PA and lateral chest radiographs from ___.

FINDINGS: Single AP portable view. Compared to the prior radiograph, there is increased pulmonary vascular congestion, consistent with moderate pulmonary edema   Keywords: increase. There is slight blunting of the costophrenic angles, likely due to small bilateral pleural effusions. Mild cardiomegaly is unchanged from the prior exam. There is no definite focal consolidation or pneumothorax.

IMPRESSION: Moderate pulmonary edema and small bilateral pleural effusions.


SubjectID: 12972442, StudyID: 54352467, Comparison: same

FINAL REPORT

INDICATION: ___-year-old woman with CHF, status post intubation and ET tube placement.

COMPARISONS: Portable chest radiograph from ___.

FINDINGS: There has been placement of an endotracheal tube with the tip 4.5 cm from the carina. Compared to the most recent prior radiograph, there is lugn volumes are increased. Again seen is moderate pulmonary edema   Keywords: again. There is no focal consolidation or pneumothorax.


SubjectID: 12972442, StudyID: 58736893, Comparison: same

FINAL REPORT

AP CHEST 9:14 P.M. ON ___

HISTORY: ___-year-old woman with COPD and coronary artery disease, acute diastolic heart failure.

IMPRESSION: AP chest compared to ___ through ___, 7:55 a.m.: New asymmetric opacification in the lateral aspect of the left mid and lower lung zones and perhaps a smaller area in the right upper lobe highlighting the minor fissure, in the absence of mediastinal or pulmonary vascular engorgement is most likely pneumonia   Keywords: new. Covering resident was contacted by telephone at 10:45 a.m., 2minutes after recognition to discuss these findings.


SubjectID: 12972442, StudyID: 56288394, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Flash pulmonary edema, evaluation for interval change.

COMPARISON: ___, 2:03 p.m.

FINDINGS: As compared to the previous radiograph, the lung volumes have slightly increased, likely to reflect improved ventilation. There are still signs indicative of mild-to-moderate pulmonary edema, but these have improved as compared to the previous examination   Keywords: improve. Borderline size of the cardiac silhouette. No evidence of newly occurred parenchymal opacities. Minimal blunting of the left costophrenic sinus, potentially indicative of a small left pleural effusion.


SubjectID: 12972442, StudyID: 55372978, Comparison: None

FINAL REPORT

PORTABLE CHEST 9:00 A.M. ___.

HISTORY: COPD. Admitted to the CCU with acute dyspnea for CHF.

IMPRESSION: AP chest compared to ___: Lung volumes are appreciably lower. Although there is distention of central pulmonary vasculature, I do not see pulmonary edema. Moderate left pleural effusion is stable. What looked like extensive pneumonia two days ago is partially obscured and no worse. No pneumothorax.


SubjectID: 12972442, StudyID: 53180965, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: COPD, increased oxygen requirement, questioning pneumonia.

TECHNIQUE: Upright portable chest view was read in comparison with most recent radiograph from ___, acquired 24 hours apart.

FINDINGS: A new, horizontally oriented opacity, in the right perihilar region is probably atelectasis. Minimal right lung base opacity and increased retrocardiac density, pronounced over last 24 hours, is either worsening atelectasis or secondary to aspiration, however, lung infection cannot be rule out. Pleural effusion on the left side, if any, is minimal. Mild vascular engorgement is unchanged, and there is no pulmonary edema   Keywords: unchanged. Followup radiographs recommended to monitor the changes in lungs.


SubjectID: 12972442, StudyID: 58713165, Comparison: same

FINAL REPORT

HISTORY: Possible flash pulmonary edema.

FINDINGS: In comparison with the study of ___, there has been substantial clearing of the bilateral pulmonary opacifications. There is still some indistinctness of engorged vessels, consistent with some residual elevation of pulmonary venous pressure   Keywords: still. Left hemidiaphragm is more sharply seen, though there still may well be some small pleural effusion and atelectasis at the left base.


SubjectID: 12972442, StudyID: 53203615, Comparison: worse

FINAL REPORT

HISTORY: Acute shortness of breath, to assess for pulmonary edema.

FINDINGS: In comparison with the study of ___, there is increased engorgement of ill-defined pulmonary vessels, consistent with worsening vascular congestion   Keywords: worse. Probable small pleural effusions with bibasilar compressive atelectasis. The cardiac silhouette actually appears slightly smaller than on the previous study.


SubjectID: 12972442, StudyID: 57195209, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with possible anaphylaxis s/p intubation // eval ETT position

COMPARISON: Chest radiograph ___.

FINDINGS: Single AP view of the chest provided. Endotracheal tube should be advanced 1-2 cm. Prominence of the pulmonary vasculature and diffuse interstitial lung markings are consistent with mild pulmonary edema. No pneumothorax. Possible pleural effusion on the left. Hilar and cardiomediastinal contours are normal.

IMPRESSION: 1. Endotracheal tube should be advanced 1-2 cm. 2. Mild pulmonary edema, significantly worse from ___   Keywords: worse.


SubjectID: 12972442, StudyID: 56081912, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with history of ESRD s/p transplant w/CKD, dCHF, jnow with hypotension // please eval for pna please eval for pna

COMPARISON: Chest radiographs since ___, most recently ___.

IMPRESSION: Pulmonary vascular congestion was most severe on ___, and has improved subsequently. There is no longer any pulmonary edema, although moderate cardiomegaly little different. There is no pleural effusion. Lungs are clear of focal abnormality.


SubjectID: 12972442, StudyID: 53381347, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with angioedema requiring intubation // interval change interval change

IMPRESSION: In comparison with the study of ___, the endotracheal tube and nasogastric tube are in good position. Continued enlargement of the cardiac silhouette with pulmonary edema that may be superimposed upon chronic interstitial lung disease   Keywords: continue. Bilateral pleural effusions with compressive atelectasis at the bases.


SubjectID: 12972442, StudyID: 50910653, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with anaphylaxis. s/p ogt placement // eval OGT placement

COMPARISON: Chest radiograph ___

FINDINGS: Single AP view of the chest provided. ET tube may be advanced 1-2 cm. An orogastric tube courses below the level of the diaphragm and terminates in the proximal stomach and should be advanced 2 cm. Otherwise, no significant changes from the examination 1 hour prior   Keywords: no significant change.

IMPRESSION: 1. ET tube may be advanced 1-2 cm. 2. An orogastric tube courses below the level of the diaphragm and terminates in the proximal stomach and should be advanced 2 cm. Otherwise, no significant changes from the examination one hour prior   Keywords: no significant change.


SubjectID: 12972442, StudyID: 56921804, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with acute sob, hypertensive // eval for pulm edema

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the pre-existing pulmonary severity. Edema has minimally decreased in edema, however, is still clearly present   Keywords: decrease. Moderate cardiomegaly persists. No pleural effusions.


SubjectID: 12972442, StudyID: 53473035, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with COPD, diverticulitis, s/p renal transplant // Eval for pneumonia vs. pulmonary infiltrates (?aspiration)

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Heart size is top-normal. Mediastinum is stable. Since the prior study there is no substantial change in upper and lower lobe interstitial opacities consistent with pulmonary edema. Potentially superimposed infectious process in the left lower lobe cannot be excluded. Bilateral pleural effusions are small.


SubjectID: 12972442, StudyID: 56749223, Comparison: better

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: History: ___F with renal failure p/w weakness // assess for edema, PNA

TECHNIQUE: Chest Frontal and Lateral

COMPARISON: ___

FINDINGS: There is minimal pulmonary vascular congestion, decreased compared to the prior study   Keywords: decrease. Mild basilar atelectasis is seen. No large pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable.

IMPRESSION: Minimal pulmonary vascular congestion, improved since ___   Keywords: improve.


SubjectID: 12972442, StudyID: 56512149, Comparison: None

FINAL REPORT

INDICATION: Cough. Evaluate for pneumonia.

COMPARISONS: Chest radiograph, ___. Chest radiograph, ___.

FINDINGS: There is mild-to-moderate pulmonary edema. There are no focal consolidations. Pleural effusions, if present, are trace. There is no pneumothorax. Mild cardiomegaly is unchanged from the prior exam. The mediastinum is normal. The osseous structures are unremarkable.

IMPRESSION: Mild-to-moderate pulmonary edema.


SubjectID: 12972442, StudyID: 55902804, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old female with end-stage renal disease status post LRRT in ___ with incisional hernia, now status post repair with congestion and wheezing concern, can consider for volume overload. Evaluate for pulmonary edema.

COMPARISON: ___. AP UPRIGHT VIEWS OF THE CHEST DURING INSPIRATION AND EXPIRATION: Extensive subcutaneous air has diminished compared to the prior exam. Interstitial edema, small right effusion and central pulmonary vascular engorgement are increased. In addition, increased opacity at the right lung base may be related to atelectasis, but developing infection is not excluded. Cardiomediastinal silhouette is stable.

IMPRESSION: 1. Increased pulmonary edema   Keywords: increase. 2. Increased right basilar opacity may be due to atelectasis, but developing infection is not excluded.


SubjectID: 12972442, StudyID: 55327023, Comparison: None

FINAL REPORT

INDICATION: Concern for subcutaneous emphysema.

COMPARISON: Radiograph available from ___. FRONTAL CHEST RADIOGRAPH: Extensive subcutaneous emphysema is new since operative chest radiograph ___. The heart is normal in size. The hilar and mediastinal contours are within normal limits. No pneumothorax or pleural effusion is seen. Evaluation of the lung parenchyma is limited due to the underlying subcutaneous gas.

IMPRESSION: Extensive subcutaneous emphysema overlying the chest. No large pneumothorax.


SubjectID: 12972442, StudyID: 55266799, Comparison: better

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman with end-stage renal disease with incisional hernia, now with recurrent hernia. Evaluate for pulmonary edema.

FINDINGS: Comparison is made to prior study from ___. There is stable cardiomegaly. There is improvement of the pulmonary edema with improved aeration at the lung bases since the prior study   Keywords: improve. No pneumothoraces are seen. There is likely a small right-sided pleural effusion.


SubjectID: 12972442, StudyID: 55022737, Comparison: worse

FINAL REPORT

PORTABLE CHEST FILM ___ AT 4:10 A.M. CLINICAL

INDICATION: ___-year-old with end-stage renal disease and recent incisional hernia repair, again with some respiratory distress, assess for interval change. Comparison is made to the patient's previous study of ___ at 413. AP portable upright chest film ___ at 4:10 a.m. is submitted.

IMPRESSION: 1. Worsening interstitial and pulmonary edema   Keywords: worse. Heart remains enlarged. Mediastinal contours are within normal limits. Bilateral layering effusions with some patchy opacity at the left base more likely reflecting compressive atelectasis rather than pneumonia or aspiration. No pneumothorax.


SubjectID: 12972442, StudyID: 55827545, Comparison: better

FINAL REPORT

INDICATION: ___-year-old female with worsening hypoxia.

COMPARISON: Chest radiograph and CT from ___. CHEST, AP: Prior pulmonary edema has cleared. There has been significant improvement in prior lingular opacities, and stable left lower and right middle lobe opacities. Small left pleural effusion persists. There is continued mild cardiomegaly and central venous congestion.

IMPRESSION: Improving multifocal pneumonia and pulmonary edema   Keywords: improving.


SubjectID: 12988457, StudyID: 56785205, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with acute decompensated heart failure and previously seen infiltrate and cough // ? PNA

TECHNIQUE: Portable chest

COMPARISON: ___.

FINDINGS: There continues to be left lower lobe opacifications in the retrocardiac region which obscures the left heart border compatible with a combination of volume loss and infiltrate. Given technique this is not significantly changed compared to the study from the prior day. There is also small amount of volume loss in the right lower lobe. The upper lungs are clear

IMPRESSION: No change   Keywords: no change.


SubjectID: 12988457, StudyID: 56757378, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with heart failure and AMS // Interval change

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: lung volumes are slightly low and there is volume loss at the bases. in addition to that there is an alveolar infiltrate involving the left lower lobe that is worsened compared to the study from the prior day. there is pulmonary vascular redistribution the heart is moderately enlarged

IMPRESSION: Increased infiltrate in the left lower lobe


SubjectID: 12988457, StudyID: 52799132, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with end stage CHF // interval change

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change.


SubjectID: 12988457, StudyID: 56544372, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man with altered mental status. Evaluate for acute cardiopulmonary process.

TECHNIQUE: Portable frontal view of the chest.

COMPARISON: Chest radiograph ___.

FINDINGS: There is a hiatal hernia. Bilateral lower lobe atelectasis is worse on the left. The lung volumes are low. There are probable small bilateral pleural effusions. Mild cardiomegaly is stable. No pneumothorax. The aortic knob is calcified.

IMPRESSION: 1. Bilateral lower lobe atelectasis is worse on the left. 2. Probable small bilateral pleural effusions. 3. Small hiatal hernia.


SubjectID: 13005295, StudyID: 57420765, Comparison: None

FINAL REPORT

EXAMINATION: Chest x-ray PA and lateral

INDICATION: ___ year old man with sever AI // opacity in the left upper lobe

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest x-ray ___

FINDINGS: The previously visualized left upper lobe opacity has now resolved. The lung is free of consolidations, pleural effusions or pneumothorax. No pulmonary edema. Stable cardiomegaly. Mediastinum and hilar within normal limits. No acute osseous abnormalities.

IMPRESSION: Previously visualized left upper lobe opacity has resolved. This rapid change suggests that this may have been due to asymmetrical pulmonary edema.


SubjectID: 13005295, StudyID: 54865413, Comparison: None

FINAL REPORT

INDICATION: ___M with h/o rhematic heart disease presenting with palpitations // eval cardiomegaly, CHF

TECHNIQUE: Frontal and lateral views of the chest.

COMPARISON: None.

FINDINGS: The heart size is enlarged. Upper mediastinal contours are normal. Heterogeneous opacity in the left upper lobe is consistent with infection. The right lung is clear. There is slight blunting of the left costophrenic angle. No pneumothorax.

IMPRESSION: 1. Left upper lobe opacity consistent with infection. 2. Cardiomegaly.


SubjectID: 13005295, StudyID: 55449116, Comparison: None

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old man with s/p avr // eval rt ptx

TECHNIQUE: Portable chest radiograph

COMPARISON: Chest x-ray ___

FINDINGS: The small right apical pneumothorax noted on yesterday's chest x-ray has decreased in size. There is a new right lung base opacity which is likely due to atelectasis. Additionally, the small to moderate left pleural effusion has increased in size. Stable cardiomegaly. Post-operative pneumopericardium has resolved. Median sternotomy wires and prosthetic aortic valve are unchanged in appearance.

IMPRESSION: 1. Interval decrease in small right apical pneumothorax. 2. New right lung base atelectasis. Slight worsening of left pleural effusion. Pneumopericardium resolved.


SubjectID: 13005295, StudyID: 52445498, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with mech AVR // eval for ptx s/p CT removal

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: The patient has been extubated with removal of the supporting tubes and lines. Heart size is enlarged, unchanged. Replaced aortic valve is in expected position. Minimal right apical pneumothorax is present. No pulmonary edema is seen. Small amount of left pleural effusion is noted. Pneumopericardium is present common minimal

NOTIFICATION: Discussed with ___ over the phone by Dr ___ at the time of dication


SubjectID: 13010075, StudyID: 59766585, Comparison: None

FINAL REPORT

INDICATION: History: ___M with severe SOB. Please evaluate for infiltrate.

TECHNIQUE: Chest PA and lateral

COMPARISON: Radiograph from ___.

FINDINGS: Moderate cardiomegaly is stable compared to exams dating back to at least ___. The hilar and mediastinal contours are normal. Small bilateral pleural effusions are persistent. Opacity at the left lung base, with obscuration of left hemidiaphragm appears similar to the prior exam and is likely secondary to atelectasis, however retrocardiac consolidation on the lateral radiograph appears to have progressed compared to the prior exam from ___, and is concerning for pneumonia. There is no evidence pneumothorax. The visualized osseous structures are unremarkable.

IMPRESSION: Left lower lobe opacity concerning for pneumonia.


SubjectID: 13010075, StudyID: 54402264, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with severe CHF. // assess interval change assess interval change

IMPRESSION: In comparison with the study of ___, there is again substantial enlargement of the cardiac silhouette without pulmonary vascular congestion. This appearance raises the possibility of underlying cardiomyopathy or pericardial effusion. Retrocardiac opacification is again consistent with volume loss or consolidation involving the left lower lung. If clinically possible, a lateral view would be most helpful.


SubjectID: 13010075, StudyID: 56880359, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with HCAP. // assess interval change

TECHNIQUE: Single portable AP view radiograph of the chest.

COMPARISON: Prior chest radiographs dating back to___.

FINDINGS: There is stable moderate to severe cardiomegaly with normal vasculature, suggesting possible pericardial effusion or cardiomyopathy. The retrocardiac opacification appears less dense, suggesting improvement of atelectasis or consolidation. There is likely a small to moderate left pleural effusion, and a small right pleural effusion. There is no pulmonary vascular congestion or pneumothorax. There is probably an old, well healed fracture of the left anterior second rib.

IMPRESSION: 1. Slight decrease in retrocardiac opacity, consistent with improving atelectasis or consolidation. 2. Stable moderate to severe cardiomegaly in the absence of pulmonary vascular congestion, suggestive of pericardial effusion or cardiomyopathy.


SubjectID: 13031024, StudyID: 59557856, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiograph.

INDICATION: History: ___F with fever // eval for pna

TECHNIQUE: Frontal and lateral views of the chest.

COMPARISON: ___.

FINDINGS: Heart size and cardiomediastinal contours are normal. The lungs are clear without focal consolidation, pleural effusion, or pneumothorax.

IMPRESSION: No acute intrathoracic process.


SubjectID: 13031024, StudyID: 51922170, Comparison: None

FINAL REPORT

INDICATION: History of chest pain. Please evaluate for acute process.

COMPARISONS: Chest radiograph from ___.

TECHNIQUE: Frontal and lateral views of the chest.

FINDINGS: The heart size is top normal. No focal consolidations concerning for pneumonia are identified. There is no pleural effusion or pneumothorax. The visualized osseous structures are unremarkable.

IMPRESSION: No acute intrathoracic process.


SubjectID: 13031024, StudyID: 57862956, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with chest pain. Evaluate for pneumonia or pneumothorax.

COMPARISON: None available.

TECHNIQUE: Frontal AP and lateral chest radiograph.

FINDINGS: The lungs are well expanded without focal opacities. The heart appears mildly enlarged but the cardiomediastinal and hilar contours are otherwise normal. There is no pleural effusion or pneumothorax.

IMPRESSION: Mild cardiomegaly. No evidence of pneumonia.


SubjectID: 13031024, StudyID: 57226618, Comparison: same

FINAL REPORT

INDICATION: Chest pain. Evaluate for acute cardiopulmonary process.

COMPARISON: Chest radiographs from ___.

TECHNIQUE: PA and lateral chest radiograph.

FINDINGS: Compared with ___, no significant change is detected   Keywords: no significant change. The lungs are well expanded, without focal opacities. The heart appears mildly enlarged, but the cardiomediastinal and hilar contours are otherwise grossly unremarkable. There is mild upper zone redistribution, without overt CHF. There is no pleural effusion or pneumothorax.

IMPRESSION: Stable mild cardiomegaly. Possible minimal stable upper zonredistibution. No evidence of pneumonia.


SubjectID: 13031024, StudyID: 56429157, Comparison: None

WET READ: ___ ___ ___ 2:33 AM Mild pulmonary vascular congestion ______________________________________________________________________________

FINAL REPORT

INDICATION: History: ___F with cp, radiating down L arm, assoc with sob // eval for sob

TECHNIQUE: Chest PA and lateral

COMPARISON: ___ chest radiograph.

FINDINGS: Mild pulmonary vascular congestion There is no focal consolidation, pleural effusion or pneumothorax. Mild cardiomegaly, otherwise the cardiomediastinal and hilar contours are normal.

IMPRESSION: Mild pulmonary vascular congestion


SubjectID: 13031024, StudyID: 55814159, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with ? pulmonary edema // please eval for interval change

TECHNIQUE: PA and lateral images of the chest.

COMPARISON: Comparison is made with chest radiographs from earlier the same day, ___, ___, and ___.

FINDINGS: The lungs are well expanded. Mild pulmonary edema is seen. There is no pleural effusion or pneumothorax. There is mild cardiomegaly.

IMPRESSION: Mild palmar edema, unchanged from prior exam   Keywords: unchanged.


SubjectID: 13031024, StudyID: 55333498, Comparison: None

FINAL REPORT

INDICATION: History: ___F with ?pna // eval for pna

TECHNIQUE: Chest PA and lateral

COMPARISON: ___

FINDINGS: Normal heart size, mediastinal and hilar contours. No focal consolidation, pleural effusion or pneumothorax.

IMPRESSION: No acute process


SubjectID: 13031024, StudyID: 52386222, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiographs.

INDICATION: ___F with SOB, fever.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiographs dated ___, CTA chest dated ___.

FINDINGS: There is no lobar consolidation, pleural effusion, pneumothorax, or frank pulmonary edema. Bilateral hilar prominence reflects known hilar lymphadenopathy as seen on prior chest CTA. The cardiomediastinal silhouette is otherwise within normal limits.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 13031024, StudyID: 54621036, Comparison: None

WET READ: ___ ___ ___ 8:12 AM 1. Mild cardiomegaly and pulmonary vascular congestion. 2. No pneumothorax. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___F with recurrent severe chest pain // eval for interval development of PTX in setting of histiocytosis

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph ___, and chest CTA ___

FINDINGS: The heart size is mildly enlarged, but unchanged. Mild prominence of the mediastinum is noted, but likely accentuated by lordotic positioning. There is mild pulmonary vascular congestion, more pronounced than on ___. There is no focal consolidation, pleural effusion or pneumothorax detected.

IMPRESSION: 1. Mild cardiomegaly and mild pulmonary vascular congestion. 2. No pneumothorax.


SubjectID: 13031024, StudyID: 53491893, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___F with shortness of breath and chest pain

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph ___

FINDINGS: Heart size is mildly enlarged. Mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Lungs are hyperinflated but clear. No focal consolidation, pleural effusion or pneumothorax is seen. No acute osseous abnormality is present.

IMPRESSION: No acute cardiopulmonary abnormality.


SubjectID: 13036667, StudyID: 54827261, Comparison: same

FINAL REPORT

EXAM: Chest, single AP upright portable view. CLINICAL INFORMATION: ___-year-old male with history of dyspnea, cough.

COMPARISON: ___.

FINDINGS: Single AP upright portable view of the chest was obtained. Dual-lead left-sided pacer device is again seen, leads unchanged in position. Aorta remains calcified and unfolded. Mild enlargement of the cardiac silhouette persists. Bibasilar atelectasis is again seen. There is minimal to no pulmonary vascular congestion.

IMPRESSION: No significant interval change   Keywords: no significant interval change.


SubjectID: 13051530, StudyID: 59970292, Comparison: None

FINAL REPORT

INDICATION: Status post fiducial marker placement x2.

TECHNIQUE: Single frontal chest a frontal PA and lateral views of the chest were obtained with.

COMPARISON: Examination performed at 0:50 on the same day.

FINDINGS: Again, the cardiac mediastinal silhouette are unchanged with enlargement of the cardiac silhouette. ___ fiducial markers are seen projecting over the left lower lobe. No appreciable pneumothorax. Vascular calcifications of the aortic arch are noted. There are surgical clips in the right likely projecting within the right breast. There is increased opacity projecting over the lower lobes on the lateral view, which may be related to an increase in atelectasis, or perhaps hemorrhage related to fiducial marker placement. Degenerative changes at the left shoulder are again noted.

IMPRESSION: No appreciable pneumothorax status post left-sided fiducial marker placement.


SubjectID: 13051530, StudyID: 54266156, Comparison: None

FINAL REPORT

INDICATION: Status post fiducial placement. Evaluate for pneumothorax.

TECHNIQUE: Single portable upright view of the chest.

COMPARISON: ___.

FINDINGS: New numerous monitoring leads are seen projecting over the patient. There appears to be some IV tubing over the right lung apex. Notable is vascular calcifications of the aortic arch. The cardiac silhouette remains enlarged, probably accentuated by the portable technique. Several surgical clips are seen projecting over the right chest wall and lung base likely breast clips. There has been interval placement of at least 1 and possibly ___ fiducial markers seen projecting over the left side of the heart, an adjacent 2 numerous suture chains. There is no evidence of left-sided pneumothorax. There is some right-sided convex scoliosis of the thoracic spine, although likely accentuated by patient positioning. Increased sclerosis seen at the left humeral head is consistent with degenerative change.

IMPRESSION: Interval left-sided fiducial marker placement. No evidence of pneumothorax.


SubjectID: 13051530, StudyID: 58267293, Comparison: None

FINAL REPORT

HISTORY: Status post left lower lobe VATS wedge biopsy. CHEST, SINGLE AP PORTABLE VIEW Two tubes overlie the left chest, presumably both left chest tubes. No pneumothorax is detected. Left hemidiaphragm is slightly elevated, with left lower lobe collapse and/or consolidation, which has progressed compared with ___. On the right, there is upper zone redistribution and increased interstitial markings, more pronounced at the right base, and possible prominence of the right hilum, similar to the prior film. There is new minimal blunting of the right costophrenic angle, consistent with a small amount of pleural fluid. Possible small pulmonary nodular density in the right mid zone partially obscured by an EKG lead. Small bleb is also present along the right mid chest wall. Clips are again noted overlying the right base, likely within the breast. Also, there appears to be a pigtail catheter in the left upper quadrant. At the periphery of these films, findings consistent with a chronic left shoulder rotator cuff tear and glenohumeral joint osteoarthritis are noted.

IMPRESSION: 1. Apparent two left chest tubes. No obvious pneumothorax. 2. Left lower lobe collapse and/or consolidation and elevated left hemidiaphragm. 3. Upper zone redistribution and increased interstitial markings are more pronounced at the base in the right lung, with prominent right hilum, unchanged. New small right effusion. 4. Possible small right mid-lung pulmonary nodule seen laterally.


SubjectID: 13051530, StudyID: 58935607, Comparison: same

WET READ: ___ ___ ___ 6:22 AM Findings consistent with decompensated congestive heart failure. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___-year-old woman with dyspnea, but no fever or leukocytosis. Evaluate for congestive heart failure.

COMPARISON: Chest radiograph from ___.

FINDINGS: There is moderate pulmonary edema and stable cardiomegaly   Keywords: stable. There is pulmonary arterial enlargement. There is a small left pleural effusion. There is no pneumothorax.

IMPRESSION: Stable cardiomegaly, moderate pulmonary edema, and small left pleural effusion, consistent with decompensated congestive heart failure   Keywords: stable.


SubjectID: 13051530, StudyID: 50202300, Comparison: better

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old woman with ESRD/Epilepsy, h/o LLL wedge resection for lung cancer with new agitation/delirium // ?PNA, worsening pulmonary edema

TECHNIQUE: Portable chest radiograph

COMPARISON: Chest x-ray ___

FINDINGS: Since the prior CXR on ___, there is new focal consolidation over the right lung base, most likely due to pneumonia. Slight improvement in the severity of pulmonary edema, now mild   Keywords: improve. Pulmonary arteries are still engorged. Small left pleural effusion. No pneumothorax. Persistent area of consolidation in the left lung base after LLL wedge resection. Stable mild to moderate cardiomegaly.

IMPRESSION: 1. New right lung base consolidation, most likely due to pneumonia. 2. Mild pulmonary edema, improved since ___   Keywords: improve.


SubjectID: 13051530, StudyID: 58056909, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with questionable consolidation. // consolidation? pna?

TECHNIQUE: Chest two views.

COMPARISON: ___.

IMPRESSION: There small bilateral pleural effusions seen best on the lateral film. There is hazy opacity in both lower lungs. Some of this is due to volume loss but an underlying infectious infiltrate can't be excluded. However, overall the appearance is improved compared to the study from the prior day. The heart continues to be moderately enlarged. The aorta is tortuous.


SubjectID: 13051530, StudyID: 57345458, Comparison: None

FINAL REPORT

INDICATION: ___F with ESRD s/p NG tube now concerning Aspiration PNA // r/o asp PNA

TECHNIQUE: Single portable upright AP image of the chest.

COMPARISON: Comparison is made with chest radiographs from ___ and ___ and CT chest from ___.

FINDINGS: Increased reticular markings are seen, probably in the right lung base, which may be projectional due to difference in patient rotation. Fiducial marker in left lower lobe masslike opacity is again seen. Enlarged right hilum is unchanged compatible with enlarged right pulmonary artery. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is mildly enlarged, similar to prior exams. Right chest wall clips again noted.

IMPRESSION: Increased reticular markings in the right lung base, which may be projectional due to difference in patient rotation.


SubjectID: 13051530, StudyID: 52563643, Comparison: None

WET READ: ___ ___ ___ 7:38 PM Increased reticulation pattern overall unchanged. Apparent increased density at the right base is likely due to differential rib projection. No definite change compared to ___ eg PNA or aspiration.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hx radiation therapy for lung cancer, just choked on her dinner with subsequent subjective dyspnea // Please assess for infiltrates

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the lung volumes have decreased. Moderate cardiomegaly and indistinct minimal peribronchial opacities in the a retrocardiac and right basal lung areas. These changes would be consistent with an aspiration event, as described in the clinical history. No pleural effusions. No pulmonary edema. Known seeds in the right lung.


SubjectID: 13051530, StudyID: 54058446, Comparison: same

FINAL REPORT

HISTORY: Renal failure, on hemodialysis with possible pneumonia.

FINDINGS: In comparison with the study of ___, there is little overall change in the asymmetric pulmonary edema   Keywords: little overall change. The suggested focal area of calcification at the right base is not appreciated now that the degree of inspiration has improved. Again there is chronic vascular dilatation in the right hilum. Surgical clips are again seen in the right breast.


SubjectID: 13051530, StudyID: 51777698, Comparison: same

FINAL REPORT

INDICATION: End-stage renal disease, on dialysis with shortness of breath.

COMPARISON: Radiographs available from ___ through ___. FRONTAL CHEST RADIOGRAPH: Moderate cardiomegaly appears stable since ___. Prominent right hilar vessels and central pulmonary vessels are unchanged. Multiple surgical clips overlie the right breast. Mild bilateral pulmonary edema appears unchanged since ___. An increased right lower opacity is suspicious for pneumonia. There is no pneumothorax or pleural effusion.

IMPRESSION: Possible new right lower lobe pneumonia. Unchanged background mild pulmonary edema   Keywords: unchanged. The findings were discussed by Dr. ___ with Dr. ___ ___ telephone at the time of interpretion 11:55 AM ___.


SubjectID: 13058887, StudyID: 59888326, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pleural effusion // chest tube

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Large pleural effusion is demonstrated on the right, unchanged. Cardiomediastinal silhouette is unchanged. Left lung is clear. No pneumothorax demonstrated.


SubjectID: 13058887, StudyID: 52512228, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with complicated parapneumonic effusion with recent chest tube placement // effusion drainage, underlying infiltrates/consolidations

IMPRESSION: As compared to ___ chest radiograph, moderate right pleural effusion has slightly decreased in size with associated improving atelectasis and or consolidation the right base. Right pleural catheter remains in place, and there is no definite pneumothorax.


SubjectID: 13058887, StudyID: 59520861, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with chest tube draining empyema // ? interval change

COMPARISON: ___.

IMPRESSION: Continued improvement in ventilation at the right lung base. Otherwise unchanged radiograph   Keywords: unchanged radiograph.


SubjectID: 13058887, StudyID: 55554055, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with sCHF, DM, Afib on coumadin, and recent diagnosis of PNA presenting with chest pain found to have complicated parapneumonic effusion s/p chest tube // Assess for interval change in chest tube and effusion; per IP please obtain before 7am on ___ Assess for interval change in chest tube and effusion; per I

IMPRESSION: In comparison with the study ___ ___, there is little overall change   Keywords: little overall change. Persistent opacification at the right base, consistent with residual effusion and atelectatic changes. Otherwise little change   Keywords: little change.


SubjectID: 13058887, StudyID: 58148532, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with empeyema, CT s/p tPA with new pain, dyspnea and 1L bloody CT output // ? effusion change

COMPARISON: ___, 07:15

IMPRESSION: As compared to the previous image, the position of the right chest tube is unchanged. The amount of pleural effusion on the right might have minimally decreased, the right lung base appears minimally better ventilated. Overall, the lung volumes have increased, notably on the right. However, partial right lower lobe atelectasis and moderate cardiomegaly persists. Minimal pulmonary edema is also still present   Keywords: still. Unchanged position of the left pectoral pacemaker.


SubjectID: 13058887, StudyID: 57616779, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with empyema s/p tPA and CT // interval drainage

IMPRESSION: As compared to prior chest radiograph of ___, pulmonary vascular congestion and interstitial edema have nearly resolved   Keywords: resolve. Exam is otherwise unchanged, with right pigtail pleural catheter adjacent to right pleural fluid collection and heterogeneous right basilar opacities.


SubjectID: 13058887, StudyID: 56665046, Comparison: worse

WET READ: ___ ___ ___ 8:07 AM Since prior chest radiograph, there has been no significant change in the appearance of the chest. Right pleural effusion similar appearance. Right basilar pigtail chest tube unchanged in position. Left lung is grossly clear.

WET READ VERSION #1 ___ ___ ___ 7:32 PM Since prior chest radiograph, there has been no significant change in the appearance of the chest. Right pleural effusion similar appearance. Right basilar pigtail chest tube unchanged in position. Left lung is grossly clear. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with empyema, sever chest pain, bright red output. // ? effusion change, pneumomediastinum

IMPRESSION: As compared to prior radiograph of several hr earlier, pulmonary vascular congestion and mild interstitial edema are new   Keywords: new. Right pigtail pleural catheter remains in place with persistent small to moderate right pleural effusion, and adjacent right mid and lower lung consolidation and atelectasis.


SubjectID: 13058887, StudyID: 56035224, Comparison: None

FINAL REPORT

EXAMINATION: Portable AP chest radiograph

INDICATION: ___ year old man with complicated parapneumonic effusion and chest tube // interval change?

COMPARISON: Chest radiograph dated ___.

FINDINGS: Lung volumes remain low. Large-to-moderate right-sided pleural effusion persists despite the presence of a pigtail catheter which appears unchanged in position, projecting over the right lower hemithorax. Adjacent platelike atelectasis and scarring is minimally worse. Probable small left pleural effusion as well as atelectasis is overall similar. No pneumothorax. Heart size and mediastinum are probably overall unchanged. The ICD is unchanged.

IMPRESSION: Persistent moderate right pleural effusion despite presence of pigtail drain over the last several days.


SubjectID: 13060436, StudyID: 51868307, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old man with newly diagnosed atrial fibrillation, congestive heart failure.

FINDINGS: Comparison is made to prior study from ___. There is cardiomegaly which is stable. There is mild prominence of the central pulmonary vasculature without overt pulmonary edema. No focal consolidation is seen. There is a small pleural effusion on the left side.


SubjectID: 13060436, StudyID: 50864870, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Edema and dyspnea on exertion.

COMPARISONS: None.

TECHNIQUE: Chest, portable AP upright.

FINDINGS: The heart is mildly enlarged. The central pulmonary vasculature is minimally prominent which may suggest fluid overload, but without frank congestive heart failure. A more focal opacity is present in the right lower lung, probably in the right lower lobe. In the setting of low clinical concern for pneumonia, this appearance can probably be attributed to atelectasis but is not specific. Minimal blunting is noted along each costophrenic sulcus; since these do not appear sharp, there may be very small pleural effusions. There is no pneumothorax.

IMPRESSION: No evidence of frank congestive heart failure, although perhaps slight fluid overload. Patchy right infrahilar opacity, probably compatible with atelectasis. If there is any potential clinical concern for pneumonia, then short-term followup radiographs could be considered, however, preferably with PA and lateral technique when feasible.


SubjectID: 13063001, StudyID: 54540250, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Hypoxic respiratory failure, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the lung volumes have slightly increased. Moderate-to-severe cardiomegaly persists and the extent of the right pleural effusion with subsequent atelectasis is constant. Unchanged evidence of mild pulmonary edema   Keywords: unchanged. No new parenchymal opacities   Keywords: new.


SubjectID: 13063001, StudyID: 57401264, Comparison: None

FINAL REPORT

PORTABLE CHEST RADIOGRAPH, ___

COMPARISON: ___ chest radiograph.

FINDINGS: Cardiac silhouette is enlarged, but there is no evidence of congestive heart failure. Lungs are clear except for minimal linear atelectasis at the left base. A questionable small left pleural effusion is noted, but there is no evidence of pneumothorax.

IMPRESSION: 1. Cardiomegaly without evidence of CHF. 2. Minor left basilar atelectasis and questionable small left pleural effusion.


SubjectID: 13063001, StudyID: 53978364, Comparison: None

FINAL REPORT

PORTABLE CHEST: ___.

HISTORY: ___ yo with altered mental status.

FINDINGS: Single portable view of the chest is compared to previous exam from ___. The lungs are clear. There is no pulmonary vascular congestion. The cardiac silhouette is enlarged but given lower lung volumes when compared to ___ likely has not changed. Atherosclerotic calcifications noted at the arch. Osseous and soft tissue structures are unchanged.

IMPRESSION: Cardiomegaly without acute cardiopulmonary process.


SubjectID: 13063188, StudyID: 57007319, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: History: ___M with dyspnea // please evaluate for acute cp process

TECHNIQUE: Portable chest radiograph

COMPARISON: Chest radiograph ___, and chest CT ___

FINDINGS: Streaky atelectasis is noted at the left lung base. Lungs are otherwise clear of consolidation, pleural effusion or pneumothorax. Pulmonary vascular congestion is mild. Mild cardiomegaly persists. Aortic arch calcifications are incidental finding.

IMPRESSION: Mild pulmonary vascular congestion.


SubjectID: 13063188, StudyID: 56993940, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with tachypnea, CHF exacerbation // c/f PNA c/f PNA

IMPRESSION: In comparison with the earlier study of this date, there is little change   Keywords: little change. Continued enlargement of the cardiac silhouette with mild elevation of pulmonary venous pressure. No evidence of acute focal pneumonia, though the area behind the heart is difficult to assess in the absence of a lateral view.


SubjectID: 13067703, StudyID: 59557085, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old male with recurrent chest pain. Question infiltrate.

COMPARISON: Radiograph dated ___ and CTA dated ___.

FINDINGS: Single frontal view of the chest demonstrates a left pectoral cardiac pacer with leads terminating in the right atrium and right ventricle. The heart is top normal in size. The mediastinal and hilar contours are within normal limits. There are increased perihilar streaky opacities, which suggests pulmonary edema   Keywords: increase. Right suprahilar pulmonary mass is redemonstrated, better correlated on cross-sectional imaging. There is dense retrocardiac probable atelectasis and small left pleural effusion.

IMPRESSION: Mild pulmonary edema. Small left effusion.


SubjectID: 13067703, StudyID: 57241942, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male status post right subclavian line positioning.

COMPARISON: Same day radiograph from 1:03 a.m.

FINDINGS: Single frontal view of the chest demonstrates interval placement of a right subclavian approach central venous catheter with tip in the lower SVC. There is no pneumothorax. A left pectoral cardiac pacer is stable in location with the leads terminating in the right atrium and right ventricle. The lung volumes are low, accentuating mild pulmonary edema. There is retrocardiac opacity and blunting in the left costophrenic angle which may reflect atelectasis and a small effusion.

IMPRESSION: Appropriate central line positioning without pneumothorax. Other findings unchanged since preceding exam.


SubjectID: 13067703, StudyID: 51140369, Comparison: None

WET READ: ___ ___ ___ 6:13 PM swan-___ catheter from inferior approach projects in distal right pa, likely beyond branches to upper lobe. new ETT approximately 2.7 cm above carina. new esophageal catheter with normal course, tip out of view below diaphragm. the transseptal catheter via inferior approach has tip projecting over expected region of left atrium. left pacermaker and right CVL unchanged. diffuse opacification of right hemithorax could represent asymmetric edema with areas of atelectasis. ______________________________________________________________________________

FINAL REPORT

CHEST PORTABLE

INDICATION: ___-year-old man with cardiac arrest, now status post Tandem heart transplant, intubation, multiple line placement. Chest x-ray to evaluate for lines and tubes. CHEST PORTABLE: Comparison is made to prior examination of ___. The lung volumes are low. The heart size is therefore likely adequate. There is some widening of the mediastinum although again this is likely due to poor inspiratory effort. There is hazy opacity and vascular haziness in both lungs consistent with interstitial edema. An ET tube is identified 3.2 cm from the carina in correct position. A pacemaker lead in the right ventricle and a second lead in the right atrium. There is a subclavian line with its tip in the distal SVC. An NG tube is noted coursing through the esophagus into the stomach. The tip of the NG tube is not identified on this film.

IMPRESSION: 1. Tubes and lines in adequate position as described above. 2. Pulmonary edema involving both lungs. 3. Widening of the mediastinum and possible cardiomegaly are likely due to low lung volumes.


SubjectID: 13073377, StudyID: 57115351, Comparison: None

FINAL REPORT

PORTABLE CHEST ___

COMPARISON: ___ radiograph.

FINDINGS: There are no new focal areas of consolidation to suggest an acute aspiration pneumonia within the lungs. Cardiac silhouette is upper limits of normal in size without change. Pulmonary vascularity is within normal limits for technique.


SubjectID: 13073377, StudyID: 56222722, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: Chest AP portable single view.

INDICATION: ___-year-old female patient with hypertension, presents with hyponatremia to 214. Followup for possible left lower lobe infiltrate.

FINDINGS: AP single view of the chest has been obtained with patient in sitting semi-upright position. Analysis is performed in direct comparison with the next preceding similar study of ___. Findings are completely unchanged in comparison with the previous study. Thus, no evidence of new acute pulmonary parenchymal infiltrates as can be identified on this portable AP single view examination. A previously described subclavian approach Port-A-Cath system remains in unchanged position and there is no pneumothorax.


SubjectID: 13078497, StudyID: 55575670, Comparison: same

FINAL REPORT

INDICATION: ___-year-old male with history of chronic interstitial lung disease, now intubated.

COMPARISON: Multiple chest radiographs dating back to ___, most recent ___, and CT chest ___.

TECHNIQUE: Semi-upright portable AP chest radiograph.

FINDINGS: The patient has a history of chronic interstitial lung disease with waxing and waning pulmonary edema and infection. Today it is largely unchanged with diffuse infiltrative and interstitial opacities stable since ___   Keywords: unchanged, stable. Bilateral pleural effusion is essentially the same. Cardiomediastinal silhouette is stable and demonstrates mild cardiomegaly. There is no pneumothorax. Enteric tube is seen once again, entering the stomach and then out of field of view. Right-sided PICC terminates within the mid SVC. An endotracheal tube terminates no less than 6 cm from the carina.

IMPRESSION: Study is essentially unchanged from priors with unchanged diffuse infiltrative and interstitial opacities.


SubjectID: 13078497, StudyID: 55557117, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Respiratory failure, assessment for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Widespread bilateral parenchymal opacities, combined to an enlarged cardiac silhouette. The monitoring and support devices are in constant position.


SubjectID: 13078497, StudyID: 58231918, Comparison: None

FINAL REPORT

AP CHEST 4:35 A.M., ___

HISTORY: CHF and pneumonia. Persistent interstitial lung disease.

IMPRESSION: AP chest compared to ___ through ___: Severe infiltrative pulmonary abnormality has been present without appreciable change since ___, progressing on a substrate of chronic interstitial lung disease that worsened appreciably between ___ and ___: Small-to-moderate bilateral pleural effusions and mild cardiomegaly are unchanged. No pneumothorax. ET tube in standard placement. Nasogastric tube passes into the stomach and out of view. A right jugular line ends just above the junction of brachiocephalic veins. No pneumothorax.


SubjectID: 13078497, StudyID: 58895837, Comparison: better

FINAL REPORT

INDICATION: ___-year-old male with history of congestive heart failure, now status post CABG.

COMPARISON: Semi-erect AP portable chest radiograph, ___.

TECHNIQUE: Portable upright AP chest radiograph.

FINDINGS: There has been interval decrease in ground-glass opacity bilaterally compared to prior study of ___ at 4:22 p.m., which represents decrease in pulmonary edema   Keywords: decrease. There has been interval decrease in observed cardiomegaly. There is bilateral small amount of pleural effusion. There are no areas of focal consolidations and no pneumothorax. The pleural surfaces are unremarkable. The endotracheal tube is no less than 6.2 cm from the carina, could be advanced 2 cm for optimal placement.

IMPRESSION: Interval reduction in pulmonary edema and cardiomegaly. ET tube can be advanced 2 cm for optimal placement.


SubjectID: 13078497, StudyID: 55206854, Comparison: better

FINAL REPORT

INDICATION: ___-year-old male with bilateral pulmonary infiltrates, status post CABG.

COMPARISON: Portable upright chest radiograph ___.

TECHNIQUE: Semi-upright portable AP radiograph of the chest.

FINDINGS: Right-sided pleural effusion is again seen largely unchanged. There is left-sided ground glass opacity which has slightly improved consistent with improving pulmonary edema   Keywords: improve. Endotracheal tube is seen in appropriate position, 6 cm from the carina. NG tube is seen entering the stomach and out of field of view. Incidental note of right lateral pleural calcification which is better seen on CT imaging.

IMPRESSION: Improving pulmonary edema with unchanged bilateral pleural effusions   Keywords: improving.


SubjectID: 13078497, StudyID: 51021074, Comparison: None

FINAL REPORT

AP CHEST 7:20 A.M. ON ___

HISTORY: CHF, pulmonary infiltrates and fevers.

IMPRESSION: AP chest compared to ___ through ___, 1:18 p.m.: Severe bilateral infiltrative pulmonary abnormality continues to worsen. Small bilateral pleural effusions and moderate cardiomegaly suggest that at least some of this abnormality is due to pulmonary edema, but the widespread recurrent infiltrative pulmonary abnormality present to varying degrees on chest CT scans since ___ suggests an underlying process such as chronic pulmonary drug toxicity. ET tube is in standard placement. Swan-Ganz catheter ends in the right pulmonary artery. No pneumothorax.


SubjectID: 13078497, StudyID: 58410688, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Hypoxic respiratory failure, intubation, evaluation of interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, endotracheal tube has been minimally advanced, it currently projects 5.3 cm above the carina with its tip. The existing extensive bilateral parenchymal opacities are unchanged in extent   Keywords: unchanged. New bilateral pleural effusions might have developed. Unchanged moderate cardiomegaly. Unchanged right central venous access line and nasogastric tube. No pneumothorax.


SubjectID: 13078497, StudyID: 50406925, Comparison: -1.0

FINAL REPORT

INDICATION: ___-year-old male, history of CHF and pneumonia, recently extubated, now desating.

COMPARISON: AP semi-upright portable chest radiograph ___.

TECHNIQUE: AP semi-upright portable chest radiograph.

FINDINGS: There has been an increase in the bilateral pulmonary edema status post extubation as evidenced by increased dense opacification, which is now nearly confluent consistent with severe pulmonary edema   Keywords: increase. The cardiomediastinal silhouette is difficult to evaluate given intervening pulmonary edema opacity, however appears unchanged   Keywords: unchanged. There is no pneumothorax. There has been complete obscuration of the costophrenic angles suggestive of bilateral pleural effusions. Right IJ catheter is unchanged in position and ends in the upper SVC. Sternotomy wires are unchanged in position, aligned along the midline with no evidence of sternal dehiscence.

IMPRESSION: Worsening, now severe, bilateral pulmonary edema   Keywords: worse. Supervening pneumonia can certainly not be excluded in the appropriate clinical setting. Interval removal of endotracheal tube. Cardiomediastinal silhouette stable.


SubjectID: 13078497, StudyID: 52864337, Comparison: better

FINAL REPORT

PORTABLE CHEST OF ___:

COMPARISON: Study of earlier the same date.

FINDINGS: There has been interval intubation, with endotracheal tube tip terminating about 5 cm above the carina. Exam is otherwise remarkable for very slight improvement in widespread bilateral alveolar opacities, particularly when compared to the chest radiograph of ___   Keywords: improve. Bilateral pleural effusions are unchanged.


SubjectID: 13078497, StudyID: 56888186, Comparison: None

WET READ: ___ ___ ___ 9:48 PM Minimal change in appearance of nodular and patchy infiltrates encompassing both lungs. ET tube remains approximately 7 cm above the carina. ______________________________________________________________________________

FINAL REPORT

CHEST ON ___

HISTORY: Respiratory distress. REFERENCE EXAM: ___ at ___.

FINDINGS: Compared to the film from earlier the same day, the appearance of the lungs with the patchy nodular infiltrates bilaterally is unchanged. The ET tube is 7 cm above the carina.


SubjectID: 13078497, StudyID: 55331519, Comparison: worse

FINAL REPORT

HISTORY: Respiratory distress with intubation.

FINDINGS: In comparison with the study of ___, there is continued substantial enlargement of the cardiac silhouette with diffuse bilateral pulmonary opacifications consistent with worsening pulmonary edema and bilateral pleural effusion   Keywords: worse. An endotracheal tube is now in place with its tip approximately 6 cm above the carina. Nasogastric tube extends at least to the antrum of the stomach where it crosses the lower margin of the image.


SubjectID: 13083369, StudyID: 57667994, Comparison: None

FINAL REPORT

EXAMINATION: Knee: Single portable view of the chest

INDICATION: ___ year old man with SOB // assess for infiltrate, edema //___ year old man with SOB

COMPARISON: ___

FINDINGS: There is greater radiodensity over the left lower hemithorax as well as in the retrocardiac region, however is not clear if this is due to simply soft tissue or actual pathology. Appears clear. The heart size is within normal limits. There is a pacemaker with 3 leads appropriate position. There is no pulmonary edemaand there is no pneumothorax.

IMPRESSION: Greater radiodensity over the left lower hemi thorax may be artifactual. A lateral radiographs is needed to see if there is a genuine abnormality in the left lower lobe.

NOTIFICATION: Paged Dr ___ at 8:44 AM to discuss the findings.


SubjectID: 13083369, StudyID: 51795605, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with PMHx COPD/CHF presents with ?greater radiodensity over the left lower hemithorax as well as in the retrocardiac region // Further characterization of radiodensity

TECHNIQUE: Chest PA and lateral

COMPARISON: ___.

FINDINGS: Previously reported asymmetrical density in the left mid and lower hemi thorax is no longer evident and is probably technical in nature. Cardiomediastinal contours are remarkable for mild cardiomegaly and indwelling biventricular ICD pacing device. Lungs are clear except for minimal linear STIR atelectasis at the right base. There are no pleural effusions.

IMPRESSION: No acute cardiopulmonary radiographic abnormality.


SubjectID: 13090739, StudyID: 58130778, Comparison: same

FINAL REPORT

INDICATION: New fever, dullness to pulmonary auscultation. Rule out infiltrate.

COMPARISON: ___.

FINDINGS: Portable frontal radiograph of the chest demonstrates a right PICC in the low SVC. The left chest wall pacer leads are in unchanged position. There is overall stable appearance of the chest with unchanged bilateral pleural effusions and mild pulmonary edema   Keywords: unchanged. Bilateral areas of atelectasis are also stable.


SubjectID: 13090739, StudyID: 56247893, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CAD s/p CABG and PCI, severe valvular disease with worsening SOB and increasing O2 requirement // Please eval for acute process and interval change.

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Known bilateral pleural effusions are constant in extent. There is mild to moderate fluid overload seen in unchanged manner   Keywords: unchanged. Also unchanged a areas of atelectasis bilaterally. In the interval, a PICC line previously projecting over the axillary region has been advanced or replaced. The tip of the current line projects over the lower SVC. There is no evidence of complications such as pneumothorax. Unchanged position of the pacemaker leads and the pacemaker generator in the left pectoral position.


SubjectID: 13090739, StudyID: 52741171, Comparison: same

FINAL REPORT

HISTORY: CHF.

FINDINGS: In comparison with the study of earlier in this date, there is again enlargement of the cardiac silhouette with pulmonary edema and bilateral pleural effusions with compressive basilar atelectasis   Keywords: again. In the appropriate clinical setting, the possibility of supervening pneumonia would have to be considered. Dual-channel pacer device remains in good position.


SubjectID: 13090739, StudyID: 50805431, Comparison: same

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Study of earlier the same date.

FINDINGS: Right PICC remains malpositioned within the right internal jugular vein, with tip of catheter extending beyond the field of view. Otherwise, no relevant short interval change since the recent study performed approximately one hour earlier when allowances are made for lower lung volumes on the current study   Keywords: no relevant short interval change.


SubjectID: 13096970, StudyID: 59099676, Comparison: better

FINAL REPORT

INDICATION: ___-year-old woman with recent V-tach arrest status post chest compressions and defibrillation, assess for rib fractures or pneumothorax.

COMPARISONS: ___.

FINDINGS: Portable chest radiograph was obtained. Small-to-moderate left pleural effusion and retrocardiac consolidation. No definite rib fractures are identified nor is pneumothorax seen. No right effusion is seen. Mild-to-moderate cardiomegaly persists with improved vascular congestion   Keywords: improve.


SubjectID: 13096970, StudyID: 56930391, Comparison: None

FINAL REPORT

CHEST, TWO VIEWS: ___.

HISTORY: ___-year-old female with shortness of breath and cough.

FINDINGS: Frontal and lateral views of the chest are compared to previous exam from ___. When compared to prior, there are developing bibasilar opacities and small bilateral effusions are now seen. Instinct pulmonary vascular markings seen superiorly. Cardiac silhouette is enlarged but grossly unchanged. Osseous and soft tissue structures are unremarkable.

IMPRESSION: Findings most suggestive of congestive failure which has progressed since ___.


SubjectID: 13096970, StudyID: 52623805, Comparison: None

FINAL REPORT

HISTORY: Palpitations.

TECHNIQUE: Portable upright AP view of the chest.

COMPARISON: ___.

FINDINGS: The heart remains moderately enlarged. The mediastinal and hilar contours are stable. The pulmonary vascularity is not engorged. Patchy opacities within the lung bases may reflect atelectasis. There is likely a trace left pleural effusion, but this has decreased compared to the prior study. Previously noted small right pleural effusion is not clearly demonstrated on the current exam. No pneumothorax is definitively noted. There are no acute osseous abnormalities.

IMPRESSION: Bibasilar patchy opacities which may reflect atelectasis. Possible small left trace pleural effusion.


SubjectID: 13096970, StudyID: 52287296, Comparison: worse

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with CHF, hypotension, evaluation of pulmonary edema.

COMPARISON: ___.

FINDINGS: There are increased interstitial markings with cephalization of the pulmonary vessels, compatible with mild interstitial pulmonary edema   Keywords: increase. Stable severe cardiomegaly. There is no pneumothorax.

CONCLUSION: New mild interstitial pulmonary edema   Keywords: new.


SubjectID: 13102520, StudyID: 59159034, Comparison: better

FINAL REPORT

PORTABLE CHEST ___

COMPARISON: Radiograph one day earlier.

FINDINGS: Indwelling support and monitoring devices remain in standard position, and pulmonary edema continues to improve with minimal residual interstitial edema remaining   Keywords: improve. Enlarged cardiac silhouette is stable in size. Small right and small-to-moderate left pleural effusions are again demonstrated with adjacent basilar atelectasis.


SubjectID: 13102520, StudyID: 56060302, Comparison: better

FINAL REPORT

PORTABLE CHEST X-RAY DATED ___

COMPARISON: ___ radiograph.

FINDINGS: Support and monitoring devices are in standard position. Stable cardiomegaly accompanied by pulmonary vascular congestion and a resolving pulmonary edema   Keywords: resolving. Left basilar atelectasis with adjacent small left pleural effusion has also slightly improved. Small right pleural effusion is also demonstrated.


SubjectID: 13102520, StudyID: 52229485, Comparison: same

FINAL REPORT

INDICATION: ___-year-old woman with COPD, CHF. Evaluate volume overload, location of ET tube.

COMPARISON: Prior chest radiographs from ___ through ___.

TECHNIQUE: Supine portable AP chest radiograph.

FINDINGS: An ET tube terminates 3.3 cm above the carina. An enteric tube courses below the diaphragm; however, the tip is not included in this examination. Right IJ venous catheter terminates at least at the mid SVC. Large cardiomegaly remains unchanged. Persistent presumably mild pulmonary edema with vascular engorgement   Keywords: persistent. Persistent opacification of the right lung base could be related to moderate amount of pleural fluid, however underlying infection or aspiration cannot be excluded.

IMPRESSION: Evidence of continued cardiac decompensation   Keywords: continue.


SubjectID: 13102520, StudyID: 51797273, Comparison: None

FINAL REPORT

HISTORY: Hypoxic respiratory failure.

FINDINGS: In comparison with the study of ___, the endotracheal tube has been removed, as has the nasogastric tube. Right IJ catheter remains in place. Continued low lung volumes with stable cardiomegaly. Pulmonary vascularity is only slightly elevated if at all. Retrocardiac opacification is consistent with some atelectatic change in the left lower lobe.


SubjectID: 13102520, StudyID: 58609962, Comparison: worse

WET READ: ___ ___ ___ 11:17 PM ETT in appropriate position. Although difficult to ASSESS, THERE MIGHT BE INTERSTITIAL EDEMA. VAGUE OPACITY IN THE RIGHT CARDIOPHRENIC ANGLE ALSO RAISES CONCERN FOR CONSOLIDATION WHICH WAS NO PRESENT IN CHEST CT AND CHEST RADIOGRAPH PERFOMED ON ___, RAISING CONCERN FOR ASPIRATION VERSUS ATELECTASIS ALTHOUGH PULMONARY INFILTRATE CANNOT BE EXCLUDED. D/W DR ___ ON ___ AT 11:15 PM VIA PHONE IMMEDIATELY AFTER DISCOVERY BY DR ___. ______________________________________________________________________________

FINAL REPORT

EXAM: Chest, single supine portable view. CLINICAL INFORMATION: Intubation.

COMPARISON: ___ at 11:40.

FINDINGS: The inferior thorax is not included on the image. There has been interval placement of an endotracheal tube, terminating approximately 2.9 cm above the level of the carina. There is persistent mild-to-moderate pulmonary edema appears slightly increased   Keywords: increase. There is left mid lung linear atelectasis/scarring. Previously noted relative more confluent opacity at the right lung base is not fully imaged on the current study. There appears to possibly be left retrocardiac opacity, although this is not fully imaged.


SubjectID: 13110574, StudyID: 59218173, Comparison: worse

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___ year old woman with ESRD and PNA // ?PNA progression, pulmonary edema

TECHNIQUE: PA and lateral chest radiograph

COMPARISON: Prior chest radiographs from ___, ___, ___, ___

FINDINGS: Since ___, bilateral pleural effusions, moderate on the right and small on the left, are increased, mild pulmonary edema is unchanged, right hilar opacity is unchanged, and left retrocardiac opacities are not clearly seen on today's exam   Keywords: increase. Lung volumes are low. The heart size is normal. No pneumothorax. Mild tracheal deviation may be due to enlarged thyroid or vascular tortuosity.

IMPRESSION: 1. Since ___, bilateral pleural effusions, moderate on the right and small on the left, are increased, mild pulmonary edema and right hilar opacity is unchanged, and left retrocardiac opacities are not clearly seen   Keywords: increase. 2. Mild tracheal deviation may be due to enlarged thyroid or vascular tortuosity. Please correlate with physical exam.


SubjectID: 13110574, StudyID: 57075738, Comparison: None

FINAL REPORT

INDICATION: History: ___F with SOB // PNA? pulm edema?

TECHNIQUE: AP and lateral

COMPARISON: Chest radiograph dated ___

FINDINGS: AP and lateral chest radiograph demonstrates a heart which is upper limits of normal in size. New since prior examination is a right pleural effusion and probable small left pleural effusion. Right hilar opacity as well as retrocardiac nodular opacities are new since prior study performed ___. Overall increased opacity projecting over the right lower lung field is additionally noted.

IMPRESSION: Bilateral pleural effusions, right greater than left, with central vascular prominence is suggestive of mild pulmonary edema. New retrocardiac opacities are noted for which infectious process cannot be excluded.


SubjectID: 13110574, StudyID: 55313839, Comparison: None

WET READ: ___ ___ ___ 3:39 AM Compared with portable examination from 11 hours prior Status post chest tube placement, right-sided pleural effusion has significantly decreased in size; no significant increase in size of right apical pneumothorax, possible small residual right apical pneumothorax. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hypotension, right sided chest pain, and recently placed chest tube // Pneumothorax? Other process to explain chest pain? Pneumothorax? Other process to explain chest pain?

IMPRESSION: Comparison to ___. Ongoing resolution of the pre-existing right pleural effusion. Stable minimal right pneumothorax of the chest tube placement. No evidence of tension. Unchanged appearance of the heart and of the left lung.


SubjectID: 13110574, StudyID: 54172458, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with pleural effusion now s/p thoracentesis // Please assess for pneumothorax

TECHNIQUE: Portable

COMPARISON: ___

FINDINGS: New right-sided pleural catheter with minimal decrease in the right-sided effusion. There remains substantial opacification of the right middle and lower lobe. New small right apical pneumothorax. Mild pulmonary edema. Small left effusion unchanged.

IMPRESSION: Insertion of right-sided pleural catheter with new small apical pneumothorax with minimal decrease in the right-sided effusion.


SubjectID: 13110574, StudyID: 58960551, Comparison: worse

FINAL REPORT

INDICATION: ___ year old woman with ESRD on HD, lung cancer, has R pleurx, COPD, on 4L NC, having anxiety attacks // ?acute process

TECHNIQUE: Portable

FINDINGS: As compared to chest radiograph from 1 day prior, slight increase in layering moderate right-sided pleural effusion post fluid also tracking along the fissure. Moderate left-sided effusion is stable. Bibasilar opacities marginally increased   Keywords: increase. No pneumothorax. Moderate cardiomegaly. Right-sided pleural catheter in similar position.

IMPRESSION: Slight increase in right-sided pleural effusion and basal opacities.


SubjectID: 13110574, StudyID: 58786031, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ yo F with PMH HTN, DMT2, MR, HRpEF, PAD s/p stent, ESRD on HD, chronic, mesenteric ischemia, bronchiectasis, COPD and recurrent pleural effusions treated with TPC concerning for malignancy who presented with hypercarbic respiratory failure and afib with RVR, transferred back to MICU with dyspnea // please evaluate for interval change please evaluate for interval change

IMPRESSION: Comparison to ___. No relevant change   Keywords: no relevant change. The small right basal pneumothorax and the position of the right chest tube is stable. Moderate cardiomegaly persists. The bilateral parenchymal opacities at the lung bases are stable   Keywords: stable. The presence of a small left pleural effusion is likely. On the right, the effusion might have minimally decreased.


SubjectID: 13110574, StudyID: 58268432, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with respiratory distress // Interval changes Interval changes

COMPARISON: Comparison to ___ at 17:19

FINDINGS: Save dictation Portable semi-erect chest radiograph ___ at 15:23 is submitted.

IMPRESSION: Persistent bilateral pleural effusions with bibasilar airspace disease, worsening on the left and stable on the right, most likely representing partial lower lobe atelectasis in the setting of effusions. Bibasilar pneumonia cannot be entirely excluded. In addition, there is a stable left apical opacity. Persistent mild interstitial edema   Keywords: persistent. Stable cardiac and mediastinal contours. Right tunneled pleural catheter crosses the mid line and is unchanged in position. Left upper extremity vascular stent again seen.


SubjectID: 13110574, StudyID: 58338830, Comparison: None

FINAL REPORT

INDICATION: ___F with hypoxia // PNA?

TECHNIQUE: Single portable view of the chest.

COMPARISON: ___.

FINDINGS: Right basilar opacity is in part due to pleural effusion which may be partially loculated and appears larger when compared to prior. Pleural-based catheter is in unchanged position compared to prior. There may also be a small left pleural effusion given blunting of left costophrenic angle. Left upper lung opacity has not significantly changed since priors. Cardiomediastinal silhouette is within normal limits. Dense atherosclerotic calcifications are noted. Left upper extremity vascular stent is visualized.

IMPRESSION: Right basilar opacity likely in part due to right-sided pleural effusion which appears partially loculated and slightly larger compared to prior. Likely some component of at adjacent atelectasis. Infection cannot be excluded.


SubjectID: 13110574, StudyID: 58146254, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF, now with worsening O2 requirement // any e/o pulm edema? any e/o pulm edema?

COMPARISON: Chest radiographs since ___, most recently ___.

IMPRESSION: Moderate right pleural effusion has increased since ___, and there may also be new consolidation at the base the right lung, either atelectasis or new pneumonia. Interstitial edema is mild elsewhere. Heart size top-normal. No pneumothorax.


SubjectID: 13110574, StudyID: 55517699, Comparison: worse

WET READ: ___ ___ ___ 3:28 PM 1. Mild pulmonary edema. 2. Bilateral pleural effusion. 3. Confluent right base opacity may represent pneumonia or asymmetric edema. Recommend follow-up radiographs after diuresis to evaluate for resolution of any edema and to assess for any underlying etiology.

WET READ VERSION #___ ___ ___ 12:36 PM Mild pulmonary edema. Left pleural effusion. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: Chest radiographs

INDICATION: History: ___F with cp and sob, HD opt. pls eval pna vs edema // History: ___F with cp and sob, HD opt. pls eval pna vs edema

TECHNIQUE: Chest PA and lateral

COMPARISON: Comparison is made with chest radiographs from ___ and ___ and CT chest from ___.

FINDINGS: Increased interstitial opacities are seen with indistinct pulmonary vasculature, consistent mild pulmonary edema   Keywords: increase. Confluent right base opacity may represent pneumonia or asymmetric edema. There are moderate right and small left pleural effusions. The cardiomediastinal silhouette is unremarkable.

IMPRESSION: Bilateral interstitial opacities may reflect recurrent interstitial edema. A more confluent right basilar opacity may represent pneumonia or asymmetric edema. Recommend follow-up radiographs after diuresis to evaluate for resolution.

NOTIFICATION: Updated findings from original wet read were communicated to Dr. ___ at 3:27 p.m. on ___ by phone.


SubjectID: 13110574, StudyID: 52371947, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with right TPC placement // r/o ptx

TECHNIQUE: Portable chest radiograph

COMPARISON: Chest radiograph ___

FINDINGS: Right basal chest tube appears repositioned in the interval. There is interval decrease in both the right and left pleural effusions. A small right pneumothorax is seen along the apex and lateral base without evidence of tension. Cardiomediastinal silhouette is unchanged with dense atherosclerotic calcification and mitral annular calcification.

IMPRESSION: 1. Repositioned right basal chest tube. 2. Interval decrease in bilateral pleural effusions. 3. Small right pneumothorax without evidence of tension.


SubjectID: 13110574, StudyID: 51931177, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with pleurex right side repositioned today with lethargy and hypotension // eval for pleural effusion, pulm edema, pneumothorax

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Tiny right pneumothorax has minimally decreased. Right chest tube is in place. Cardiomediastinal contours are unchanged and midline. Small left effusion is a stable. Spiculated lesion in the left upper lobe and emphysema are better seen in prior CT. The trachea is deviated to the left due to a thyroid nodule, also better seen on prior CT


SubjectID: 13110574, StudyID: 51863585, Comparison: worse

FINAL REPORT

INDICATION: Shortness of breath, evaluate for evidence of CHF.

COMPARISON: AP chest radiograph on ___. PA and lateral chest x-ray on ___.

FINDINGS: PA and lateral chest radiographs were compared with AP radiograph on ___. Again seen in cardiomegaly with interstitial edema worsened compared to ___   Keywords: worse. Lateral views demonstrate that a left lung base opacity most likely represents a small pleural effusion with associated atelectasis, though infection cannot be excluded. Mild patchy opacity is also noted in the right lung base, with a small right pleural effusion. Known left apical ill-defined opacity is redemonstrated.

IMPRESSION: 1. Bibasilar opacities, possibly atelectasis, though infection is not excluded. 2. Mild interstitial edema, new from ___, with small bilateral pleural effusions   Keywords: new. 3. Unchanged left apical ill-defined opacity.


SubjectID: 13110574, StudyID: 51707348, Comparison: worse

PROVISIONAL

FINDINGS

IMPRESSION (PFI): ___ ___ ___ 10:03 AM 1. Worsened interstitial edema compared to ___   Keywords: worse. 2. Left lower lobe opacity may represent an area of atelectasis or pleural effusion. Pneumonia cannot be excluded. ______________________________________________________________________________

FINAL REPORT

INDICATION: History of CHF with increasing shortness of breath and chest pain. Evaluate for fluid overload.

COMPARISON: Multiple prior chest radiographs, most recently on ___.

FINDINGS: Single AP radiograph of the chest demonstrates mild interstitial edema bilaterally, new from ___   Keywords: new. The left internal jugular catheter has been removed. The cardiomediastinal silhouette is mildly enlarged, unchanged. There are patchy opacities in the lung bases with probable small bilateral pleural effusions. The ;eft apical ill-defined nodular opacity is similar compared to the prior study.

IMPRESSION: 1. New mild interstitial pulmonary edema compared to ___ with small bilateral pleural effusions   Keywords: new. 2. Bibasilar opacities may represent atelectasis though pneumonia cannot be excluded. 3. Unchanged left apical ill-defined nodular opacity.


SubjectID: 13127894, StudyID: 58201100, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Status post endotracheal intubation.

COMPARISONS: Earlier in the same day.

TECHNIQUE: Chest, AP portable supine.

FINDINGS: The patient has been intubated. The endotracheal tube terminates in the right mainstem bronchus. An orogastric tube passes into the stomach. The cardiac, mediastinal and hilar contours appear similar. Better demonstrated is a persistent retrocardiac consolidation with air bronchograms in the left lower lobe. The right lung base appears less opacified than before, arguing against an addition focus of pneumonia in this area, although there is a persistent suspected pleural effusion based on veil-like layering. Moderate pulmonary edema appears similar   Keywords: similar.

IMPRESSION: Right main stem bronchus intubation with no other definite change. Dr. ___ discussed the findings with Dr. ___ at 7:___ p.m. by telephone.


SubjectID: 13127894, StudyID: 57491726, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Status post endotracheal tube placement.

COMPARISONS: 15 minutes earlier.

TECHNIQUE: Chest, AP supine.

FINDINGS: Endotracheal tube remains in the right mainstem bronchus. Apparently, however, this film was acquired very shortly before retracting the tube by 4 cm according to the referring physician, ___.___, with whom Dr. ___ spoke at 7:33 p.m by telephone. There has been no definite change.


SubjectID: 13127894, StudyID: 54635890, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Shortness of breath and hypoxia.

COMPARISONS: ___.

TECHNIQUE: Chest, semi-upright AP portable.

FINDINGS: The heart is again enlarged. The mediastinal and hilar contours appear unchanged. There is moderate diffuse predominantly central interstitial opacification with indistinct vessels suggesting pulmonary edema. A retrocardiac consolidation is present with air bronchograms. There are also suspected pleural effusion on the right side and possibly a focal opacity is developing at the right lung base that may be due to early infection.

IMPRESSION: 1. Findings suggesting moderate pulmonary edema. 2. Consolidation suspected in the left lower lobe. 3. Patchy right lower lung opacification; an area of confluent edema could be considered versus an additional early developing focus of infection   Keywords: developing.


SubjectID: 13127894, StudyID: 59748091, Comparison: better

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman with COPD and hypoxia.

FINDINGS: Comparison is made to prior study from ___. There is cardiomegaly. There is unchanged large left-sided pleural effusion with left retrocardiac opacity. There is mild improved aeration of the pulmonary edema since the previous study   Keywords: improve. There are no pneumothoraces.


SubjectID: 13127894, StudyID: 54185517, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Respiratory distress, assessment for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Low lung volumes. Massive cardiomegaly with enlargement of the left atrium. Bilateral pleural effusions. Mild fluid overload. No evidence of pneumonia.


SubjectID: 13127894, StudyID: 53737948, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old woman with history of COPD, hypercarbia and cirrhosis, now presenting with dyspnea.

COMPARISON: Chest radiograph ___. PORTABLE AP CHEST RADIOGRAPH: Massive cardiomegaly is re-demonstrated. In comparison to the prior study, there is mild worsening of the pulmonary edema. Small right and moderate-sized left pleural effusions and retrocardiac left basal consolidation are stable.

IMPRESSION: Mild worsening of pulmonary edema   Keywords: worse.


SubjectID: 13127894, StudyID: 51057934, Comparison: worse

WET READ: ___ ___ ___ 8:14 PM Slightly decreased aeration of right lung base from ___. Unchanged large left-sided pleural effusion with left retrocardiac opacity may represent pneumonia.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with fever, cough, rule out pneumonia.

COMPARISON: Multiple chest x-rays from ___ to ___.

FINDINGS: Mild pulmonary edema has increased since ___   Keywords: increase. Left lower lobe is still collapsed with adjacent moderate pleural effusion. Right small pleural effusion has worsened. Moderate cardiomegaly is stable. There is no pneumothorax.

CONCLUSION: 1. Mild pulmonary edema has worsened since ___ with increased small right pleural effusion   Keywords: increase, worse. 2. Left lower lobe collapse with mild-to-moderate pleural effusion is unchanged.


SubjectID: 13127894, StudyID: 53831179, Comparison: better

FINAL REPORT

HISTORY: ___-year-old female with respiratory failure, evaluate for interval change.

COMPARISON: ___.

FINDINGS/

IMPRESSION: Portable semi-upright chest radiograph demonstrates appropriate and unchanged positioning of endotracheal and nasogastric tube. Compared with ___, bibasilar opacities, bilateral moderate pleural effusions, improved mild pulmonary edema, cardiac, and mediastinal contours are unchanged   Keywords: improve.


SubjectID: 13127894, StudyID: 50759091, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman with respiratory failure and is intubated.

FINDINGS: Comparison is made to prior study from ___. The endotracheal tube, feeding tube, right-sided central line are all appropriately positioned. There is a left retrocardiac opacity and bilateral pleural effusions. There is mild pulmonary interstitial edema. There are no pneumothoraces.


SubjectID: 13127894, StudyID: 58637095, Comparison: None

FINAL REPORT

SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Patient with sepsis/pneumonia. Comparison is made with prior study performed a day earlier. Moderate-to-severe cardiomegaly is obscured by pleuroparenchymal abnormalities. Large left pleural effusion associated with adjacent atelectasis and small right effusion with right lower lobe atelectasis is unchanged. There is mild vascular congestion. ET tube is in standard position. Right subclavian catheter tip is at the cavoatrial junction/upper right atrium. NG tube tip is out of view below the diaphragm. There is a second esophageal catheter, the tip is at the level of the hemidiaphragm. Left peripherally inserted catheter tip is in the axillary vein.

IMPRESSION: No interval change in bilateral pleural effusions and atelectasis.


SubjectID: 13127894, StudyID: 50931676, Comparison: worse

FINAL REPORT

HISTORY: Respiratory failure question edema.

COMPARISON: Deep ___.

FINDINGS: ET tube ends 2.6 cm above the carina. Right subclavian line is in unchanged position. An NG tube ends in the stomach. The left pleural effusion is larger since yesterday. Widespread opacities also worse since yesterday are consistent with worsening pulmonary edema   Keywords: worse. Severe cardiomegaly is unchanged. No pneumothorax.

IMPRESSION: Worsening left pleural effusion and pulmonary edema consistent with worsening heart failure   Keywords: worse.


SubjectID: 13127894, StudyID: 57058544, Comparison: None

FINAL REPORT

INDICATION: Respiratory failure. Evaluate for interval change.

COMPARISON: Most recent radiograph from ___ and a series of older studies dating back to ___. CTA of the chest from ___.

FINDINGS: A bedside AP radiograph of the chest once again demonstrates marked cardiomegaly as well as a moderate right and small left pleural effusion. The left cardiac border and left hemidiaphragmatic contour remain obscured, likely by a combination of atelectasis and effusion, although pneumonia cannot be excluded depending on the clinical setting. There is stable widening of mediastinum, consistent with elevated central venous pressure. An endotracheal tube terminates no less than 1.5 cm above the carina with the patient's neck significantly flexed. An OG tube courses into the stomach and out of field of view and a right PICC terminates within the right atrium, and could be pulled back 1.5 cm to ensure seatment in the lower one-third of the SVC.

IMPRESSION: 1. Stable moderate bilateral pleural effusions, bibasilar atelectasis, and pulmonary vascular congestion without evidence of pulmonary edema. 2. The right PICC lies within the right atrium and could be pulled back 1.5 cm for proper positioning in the lower one-third of the SVC. NOTE: Findings related to PICC positioning were communicated to the patient's nurse by Dr. ___ ___ telephone on ___ at 13:00.


SubjectID: 13127894, StudyID: 52468111, Comparison: better

FINAL REPORT

INDICATION: ___-year-old woman with respiratory failure.

COMPARISONS: ___.

FINDINGS: Endotracheal tube and nasogastric tube have been removed. Right PICC terminates in the mid to distal SVC. Vascular congestion, bibasilar atelectasis and effusions are slightly improved   Keywords: improve. Mild Cardiac size remains moderately enlarged.


SubjectID: 13135946, StudyID: 58519194, Comparison: None

FINAL REPORT

HISTORY: ET tube placement. CHEST, SINGLE AP PORTABLE VIEW. An ET tube is present -- the tip lies approximately 2.9 cm above the carina. Right subclavian central line tip overlies the SVC/RA junction. No pneumothorax is detected. Status post sternotomy, with prosthetic valve and multiple clips in the mediastinum, near the thoracic inlet, and in the upper abdomen. Unusual density overlying the gastric fundus may represent some residual oral contrast within the stomach. Attention to this area on followup films is requested. There are bilateral effusions, with some underlying atelectasis. Retrocardiac opacity is consistent with left lower lobe collapse and/or consolidation. Upper zone redistribution and mild diffuse vascular blurring likely reflects CHF.

IMPRESSION: 1) Interval placement of the ET tube, tip in satisfactory position above the carina. Otherwise, overall similar. 2) Radiopacity over stomach - ? residual contrast. Clinical correlation requested. 3) LLL collpase consolidation. 4) Bilateral effusions. 5) Probable CHF.


SubjectID: 13135946, StudyID: 53363173, Comparison: same

FINAL REPORT

HISTORY: Pulmonary failure, assess Dobbhoff. CHEST, SINGLE AP PORTABLE VIEW. Rotated positioning. A Dobbhoff tube is present -- the radiopaque tip overlies the upper stomach. Focal density in the left upper quadrant appears to represent contrast in relation to the stomach near the GE junction An additional nasogastric type tube is present, tip extending beneath the diaphragm off film. An ET tube is present -- the tip is obscured but appears to lie approximately 3.5 cm above the carina. The right subclavian central line tip overlies the distal SVC. Sternotomy wires, mediastinal and ? upper abdominal clips are present. There is upper zone redistribution and diffuse vascular blurring, consistent with CHF. There is increased retrocardiac density, consistent with left lower lobe collapse and/or consolidation. There are small-to-moderate bilateral effusions, with underlying collapse and/or consolidation.

IMPRESSION: 1. Dobbhoff tube tip overlying stomach. Residual contrast appears unchanged compared with ___ at 2:29 a.m. The absence of interval change is atypical and raises question of local pooling of contrast. Clinical correlation requested. 2. Bilateral effusions with underlying collapse and/or consolidation, unchanged. 3. CHF findings, also grossly unchanged   Keywords: unchanged.


SubjectID: 13135946, StudyID: 58348130, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman with mitral valve repair.

FINDINGS: Comparison is made to the prior study from ___. An endotracheal tube has been placed and the distal tip is at the level of the aortic knob, 5 cm above the carina. The Swan-Ganz catheter is unchanged. There is a persistent cardiomegaly. There is a right-sided pleural effusion. There is prominence of the pulmonary interstitial markings. No pneumothoraces are identified.


SubjectID: 13135946, StudyID: 56680924, Comparison: better

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman status post CABG with possible pneumothorax.

FINDINGS: Comparison is made to prior study from ___. There is a Swan-Ganz catheter whose distal lead tip is in the main pulmonary outflow tract. The cardiac silhouette is enlarged. There is again seen moderate right-sized pleural effusion which is stable. There is some improvement in the pulmonary vascular edema   Keywords: improve. There are no pneumothoraces identified.


SubjectID: 13135946, StudyID: 52547146, Comparison: None

FINAL REPORT

SINGLE FRONTAL VIEW OF THE CHEST: REASON FOR EXAM: Status post CABG and MVR. Comparison is made with prior study ___. There has been increase in moderate right pleural effusion. If any there is a small left pleural effusion. There is mild stable vascular congestion. Cardiomediastinal contours are unchanged. Swan-Ganz catheter tip is in the main pulmonary artery. There is no evident pneumothorax. Left chest tube remains in unchanged position. Sternal wires are in unchanged position.

IMPRESSION: increase in moderate right pleural effusion.


SubjectID: 13138475, StudyID: 59923277, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Endotracheal tube placement, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has been intubated. The tip of the endotracheal tube projects 6.5 cm above the carina. There is no evidence of complications, notably no pneumothorax. The known massive bilateral lung parenchymal changes are constant.


SubjectID: 13138475, StudyID: 58329501, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Hypotension, jugular vein catheter.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has received a left internal jugular vein catheter. The tip of the catheter projects over the mid-to-lower SVC. The course of the catheter is unremarkable. There is no evidence of complication. The massive bilateral lung parenchymal changes are constant.


SubjectID: 13138475, StudyID: 56542426, Comparison: same

WET READ: ___ ___ ___ 9:50 PM Right and left upper lobe opacities concerning for multifocal pneumonia. ___ be component for hemorrhage given history of Wegeners.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior study from ___ and a CTA chest from ___. CLINICAL

HISTORY: Short of breath, assess for pneumonia.

FINDINGS: In this patient with known granulomatous polyangiitis, multiple areas of consolidation with peribronchovascular opacity is most confluent in the left mid and lower lung, slightly increased from prior exam. There is also subtle increased opacity in the right upper lobe. Findings are concerning for pneumonia. Otherwise, no significant change   Keywords: no significant change.


SubjectID: 13138475, StudyID: 54706917, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Known granulomatous disease, status post breast cancer and tracheal balloon dilatation. Evaluation for orogastric tube placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has received a nasogastric tube. The course of the tube is unremarkable, the tip of the tube projects over the middle parts of the stomach. The other monitoring and support devices as well as the massive known parenchymal lung changes are constant. No pneumothorax. Contrast material is seen in the left renal collecting system.


SubjectID: 13138475, StudyID: 59568800, Comparison: same

FINAL REPORT

HISTORY: Patient with granulomatosis polyangitis and respiratory failure. Tube placement (discussed with Dr. ___, ___ tube had been pulled back).

COMPARISON: ___ at 10:11.

FINDINGS: The ET tube has been repositioned and is now 7.2 cm above the carina. The left jugular line is in unchanged position in the mid SVC. The NG tube extends below the diaphragm including the side port. Bilateral multifocal consolidation is unchanged from this morning. No change in left lower lobe collapse, and small bilateral pleural effusions. Cardiomediastinal silhouette is normal. No pneumothorax.

IMPRESSION: 1. ET tube tip now high, 7.2 cm above the carina. 2. Otherwise no change from prior the exam this morning   Keywords: no change. Telephone notifaction of Dr ___ by Dr ___ at 16:05 ___.


SubjectID: 13138475, StudyID: 58162740, Comparison: None

WET READ: ___ ___ ___ 6:44 PM ETT now terminates 4.5 cm above the carina. Otherwise, no appreciable change since radiograph of 14:07pm with widespread opacities compatible with infection or vasculitis. - ___ p_________________________________________________________________________________

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with Wegener, respiratory failure, ET tube.

COMPARISON: Multiple chest x-rays from ___ to ___.

FINDINGS: ET tube ends 4.7 cm above carina. Left jugular line is in mid SVC. Bilateral widespread opacities are unchanged with left lower lobe collapse. Small bilateral pleural effusions are also stable. There is no pneumothorax. NG tube is in the stomach. Cardiac contour is not enlarged.

CONCLUSION: 1. Tube and lines are in adequate position. 2. The remainder of the exam is unchanged.


SubjectID: 13138475, StudyID: 58041517, Comparison: same

FINAL REPORT

INDICATION: Patient with respiratory failure.

COMPARISON: Multiple chest x-rays from ___ to ___ and chest CTs from ___ to ___.

FINDINGS: The patient is known with granulomatosis with polyangiitis. Bilateral multifocal consolidation is unchanged since yesterday. Left lower lobe is still completely collapsed. Bilateral pleural effusions are small. ET tube ends 4.9 cm above carina. Left jugular line is in adequate position in mid SVC. There is no pneumothorax. Mediastinal and cardiac contours are normal. NG tube is in the stomach.

CONCLUSION: 1. Patient with known Wegener granulomatosis and stable bilateral widespread opacities   Keywords: stable. It could represent infection, opacities related to the vasculitis or hemorrhage. 2. Tube and lines are in adequate position.


SubjectID: 13138475, StudyID: 53796243, Comparison: same

WET READ: ___ ___ ___ 5:43 PM OGT terminates below the diaphragm. Otherwise, no significant change since study 1 hour prior. - EAhn p_________________________________________________________________________________

FINAL REPORT

HISTORY: OG tube adjustment, evaluate OG tube.

COMPARISON: ___ at 16:19.

FINDINGS: The OG tube extends below the diaphragm with the tip not seen on this image. Support devices are in unchanged position. No significant change compared with 1 hr prior   Keywords: no significant change.

IMPRESSION: OG tube extends below the diaphragm with tip not seen on this image. Otherwise, no significant change from 1 hr prior   Keywords: no significant change.


SubjectID: 13138475, StudyID: 53307383, Comparison: same

FINAL REPORT

PORTABLE AP CHEST X-RAY.

INDICATION: Patient with respiratory failure, pneumonia cavity.

COMPARISON: Multiple chest x-rays from ___ to ___, yesterday's CT scan.

FINDINGS: Left upper lobe and right lower lobe opacities have improved over a short period of time. The other opacities are unchanged   Keywords: unchanged. Left lower lobe collapse is stable. Mild-to-moderate bilateral pleural effusions are stable. There is no pneumothorax. ET tube ends 5.3 cm above carina. Left jugular line is at mid SVC. NG tube is in the stomach.

CONCLUSION: 1. Patient is known with complicated granulomatosis with polyangiitis. Considering the fast improvement of left upper lobe and right lower lobe opacities, this could have been due to hemorrhage or aspiration rather than pneumonia. 2. Tubes and lines are in adequate position.


SubjectID: 13138475, StudyID: 53199729, Comparison: None

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with multifocal pneumonia, multiple intubations, currently intubated. Progression of multifocal pneumonia.

COMPARISON: Multiple chest x-rays from ___ to ___.

FINDINGS: ET tube ends 6.1 cm above carina. Left jugular line is in adequate position in mid SVC. NG tube is in the stomach. Bilateral widespread opacities are unchanged with left lower lobe collapse. Small pleural effusions are stable. There is no pneumothorax.

CONCLUSION: 1. Tubes and lines are in adequate position. 2. Widespread bilateral opacities which could represent multifocal pneumonia but also opacities related to the vasculitis are unchanged.


SubjectID: 13138475, StudyID: 51087818, Comparison: same

FINAL REPORT

HISTORY: Chronic respiratory failure. Question pneumonia.

COMPARISON: ___ at 17:33.

FINDINGS: ET tube, OG tube and left internal jugular line are all in standard position. There is no significant change from the preceding study   Keywords: no significant change. The cardiomediastinal silhouette is stable. No pneumothorax is present. No new consolidations are seen.

IMPRESSION: No significant change from prior study   Keywords: no significant change.


SubjectID: 13138475, StudyID: 59520529, Comparison: None

FINAL REPORT

CLINICAL

HISTORY: Renal failure. CHEST AP Comparison made with the prior chest x-ray of ___. The position of the PICC line and the tracheostomy tube is satisfactory and unchanged. Bilateral pleural effusions are now present, which were not seen on the prior chest x-ray. Atelectasis at the left base is still present.

IMPRESSION: bilateral pleural effusions, not present on prior chest x-ray.


SubjectID: 13138475, StudyID: 54000520, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Status post tracheostomy. The massive bilateral parenchymal opacities, associated with likely pleural plaques, are constant in extent and severity. Constant size of the cardiac silhouette. Constant small left pleural effusion. On today's examination, there is mild hyperinflation of the stomach.


SubjectID: 13138475, StudyID: 50211122, Comparison: None

FINAL REPORT

HISTORY: Respiratory failure.

FINDINGS: In comparison with the study of ___, tracheostomy tube is in place. Central catheter again extends to the mid portion of the SVC. The orogastric tube has been removed. Opacification in the retrocardiac region is again consistent with substantial volume loss in left lower lobe with layering pleural effusion. Mild atelectatic changes are seen at the right base. No evidence of acute pneumothorax.


SubjectID: 13138475, StudyID: 59421513, Comparison: None

FINAL REPORT

SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: New pneumonia, intermittent desaturation overnight. Comparison is made with prior study ___. Extensive bilateral multifocal lung consolidations consistent with multifocal pneumonia is minimally increased in the right upper lobe. Cardiomediastinal contours are unchanged. Small bilateral pleural effusion on the right and small-to-moderate left effusion on the left are unchanged. There is no pneumothorax. Left IJ catheter tip is in the mid-to-lower SVC.

IMPRESSION: Mild worsening of multifocal pneumonia.


SubjectID: 13138475, StudyID: 58660085, Comparison: None

FINAL REPORT

CHEST ON ___

HISTORY: Bronchial stent placement.

FINDINGS: Compared to the study from the prior day, the endotracheal tube has been removed. The PICC line tip projects over the spine but this is felt to be rotational, as the tip was previously seen to be at the cavoatrial junction. There is volume loss at the left base that has increased slightly. There is increased alveolar infiltrate in both lower lungs. It is unclear if some of this is due to volume loss, aspiration or infectious infiltrate. More patchy areas of alveolar infiltrate throughout the lungs are again visualized. Old rib fractures on the right are again seen.


SubjectID: 13138475, StudyID: 58329062, Comparison: None

FINAL REPORT

CHEST ON ___

HISTORY: Wegener's granulomatosis, intubated, question interval change. REFERENCE EXAM: ___.

FINDINGS: The ET tube and NG tube, left-sided PICC line are unchanged. There continues to be some volume loss in the left lower lung. Otherwise, the appearance of the lungs and prior right-sided rib fractures are unchanged.


SubjectID: 13138475, StudyID: 57293457, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Study of earlier the same date.

FINDINGS: Left PICC has been withdrawn by several centimeters, with the distal tip now terminating in the region of the left subclavian vein at the level of the middle third of the left clavicle. Heart size remains normal. Multifocal pulmonary opacities with basilar predominance have slightly worsened in the left lower lobe in the interval. Additionally, multiple poorly defined nodular opacities persist bilaterally. These findings may reflect a combination of infection and hemorrhage in this patient with history of vasculitis. Small right pleural effusion is unchanged, but a moderate left pleural effusion has increased in size. Multifocal sclerotic skeletal lesions are unchanged and more fully characterized on CT. Healed rib fractures are also noted.


SubjectID: 13138475, StudyID: 52186196, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with Wegener's and history of post-obstructive pneumonia and now with increasing shortness of breath. Evaluate for pneumonia or edema.

COMPARISONS: Multiple prior radiographs, most recently of ___.

FINDINGS: Frontal upright view of the chest was obtained. A left midline catheter, previously positioned within the left subclavian vein, now terminates at the junction of the left axillary and subclavian veins. Allowing for positional differences, there has been no interval change in multifocal basilar-predominant consolidations. Multiple superimposed bilateral ill-defined nodular opacities are similar to prior and may be related to known vasculitis. Small right and moderate left pleural effusions are unchanged. The heart size is normal. No pneumothorax.

IMPRESSION: 1. Multifocal basilar-predominant consolidation and diffuse ill-defined nodular opacities, similar to prior study. Findings are compatible with multifocal pneumonia possibly coexisting with pulmonary hemorrhage in this patient with known vasculitis. 2. Moderate left and small right pleural effusion are similar to prior. 3. Left midline catheter now terminates at the junction of the axillary and subclavian veins.


SubjectID: 13138475, StudyID: 53842858, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Granulomatosis, dyspnea, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Extensive bilateral parenchymal opacities are constant in extent and severity. No newly appeared parenchymal opacities   Keywords: new. Monitoring and support devices are constant. No change in appearance of the cardiac silhouette.


SubjectID: 13138475, StudyID: 51945242, Comparison: 0.0

FINAL REPORT

HISTORY: Wegener's with worsening respiratory status.

FINDINGS: In comparison with the study of ___, there appears to be some increasing opacification in the retrocardiac region with poor definition of the descending aorta   Keywords: increasing. This could reflect increased volume loss in the left lower lobe or possibly a region of consolidation if consistent with the clinical scenario. Remainder of the study is unchanged with extensive bilateral parenchymal opacities and pleural plaques   Keywords: unchanged. Tracheostomy tube remains in place.


SubjectID: 13138475, StudyID: 53357283, Comparison: same

FINAL REPORT

HISTORY: Wegener's and multifocal pneumonia.

FINDINGS: In comparison with the study of ___, there is little interval change   Keywords: little interval change. Monitoring and support devices remain in place. Diffuse bilateral pulmonary opacifications persist.


SubjectID: 13140001, StudyID: 57293899, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p MVR, MAZE // follow up effusions

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the patient has been extubated and the nasogastric tube was removed. The Swan-Ganz catheter and the pleural and mediastinal drains are in unchanged position. No pneumothorax. No larger pleural effusions. Moderate cardiomegaly persists. No pneumothorax.


SubjectID: 13140001, StudyID: 56496254, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p MVR // eval for ptx s/p CT removal

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the Swan-Ganz catheter and the mediastinal drains have been removed. There is no larger pneumothorax and no pleural effusions. Minimal increase in severity of the platelike atelectasis in the mid left lung. Substantial cardiomegaly persists.


SubjectID: 13165812, StudyID: 58614811, Comparison: None

FINAL REPORT

SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Hypoxia. Comparison is made with prior study ___. Large left effusion associated with adjacent atelectasis is unchanged. Right upper lobe perihilar consolidation has worsened. Right lower lobe opacity, a combination of pleural effusion and adjacent consolidation is grossly unchanged. There is no pneumothorax. Cardiac size cannot be evaluated.

IMPRESSION: Worsening pneumonia in the right upper lobe.


SubjectID: 13165812, StudyID: 51638412, Comparison: None

FINAL REPORT

INDICATION: ___F w COPD (refuses oxygen at home), CAD, HTN, HLD who presents from her assisted living with CHF exacerbation, found to have PNA on chest CT now with increased work of breathing // ?effusion, worsening PNA

TECHNIQUE: Portable AP chest

COMPARISON: Chest radiograph ___. CT chest ___.

FINDINGS: Moderate bilateral pleural effusions with adjacent compressive atelectasis are not significantly changed since recent CT although there is some redistribution. Reticulated opacity in the right mid and upper lung is slightly worse. The left upper lobe is relatively clear. The heart is partially obscured by pleural effusions and not well evaluated. The aortic knob is calcified. Pleural thickening at the right apex is re- demonstrated. There is no pneumothorax.

IMPRESSION: 1. Persistent moderate bilateral pleural effusions are not significantly changed since recent CT 2. Reticulated opacity in the mid and upper right lung is worse concerning for persistent pneumonia


SubjectID: 13178765, StudyID: 59491625, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with respiratory distress and hypoxia. Evaluate for acute process.

TECHNIQUE: Portable upright chest radiograph was obtained.

COMPARISON: None available.

FINDINGS: The endotracheal tube terminates 1.4 cm above the level of the carina, approaching the orifice of the right mainstem bronchus, and the enteric tube terminates in the stomach. There is slight elevation of the left hemidiaphragm. Diffuse alveolar airspace opacities are noted, most pronounced in a perihilar pattern, right greater the left, concerning for severe pulmonary edema. There is a small left pleural effusion. The heart is mildly enlarged in size given the AP technique. Mediastinal contour is unremarkable. No pneumothorax is detected. Right costophrenic angle is excluded from the field of view.

IMPRESSION: 1. Severe pulmonary edema and small left pleural effusion. 2. Low positioning of the endotracheal tube, terminating 1.4 cm above of the level of the carina and approaching the orifice of the right mainstem bronchus. Recommend pull back. The enteric tube terminates in the stomach.


SubjectID: 13178765, StudyID: 58557838, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M w/flash pulm edema now intubated // interval changes, signs of consolidations/PNA

TECHNIQUE: Portable AP chest radiograph.

COMPARISON: Chest radiograph ___

FINDINGS: Support and monitoring equipment are unchanged in appearance when compared to the prior study. There are persistent bilateral extensive airspace opacities, likely reflecting pulmonary edema   Keywords: persistent. This is similar in appearance when compared to the prior studies   Keywords: similar in appearance. Small left pleural effusion. Probable right-sided pleural effusion also. No pneumothorax seen.

IMPRESSION: Bilateral extensive airspace opacities likely reflect pulmonary edema, superimposed infection cannot be excluded.


SubjectID: 13178765, StudyID: 51395464, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M w/hx of DM2, HTN, HLD, CAD, cerebral palsy, inferior STEMI (___), sCHF (EF ___%), CKD (baseline Cr 3), presenting for respiratory failure. // Aspiration? Other acute change Aspiration? Other acute change

IMPRESSION: In comparison with the study of ___, the endotracheal and nasogastric tubes have been removed. Bilateral opacifications, more prominent on the right, processed. Although this most likely represents asymmetric pulmonary edema, in view of the clinical history the possibility of superimposed pneumonia would be impossible to exclude, especially in the absence of a lateral view.


SubjectID: 13178765, StudyID: 57499562, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M w/hx of DM2, HTN, HLD, CAD, cerebral palsy, inferior STEMI (___), sCHF (EF ___%), CKD (baseline Cr 3), presenting for respiratory failure. // interval changes, consolidations, pulm edema interval changes, consolidations, pulm edema

COMPARISON: Chest radiographs since ___, most recently ___.

IMPRESSION: Moderate pulmonary edema has changed in distribution, but not in overall severity. Small left pleural effusion is larger. Heart size top-normal. Right jugular line ends in the upper SVC.


SubjectID: 13178765, StudyID: 56744155, Comparison: None

FINAL REPORT

INDICATION: ___M w/HF, pulm edema // Interval changes, possible effusions, pulm edema

TECHNIQUE: Chest PA and lateral

FINDINGS: Given for differences in technique, Moderate pulmonary edema has not substantially changed. Small left pleural effusion is stable. Heart size top-normal. Right jugular line ends in the upper SVC.

IMPRESSION: No substantial interval change, moderate pulmonary edema and small left effusion


SubjectID: 13194187, StudyID: 59898211, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with CHF // Please evaluate interval change Please evaluate interval change

IMPRESSION: In comparison with the study of ___, there is again substantial enlargement of the cardiac silhouette with no evidence of vascular congestion. This discordance is consistent with cardiomyopathy. Opacification at the left base is again consistent with volume loss in the lower lobe and moderate pleural he fusion.


SubjectID: 13194187, StudyID: 56957381, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___-year-old man with a history of CHF, now with decreased breath sounds at the right base.

TECHNIQUE: Chest PA and lateral

COMPARISON: Multiple prior chest radiographs, most recent from ___.

FINDINGS: Interval removal of left PICC. Stable, severe cardiomegaly. Normal mediastinal and hilar contours. Left lower lobe consolidation may reflect atelectasis or pneumonia. Likely improved left pleural effusion.

IMPRESSION: Likely improved left pleural effusion. Left lower lobe consolidation may reflect atelectasis or pneumonia.


SubjectID: 13207128, StudyID: 58293711, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST X-RAY OF ___

COMPARISON: ___ radiograph.

FINDINGS: The patient is status post recent median sternotomy and aortic valve surgery. Cardiomediastinal contours are stable in the postoperative period. Atelectasis in the left retrocardiac region has slightly improved since the previous examination. Right retrocardiac atelectasis is unchanged. Small bilateral pleural effusions are present, left greater than right.

IMPRESSION: Improving left retrocardiac atelectasis. Persistent small pleural effusions, left greater than right.


SubjectID: 13207128, StudyID: 50156596, Comparison: None

FINAL REPORT

PORTABLE CHEST OF ___

COMPARISON: Radiograph of one day earlier.

FINDINGS: The patient is status post median sternotomy and aortic valve replacement. Interval removal of midline drain with no evidence of pneumothorax or pneumomediastinum. Stable post-operative appearance of the cardiomediastinal contours. Slight worsening of retrocardiac atelectasis and persistent small left pleural effusion. Probable small right pleural effusion as well.


SubjectID: 13210648, StudyID: 59007362, Comparison: None

FINAL REPORT

INDICATION: Weakness.

COMPARISON: CT ___.

FINDINGS: Frontal AP and lateral views of the chest were obtained. Right basilar opacity is likely due to a combination of pleural effusion and atelectasis as seen on the concurrent CT abdomen. A rounded opacity in the right mid lung is likely loculated fluid in the right major fissure, given the partially loculated pleural effusion. The right upper lung zone and the left lung are clear aside from mild left basilar atelectasis. Heart size is top normal. The aorta is tortuous. Hilar contours are normal.

IMPRESSION: Partially loculated right pleural effusion. A right mid lung opacity is likely fluid in the major fissure. Followup CXR is recommended to ensure resolution.


SubjectID: 13210648, StudyID: 53186752, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST X-RAY, ___.

COMPARISON: Study of ___.

FINDINGS: Heart is normal in size with left ventricular configuration, and the aorta is tortuous. Pulmonary vascularity is normal. Partially loculated right pleural effusion has decreased in size, with small residual loculated component remaining laterally, which has decreased in width from approximately 1.8 cm to 0.8 cm. An incompletely marginated elliptical 2 cm diameter opacity located central to this region is unchanged in size measuring about 3 cm. Minimal linear atelectasis is present at both lung bases. Bones are diffusely demineralized.

IMPRESSION: Decreased partially loculated right pleural effusion with small residual loculated component laterally and probable 3 cm intrafissural collection. Followup radiograph in ___ weeks may be helpful to document resolution and to exclude a solid pleural lesion.


SubjectID: 13211467, StudyID: 58441654, Comparison: worse

FINAL REPORT

CHEST ON ___

HISTORY: MI, worsening respiratory distress.

FINDINGS: The heart is mildly enlarged. The aorta is mildly tortuous with some calcifications. There is increased pulmonary vascular redistribution and some patchy alveolar infiltrates   Keywords: increase. There is no effusion. Compared to the study from the prior day the fluid status is slightly worse.


SubjectID: 13211467, StudyID: 55514159, Comparison: None

FINAL REPORT

INDICATION: Chest pain.

COMPARISON: Chest radiograph from ___.

FINDINGS: There are bilateral increased interstitial opacities with bibasilar atelectasis. Minimally enlarged cardiomediastinal silhouette which appears stable in size in comparison to the prior study. Otherwise, the lungs are without a focal consolidation. If any, there is a small left pleural effusion .

IMPRESSION: Mild to moderate pulmonary edema with bibasilar atelectasis.


SubjectID: 13211467, StudyID: 54987367, Comparison: worse

FINAL REPORT

HISTORY: ___-year-old female with recent posterior STEMI, with continued hypoxia despite diuresis.

COMPARISON: ___.

FINDINGS: Portable semi-upright chest radiograph demonstrates perihilar airspace opacities, and a small though increased right pleural effusion. Lung volumes are low. The cardiac silhouette remains moderately enlarged, the mediastinal contours are notable for calcification of the aortic knob and marked central venous engogement.

IMPRESSION: Lower lung volumes, with increase in moderate pulmonary edema and a small though increased right pleural effusion   Keywords: increase. Moderate cardiomegaly, unchanged.


SubjectID: 13211467, StudyID: 54277020, Comparison: better

FINAL REPORT

HISTORY: ___-year-old man, recently intubated.

COMPARISON: ___ at ___ hours.

FINDINGS: Portable frontral chest radiograph. An endotracheal tube has been placed in the interim, the tip is positioned 4 cm from the level of the carina. An NG tube has been placed, the tip is within the stomach. Lung volumes are improved, with note of linear atelectasis in the right mid lung. There is mild pulmonary edema, though venous engorgment has improved likely from positive pressure ventilation   Keywords: improve. No pneumothorax. The cardiac silhouette and mediastinal contours demonstrate decreased azygous engorgment.

IMPRESSION: 1. Interval intubation, with appropriate position of the ET tube and improvement in lung volumes. 2. Mild pulmonary edema though venous engorgment has decreased   Keywords: decrease.


SubjectID: 13211467, StudyID: 51436832, Comparison: better

FINAL REPORT

INDICATION: ___-year-old man with MI and intubated, assess for interval change.

COMPARISONS: ___.

FINDINGS: Endotracheal tube and nasogastric tube have been removed. Lungs are low in volume but clear with improved pulmonary edema and trace left greater than right pleural effusions   Keywords: improve. Cardiomegaly is mild and unchanged.


SubjectID: 13230656, StudyID: 59717817, Comparison: None

FINAL REPORT

PORTABLE CHEST FILM, ___ AT 8:13 CLINICAL

INDICATION: ___-year-old with CHF, check Swan placement. Comparison is made to the patient's previous studies dated ___ at 8:17. Portable chest film dated ___ at 8:13 is submitted.

IMPRESSION: 1. Right internal jugular Swan-Ganz catheter continues to have its tip in the right interlobar artery. There is persistent patchy opacity at the left base and to a lesser extent at the right base which either reflects patchy atelectasis or pneumonia. Clinical correlation is advised. No evidence of pulmonary edema. No pneumothorax. Overall cardiac and mediastinal contours are stable.


SubjectID: 13230656, StudyID: 54933147, Comparison: None

FINAL REPORT

PORTABLE CHEST FILM ___ AT 817 CLINICAL

INDICATION: ___-year-old with CHF and Swan in place. Evaluate position. Comparison is made to the patient's prior study of ___ at ___ and a single fluoroscopic image from ___ at ___. Portable AP upright chest film ___ at 817 is submitted.

IMPRESSION: 1. Right internal jugular Swan-Ganz catheter continues to have its tip in the right interlobar artery. Lung volumes are diminished, and there continue to be patchy opacities at both bases favoring patchy atelectasis, although bibasilar pneumonia or aspiration should also be considered. There is likely a small left layering effusion. There is no evidence of pulmonary edema or pneumothorax. Overall cardiac and mediastinal contours are stable.


SubjectID: 13230656, StudyID: 54661910, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph of one day earlier.

FINDINGS: Swan-Ganz catheter has been withdrawn slightly, now terminating in the proximal right pulmonary artery, with no visible pneumothorax. Stable appearance of cardiomediastinal contours. Slight worsening of bibasilar opacities, left greater than right, and persistent small left pleural effusion. No visible pneumothorax.


SubjectID: 13230656, StudyID: 50146634, Comparison: same

FINAL REPORT

HISTORY: Evaluate Swan-Ganz catheter position.

TECHNIQUE: Frontal view of the chest.

COMPARISON: Multiple chest radiographs most recent on ___ at 11:04

FINDINGS: A Swan-Ganz catheter is seen with its tip ending in the right ventricle, out of position. Heart size and mediastinum are unchanged. Bibasilar opacities and bilateral pleural effusions are very minimally improved from prior study. There is no evidence of pneumothorax.

IMPRESSION: Swan-Ganz catheter is seen with its tip ending in the right ventricle, of position. Otherwise no significant change from the prior study   Keywords: no significant change.


SubjectID: 13230656, StudyID: 53540094, Comparison: None

FINAL REPORT

HISTORY: Shortness of breath, question increased pulmonary vasculature.

COMPARISON: A ___ and chest CT dated ___.

FINDINGS: Frontal and lateral radiographs of the chest demonstrates stable mild cardiomegaly. The lower lobes are chronically consolidated consistent with chronic aspiration but an acute pneumonia is possible. No pulmonary vascular congestion.


SubjectID: 13230656, StudyID: 56739882, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with systolic heart failure on milrinone with ___ in place. // compare to prior compare to prior

IMPRESSION: In comparison with the study of ___, there is little change   Keywords: little change. Monitoring and support devices remain in place. No evidence of acute pneumonia or vascular congestion.


SubjectID: 13230656, StudyID: 55642107, Comparison: None

WET READ: ___ ___ 8:12 AM Monitoring and support devices are in stable position. There is no pneumothorax. Mild cardiomegaly is unchanged. There is no pulmonary edema.

WET READ VERSION #___ ___ ___ ___ 7:48 PM Monitoring and support devices are in stable position. There is no pneumothorax. Mild cardiomegaly is unchanged. There is no pulmonary edema. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with systolic heart failure on milrinone with swanz ganz in place. // Compare to prior Compare to prior

IMPRESSION: In comparison with the study of ___, the monitoring and support devices remain in place. No evidence of acute pneumonia or vascular congestion.


SubjectID: 13230656, StudyID: 53939496, Comparison: None

FINAL REPORT

HISTORY: Cardioversion.

FINDINGS: In comparison with study of ___, there is little change in the appearance of the monitoring and support devices. No evidence of acute pneumonia or vascular congestion or pleural effusion.


SubjectID: 13230656, StudyID: 54417975, Comparison: same

WET READ: ___ ___ ___ 8:21 AM Swan-Ganz catheter has been retracted, now terminating in the pulmonary outflow tract. Otherwise, no significant interval change in appearance of the chest since the prior study.

WET READ VERSION #1 ___ ___ ___ 8:49 PM Swan-Ganz catheter has been retracted, now terminating in the pulmonary outflow tract. Otherwise, no significant interval change in appearance of the chest since the prior study. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with s/p right heart cath // evaluate for edema vs. consolidation

COMPARISON: ___

IMPRESSION: Status post retraction of a Swan-Ganz catheter. The tip of the catheter now projects over the central parts of the right pulmonary artery. No other relevant changes   Keywords: no other relevant change.


SubjectID: 13230656, StudyID: 53616328, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with s/p right heart catheterization with ___ ganz in place // evaluate for placement of catheter and change from previous

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is noted   Keywords: no relevant change. The Swan-Ganz catheter is in unchanged correct position, with the tip projecting over the proximal parts of the right pulmonary artery. Unchanged ECG leads. Moderate cardiomegaly without pulmonary edema. No pleural effusions. No pneumonia. No pneumothorax. The course and position of the right PICC line is also constant.


SubjectID: 13230656, StudyID: 53575428, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with ___ ganz catheter placement currently on milrinone // compare to prior

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. No pneumothorax. Unchanged position of the Swan-Ganz catheter and the pacemaker wires. No pleural effusions. No pneumothorax. No pulmonary edema. Unchanged size of the cardiac silhouette.


SubjectID: 13233598, StudyID: 52529166, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hypovolemic shock s/p cath // CCU AM rounds

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: ET tube tip is 5 cm above the carinal. NG tube tip is in the stomach. There is no change in the cardiomediastinal silhouette and left prominence of the pulmonary artery as well as right perihilar opacities. No pneumothorax is seen


SubjectID: 13233598, StudyID: 52074975, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with edema // edema?

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: There is no pulmonary edema. Moderate cardiomegaly is stable. Widening mediastinum has markedly improved. Retrocardiac atelectasis have minimally increased. Right perihilar atelectasis are unchanged. ET tube is in standard position. NG tube tip is in the stomach. There is no pneumothorax. There are low lung volumes.


SubjectID: 13233598, StudyID: 51110815, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hypovolemic shock, now intubated // OGT placement

TECHNIQUE: Single frontal view of the chest

COMPARISON: Concurrent CT abdomen

FINDINGS: Cardiac size is top normal. ET tube is in standard position. NG tube tip is out of view below the diaphragm. . There is no pneumothorax or pleural effusion. There is mild vascular congestion. New widening of the mediastinum could be due to engorgement of the vessels, attention in followup is recommend. Perihilar opacities and left lower lobe opacities are likely atelectasis, aspiration should be considered

IMPRESSION: New widened mediastinum Mild vascular congestion   Keywords: new. Bilateral atelectasis. ?aspiration.


SubjectID: 13243522, StudyID: 59543799, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CF, intubated with recurrent fevers // please assess for interval change

TECHNIQUE: Portable AP chest radiograph.

COMPARISON: Chest radiograph ___

FINDINGS: Support lines and tubes are unchanged in appearance when compared to the prior study. There are persistent multifocal airspace opacities throughout both lungs total relative sparing of the left apex   Keywords: persistent. In addition there are ring shadows and tram-tracking suggests of bronchiectasis, consistent with the patient's known history of cystic fibrosis. No definite pleural effusions. No pneumothorax seen.

IMPRESSION: Unchanged appearances of multifocal airspace opacities consistent with a multifocal pneumonia. Background changes of bronchiectasis.


SubjectID: 13243522, StudyID: 59302003, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with dyspnea and recent BAL // Assess lungs for opacification

TECHNIQUE: Portable AP chest radiograph.

COMPARISON: Chest radiograph ___

FINDINGS: Support lines and tubes are unchanged in appearance when compared to the prior study. Multifocal airspace opacities with areas of bronchiectasis are similar when compared to the prior study   Keywords: similar. No pneumothorax seen. No definite pleural effusion.

IMPRESSION: No significant interval change when compared to the prior study   Keywords: no significant interval change.


SubjectID: 13243522, StudyID: 58090034, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CF and respiratory distress and high CO2, necessitating intubation. Check ET tube position // Position of ET tube Position of ET tube

COMPARISON: Comparison to ___ at 11:47

FINDINGS: Portable semi-erect chest radiograph ___ at 13:17 is submitted.

IMPRESSION: Interval intubation with the endotracheal tube having its tip approximately 4 cm above the carinal. Interval placement of nasogastric tube with its tip projecting over the stomach. Left-sided pacer and right-sided Port-A-Cath unchanged in position. Bilateral parenchymal process is unchanged being more consolidative in the right upper lung and left lower lung. No pneumothorax. Probable left layering effusion. Overall cardiac and mediastinal contours are difficult to assess due to the diffuse parenchymal process.


SubjectID: 13243522, StudyID: 56504573, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CF with worsening respiratory failure. // PNA vs fluid. Interval changes. PNA vs fluid. Interval changes.

IMPRESSION: In comparison with the study of ___, there is little interval change   Keywords: little interval change. Again there is evidence of severe chronic bronchiectasis, peribronchial infiltration, and severely enlarged hila with consolidation in the left mid to lower lung. The extensive opacification in the right apical region is unchanged. Monitoring and support devices are similar to the previous study.


SubjectID: 13243522, StudyID: 55259774, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cystic fibrosis with progressive hypercapnia // eval for interval change eval for interval change

COMPARISON: ___

IMPRESSION: ET tube tip is 6 cm above the carinal. Left internal jugular line tip is at the level of mid SVC. Pacemaker leads terminate in the right atrium and right ventricle as well as left ventricular it epicardial lead is placed. The widespread consolidations appear to be involving the entire lung of the background of emphysema an overall unchanged since previous examination. The presence of bronchiectasis is also possible


SubjectID: 13243522, StudyID: 54886322, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cystic fibrosis with hypoxic respiratory failure // eval for interval change eval for interval change

COMPARISON: ___ obtained at 20:45

IMPRESSION: Multifocal consolidations are similar to previous examination. ET tube tip, pacemaker leads, NG tube are in the stomach. No interval change in pleural effusion or development of pneumothorax is present.


SubjectID: 13243522, StudyID: 54459525, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CF respiratory failure // new IJ placement new IJ placement

COMPARISON: Chest radiographs ___ through ___.

IMPRESSION: No change in severe multifocal pneumonia in the setting of bronchiectasis due to cystic fibrosis. Pulmonary arterial hypertension is chronic. Heart size is normal. Pleural effusions are small if any. No pneumothorax. ET tube and right subclavian infusion port catheter are in standard placements. Atrial biventricular pacer leads are unchanged in their positions.


SubjectID: 13243522, StudyID: 53864625, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CF flare, hypercapneic resp failure. almost self extubated due to agitation. // almost self-extubated almost self-extubated

COMPARISON: Chest radiographs ___ through ___.

IMPRESSION: ET tube in standard placement. Feeding tube ends just barely at the gastroesophageal junction. Multifocal pneumonia has not improved in any location since ___, continues to spread in all lobes. There probably a cavitated abscess in the right lower lobe and a second possible abscess in the left lower. Heart is top-normal size. The pleural effusions are small.


SubjectID: 13243522, StudyID: 55363761, Comparison: None

FINAL REPORT

INDICATION: ___ year old man s/p icd implant vis subclavian // r/o ptx

TECHNIQUE: Portable chest x-ray.

COMPARISON: Chest radiographs dated ___ through ___.

FINDINGS: Portable semi-upright radiograph of the chest demonstrates low lung volumes which results in bronchovascular crowding. Chronic collapse of the right upper lobe and severe multi focal bronchiectasis and scarring is stable. Opacity in the left upper lobe represents engorged vessels and worsening of bronchial impaction. Moderate cardiomegaly is unchanged. Small left-sided pleural effusion is new. No pneumothorax. The ICD is in the appropriate position with leads seen in the right atrium and right ventricle. The right-sided Port-A-Cath ends in the right atrium.

IMPRESSION: No pneumothorax.


SubjectID: 13243522, StudyID: 53771660, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CF, MDR PNA // interval changes

TECHNIQUE: Portable semi-erect chest radiograph

COMPARISON: Multiple prior studies most recent dated ___

FINDINGS: The masslike airspace opacity at the right hilum has improved slightly in appearance. Ring shadows in the right upper lobe are more prominent than on the prior study but similar in degree when compared to an earlier study from ___. These likely reflect background changes of cystic fibrosis. There is improved aeration of the left lung with consequent improved visualization of airspace opacity at the left lung base. No pneumothorax seen.

IMPRESSION: Slight interval improvement in the right perihilar airspace opacity, otherwise no significant interval change when compared to the prior study.


SubjectID: 13243522, StudyID: 53409226, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with end stage CF intubated on multiple abx still spiking fevers // please assess for interval change please assess for interval change

IMPRESSION: In comparison with the study of ___, there is increased bilateral pulmonary opacifications   Keywords: increase. It is difficult to determine whether this represents superimposed pulmonary edema, possibly related to over hydration, or worsening bilateral pneumonia   Keywords: worse. The endotracheal tube is not definitely seen on this technically limited study.


SubjectID: 13244322, StudyID: 59503554, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with recent hypothermia, cough and aspiration risk // ?acute intrapulmonary process ?acute intrapulmonary process

IMPRESSION: In comparison with the study of ___, there is stable enlargement of the cardiac silhouette without appreciable vascular congestion. Some retrocardiac opacification is again seen, which could represent atelectasis or even superimposed pneumonia.


SubjectID: 13244322, StudyID: 55689689, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with increasing secretions // eval for edema or PNA

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Moderate cardiomegaly is stable. Vascular congestion has resolved   Keywords: resolve. Residual opacities in the left lower lobe could be atelectasis or pneumonia in the appropriate clinical setting. There is no pneumothorax or large pleural effusions. Enlargement of the main pulmonary artery is again noted.


SubjectID: 13244322, StudyID: 59093574, Comparison: same

WET READ: ___ ___ ___ 8:10 AM The OG tube terminates in the gastric body with the side port below the GE junction. The ET tube is in unchanged position. Bilateral parenchymal opacities likely reflecting pulmonary edema are overall unchanged given differences in technique.

WET READ VERSION #1 ___ ___ ___ 10:50 PM The OG tube terminates in the gastric body with the side port below the GE junction. The ET tube is in unchanged position. Bilateral parenchymal opacities likely reflecting pulmonary edema are overall unchanged given differences in technique. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with new OG tube // Please eval OG tube placement

COMPARISON: ___.

IMPRESSION: No relevant change as compared to the previous examination   Keywords: no relevant change. The patient has received a nasogastric tube. The course of the tube is unremarkable, the tip of the tube projects over the middle parts of the stomach. The appearance of the heart and the lung bases is constant.


SubjectID: 13244322, StudyID: 58417925, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hypoxic respiratory failure // Interval change.

COMPARISON: ___.

IMPRESSION: Minimal improvement of the known parenchymal opacities   Keywords: improve. Moderate cardiomegaly persists. Low lung volumes and bilateral areas of basilar atelectasis are unchanged. Unchanged monitoring and support devices.


SubjectID: 13244322, StudyID: 56083734, Comparison: same

FINAL REPORT

INDICATION: Evaluate endotracheal tube placement.

COMPARISON: Chest radiographs from ___, ___.

FINDINGS: A portable frontal chest radiograph demonstrates an endotracheal tube terminating in the mid thoracic trachea and enteric tube terminating in the stomach. A left PICC has been repositioned, now terminating in the mid to low SVC. Heart size remains moderately enlarged. Retrocardiac atelectasis and mild pulmonary edema is unchanged   Keywords: unchanged. Right pleural fluid is minimal, if any. Lucency along the left upper lung is likely related to an overlying skin fold.

IMPRESSION: 1. Unchanged retrocardiac atelectasis and moderate pulmonary edema   Keywords: unchanged. 2. Repositioned left PICC, which now terminates in the mid to low SVC.


SubjectID: 13244322, StudyID: 50072026, Comparison: 0.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with pneumonia and volume overload and intubated. // interval change

IMPRESSION: As compared to ___ chest radiograph, bilateral diffuse pulmonary opacities have improved in severity with residual more confluent asymmetrical opacity in the right upper lobe which could potentially represent asymmetrical edema or infectious pneumonia coexisting with edema   Keywords: improve. Right pleural effusion has also decreased in size. No other relevant Short interval changes   Keywords: no other relevant short interval change.


SubjectID: 13244322, StudyID: 57472170, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with NG tube placement // NG tube placement

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no complications, notably no pneumothorax. The extensive right upper lobe predominant parenchymal opacity is minimally decreased in extent and severity.


SubjectID: 13244322, StudyID: 55516664, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with NGT // ngt tube placement

COMPARISON: ___.

IMPRESSION: The tip of the nasogastric tube now projects over the middle parts of the stomach. The course is unremarkable. Otherwise unchanged radiograph   Keywords: unchanged radiograph. No evidence of complications such as pneumothorax.


SubjectID: 13244322, StudyID: 56995230, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with pneumonia s/p full course antibiotics, heavy upper airway secretions with aspiration risk // change from prior? change from prior?

IMPRESSION: In comparison with the study of ___, the endotracheal tube and nasogastric tube have been removed. The tip of the left subclavian catheter again extends to the lower SVC. Dense opacification is again seen in the right upper zone, consistent with pneumonia. Cardiac silhouette remains enlarged and there is some element of pulmonary vascular congestion. Some asymmetric opacification at the left base could the focus of aspiration in the appropriate clinical setting.


SubjectID: 13244322, StudyID: 52837292, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with PNA, SBP ___s suddenly this morning and crackles on exam // flash pulmonary edema? flash pulmonary edema?

IMPRESSION: In comparison with the earlier study of this date, the right upper lung opacification is stable or slightly enlarging. No definite change in the relatively mild pulmonary vascular congestion. No evidence of pneumothorax.


SubjectID: 13268981, StudyID: 59209392, Comparison: worse

FINAL REPORT

PORTABLE CHEST FROM ___ AT 8:31 CLINICAL

INDICATION: ___-year-old with severe pulmonary hypertension and CHF, assess for interval change. Comparison is made to the patient's previous study dated ___ at 19:03. A portable semi-erect chest film ___ at 8:32 is submitted.

IMPRESSION: 1. There is increasing perihilar vascular congestion suggestive of worsening perihilar edema   Keywords: worse, increasing. The left hemidiaphragm remains elevated, which may represent a chronic finding and clinical correlation would be advised. Probable small bilateral effusions, though these are better appreciated on the CT dated ___. Overall cardiac and mediastinal contours are unchanged. No pneumothorax.


SubjectID: 13268981, StudyID: 51878846, Comparison: None

FINAL REPORT

CHEST, TWO VIEWS: ___.

HISTORY: ___-year-old male with CHF and shortness of breath for two weeks.

COMPARISON: None.

FINDINGS: AP and lateral views of the chest. There is left basilar opacity which may be in part due to elevated left hemidiaphragm, better seen on the lateral view. Instinct pulmonary vascular markings are identified throughout. There is a small right and possible trace left effusion. Linear opacity in the right mid lung is potentially subsegmental atelectasis or fluid within the fissure. Basilar opacities may also in part be due to atelectasis noting that infection would be difficult to exclude. The cardiac silhouette is moderately enlarged. Hypertrophic changes seen in the spine.

IMPRESSION: Findings suggestive of pulmonary vascular congestion and small right effusion. Probable elevation of left hemidiaphragm. Bibasilar opacities potentially atelectasis noting infection is difficult to exclude.


SubjectID: 13268981, StudyID: 52304591, Comparison: worse

FINAL REPORT

PORTABLE CHEST X-RAY OF ___

COMPARISON: ___ radiograph.

FINDINGS: Interval removal of Swan-Ganz catheter with residual right internal jugular vascular sheath remaining in place. Heart size is normal. Pulmonary vascular congestion is accompanied by diffuse interstitial edema, new since the recent radiograph   Keywords: new. Additionally, more confluent opacities have developed at both lung bases, which may be due to atelectasis, aspiration or developing pneumonia. Moderate elevation of left hemidiaphragm and small left pleural effusion are unchanged.


SubjectID: 13268981, StudyID: 51734347, Comparison: None

FINAL REPORT

AP CHEST, 7:36 A.M., ___

HISTORY: ___-year-old man with pulmonary hypertension and heart failure. Is there any change in pulmonary edema?

IMPRESSION: Mild edema on ___ has almost cleared. Consolidation at the left lung base adjacent to persistent atelectasis over the elevated left hemidiaphragm has worsened. This should be followed to exclude pneumonia. Upper lungs are grossly clear. Heart size is top normal.


SubjectID: 13272743, StudyID: 59293790, Comparison: nan

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with CHF exacerbation, known bilateral pleural effusions and pulm congestion // Evaluate for interval changes.

IMPRESSION: As compared to ___ radiograph, pulmonary vascular congestion and mild edema have improved   Keywords: improve. Interval slight decrease in bilateral pleural effusions and adjacent basilar lung opacities. No other relevant changes   Keywords: no other relevant change.


SubjectID: 13272743, StudyID: 53297669, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___F with known PNA with pleural effusion with worsening sob

COMPARISON: None

FINDINGS: PA and lateral views of the chest provided. Loops a right upper extremity access PICC line is seen with its tip in the low SVC. Pulmonary vascular congestion is noted with mild interstitial pulmonary edema. Small to moderate bilateral pleural effusions are present, left greater than right. There is airspace consolidation in the left lower lobe which may represent atelectasis and/or pneumonia. No pneumothorax. Heart size is difficult to assess. Mediastinal contour appears grossly unremarkable. Bony structures are intact.

IMPRESSION: PICC line positioned appropriately. Small to moderate bilateral pleural effusions, pulmonary congestion and mild pulmonary edema. Retrocardiac opacity concerning for atelectasis and/or pneumonia.


SubjectID: 13273041, StudyID: 57430534, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: ___ as well as a CT from ___. CLINICAL

HISTORY: Short of breath, end-stage renal disease, on hemodialysis.

FINDINGS: Portable AP upright chest radiograph is obtained. The patient is known to have a chronic left pleural effusion which appears loculated. There is also significant left lower lobe collapse and possible consolidation. A small right pleural effusion is noted. Pulmonary edema is present. Heart size cannot be assessed. Mediastinal contour is stable. Bony structures are intact.

IMPRESSION: Pulmonary edema, bilateral effusions, large and loculated on the left appearing stable, and small right effusion appearing slightly diminished from prior.


SubjectID: 13273041, StudyID: 52746798, Comparison: None

FINAL REPORT

INDICATION: Evaluate change in pulmonary edema and chronic loculated left pleural effusion in patient with end-stage renal disease and Wegener's granulomatosis.

COMPARISON: Most recent radiograph from ___ and a series of older studies dating back to ___.

FINDINGS: PA and lateral radiographs of the chest demonstrate interval resolution of pulmonary edema with persistence of the chronic loculated pleural effusion on the left. The lungs are chronically hyperinflated, consistent with chronic lung disease. There is no pneumothorax. Cardiomegaly is stable.

IMPRESSION: Resolution of pulmonary edema with persistence of chronic loculated left pleural effusion.


SubjectID: 13273041, StudyID: 56455775, Comparison: better

FINAL REPORT

INDICATION: ___ year old man with respiratory failure and loculated pleural effusion // please eval for interval change

TECHNIQUE: 2 Frontal views of the chest

COMPARISON: ___

FINDINGS: Prosthetic aortic valve is in unchanged position. Aeration of bilateral lungs are improved compared to 2 days ago. There is persistent bibasilar opacity with moderate right and trace left pleural effusions, similar to before. Enlarged cardiac silhouette is unchanged. Pulmonary vascular congestion is improved   Keywords: improve   Keywords: improve.

IMPRESSION: 1. Pulmonary vascular congestion is improved. 2. Moderate right lung base opacity and pleural effusion and small left lung base opacity and pleural effusion appear similar to 2 days ago.


SubjectID: 13273041, StudyID: 53031998, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with fever , cough, fatigue, and hypoxia. Evaluate for pneumonia or other acute process.

TECHNIQUE: Single portable AP view of the chest.

COMPARISON: Chest radiograph of ___.

FINDINGS: Compared to the radiograph of ___, no relevant change   Keywords: no relevant change. Bilateral pleural thickening is stable. There is mild fluid overload without overt pulmonary edema. Moderate cardiomegaly persists. The opacity at the right lung base, likely pleural fluid with a loculated component, is similar in appearance since ___. No pneumothorax.

IMPRESSION: 1. No new focal consolidation concerning for pneumonia. 2. Right lower lobe opacity, likely pleural fluid with a loculated component, is similar in appearance since ___.


SubjectID: 13273041, StudyID: 52855659, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with known CHF now with cough/SOB clear CXR earlier today, worsening dyspnea/tachypnea. // ? fluid overload

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: There has been interval increase in the amount of alveolar infiltrate compared to the study from the prior day. This is now most marked in the right upper and lower lung. There continues to be a moderate right and small left pleural effusion. There is pulmonary vascular redistribution.

IMPRESSION: Worsened CHF   Keywords: worse. An underlying infectious infiltrate on the right cannot be excluded.


SubjectID: 13273041, StudyID: 52392146, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with dyspnea off HD // PNA?

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, there is a minimal increase in extent of the right pleural effusion. Moderate pulmonary edema persists   Keywords: persists. Moderate cardiomegaly with areas of atelectasis in the retrocardiac lung regions. No pneumothorax.


SubjectID: 13273041, StudyID: 50778839, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Study of earlier the same date.

FINDINGS: Bilateral asymmetrically distributed pulmonary opacities with mid and lower lung predominance have slightly worsened in the interval on the right and slightly improved on the left, but overall severity is probably similar. Bilateral pleural effusions are again demonstrated, slightly improved on the left and unchanged on the right.


SubjectID: 13282748, StudyID: 58644979, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF exacerbation // Evaluate for interval change

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: The lungs are clear. Bilateral effusions are small. Cardiomediastinal contours are unchanged with mild cardiomegaly. Patient is status post CABG. Pacer leads are in standard position. There is no evident pneumothorax. Sternal wires are aligned.


SubjectID: 13282748, StudyID: 53048625, Comparison: None

FINAL REPORT

INDICATION: ___M with chf // eval for pulm edema

TECHNIQUE: Single portable view of the chest.

COMPARISON: ___.

FINDINGS: Prior right-sided central venous catheter is no longer visualized. Left chest wall single lead pacing device and multiple abandoned epicardial leads are again noted. Median sternotomy wires and mediastinal clips are noted. Cardiomediastinal silhouette is stable. There is no focal consolidation or pulmonary edema. There is no large effusion.

IMPRESSION: No acute cardiopulmonary process,


SubjectID: 13282748, StudyID: 58639690, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___M with chf // eval for chf

COMPARISON: ___ at 14 35

FINDINGS: Probable background hyperinflation/COPD. The patient is status post sternotomy. The cardiomediastinal silhouette is enlarged, but unchanged. Left-sided pacemaker/AICD type device is present, with lead tip unchanged. Multiple epicardial pacing wire is are present, similar to the prior film. There is upper zone redistribution, but no overt CHF. No focal infiltrate or effusion is identified. Minimal atelectasis versus slight thickening of the minor fissure is noted. Slight pleural thickening along lower chest walls bilaterally may relate to body habitus rather than frank pleural thickening. .

IMPRESSION: 1. COPD and cardiomegaly, with AICD type device, similar to the prior film. 2. There is upper zone redistribution, without other evidence of CHF.


SubjectID: 13282748, StudyID: 50873538, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with fall, hypotension, heart failure

COMPARISON: Prior study from ___

FINDINGS: AP portable upright view of the chest. Left chest wall AICD is unchanged. Multiple wires overlying the heart likely represent abandoned pacer leads. Midline sternotomy wires and mediastinal clips are again noted. Cardiomegaly is stable. Lung volumes are low though the lungs appear clear. Mild hilar congestion. Trace bilateral pleural effusions likely present. No overt edema. No pneumothorax. Bony structures are intact.

IMPRESSION: Stable cardiomegaly with mild congestion and probable tiny bilateral pleural effusions.


SubjectID: 13282748, StudyID: 57488572, Comparison: None

FINAL REPORT

EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 1 EXAM

INDICATION: ___ year old man s/p NG tube // NG placement NG placement

IMPRESSION: In comparison with the study of ___, there has been placement of a nasogastric tube that extends into the stomach. The side hole is at the level of the esophagogastric junction, and the tube should be advanced at least 5-10 cm for more optimal positioning. Otherwise, little change in the monitoring and support devices and appearance of the heart and lungs.


SubjectID: 13282748, StudyID: 56757231, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with fever // r/o consolidation r/o consolidation

COMPARISON: Comparison to ___ at 00:47

FINDINGS: Portable supine chest radiograph ___ at 00:23 is submitted.

IMPRESSION: Left-sided pacer unchanged in position. Nasogastric tube courses below the diaphragm with the tip not identified on the current study. Interval removal of the right internal jugular dual-lumen catheter. Status post median sternotomy with stable postoperative cardiac and mediastinal contours. Interval appearance of bilateral diffuse parenchymal process favoring moderate pulmonary and interstitial edema; an infectious process would be less likely. No pneumothorax, although the sensitivity to detect pneumothorax is diminished given supine technique.


SubjectID: 13282748, StudyID: 54032889, Comparison: worse

WET READ: ___ ___ ___ 4:51 PM Mild pulmonary edema. Moderate right and trace left pleural effusions.

WET READ VERSION #___ ___ ___ ___ 8:44 AM Mild to moderate pulmonary edema, right greater left. Small right pleural effusion, probable trace left pleural effusion. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: Chest radiographs

INDICATION: History: ___M with dyspnea, CHF, crackles, hypoxia // eval edema, PNA

TECHNIQUE: Chest PA and lateral

COMPARISON: Single portable supine frontal image chest.

FINDINGS: There are low lung volumes. Increased interstitial markings and indistinct pulmonary vasculature is consistent mild pulmonary edema   Keywords: increase. There is a moderate right pleural effusion and a trace left pleural effusion, which creates the visible disparity in opacity of the hemithoraces. Moderate cardiomegaly is noted. Mediastinal clips pacemaker, inserts are noted.

IMPRESSION: Mild pulmonary edema. Moderate right and trace left pleural effusions.


SubjectID: 13282748, StudyID: 57455414, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (AP AND LAT)

INDICATION: History: ___M with shortness of breath, altered mental status, history of subdural hematoma on anticoagulants

TECHNIQUE: Upright AP and lateral views the chest

COMPARISON: Chest radiograph ___

FINDINGS: Dual lumen right sided central venous catheter tip terminates the lower SVC. Left-sided AICD device is noted with single lead in unchanged position. Epicardial leads, median sternotomy wires, and CABG clips are demonstrated. Heart size remains moderately enlarged, unchanged. Mediastinal and hilar contours are similar. Mild pulmonary vascular congestion is unchanged from prior   Keywords: unchanged. There is blunting of the costophrenic angles bilaterally compatible with trace pleural effusions, unchanged. No focal consolidation or pneumothorax is present. No acute osseous abnormality is visualized.

IMPRESSION: Mild pulmonary vascular congestion and trace bilateral pleural effusions, unchanged   Keywords: unchanged.


SubjectID: 13282748, StudyID: 52513175, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with hypotension

TECHNIQUE: Portable upright AP view of the chest

COMPARISON: Chest radiograph ___

FINDINGS: Patient is status post median sternotomy, CABG, and placement of several epicardial leads. Left-sided AICD device is noted with single lead terminating in the right ventricle. Dual lumen right subclavian central venous catheter tip terminates in the lower SVC. Heart size remains mild to moderately enlarged. Mediastinal and hilar contours are unremarkable. There is mild pulmonary vascular congestion without overt pulmonary edema. Small bilateral pleural effusions are unchanged from the previous radiograph. There is no focal consolidation or pneumothorax. Minimal atelectasis is noted in the lung bases.

IMPRESSION: Small bilateral pleural effusions and mild pulmonary vascular congestion.


SubjectID: 13282748, StudyID: 57350848, Comparison: None

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: History: ___M with fall, altered mental status ; acute process

TECHNIQUE: Portable, upright frontal radiograph view of the chest.

COMPARISON: Chest radiograph dated ___.

FINDINGS: Dual-lumen right central venous catheter tip projects over the low SVC, unchanged. Left single lead ACID is unchanged in position. The patient is status post median sternotomy. Numerous mediastinal clips and epicardial pacing wires are unchanged. Lung volumes remain low. Interval increase in left lower lobe opacity likely reflects a combination of atelectasis and mild edema. Bilateral pleural effusions are small, perhaps slightly increased from the prior exam. The heart moderately enlarged.

IMPRESSION: Findings most consistent with mild volume overload. No pneumonia.


SubjectID: 13282748, StudyID: 55594585, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hx of EF ___%, CAD, ICD, psychogenic polydipsia presenting with increased weight and AMS. // interval change interval change

IMPRESSION: Comparison to ___. Status post CABG. Normal alignment of the sternal wires. Left pectoral pacemaker and right hemodialysis catheter. Moderate cardiomegaly. Mild fluid overload but no overt pulmonary edema. No interval appearance of parenchymal opacities of pleural effusions.


SubjectID: 13282748, StudyID: 57345070, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with a history of DM, HFrEF (EF ___%), Afib on warfarin and recent hospitilazation complicated by VT arrest, now presenting with hemodynamically stable ventricular tachycardia refractory to ATP and lidocaine, with plan for EPS and possible ablation // eval volume status

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the patient has been extubated and the nasogastric tube has been removed. The lung volumes are increased, reflecting improved ventilation, notably at the left lung bases. There is no overt pulmonary edema and no evidence of pneumonia. The size of the cardiac silhouette remains enlarged. No larger pleural effusions are seen. Unchanged alignment of sternal wires and clips of the CABG. Unchanged course of the pacemaker lead.


SubjectID: 13282748, StudyID: 55715346, Comparison: None

WET READ: ___ ___ 9:36 PM The endotracheal tube appears well positioned, approximately 3.3 cm above the carina. Compared to the prior study, there is little interval change, with minimal increase in pulmonary vascular engorgement. ______________________________________________________________________________

FINAL REPORT

HISTORY: Intubation and cardioversion.

FINDINGS: In comparison with the study of ___, there is now an endotracheal tube in place with the tip approximately 3.2 cm above the carina. There are lower lung volumes with evidence of some pulmonary vascular congestion and atelectatic changes at the left base.


SubjectID: 13282748, StudyID: 53846187, Comparison: None

FINAL REPORT

EXAMINATION: Portable AP chest x-ray

INDICATION: ___ year old man with with acute on chronic systolic heart failure // evaluate extent of pulmonary edema

TECHNIQUE: AP projection

COMPARISON: Portable AP chest x-ray obtained ___.

FINDINGS: There is again seen a left upper chest device with associated single lead projecting in stable position. Stable appearance of multiple median sternotomy wires and surgical clips. The mediastinal silhouette is unchanged in appearance. The cardiac silhouette shows stable enlargement. There is no change in the appearance of the bilateral lungs, without evidence of any new focal consolidations. There is no overt pulmonary edema. There are no pneumothoraces or effusions.

IMPRESSION: No pulmonary edema. Stable chest x-ray.


SubjectID: 13282748, StudyID: 57119870, Comparison: None

FINAL REPORT

INDICATION: ___M with severe epigastric pain and chest pain // Eval for free air or wide mediastinum

TECHNIQUE: Single portable view of the chest.

COMPARISON: ___.

FINDINGS: Relatively low lung volumes noted on the current exam with secondary crowding of the bronchovascular markings. Left chest wall pacing device is again noted. Mediastinal clips, mediastinal wires transitional pericardial densities in process. The lungs are grossly clear

IMPRESSION: No definite acute cardiopulmonary process.


SubjectID: 13282748, StudyID: 56723044, Comparison: None

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old man intubated with OG tube placed.

FINDINGS: Comparison is made to previous study from ___. There has been placement of an orogastric tube whose tip and side port are in the fundus of the stomach. Endotracheal tube, right IJ line, and median sternotomy wires are all unchanged in position. There is unchanged cardiomegaly. There are low lung volumes with atelectasis at the lung bases.


SubjectID: 13282748, StudyID: 53338134, Comparison: same

WET READ: ___ ___ ___ 2:09 AM ET tube in satisfactory position. Enteric tube ends just below the diaphragm with the side hole likely still within the esophagus; although, it is difficult to visualize. ______________________________________________________________________________

FINAL REPORT

INDICATION: History: ___M with septic now intubated // ? tube placement

COMPARISON: ___ at 0:06.

FINDINGS: Portable frontal supine radiograph of the chest demonstrates interval placement of an ET tube ending 3.3 cm above the carina. An enteric tube is seen passing just below the diaphragm. The side hole is not well visualized however it is likely within the esophagus. The right internal jugular central venous catheter is in unchanged position ending in the mid SVC. Lung volumes are lower. Otherwise, there is no significant change compared to 20 minutes prior   Keywords: no significant change.

IMPRESSION: ET tube in satisfactory position. Enteric tube ends just below the diaphragm with the side hole likely still within the esophagus; although, it is difficult to visualize.


SubjectID: 13282748, StudyID: 51263095, Comparison: same

FINAL REPORT

INDICATION: History: ___M with new right IJ // ? line placement

COMPARISON: ___.

FINDINGS: Portable supine frontal radiograph of the chest demonstrate a new right internal jugular central venous catheter ending in the mid SVC. There is otherwise no change in the appearance of the chest compared to 6 hours prior   Keywords: no change. No pneumothorax.

IMPRESSION: Right IJ ends in the mid SVC.


SubjectID: 13282748, StudyID: 50151875, Comparison: None

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old man with cholangitis. Evaluate OG tube placement.

FINDINGS: Comparison is made to prior study from ___. The endotracheal tube, enteric tube, right IJ central line, and AICD are unchanged in position. There are low lung volumes, cardiomegaly and some atelectasis at the lung bases. Overall, findings are stable.


SubjectID: 13282748, StudyID: 51414729, Comparison: None

FINAL REPORT

INDICATION: ___ year old man w66M w/hx of multiple cardiac co-morbidities (for severe advanced sCHF (LVEF: ___%), CAD s/p MI and CABG in ___, and VT s/p St ___ ICD, permanent A.fib s/p AVJ ablation, and mild mitral regurgitation) and asymptomatic hyponatremia, multiple admissions for CHF exacerbation, presents from scheduled dialysis w/5kg weight gain, AMS, and worsening weakness // interval change

TECHNIQUE: Portable semi-upright AP chest

COMPARISON: Chest radiographs ___ through ___

FINDINGS: Right internal jugular hemodialysis catheter is in the low SVC. Left chest wall defibrillator terminates in the right ventricle. Multiple abandoned epicardial pacing wires project over the heart. Median sternotomy wires are grossly intact. Moderate cardiomegaly is stable. There is interval mildly increased fluid in the minor fissure and layering at the right base. Small left pleural effusion is likely unchanged. There is no frank pulmonary edema.

IMPRESSION: 1. Slight increase in right pleural effusion. Stable small left pleural effusion. 2. No frank pulmonary edema. 3. Stable moderate cardiomegaly.


SubjectID: 13282748, StudyID: 54904715, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: ICD, evaluation for lead position.

COMPARISON: Semi-erect radiograph from ___.

FINDINGS: As compared to the previous image, the frontal and lateral radiographs show the pacemaker lead projecting over the right ventricle. The course of the lead is unremarkable. Sternal wires and clips are unchanged. No pulmonary edema. No pneumothorax.


SubjectID: 13282748, StudyID: 50582620, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: New ICD, evaluation for pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has received a left pectoral ICD. The course of the leads is unremarkable, the tip of the leads project over the right ventricle. Pre-existing sternal wires and clips after bypass surgery are in unchanged position. Unchanged moderate cardiomegaly without pulmonary edema   Keywords: unchanged. No evidence of pneumothorax. No larger pleural effusions.


SubjectID: 13284345, StudyID: 59087662, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, mild pulmonary edema. Reassessment.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is a further improvement of the known pulmonary edema   Keywords: improve. The pulmonary edema currently is mild. The size of the cardiac silhouette is unchanged and still enlarged. There are no pleural effusions or other complications. Minimal retrocardiac atelectasis persists.


SubjectID: 13284345, StudyID: 54645724, Comparison: None

FINAL REPORT

HISTORY: Chest pain.

TECHNIQUE: PA and lateral views of the chest.

COMPARISON: ___.

FINDINGS: There is moderate to severe cardiomegaly. The aorta is mildly tortuous. There is mild pulmonary edema with perihilar haziness and vascular indistinctness. Patchy retrocardiac opacity likely reflects atelectasis. No pleural effusion or pneumothorax is seen. There are mild degenerative changes in the thoracic spine.

IMPRESSION: Mild pulmonary edema.


SubjectID: 13299872, StudyID: 57287933, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with influenza, hypertensive urgency and respiratory distress, now intubated. // evaluate for PNA, ARDS, pulmonary congestion

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The monitoring and support devices are constant. Mild cardiomegaly persists. Bilateral areas of parenchymal opacities are unchanged as compared to the previous image   Keywords: unchanged. A small pleural effusion on the left cannot be excluded. No pneumothorax. No overt pulmonary edema.


SubjectID: 13299872, StudyID: 56258520, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with shortness of breath. Evaluate for pneumonia.

TECHNIQUE: Portable upright chest radiograph

COMPARISON: Chest radiograph from ___ at ___.

FINDINGS: As seen on recently obtained chest radiograph, there are bibasilar opacities in a bronchovascular distribution, which are exacerbated by low lung volumes. Cardiomediastinal silhouette is normal, and the descending thoracic aorta is tortuous and calcified. No pleural effusion or pneumothorax.

IMPRESSION: Bibasilar opacities as seen on recently obtained chest radiograph, thin concern for pneumonia.


SubjectID: 13299872, StudyID: 55635891, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with ett // ett

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___ at 18:53.

FINDINGS: Interval placement of endotracheal tube, terminating approximately 2.2 cm above the carina. There has also been interval placement of an enteric tube, terminating in the stomach. The cardiac and mediastinal silhouettes are stable. There are increased bibasilar opacities which could be due to aspiration superimposed on infection. Mild prominence and indistinctness of the hila may be due to mild pulmonary edema. No large pleural effusion is seen. There is no pneumothorax.

IMPRESSION: Endotracheal tube terminates approximately 2.2 cm above the carina. Enteric tube courses into the stomach. Increased bibasilar opacities could relate to fluid overload although aspiration superimposed on infection could be present   Keywords: increase. Mild prominence and indistinctness of the hila may be due to mild pulmonary edema.


SubjectID: 13299872, StudyID: 55481814, Comparison: worse

FINAL REPORT

INDICATION: Cough and dyspnea. Evaluate for infiltrate.

TECHNIQUE: Chest PA and lateral

COMPARISON: ___.

FINDINGS: PA and lateral views. Heart size is within normal limits. Tortuous and calcified aorta is again seen. There are new peribronchial opacities in bilateral lower lobes   Keywords: new. There is also unchanged linear scarring at the lateral left base. There is no evidence for pulmonary edema or pleural effusion. Scoliosis and degenerative changes are again seen in the spine.

IMPRESSION: New peribronchial opacities in bilateral lower lobes, suggesting bronchopneumonia.

RECOMMENDATION(S): Recommend follow up after treatment.

NOTIFICATION: Results documented in PACS by Dr. ___ on ___ at 17:43.


SubjectID: 13299872, StudyID: 53591122, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with flu and pneumonia // assess interval change

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the pre-existing opacity at the right lung base has completely resolved. On the left, the opacity, likely reflecting atelectasis, has mildly increased. The lung volumes are low. Severe scoliosis with subsequent asymmetry of the ribcage. Borderline size of the cardiac silhouette. The monitoring and support devices are in correct position. No pneumothorax.


SubjectID: 13299872, StudyID: 53364932, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with flu and pneumonia s/p cath // assess for interval change

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the patient has been extubated and the nasogastric tube was removed. The right internal jugular vein catheter is in unchanged position. Moderate increase of the mid and lower lung parenchymal bilateral opacities. No pleural effusions. No pneumothorax.


SubjectID: 13299872, StudyID: 50459960, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with R IJ CVL placement // eval line placement

TECHNIQUE: AP view chest

COMPARISON: Multiple chest radiographs most recent on ___ at 22:32

FINDINGS: An endotracheal tube terminates 3.8 cm above the carinal. A right internal jugular catheter terminates at the cavoatrial junction. A nasogastric tube is coiled within the stomach. The cardiomediastinal and hilar contours are stable from the most recent prior exam. Bibasilar opacities, which could be related to atelectasis or aspiration are stable. There is no evidence of pneumothorax. There is decreased interstitial prominence from the prior examination consistent with improved pulmonary edema   Keywords: improve.

IMPRESSION: Persistent bibasilar opacities could represent atelectasis or aspiration. Decreased interstitial prominence consistent with improved pulmonary edema   Keywords: improve, decrease.


SubjectID: 13306109, StudyID: 53208014, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___-year-old man with a history of lymphoma and angioedema, now intubated for airway protection. Evaluate ETT placement.

TECHNIQUE: Portable AP chest radiograph

COMPARISON: Multiple prior chest radiographs, most recent from ___.

FINDINGS: ET tube ends 6.7 cm above the carina. Left Port-A-Cath ends in the right atrium. Normal cardiomediastinal and hilar contours. Normal pleural surfaces. Fully expanded, clear lungs.

IMPRESSION: Appropriate ET tube placement. No acute cardiopulmonary process.


SubjectID: 13306109, StudyID: 52850734, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with febrile neutropenia // PNA? PNA?

IMPRESSION: In comparison with the study of ___, the monitoring and support devices are unchanged. No evidence of acute cardiopulmonary disease.


SubjectID: 13312271, StudyID: 59418167, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male status post arrest and intubated. Question infiltrate.

COMPARISON: None available.

FINDINGS: Single frontal view of the chest demonstrates the ET tube terminating approximately 1.7 cm above the carina. An enteric tube courses inferiorly out of view into the stomach. The heart is normal in size. There is evidence of prior coronary arterial bypass surgery and aortic valve replacement. Calcifications are seen in the aortic arch. The lung volumes are low. There is moderate perihilar fluffy opacity as well as veil-like appearance of the lungs, left greater than right, suggestive of vascular congestion and mild pulmonary edema. The opacities appear particularly confluent in the right greater than left lower lungs, which could represent sequela of aspiration, with infection not excluded in the appropriate clinical setting.

IMPRESSION: 1. ET tube 1.7 cm from the carina, should be retracted by approximately 2 cm. 2. Perihilar opacities and veil-like lung attenuation, suggesting mild edema. 3. More confluent opacity in the lung bases could be related to aspiration, with infection not excluded in the appropriate clinical setting. Findings reported to Dr. ___ via phone at 12:30 a.m. on ___.


SubjectID: 13312271, StudyID: 59385704, Comparison: None

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with pulmonary cardiac arrest.

COMPARISON: Chest x-ray and CT scan of ___.

FINDINGS: ET tube ends 3.5 cm above carina. NG tube is in adequate position. Improvement of right lower lobe density; improvement has been on a short period of time, so it was probably secondary to aspiration. Stability of bilateral mild pulmonary edema. Stability also of left lower lobe density. Mediastinal and cardiac contour are within normal limits. No pneumothorax or pleural effusion.

CONCLUSION: 1. Lines and tubes are in adequate position. 2. Improvement of right lower lobe aspiration. Left lower lobe density is, however, stable. 3. Stability of mild pulmonary edema.


SubjectID: 13312271, StudyID: 55504573, Comparison: same

FINAL REPORT

INDICATION: ___-year-old man with CABG, status post cardiac arrest, now fluid overloaded, assess pulmonary edema/infection.

COMPARISON: ___.

TECHNIQUE: Portable semi-upright chest radiograph.

FINDINGS: Position of endotracheal tube and right IJ central venous catheter is unchanged. The sternotomy wires, surgical clips, and NG tube are noted. Cardiomediastinal silhouette is unchanged. Lungs are well expanded and clear. A small left pleural effusion is unchanged. No pneumothorax.

IMPRESSION: No radiographic evidence of acute pneumonia. Stable mild pulmonary edema   Keywords: stable.


SubjectID: 13312271, StudyID: 50405802, Comparison: None

FINAL REPORT

HISTORY: Cardiac arrest.

FINDINGS: In comparison with the study of ___, the endotracheal tube tip lies approximately 4 cm above the carina. Nasogastric tube extends into the stomach. Right IJ catheter tip is in the mid-to-lower portion of the SVC. There are lower lung volumes than on the previous study. Areas of atelectasis are seen at the bases with blunting of the costophrenic angles consistent with pleural fluid. There is some indistinctness of pulmonary vessels, consistent with the clinical impression of fluid overload and elevated pulmonary venous pressure. Although no discrete focal pneumonia is appreciated, this would be difficult to exclude in the appropriate clinical setting.


SubjectID: 13312271, StudyID: 58564401, Comparison: better

FINAL REPORT

PORTABLE CHEST FILM ___ AT 801 CLINICAL

INDICATION: ___-year-old with CHF exacerbation, question edema, question pneumonia. Comparison to prior study of ___ at 305. Portable upright chest film ___ at 801 is submitted.

IMPRESSION: 1. Status post median sternotomy for CABG with stable post-operative cardiac and mediastinal contours. There has been interval improvement in aeration with residual mild-to-moderate pulmonary edema remaining   Keywords: improve. Lung volumes are slightly lower. There is possibly a small left effusion. The patient's mandible obscures the lung apices. No pneumothorax is appreciated.


SubjectID: 13312271, StudyID: 57252651, Comparison: worse

FINAL REPORT

INDICATION: Respiratory distress, assess for CHF.

COMPARISONS: ___ and CT chest of ___.

FINDINGS: Frontal view of the chest . Heart is mildly enlarged. Bilateral airspace opacities likely represent pulmonary edema, progressed since prior   Keywords: progressed. Left costophrenic angle is blunted, suggestive of small pleural effusion. No definite right pleural effusion is seen. There is no pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Sternotomy wires, coils, prosthesis and multiple surgical clips are noted.

IMPRESSION: Mild cardiomegaly, small left pleural effusion and is moderate pulmonary edema, increased since ___   Keywords: increase.


SubjectID: 13312271, StudyID: 55024838, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man intubated, please assess for tubes and line and if there are infiltrates.

COMPARISON: ___.

FINDINGS: Portable AP chest radiograph is obtained with the patient in the supine position. Endotracheal tube now appears to terminate 1 cm above the carina and is considered too low. Right internal jugular central venous catheter is unchanged. NG tube appears to enter the stomach, but the tip is not visualized. Heart size cannot be accurately assessed due to the AP projection, but and cardiomediastinal contours are unchanged. Mild improvement in right basilar atelectasis. Small bilateral pleural effusions. No pneumothorax.

IMPRESSION: 1. Endotracheal tube is positioned too low. Suggest pulling the tube back 2-3 cm. 2. Improvement in bibasilar atelectasis with presence of small bilateral pleural effusions.


SubjectID: 13312360, StudyID: 58273746, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with heart failure, hemoptysis and epistaxis // changes in infiltrate

COMPARISON: ___ and ___.

FINDINGS: Portable AP portable view of the chest demonstrates low lung volumes. Hilar mediastinal silhouettes are unchanged. Heart size is top-normal. Pulmonary edema and right lung opacity seen on prior studies have resolved. No focal consolidation or pleural effusion. Patient is status post medial sternotomy. Multiple surgical clips projected over the cardiomediastinal silhouette.

IMPRESSION: Interval resolution of pulmonary edema and right lung base opacity.


SubjectID: 13312360, StudyID: 54462999, Comparison: None

WET READ: ___ ___ ___ 8:29 PM Post-surgical changes with stable cardiac outline. Mildly increased bilateral interstitial opacities suggestive of mild pulmonary edema. No significant pleural effusions identified. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Shortness of breath, evaluation for pleural effusions.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the pigtail catheter on the right was removed. No complications, notably no pneumothorax. Sternal wires and clips after CABG are unchanged. No pulmonary edema. No pleural effusions. No pneumonia.


SubjectID: 13312360, StudyID: 56903038, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF exacerbation // eval for pna

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the malpositioned right PICC line has been removed. Otherwise there is no relevant change in appearance of the lung parenchyma, the heart and mediastinum. No pneumothorax.


SubjectID: 13312360, StudyID: 54853704, Comparison: same

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph of ___.

FINDINGS: Stable cardiomegaly accompanied by mild pulmonary vascular congestion, but no overt pulmonary edema   Keywords: stable.


SubjectID: 13332932, StudyID: 55222082, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with dyspnea, on BiPAP.

COMPARISON: None available.

TECHNIQUE: Single frontal chest radiograph was obtained portably with the patient in an upright position.

FINDINGS: Heart size is enlarged. There is mild interstitial pulmonary edema. Left pleural effusion may be present. No pneumothorax is seen. Sternal wires appear intact.

IMPRESSION: Mild pulmonary edema and cardiomegaly.


SubjectID: 13332932, StudyID: 52624798, Comparison: better

FINAL REPORT

AP CHEST, 8:15 A.M., ___

HISTORY: Hypoxia, possible edema.

IMPRESSION: AP chest compared to 1:30 a.m.: Somewhat asymmetric pulmonary edema has improved in the perihilar regions since earlier in the day   Keywords: improve. Severe cardiomegaly and at least a small left pleural effusion persist. Conventional radiographs would be required to see if the pulmonary findings are more extensive than just edema.


SubjectID: 13339751, StudyID: 58384032, Comparison: same

WET READ: ___ ___ ___ 8:20 AM Slight increased opacity at the left lung base, which may reflect atelectasis, although infection is not excluded in the correct clinical setting. Cardiomediastinal and hilar contours are stable. No pneumothorax or large pleural effusion.

WET READ VERSION #1 ___ ___ ___ 8:25 PM Slight increased opacity at the left lung base, which may reflect atelectasis, although infection is not excluded in the correct clinical setting. Cardiomediastinal and hilar contours are stable. No pneumothorax or large pleural effusion. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with tachypnea, somnolence // eval pulm edema, pneumonia eval pulm edema, pneumonia

IMPRESSION: In comparison with the study of ___, there is some mild increase in opacification at the left base. Although this most likely represents atelectatic changes, in the appropriate clinical setting superimposed pneumonia would have to be considered. Otherwise little change   Keywords: little change.


SubjectID: 13339751, StudyID: 56999521, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with afib and COPD now intubated // ET tube placemement ET tube placemement

IMPRESSION: In comparison with the study of ___, there has been placement of an endotracheal tube, with its tip approximately 6 cm above the carina. The patient has taken a better inspiration and there is an no evidence of consolidation at the bases. Blunting of the costophrenic angles is again seen and there is no evidence of vascular congestion. Nasogastric tube extends at least to the mid body of the stomach, where it crosses the lower margin of the image.


SubjectID: 13339751, StudyID: 53131982, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with COPD exacerbation, hypercarbic respiratory failure // pulmonary infiltrate, atelectasis

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Heart size and mediastinum are stable. There is interval development of vascular enlargement/mild pulmonary edema   Keywords: development. There is no interval development of visible pleural effusion. No pneumothorax is seen. The patient was extubated in the meantime interval.


SubjectID: 13349201, StudyID: 59836982, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with pleural effusion // r/o effusion

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The massive bilateral parenchymal opacities in both upper lungs are constant in appearance. Massive cardiomegaly with retrocardiac and right basilar atelectasis. No larger pleural effusions. Unchanged monitoring and support devices.


SubjectID: 13349201, StudyID: 59023370, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CAD and recent stroke now with pulmonary edema // Assess interval change

IMPRESSION: As compared to ___, pulmonary edema has decreased in severity overall, but a confluent opacity in the right apex has apparently worsened   Keywords: decrease. It is uncertain whether this reflects asymmetrical edema or superimposed process such as infectious pneumonia. Small pleural effusions are present, but there is no visible pneumothorax.


SubjectID: 13349201, StudyID: 52589812, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with ischemic stroke, heart failure // please evaluate for interval change

IMPRESSION: As compared to ___ radiograph, bilateral upper and mid lung predominant airspace opacities have worsened, and may reflect asymmetrical distribution of edema   Keywords: worse. Followup radiographs after diuresis would be helpful to exclude infectious pneumonia. Stable cardiomegaly and persistent bilateral pleural effusions.


SubjectID: 13349201, StudyID: 59756834, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CGF, stroke, now with worsening uremia // fluid status, volume overload

IMPRESSION: As compared to ___ radiograph, upper and mid lung predominant consolidations appears slightly worse, but artifact in this region limits direct comparison. Exam is otherwise similar to the recent exam except for slight improved aeration at both lung bases.


SubjectID: 13349201, StudyID: 52414097, Comparison: worse

FINAL REPORT

EXAMINATION: Portable Chest Radiograph

INDICATION: ___ year old woman with dchf PNA, new ng tube // Ngt placement

TECHNIQUE: Portable Chest Radiograph

COMPARISON: CXR ___ at 10:13AM

FINDINGS: The new nasogastric tube terminates in the known moderately-sized hiatal hernia. Previous Dobbhoff tube has been removed. Other support are lines and devices are unchanged in position. The bilateral lung opacities are not significantly changed since the prior CXR performed earlier this morning, except for possible worsening of bibasilar opacities   Keywords: worse. There is no pneumothorax. Stable cardiomediastinal silhouette.

IMPRESSION: 1. New NG tube terminates in known hiatal hernia. 2. Multifocal airspace opacities with slight worsening at the lung bases since recent study   Keywords: worse.

NOTIFICATION: Findings telephoned to Dr. ___ by Dr. ___ on ___ 3:45PM.


SubjectID: 13349201, StudyID: 57149106, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ y/o history of insulin dependent diabetes, ischemic cardiomyopathy (EF=___%), ICD in ___, peripheral vascular disease, hyperthyroidism and CAD, s/p recent STEMI, s/p CABG x 4 in ___ (LIMA to LAD, SVG to OM1, OM2 and RCA), s/p left ventricular aneurysm repair, who presents w/HF exacerbation found to have focal neuro deficits and ?aspiration event. Assess for acute process, evidence of aspiration

TECHNIQUE: Portable AP radiograph of the chest from ___.

COMPARISON: ___.

FINDINGS: There is increased airspace opacification of the right lung base, which may be due to aspiration or infection. Slightly increased retrocardiac left basilar airspace opacification may either be due to atelectasis or aspiration. There is also new mild pulmonary edema   Keywords: new. There is no pneumothorax. The patient has had prior median sternotomy. A left pectoral AICD remains in place.

IMPRESSION: New bibasilar airspace opacities might be due to aspiration or infection. New mild pulmonary edema   Keywords: new. Stable cardiomegaly.


SubjectID: 13364851, StudyID: 54582275, Comparison: None

WET READ: ___ ___ 4:16 AM Moderate to severe pulmonary edema. ______________________________________________________________________________

FINAL REPORT

INDICATION: History: ___M with chest pain // ?pulm edema

TECHNIQUE: Portable semi-upright chest radiograph.

COMPARISON: Chest radiographs dated ___ and ___.

FINDINGS: There is moderate to severe pulmonary edema. Emphysematous changes are seen in the upper lobes bilaterally. The heart is top-normal in size. The patient is status post CABG. No pneumothorax or pleural effusion.

IMPRESSION: Moderate to severe pulmonary edema. Acute pulmonary edema is most common in the setting of acute myocardial infarction.


SubjectID: 13364851, StudyID: 53526938, Comparison: 0.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with bilateral pumonary edema in setting of NSTEMI // Interval change? Interval change?

IMPRESSION: In comparison with the study ___, there has been substantial improvement in the bibasilar opacifications, consistent with much improved pulmonary venous status   Keywords: improve. Nevertheless, there is still evidence of some elevation in pulmonary venous pressure. Dense streak of atelectasis is again seen at the left base. Otherwise little change   Keywords: little change.


SubjectID: 13374841, StudyID: 58911904, Comparison: better

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Evaluation of pleural effusion.

COMPARISON: Multiple chest x-rays from ___ through ___.

FINDINGS: Sternotomy was recently done for mitral valve repair. Mild pulmonary edema has improved   Keywords: improve   Keywords: improve. Left moderate pleural effusion and small right pleural effusion has also decreased in size. Right jugular line has been removed. Moderate cardiac contour enlargement is unchanged since ___. There is no pneumothorax.

CONCLUSION: 1. Mild pulmonary edema has improved. 2. Moderate left pleural effusion and right small pleural effusion has also improved.


SubjectID: 13374841, StudyID: 57978832, Comparison: worse

FINAL REPORT

HISTORY: ___-year-old female with mitral valve repair presenting with hypoxia and dyspnea. Rule out CHF.

COMPARISON: Multiple prior chest radiographs, most recently of ___.

FINDINGS: Single frontal view of the chest was obtained. Moderate cardiomegaly is similar to prior. Mild pulmonary edema is slightly increased since the prior exam   Keywords: increase. Moderate left pleural effusion and small right pleural effusions are similar to prior, allowing for difference in patient position. Sternotomy wires and aortic valve repair are similar to prior.

IMPRESSION: Mild pulmonary edema, increased since ___, with moderate left and small right pleural effusions with adjacent atelectasis   Keywords: increase.


SubjectID: 13374841, StudyID: 58340708, Comparison: None

FINAL REPORT

HISTORY: Tube removal.

FINDINGS: In comparison with study of ___, all of the monitoring and support devices have been removed except for a right IJ sheath. Specifically, there is no evidence of appreciable pneumothorax. Continued enlargement of the cardiac silhouette with bilateral pleural effusions and elevated pulmonary venous pressure.


SubjectID: 13374841, StudyID: 56333486, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Left pleural effusion.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the extent of the left pleural effusion is unchanged. Unchanged moderate cardiomegaly, unchanged minimal fluid overload in the right lung and the left lung apex   Keywords: unchanged. Unchanged sternal wires.


SubjectID: 13374841, StudyID: 53662824, Comparison: None

FINAL REPORT

HISTORY: MV repair, question pneumothorax, line change. CHEST, SINGLE AP PORTABLE VIEW. Compared with earlier the same day at 7:34 a.m., the right IJ sheath has been changed to a right IJ central line with tip over distal SVC. No pneumothorax is detected. Otherwise, I doubt significant interval change. Again seen is cardiomegaly, with sternotomy wires and prosthetic valve. The hilar are also prominent. There is upper zone redistribution, diffuse vascular blurring and probable areas of alveolar edema, consistent with CHF and pulmonary edema. There is a moderately large left effusion with underlying collapse and/or consolidation and a small-to-moderate right effusion with underlying collapse and/or consolidation. The left effusion may be slightly larger, but more likely appears different due to differences in positioning.

IMPRESSION: 1) New right IJ central line with tip over distal SVC. No pneumothorax detected. 2) CHF. Bilateral left greater than right effusions with underlying collapse and/or consolidation. Equivocal slight increase in the left effusion.


SubjectID: 13388171, StudyID: 50430665, Comparison: None

FINAL REPORT

PORTABLE CHEST OF ___

COMPARISON: Radiograph of one day earlier.

FINDINGS: Allowing for differences in technique and projection, there has not been a substantial change in the appearance of the chest since recent study of one day earlier. Left PICC is similar in position, but there is apparent redundancy within the catheter within the left upper extremity.


SubjectID: 13398212, StudyID: 59348908, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Hypoxemia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the pre-existing pulmonary edema has slightly worsened   Keywords: worse. The lung volumes have decreased and a new right pleural effusion might have developed. The size of the cardiac silhouette remains enlarged. At the time of dictation and observation, the referring physician, ___. ___, was paged for notification at 8:28 a.m., on the ___.


SubjectID: 13398212, StudyID: 55849509, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Respiratory distress, new opacities, evaluation after hemodialysis.

COMPARISON: ___.

FINDINGS: Compared to the previous radiograph, after hemodialysis, the lung volumes have increased and the extent and severity of the pre-existing opacities have minimally decreased   Keywords: decrease. However, relatively extensive right-sided and left perihilar opacities are seen. The fact that these did not so far respond to hemodialysis could be an indication for their infectious nature. Minimal right pleural effusion persists. Persistent moderate cardiomegaly. No pneumothorax.


SubjectID: 13399882, StudyID: 55205166, Comparison: same

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old man with pulmonary edema, possible pneumonia. Evaluate interval change.

FINDINGS: There is an unchanged left-sided dual-lead pacemaker. There is cardiomegaly and engorgement of the vascular pedicle. There is again seen diffuse prominence of the pulmonary vascular markings with more confluent opacities within the right base and left base   Keywords: again. These are unchanged. There are small bilateral pleural effusions. There are no pneumothoraces. Overall, there has been no interval change   Keywords: no interval change.


SubjectID: 13399882, StudyID: 50318807, Comparison: None

WET READ: ___ ___ ___ 9:48 PM Stable decompensated congestive heart failure with cardiomegaly, central vascular engorgement, moderate pulmonary edema, small bilateral pleural effusions.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

HISTORY: Pulmonary edema and possible PNA.

FINDINGS: Comparison is made to the prior radiographs from ___ as well as chest CT from ___. There is a dual-lead left-sided pacemaker with tips in the right atrium and right ventricle. They are intact. There is cardiomegaly and enlargement of the vascular pedicle. There are diffuse airspace opacities bilaterally suggestive of pulmonary edema. These findings are unchanged. There are small bilateral pleural effusions. There are no pneumothoraces.


SubjectID: 13399882, StudyID: 50025006, Comparison: same

FINAL REPORT

HISTORY: Pacemaker with new-onset heart failure.

FINDINGS: In comparison with the study of ___, there is continued enlargement of the cardiac silhouette with pulmonary edema and bilateral pleural effusions with compressive atelectasis at the bases   Keywords: continue. Pacemaker device remains in place. Opacification over the lower portion of the glenohumeral joint on the right is again seen. When the condition of the patient improves, views of the right shoulder would be helpful.


SubjectID: 13405890, StudyID: 57227071, Comparison: 1.0

FINAL REPORT

INDICATION: History: ___F with fall, abrasions over scapula and left elbow, pls eval for fx //

TECHNIQUE: Chest PA and lateral

COMPARISON: ___

FINDINGS: There is stable moderate enlargement of the cardiac silhouette. Mild pulmonary edema is not significantly changed from 2 days prior   Keywords: not significantly changed. Continued interval improvement of pleural effusions now likely small bilaterally. Atherosclerotic calcification aortic arch is stable. Degenerative changes of both shoulders. No displaced rib fracture.

IMPRESSION: 1. Mild pulmonary edema with small bilateral pleural effusions slightly improved from 2 days prior   Keywords: improve. 2. No displaced rib fracture

RECOMMENDATION(S): If concern for rib fracture, a rib series could be performed with a localizer at site of pain.


SubjectID: 13405890, StudyID: 54710208, Comparison: 0.0

FINAL REPORT

INDICATION: ___F with fall // ? fx, PNA

TECHNIQUE: AP and lateral views of the chest.

COMPARISON: ___.

FINDINGS: Since prior, there has been interval improvement in the bibasilar opacities which still partially persist   Keywords: improve. Degree of pulmonary edema has not significantly changed   Keywords: not significantly changed. Cardiomegaly and tortuosity of the thoracic aorta are noted. Atherosclerotic calcifications are noted at the aortic arch. Severe degenerative changes at the shoulders bilaterally.

IMPRESSION: Improving bibasilar opacities suggesting resolving effusions. Adjacent atelectasis is seen noting that infection cannot be excluded. Moderate pulmonary edema.


SubjectID: 13410750, StudyID: 58536381, Comparison: None

FINAL REPORT

EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: CHF, cough, altered mental status.

COMPARISON: ___.

FINDINGS: Frontal and lateral views of the chest were obtained. The patient is status post median sternotomy. Triple-lead left-sided pacer device is again seen with leads in similar position as compared to the prior study. The cardiac silhouette is moderate to severely enlarged, which could be due to underlying pericardial effusion or cardiomyopathy. There is persistent left base opacity may be due to combination of pleural effusion and atelectasis. Trace right pleural effusion is also seen. There is mild-to-moderate pulmonary edema suggesting fluid overload. The aortic knob remains calcified. No evidence of pneumothorax is seen.

IMPRESSION: Moderate-to-severe enlargement of the cardiac silhouette could be due to cardiomyopathy or pericardial effusion. Left base opacity, likely combination of pleural effusion and atelectasis, underlying consolidation difficult to exclude. Trace right pleural effusion. Vascular congestion/edema.


SubjectID: 13410750, StudyID: 54416721, Comparison: better

WET READ: ___ ___ ___ 9:46 PM Mild pulmonary vascular congestion, improved from prior. Persistent moderate left pleural effusion and stable cardiac silhouette. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, assessment for interval change. Evaluation for pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is a minimal improvement of the pre-existing pulmonary edema   Keywords: improve. Moderate cardiomegaly, however, persists, as do the pleural effusions, left more than right. No pneumothorax. No interval appearance of parenchymal opacities. The left pectoral Port-A-Cath is in constant position.


SubjectID: 13420559, StudyID: 59479390, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with ___ of unknown etiology, HF, CAD with wheezing on exam and lower extremity edema. // Pulmonary edema?

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, there is unchanged evidence of mild to moderate pulmonary edema   Keywords: unchanged. The severity of these changes is not substantially worsened since the previous examination. Moderate cardiomegaly with left pectoral pacemaker persists. No larger pleural effusions. Mild to moderate retrocardiac atelectasis.


SubjectID: 13420559, StudyID: 54439064, Comparison: None

WET READ: ___ ___ 8:16 PM New small left pleural effusion. Left retrocardiac atelectasis. Mild pulmonary edema slightly improved. No new consolidation.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman with restrictive lung disease.

FINDINGS: Comparison is made to previous study from ___. There is a left-sided pacemaker which is unchanged. The heart size is enlarged. There is again seen a 3.6 cm oval calcification in the left perihilar region. There is a persistent left retrocardiac opacity.


SubjectID: 13435701, StudyID: 50419169, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (AP AND LATERAL)

INDICATION: History: ___M with history is subdural hematoma and epidural hematoma presents with worsened altered mental status

TECHNIQUE: Upright AP and lateral views of the chest

COMPARISON: ___

FINDINGS: Moderate to severe cardiomegaly is re- demonstrated. The aortic arch is calcified. Mediastinal contour is similar. There is mild pulmonary edema, new compared to the previous study   Keywords: new. Small bilateral pleural effusions are present. No pneumothorax is identified. No acute osseous abnormality is visualized.

IMPRESSION: Mild pulmonary edema and small bilateral pleural effusions.


SubjectID: 13435701, StudyID: 50248305, Comparison: better

WET READ: ___ ___ ___ 8:52 AM Compared to the prior radiograph, mild pulmonary edema has decreased. Moderate to severely enlarged cardiomediastinal silhouette is unchanged. There is no pneumothorax or large pleural effusion.

WET READ VERSION #1 ___ ___ ___ 11:08 PM Compared to the prior radiograph, mild pulmonary edema has decreased. Moderate to severely enlarged cardiomediastinal silhouette is unchanged. There is no pneumothorax or large pleural effusion. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF with altered mental status // evaluation evaluation

IMPRESSION: In comparison with the study of ___, there has been substantial decrease in the degree of pulmonary edema   Keywords: decrease. Substantial enlargement of the cardiac silhouette process. Some atelectatic changes are seen at the left base.


SubjectID: 13455616, StudyID: 53215141, Comparison: None

WET READ: ___ ___ ___ 8:44 PM Compared to the prior chest radiograph performed 2 hours prior, the Swan-Ganz catheter has been slightly retracted; however, it still ends in the left pulmonary artery. The remaining support devices are unchanged in position. The lungs are clear. The cardiac and mediastinal contours are stable. ___ ___. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with s/p tv repair, MV repair, AVR, s/p TV repair, AVR ? PA line position.

TECHNIQUE: Portable AP radiograph of the chest from ___.

COMPARISON: Earlier the same day at 15:35.

FINDINGS: Since the prior exam, the Swan-Ganz catheter has been slightly withdrawn, but it still ends in the proximal left pulmonary artery. The patient has had recent sternotomy with aortic valve replacement. Sternotomy wires are intact and aligned. The side port of the enteric tube sits at the GE junction. Advancement by at least 5 cm should be considered for more optimal positioning within the stomach. Remaining support devices, including an ET tube and mediastinal drain remain in satisfactory position. The lungs are clear. There is no pneumothorax. Mild cardiomegaly despite the projection is unchanged.

IMPRESSION: Interval repositioning of the Swan-Ganz catheter, which terminates in the left pulmonary artery. Side port of enteric tube is at GE junction. Advancement by at least 5 cm should be considered for more optimal positioning within the stomach. All remaining support devices in satisfactory position. Clear lungs. Stable cardiomegaly.


SubjectID: 13455616, StudyID: 52129903, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p line change and ct removal // eval for line placement/ ptx

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Right IJ catheter tip is in thecavoatrial junction. There is no pneumothorax. Moderate cardiomegaly and widened mediastinum are unchanged. Retrocardiac atelectasis have increased. There is no pulmonary edema. Sternal wires are aligned.


SubjectID: 13462752, StudyID: 58026478, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF // edema? edema?

IMPRESSION: In comparison with the study of ___, the cardiac silhouette is more prominent and the pulmonary vessels are less well defined, consistent with increase in pulmonary venous pressure. No definite pleural effusion or acute focal pneumonia.


SubjectID: 13462752, StudyID: 56081264, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p STEMI with LVEF ___% and crackles on exam // Pulmonary edema? Pulmonary edema?

IMPRESSION: In comparison with the study of ___, there is increasing indistinctness of engorged pulmonary vessels, consistent with worsening pulmonary vascular congestion   Keywords: increasing, worse. Continued enlargement of the cardiac silhouette


SubjectID: 13462752, StudyID: 55499834, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with recent MI, HF, now with respiratory distress // pulm edema improvement?

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Heart size and mediastinum are unchanged. Mild vascular engorgement is present but no overt pulmonary edema is seen. Bibasal opacities might reflect worsening of the interstitial edema toward the lung bases although infectious process cannot be excluded   Keywords: worse. Since no prior imaging B 4 although ___ ___ is present, the interstitial changes in the lung bases may be in part chronic and father comparison with remote studies or assessment with chest CT might be considered


SubjectID: 13462752, StudyID: 55165038, Comparison: None

FINAL REPORT

HISTORY: Acute MI, status post PCI. Question pulmonary congestion. CHEST, SINGLE AP PORTABLE VIEW. No previous chest x-rays on PACS record for comparison. Lordotic positioning. There is mild-to-moderate cardiomegaly. The aorta is calcified and minimally unfolded. There is borderline upper zone re-distribution, without other evidence of CHF. There is minimal atelectasis/scarring at both lung bases. No frank consolidation or effusion is identified.

IMPRESSION: Bibasilar atelectasis. Cardiomegaly. No CHF, frank consolidation or effusion.


SubjectID: 13471464, StudyID: 56428833, Comparison: None

FINAL REPORT

HISTORY: CABG with tube removal.

FINDINGS: In comparison with the study of ___, the monitoring and support devices have been removed except for a right IJ sheath. There is a small pneumothorax on the right that appears slightly decreased from the previous examination. Retrocardiac opacification is consistent with substantial volume loss in the left lower lobe.


SubjectID: 13471464, StudyID: 56394023, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___ radiograph.

FINDINGS: Midline drain and right chest tube remain in place, with persistent small left apical pneumothorax and a small to moderate right apical lateral pneumothorax, both slightly improved since the recent chest x-ray. Cardiomediastinal contours are stable in appearance. Although left lower lobe atelectasis has improved, there is worsening opacity at the right lung base, probably a combination of atelectasis and adjacent small right pleural effusion. Small left pleural effusion is unchanged.


SubjectID: 13471464, StudyID: 52360473, Comparison: None

FINAL ADDENDUM ADDENDUM: The right IJ sheath has been removed and replaced with a catheter that extends to the lower portion of the SVC. ______________________________________________________________________________

FINAL REPORT

HISTORY: To assess for pneumothorax.

FINDINGS: In comparison with the earlier study of this date, the degree of pneumothorax is probably unchanged, considering the differences in patient position. Remainder of the study is also unchanged.


SubjectID: 13471464, StudyID: 50816743, Comparison: None

FINAL REPORT

INDICATION: ___-year-old woman with bilateral pneumothoraces. Evaluate.

COMPARISON: Chest radiograph from ___ at 11:39 a.m.

FINDINGS: Portable supine chest radiograph was provided. Endotracheal tube, nasogastric tube, Swan catheter, mediastinal drains and right chest tube are unchanged in position. Median sternotomy wires are intact. Again seen are small bilateral pneumothoraces, right greater than left, unchanged. There is no focal consolidation. Left basilar opacity is most likely atelectasis. There is scoliosis of the upper thoracic spine.

IMPRESSION: Stable bilateral small pneumothoraces, right greater than left.


SubjectID: 13473495, StudyID: 58858468, Comparison: None

FINAL REPORT

INDICATION: ___M with ESRD DM2 morbody Afib RVR crackles on lower lung field // evalu pulomonary edema vs pna

TECHNIQUE: AP upright view of the chest.

COMPARISON: Chest radiograph ___, ___. Fistulogram ___.

FINDINGS: A right subclavian approach dialysis catheter is again noted with tip terminating in the right atrium. A left subclavian vein stent is visualized projecting over the left lung apex. Moderate cardiomegaly is again visualized. The mediastinal and hilar contours are unremarkable. There is no pneumothorax or large pleural effusion. Lung volumes are slightly low without focal consolidation concerning for pneumonia. There is no overt pulmonary edema.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 13473495, StudyID: 54904335, Comparison: -1.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with ESRD, afib RVR, confusion, GPC bacteremia, BP dropping // infiltrates?

TECHNIQUE: Single frontal view of the chest

COMPARISON: Study performed 3 hours earlier

IMPRESSION: Interval continue worsening of moderate pulmonary edema   Keywords: worse. Increasing small bilateral effusions. No other interval change from prior study   Keywords: no other interval change.


SubjectID: 13473495, StudyID: 53400246, Comparison: 0.0

WET READ: ___ ___ 10:38 AM 1. Interval increase in retrocardiac opacity, which may represent atelectasis but cannot exclude aspiration or pneumonia in the right clinical setting. 2. Increase in pulmonary vascular engorgement, without frank edema. --___

WET READ VERSION #___ ___ ___ ___ 12:05 AM 1. Interval increase in retrocardiac opacity, which may represent atelectasis but cannot exclude aspiration or pneumonia in the right clinical setting. 2. Increase in pulmonary vascular engorgement, without frank edema. -___ ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cough and AMS // pneumonia?

TECHNIQUE: Single frontal view of the chest

COMPARISON: Study performed the same day earlier in the morning

IMPRESSION: Mild to moderate vascular congestion has increased   Keywords: increase. Bibasilar atelectasis have increased. If any there is a small right effusion. No other interval change from prior study   Keywords: no other interval change.


SubjectID: 13473495, StudyID: 58371511, Comparison: None

FINAL REPORT

CHEST ON ___

HISTORY: Hypoxia. REFERENCE EXAM: ___.

FINDINGS: There continues to be severe cardiomegaly and low lung volumes. Aeration in the right is improved, but there continues to be areas of volume loss/infiltrate in both lower lungs. Overall, the fluid status is slightly improved compared to the study from the prior day. An underlying infectious infiltrate, particularly in the lower lobes cannot be excluded.


SubjectID: 13473495, StudyID: 55720395, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old male with retroperitoneal bleed, anuria, and shortness of breath.

COMPARISON: Comparison is made with chest radiograph from ___ and ___.

FINDINGS: Two frontal images of the chest were obtained. This exam is limited by underpenetration due to patient's body habitus and by rotation of the patient. There is increased vascular congestion since previous imaging   Keywords: increase. The right IJ catheter is seen with the tip in the mid to low SVC. No pneumothorax or other complications are identified. The relative radiolucency of the left lung compared to the right lung is likely an artifact secondary to patient rotation. There is no clear evidence of pleural effusion on this exam. Cardiomediastinal silhouette is unchanged.

IMPRESSION: Worsening pulmonary vascular congestion   Keywords: worse. New right IJ line with tip in the mid to low SVC.


SubjectID: 13473495, StudyID: 58228725, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: Chest AP portable single view.

INDICATION: ___-year-old male patient with cough and elevated white blood count, evaluate for pneumonia.

FINDINGS: AP single view of the chest has been obtained with patient in sitting semi-upright position. Comparison is made with the next preceding similar study of ___. Unchanged appearance of cardiac enlargement without typical configurational abnormality. Mediastinal structures also unchanged. The pulmonary vasculature is not congested anymore and there is no evidence of pleural effusion as the lateral pleural sinuses are free. No new pulmonary parenchymal infiltrates can be identified. No pneumothorax is seen in the apical area. As before, a right internal jugular approach central venous line is seen and terminates in the mid portion of the SVC.

IMPRESSION: No evidence of new acute pulmonary infiltrates. Observe that chest image quality is limited related to patient's morbid obesity.


SubjectID: 13473495, StudyID: 53720613, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Morbidly obese patient, shortness of breath.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Low lung volumes and moderate cardiomegaly without evidence of pulmonary edema or pleural effusions. Moderate retrocardiac atelectasis. No evidence of pneumonia.


SubjectID: 13473495, StudyID: 56526400, Comparison: None

WET READ: ___ ___ ___ 6:33 PM No pneumothorax. Persistent low lung volumes, pulmonary vascular congestion, bibasilar atelectasis and small bilateral pleural effusions. Stable moderate cardiomegaly. Overall appearance is unchanged from 7:41 a.m.. ______________________________________________________________________________

FINAL REPORT

HISTORY: Renal failure with attempted subclavian placement, to assess for pneumothorax.

FINDINGS: In comparison with the earlier study of this date, there is no evidence of pneumothorax. Little change in the appearance of the heart and lungs with continued low lung volumes, moderate cardiomegaly, elevated pulmonary venous pressure, and bilateral pleural effusions, more prominent on the left.


SubjectID: 13473495, StudyID: 53351384, Comparison: None

FINAL REPORT

INDICATION: History of Gram-negative rod bacteremia, intubated, please evaluate for interval change.

COMPARISONS: Multiple chest radiographs dated back to ___ and CT from ___.

TECHNIQUE: Single AP portable exam of the chest.

FINDINGS: The ET tube terminates 3.9 cm above the carina. There is an enteric tube which extends well below the diaphragm. Again seen is severe cardiomegaly, stable since at least ___. The lung volumes continued to be low with evidence of elevated pulmonary venous pressure and moderate bilateral pleural effusions, left greater than right. There appears to be slight interval worsening of the bibasilar atelectasis. There is no evidence of a pneumothorax. Note is again made of stable elevation of the right hemidiaphragmatic contour.

IMPRESSION: Slight interval worsening of atelectasis at the left lung base. Stable moderate bilateral pleural effusions, left greater than right.


SubjectID: 13473495, StudyID: 53000263, Comparison: None

FINAL REPORT

HISTORY: Bacteremia with bilateral consolidations.

FINDINGS: In comparison with the study of ___, there is continued substantial enlargement of the cardiac silhouette with elevated pulmonary venous pressure. Probable bilateral layering pleural effusions with compressive atelectasis at the bases. In the appropriate clinical setting, supervening pneumonia would have to be seriously considered.


SubjectID: 13473781, StudyID: 59379638, Comparison: None

FINAL REPORT

HISTORY: CHF, hypoxemic to ___%, increased cough question acute process or edema.

COMPARISON: ___.

FINDINGS: Diffusely enlarged cardiomediastinal silhouette is stable and chronic dating back to ___. Compared with most recent prior radiograph, bibasilar opacities have resolved. No focal consolidation, pleural effusion or pneumothorax is present. There is no evidence of pulmonary vascular congestion.

IMPRESSION: No acute intrathoracic process. Stable chronic severely enlarged cardiac silhouette.


SubjectID: 13473781, StudyID: 57373953, Comparison: None

FINAL REPORT

INDICATION: ___-year-old woman with BRBPR, now with worsening mental status and fevers.

COMPARISON: Chest radiograph ___ PORTABLE SEMI-UPRIGHT CHEST RADIOGRAPH: The cardiomediastinal and hilar contours are stable, with stable severe cardiomegaly. No pulmonary consolidation, edema or pneumothorax is seen. A small left pleural effusion is present.

IMPRESSION: Severe cardiomegaly and a small left effusion. No evidence of pneumonia.


SubjectID: 13473781, StudyID: 59067739, Comparison: None

FINAL REPORT

INDICATION: New leukocytosis, assess for pneumonia.

TECHNIQUE: AP upright radiograph of the chest.

COMPARISONS: Multiple previous examinations, most recently ___.

FINDINGS: There is stable marked enlargement of the heart with mild pulmonary vascular congestion without overt edema. Retrocardiac opacity with subtle air bronchograms could reflect left lower lobe pneumonia. Small left pleural effusion cannot be excluded. There is no pneumothorax or right pleural effusion.

IMPRESSION: Possible left lower lobe pneumonia. If clinical status permits, PA and lateral radiographs would allow for better evaluation. These findings were discussed with Dr. ___ by Dr. ___ at ___ on ___ by phone.


SubjectID: 13473781, StudyID: 57035793, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

TECHNIQUE: PA and lateral chest views were reviewed in comparison with prior chest radiographs through ___, with the most recent from ___.

FINDINGS: Severely enlarged heart is stable. Bilateral small pleural effusions, left side more than right, and mild bibasal atelectasis is present. No evidence of pneumonia. Mediastinal and hilar contours are stable.


SubjectID: 13473781, StudyID: 53148581, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Hypoxemia, spiking fevers, evaluation for intrathoracic process.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, severe cardiomegaly persists and the presence of a left pleural effusion cannot be excluded. In addition to these findings, today's image shows mild pulmonary edema. Left retrocardiac atelectasis. No pneumothorax.


SubjectID: 13474359, StudyID: 59183389, Comparison: None

WET READ: ___ ___ ___ 1:25 PM Bilateral mid-lower lung opacities concerning for aspiratiohn and/or pneumonia. Small b/l pleural effusions. ______________________________________________________________________________

FINAL REPORT

INDICATION: Hypercapnia, increasing oxygen requirement in patient with chronic severe COPD.

COMPARISON: Chest radiograph from ___, CT chest ___. PORTABLE UPRIGHT RADIOGRAPH OF THE CHEST: There are increased opacities in the bilateral mid-lower lungs with small bilateral pleural effusions, left > right. The heart size is top normal. There is no pneumothorax.

IMPRESSION: Bilateral mid-lower lung opacities concerning for aspiration and/or pneumonia. Small b/l pleural effusions.


SubjectID: 13474359, StudyID: 53674279, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old male with increased oxygen requirement and history of COPD.

COMPARISON: Portable AP upright chest radiograph, ___ and CT chest ___.

TECHNIQUE: Portable AP upright chest radiograph.

FINDINGS: Lung volumes are stable with improvement in bilateral lower lobe opacification previously ascribed to aspiration pneumonia. There has also been interval decrease in pleural effusions; however, a mild increase in vascular congestion is observed with stable cardiomegaly   Keywords: increase. There is no pneumothorax. There is characteristic widening of the ascending aorta consistent with severe aortic stenosis better seen on prior CT imaging.

IMPRESSION: 1. Improving aspiration pneumonitis with decreasing bilateral pleural effusion. 2. Increasing vascular congestion with stable cardiomegaly   Keywords: increasing. 3. Severe aortic stenosis as demonstrated on ___ CT.


SubjectID: 13474359, StudyID: 58712349, Comparison: better

FINAL REPORT

AP CHEST, 1:30 A.M. ON ___

HISTORY: COPD and pneumonia, question interval change.

IMPRESSION: AP chest compared to ___: Pulmonary vascular congestion has improved since 2 a   Keywords: improve.m. on ___, but moderate left pleural effusion, severe bibasilar atelectasis, and mediastinal vascular engorgement persist, and heart size is top normal. ET tube is in standard placement. Right jugular line ends in the SVC. No pneumothorax.


SubjectID: 13474359, StudyID: 55758240, Comparison: None

FINAL REPORT

INDICATION: Shortness of breath, evaluate for pneumonia.

COMPARISON: Chest x-ray ___.

FINDINGS: Single AP radiograph of the chest demonstrates mild pulmonary edema with bibasilar opacifications likely representing atelectasis. Small bilateral pleural effusions are noted. The right minor fissure is prominent. The cardiac silhouette is mildly enlarged, and the mediastinal contour is unchanged. No pneumothorax.

IMPRESSION: Mild congestive heart failure with bibasilar atelectasis and small bilateral pleural effusions.cardiomediastinal silhouette consistent with


SubjectID: 13474359, StudyID: 54010661, Comparison: same

WET READ: ___ ___ ___ 11:29 AM Interval placement of the endotracheal tube, terminating approximately 7 cm above the carina. Nasogastric tube tip appears to be in the distal esophagus and should be advanced. ______________________________________________________________________________

FINAL REPORT

INDICATION: Status post intubation. Evaluate ETT tube placement.

COMPARISONS: Chest x-ray on ___.

FINDINGS: AP radiographs of the chest demonstrate interval placement of an endotracheal tube tip located approximately 7 cm above the carina. A nasogastric tube is visualized but its distal course is not well seen, with tip appearing to terminate in the distal esophagus, above the diaphragm. There is continued bibasilar opacification of the lungs compatible with mild congestive heart failure and small bilateral pleural effusions   Keywords: continue. No pneumothorax.

IMPRESSION: Interval placement of the endotracheal tube, terminating approximately 7 cm above the carina. Nasogastric tube tip appears to be in the distal esophagus and should be advanced.


SubjectID: 13474359, StudyID: 53782158, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Endotracheal tube positioning. Status post endovascular repair.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Moderate pulmonary edema with cardiomegaly and bilateral areas of atelectasis. No newly occurred focal parenchymal opacity suggesting pneumonia. Unchanged position of the monitoring and support devices. No pneumothorax.


SubjectID: 13474359, StudyID: 51587495, Comparison: same

WET READ: ___ ___ ___ 11:32 AM 1. No pneumothorax. 2. Stable positioning of ET tube. Nasogastric tube tip is only seen in the distal esophagus and should be advanced. 3. Continued mild congestive heart failure   Keywords: continue. ______________________________________________________________________________

FINAL REPORT

INDICATION: Post-intubation with low sats. Evaluate for pneumothorax.

COMPARISONS: Multiple prior chest radiographs on ___.

FINDINGS: AP radiograph of the chest demonstrates no pneumothorax. The endotracheal tube is stable in position approximately 6 cm above the carina. As before, the tip of the nasogastric tube can only be seen to the level of the distal esophagus and should be advanced. There is persistent bibasilar opacification, with small bilateral pleural effusions, and enlarged cardiomediastinal silhouette, consistent with mild congestive heart failure   Keywords: persistent.

IMPRESSION: 1. No pneumothorax. 2. Stable positioning of ET tube. Nasogastric tube tip is only seen in the distal esophagus and should be advanced. 3. Continued mild congestive heart failure.


SubjectID: 13474359, StudyID: 51414508, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: COPD, status post extubation, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has been extubated and the central venous access line has been removed. Lung volumes are relatively large. There is evidence of cardiomegaly and mild fluid overload. Unchanged right basal atelectasis and presence of a small left pleural effusion with subsequent left retrocardiac atelectasis. No other changes   Keywords: no other change.


SubjectID: 13475033, StudyID: 58495524, Comparison: worse

FINAL REPORT

PORTABLE CHEST, ___.

HISTORY: ___-year-old male with shortness of breath.

FINDINGS: Single portable view of the chest is compared to previous exam from ___. Dual-lumen right subclavian central line is again seen with tip at the RA-SVC junction. Increased interstitial markings seen throughout the lungs are again noted and suggestive of chronic interstitial disease   Keywords: increase. Right mid lung opacity has resolved. The cardiomediastinal silhouette is stable as are the osseous and soft tissue structures.

IMPRESSION: No acute cardiopulmonary process. Persistent increased interstitial markings in the lungs compatible with chronic interstitial disease   Keywords: increase. Interval resolution of the right mid lung opacity since prior.


SubjectID: 13475033, StudyID: 52361758, Comparison: same

FINAL REPORT

HISTORY: GI bleed with possible aspiration.

FINDINGS: In comparison with the study of ___, there is little overall change   Keywords: little overall change. Again, there is enlargement of the cardiac silhouette with diffuse prominence of interstitial markings. This could reflect chronic interstitial lung disease, possibly with superimposed elevation of pulmonary venous pressure. Central line remains in place.


SubjectID: 13475033, StudyID: 57951979, Comparison: same

FINAL REPORT

HISTORY: ESRD with new cough, to assess for pneumonia.

FINDINGS: In comparison with the study of ___, there is little change   Keywords: little change. Enlargement of the cardiac silhouette persists with chronic interstitial prominence as seen on recent CT. The possibility of some element of elevated pulmonary venous pressure must be considered. No focal consolidation.


SubjectID: 13475033, StudyID: 55966450, Comparison: None

FINAL REPORT

INDICATION: Shortness of breath.

COMPARISON: Chest radiograph available from ___. CT examination from ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: The heart is mildly enlarged. Again seen are widespread reticular opacities, denoting chronic interstitial disease, better seen on the CT examination from ___. No superimposed consolidation, pneumothorax, or pleural effusion is seen.

IMPRESSION: No acute intrathoracic process.


SubjectID: 13483571, StudyID: 54592179, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, evaluation for dyspnea.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Sternal wires are in constant alignment, the clips and the pacemaker wires are in constant position. There is unchanged mild cardiomegaly and evidence of a small left pleural effusion, combined to a small left basal atelectasis. Mild fluid overload is still present   Keywords: still.


SubjectID: 13483571, StudyID: 52616906, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Dyspnea, fever, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is a mildly increasing overinflation of the stomach. The radiograph also shows unchanged evidence of mild fluid overload as well as of cardiomegaly   Keywords: unchanged. There is no focal parenchymal opacity suggesting the presence of pneumonia. No pleural effusions. No pneumothorax.


SubjectID: 13483571, StudyID: 50880194, Comparison: None

FINAL REPORT

PORTABLE CHEST X-RAY, ___

COMPARISON: ___ radiograph.

FINDINGS: Permanent pacemaker remains in place, and cardiomegaly is stable. Pulmonary vascular congestion is accompanied by minimal interstitial edema. Worsening patchy opacity at left lung base could be due to atelectasis or developing pneumonia, and is accompanied by a small left pleural effusion.


SubjectID: 13483571, StudyID: 51774743, Comparison: None

FINAL REPORT

HISTORY: Fever and cough.

TECHNIQUE: PA and lateral chest radiograph 2 views.

COMPARISON: ___.

FINDINGS: The cardiac silhouette is mildly enlarged. Left-sided pacer leads are unchanged. There is a central pulmonary vascular congestion with mild edema. Heterogeneous bibasilar opacities are likely due to edema however in the correct clinical circumstance infection cannot be excluded. There are tiny bilateral pleural effusions. There is no pneumothorax. The visualized osseous structures are grossly unremarkable.

IMPRESSION: Mild pulmonary edema. Heterogeneous bibasilar opacities are likely due to edema however infection cannot be excluded given the correct clinical circumstance. Small effusions.


SubjectID: 13500179, StudyID: 56652033, Comparison: same

FINAL REPORT

HISTORY: ICD placement, evaluate lead position.

TECHNIQUE: Frontal and lateral chest radiographs were obtained.

COMPARISON: Comparison is made to chest radiographs dated ___.

FINDINGS: As compared to the prior examination, there has been no significant interval change   Keywords: no significant interval change. Redemonstrated is a left pectoral pacemaker with leads seen intact and terminating in their expected positions. The patient is also status post CABG with median sternotomy wires seen well aligned. There is no evidence of pneumothorax, focal consolidation, pleural effusion, or pulmonary edema. Stable, mild to moderate cardiomegaly is noted. Mediastinal contours are normal. No bony abnormality is detected.

IMPRESSION: Left pectoral pacemaker with intact leads terminating in their expected positions. No evidence of pneumothorax.


SubjectID: 13500179, StudyID: 50927502, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: ICD placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Position of the ICD leads is unchanged. Unchanged position of the left pectoral generator. The lung volumes remain low and the cardiac silhouette is at the upper range of normal but no evidence of pulmonary edema is seen. There is no sign indicative of pneumothorax.


SubjectID: 13500179, StudyID: 55131820, Comparison: None

WET READ: ___ ___ ___ 10:14 PM bilateral low lung vol with crowding of bronchovascular markings and with accentuation of cardiac silhouette. dual electrode pacemaker along left chest with leads in ra and rv. Minimal opacification at left costophrenic angles, trace left pleural effusion can't be excluded, although this may represent overlying soft tissues. No large ptx. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: History of heart block and status post dual-chamber pacemaker, questionable pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, a left pectoral chest maker has been implanted. The leads are in expected position. There is no evidence of pneumothorax. Minimal atelectasis at the lung bases. Normal size of the cardiac silhouette. No pulmonary edema.


SubjectID: 13500179, StudyID: 51600618, Comparison: None

FINAL REPORT

INDICATION: Evaluate pacemaker leads.

COMPARISONS: Chest radiograph ___. Chest radiograph ___.

FINDINGS: A permanent pacemaker capsule is seen in the anterior axillary position with two intracavitary electrodes. The leads are in the proper position with the atrial lead in the anterior lateral wall of the right atrium and the ventricular lead in the apical portion of the right ventricle. The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. Cardiomediastinal silhouette is unchanged.

IMPRESSION: 1. Pacemaker leads in the proper position. 2. No pneumothorax.


SubjectID: 13503683, StudyID: 56478341, Comparison: same

FINAL REPORT

INDICATION: History: ___F with shortness of breath // acute process?

COMPARISON: Multiple prior exams, most recently of the same-day 1 hr prior.

TECHNIQUE: Single frontal view of the chest.

FINDINGS: Widespread interstitial lung opacities are similar to the study 1 hr prior, allowing for differences in inspiratory effort   Keywords: similar. Findings remain consistent with pulmonary edema and possible superimposed infection   Keywords: remain. Alternatively, acute lung disease is a possibility. Otherwise, no relevant change since the prior exam   Keywords: no relevant change.


SubjectID: 13503683, StudyID: 52945696, Comparison: worse

FINAL REPORT

INDICATION: History: ___F with cough // acute process?

COMPARISON: Multiple prior exams, most recently chest radiographs of ___

TECHNIQUE: Frontal and lateral views of the chest.

FINDINGS: The heart is mildly enlarged. Mediastinal contours are otherwise stable. Diffuse interstitial opacities are new since the prior exam and may represent pulmonary edema with possible superimposed interstitial pneumonia   Keywords: new. No substantial pleural effusion. No pneumothorax.

IMPRESSION: Widespread interstitial opacities, consistent with pulmonary edema with possible superimposed infection.


SubjectID: 13536343, StudyID: 56464518, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with acute onset right-sided weakness s/p IV fibrinolysis therapy // ?pulm edema vs consolidation

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the extent and severity of the pre-existing right upper lobe opacity has moderately increased. Also increased is the extent of the left pleural effusion. Moderate cardiomegaly. Moderate pulmonary edema, unchanged as compared to the previous examination   Keywords: unchanged. The lung volumes remain low.


SubjectID: 13536343, StudyID: 55669152, Comparison: better

FINAL REPORT

INDICATION: ___ year old woman with stroke, CHF // eval for pulm edema

COMPARISON: Compared to radiographs from ___.

IMPRESSION: There is unchanged cardiomegaly. There is a left-sided pleural effusion and left retrocardiac opacity which is unchanged. There is minimal improvement of the pulmonary edema; however, it remains moderate in severity   Keywords: improve. A small right-sided pleural effusion is seen. There are no pneumothoraces.


SubjectID: 13536343, StudyID: 55579765, Comparison: None

WET READ: ___ ___ ___ 11:29 AM 1. Moderate-severe left and small right pleural effusions, cardiomegaly, and pulmonary edema suggestive of volume overload. 2. The combination of atelectasis and pleural effusions obscure the left heart border and left hemidiaphragm, and underlying consolidation cannot be excluded. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: Chest radiograph.

INDICATION: History: ___F with stroke, heart failure // pulmonary edema

TECHNIQUE: Chest PA and lateral

COMPARISON: Comparison is made to chest radiographs dated ___.

FINDINGS: Low lung volumes are noted. There is a moderate-large left and small right pleural effusion, some increase on the prior examination. The left hemidiaphragm and left heart border are obscured, likely secondary to pleural effusion and adjacent atelectasis, although underlying consolidation cannot be excluded. Additionally, there is bilateral hilar prominence and cephalization of the pulmonary vasculature, suggestive of pulmonary edema. There is no pneumothorax identified. The cardiomediastinal silhouette is partially obscured but appears enlarged, unchanged as compared to the prior examination. Moderate-severe, right acromioclavicular joint degenerative changes are noted.

IMPRESSION: 1. Moderate-severe left and small right pleural effusions, cardiomegaly, and pulmonary edema suggestive of volume overload. 2. The combination of atelectasis and pleural effusions obscure the left heart border and left hemidiaphragm, and underlying consolidation is likely.


SubjectID: 13536343, StudyID: 51914838, Comparison: None

FINAL REPORT

HISTORY: Hypoxia, oxygen requirement.

TECHNIQUE: Upright AP and lateral views of the chest.

COMPARISON: Chest radiograph ___ and torso CT ___.

FINDINGS: The heart remains moderately enlarged with left ventricular predominance. The mediastinal and hilar contours are unchanged, with tortuosity of the thoracic aorta again noted. Diffuse atherosclerotic calcification of the aorta is re- demonstrated. There are low lung volumes. The pulmonary vascularity is not engorged. Large hiatal hernia is again demonstrated. Streaky opacities in the lung bases, including a somewhat more ovoid appearing opacity in the left lung base, likely reflect atelectasis. No pneumothorax is detected. Degenerative changes of both acromioclavicular joints are noted. Compression deformity of the T12 vertebral body is unchanged compared to the prior CT from ___.

IMPRESSION: Large hiatal hernia with bibasilar atelectasis.


SubjectID: 13536343, StudyID: 51172564, Comparison: None

FINAL REPORT

INDICATION: Right IJ CVL line, evaluation for pneumothorax.

COMPARISON: Comparison made to chest radiograph performed same day.

FINDINGS: Interval placement of right-sided central venous catheter terminating at the cavoatrial junction. Otherwise, unchanged exam with large intrathoracic stomach and bibasilar atelectasis. No pneumothorax or pleural effusion identified. Stable cardiomediastinal and hilar contours.

IMPRESSION: Right-sided central venous catheter terminating at the cavoatrial junction. No pneumothorax.


SubjectID: 13536747, StudyID: 59786177, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with right lung collapse // eval for PTX vs. Right main stem intubation eval for PTX vs. Right main stem intubation

IMPRESSION: In comparison with the previous film of this date, bilateral pneumothoraces are again seen. On a subsequent image dictated previously, a left chest tube was inserted.


SubjectID: 13536747, StudyID: 59634592, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with s/p tvr. S/p ct placement.

TECHNIQUE: Single portable AP view of the chest.

COMPARISON: Prior Chest x-rays from ___.

FINDINGS: There has been interval placement of the left chest tube with resolution of the left pneumothorax. However, the pneumothorax in the right lung has increased in size. There is no significant mediastinal shift. Projecting over the right axilla, there is a linear in needle-like opacity, which could be a marker outside the patient. There is stable severe cardiomegaly.

IMPRESSION: 1. Interval placement of a left-sided chest tube with resolution of the left pneumothorax. However, the pneumothorax of the right lung has increased in size. 2. Needle-like linear opacity projecting over the right axilla, which could be a marker outside the patient. Correlation on direct physical exam is advised.

NOTIFICATION: The above findings and recommendation were communicated via telephone with Dr. ___ to ___ NP at 15:50 ___, ___ min after discovery.


SubjectID: 13536747, StudyID: 59316726, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p MVRepair/tricuspid repair // eval for pneumothoraces with bilateral chest tubes to water seal eval for pneumothoraces with bilateral chest tubes to water

IMPRESSION: In comparison with the study of ___, with the 2 chest tubes on water seal, there is no evidence of appreciable pneumothorax. The endotracheal tube, Swan-Ganz catheter, and nasogastric tube have all been removed. Continued enlargement of the cardiac silhouette with bibasilar opacifications, consistent with relatively mild atelectatic changes on the right and more prominent volume loss in the left lower lobe with pleural effusion.


SubjectID: 13536747, StudyID: 56197081, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with MVR/TVR // r/o L ptx, ct to water seal

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the left chest tube is now on water-seal. There is no evidence for the development of a pneumothorax. Unchanged appearance of the cardiac silhouette and of the known parenchymal opacity at the right lung base. A small right pleural effusion, however, might have developed.


SubjectID: 13536747, StudyID: 51295363, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p MV repair and ct removal // r/o ptx r/o ptx

IMPRESSION: In comparison with the study of earlier in this date, the right chest tube is been removed and there is no evidence of pneumothorax. Left chest tube remains in place. There is a better expansion of the lungs. Continued enlargement of cardiac silhouette with bilateral opacifications at the bases.


SubjectID: 13536747, StudyID: 50410697, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with mvr/tv ring. S/p R ct placement.

TECHNIQUE: Single portable AP view of the chest.

COMPARISON: Multiple chest radiographs from the same date and from ___.

FINDINGS: There has been interval placement of a right sided chest tube with near-resolution of the right pneumothorax. There may just be a minimal right residual pneumothorax, similarly to the left side, which also has a chest tube in place. The previously described needle-like opacity projecting over the right axilla is no longer present. There is stable severe cardiomegaly.

IMPRESSION: Interval placement of a right-sided chest tube with near resolution of the right pneumothorax.


SubjectID: 13536747, StudyID: 52465223, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p MVR with CT clamped // eval for left ptx eval for left ptx

COMPARISON: Chest radiographs ___ through ___.

IMPRESSION: Tiny left apical pneumothorax persists, left apical pleural tube in place. No appreciable right pneumothorax. Moderate bilateral pleural effusions stable. Leftward mediastinal shift is indirect evidence that bibasilar atelectasis in the left lower lobe is worse than the right. Heart is moderately enlarged but unchanged. There is no pulmonary edema.


SubjectID: 13536747, StudyID: 51518172, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with s/p MVrep/TV rep // r/o ptx, chest tube clampedPLEASE DO FILM AT 4PM r/o ptx, chest tube clampedPLEASE DO FILM AT 4PM

IMPRESSION: In comparison with the study of ___, the left chest tube has been clamped. No definite pneumothorax is seen, though the ribs overlie the area of the previously described small pneumothorax. Otherwise little change   Keywords: little change.


SubjectID: 13536747, StudyID: 50499531, Comparison: None

WET READ: ___ ___ ___ 10:04 AM No definitive evidence of pneumothorax.

WET READ VERSION #1 ___ ___ ___ 10:39 PM No definitive evidence of pneumothorax.

WET READ VERSION #2 ___ ___ ___ 9:46 AM No definitive evidence of pneumothorax. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with mvr/tvrep // r/o ptx, s/p ct d/c r/o ptx, s/p ct d/c

COMPARISON: Comparison to ___ at 16:14

FINDINGS: Portable AP upright chest ___ at 17:47 is submitted.

IMPRESSION: Interval removal of the left chest tube. A lucency along the medial left apex likely represents a tiny apical pneumothorax, which is stable if not slightly smaller than that seen on the ___ plain radiograph from 5:04pm. Followup imaging would be recommended. There continue be layering effusions with patchy bibasilar airspace opacities which may reflect atelectasis, although pneumonia can not be excluded. No pulmonary edema. Status post median sternotomy with overall stably enlarged cardiac and mediastinal contours.

NOTIFICATION: Findings were communicated by phone to the patient's covering nurse, ___, on ___ at 10:00 at the time of discovery.


SubjectID: 13536747, StudyID: 55113201, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with s/p MVR/TVr // eval postop changes eval postop changes

COMPARISON: Comparison to ___ at 17:46

FINDINGS: PA and lateral views of the chest ___ at 14:10 are submitted.

IMPRESSION: Bilateral layering effusions with bibasilar airspace opacities likely reflecting compressive atelectasis in the setting of pleural effusions. No pulmonary edema. Status post median sternotomy with stable cardiac enlargement. The previously seen left apical pneumothorax is barely visible on the current examination.


SubjectID: 13537167, StudyID: 59976566, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with DM, CAD, CHF who presented with VT and cardiogenic shock. // confirm OGT, confirm balloon pump placement

TECHNIQUE: Single frontal view of the chest

COMPARISON: Study performed 7 hours earlier.

IMPRESSION: NG tube tip isin the stomach. Intra-aortic balloon pump is in standard position. No other interval change from prior study   Keywords: no other interval change.


SubjectID: 13537167, StudyID: 55194126, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with vtach arrest on balloon pump // evaluate for position of balloon pump

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the patient has been extubated and the nasogastric tube was removed. The patient still carries an intra-aortic balloon pump, with the tip projecting 5 mm above the upper most part of the aortic arch, as well as a right internal jugular vein catheter. The size of the cardiac silhouette remains moderately enlarged but no signs of pulmonary edema are present at the current time point   Keywords: remains. No pleural effusions. Minimal atelectasis at the left lung basis.


SubjectID: 13537167, StudyID: 50557705, Comparison: None

FINAL REPORT

INDICATION: CHF and V tach with cardiogenic shock with intra-aortic balloon placement. Evaluate for positional changes of intra-aortic balloon.

COMPARISON: ___ at 8:27 a.m.

FINDINGS: AP view of the chest. Cardiomegaly is unchanged. ET tube is unchanged and in appropriate position. An enteric tube is stable. AICD with leads is unchanged. The intra-aortic balloon pump has been repositioned slightly more inferiorly, now in appropriate position with its tip in the superior portion of the descending aorta. No focal consolidation. No pleural effusion or pneumothorax. No evidence of pulmonary edema.

IMPRESSION: Intra-aortic balloon pump has been repositioned slightly inferiorly and now is in appropriate position in the superior portion of the descending aorta. Otherwise, unchanged.


SubjectID: 13537167, StudyID: 59738820, Comparison: same

FINAL REPORT

HISTORY: Tube placements.

FINDINGS: In comparison with the study of ___, there is essentially no change in the appearance of the Swan-Ganz catheter and pacer. The tip of the IABP has been withdrawn and now measures approximately 1.5 cm below the transverse arch. Continued enlargement of the cardiac silhouette without pulmonary edema or acute focal pneumonia   Keywords: continue.


SubjectID: 13537167, StudyID: 55911859, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF being worked up for LVAD/heart transplant // evaluate ___ and volume status

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen in appearance of the Swan-Ganz catheter, the aortic balloon pump and the pacemaker leads. The Swan-Ganz catheter could be slightly pulled back, by approximately 2-3 cm. The tip of the aortic balloon pump projects approximately 5 mm be low the upper most portion of the aortic arch. Moderate cardiomegaly persists. Likely calcified left ventricular aneurysm. No pulmonary edema. No larger pleural effusions.


SubjectID: 13537167, StudyID: 55196078, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with ventricular tachycardia and IABP. // Swan placement and IABP placement.

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Intra-aortic balloon pump has been inserted with its tip terminating approximately 5 mm below the roof of the aortic arch and should be pulled back at least 3 cm. Cardiomegaly, pacemaker leads and Swan-Ganz catheter terminating in the right upper lobe pulmonary arteries are unchanged in position. Lungs are clear and there is no pulmonary edema.


SubjectID: 13537167, StudyID: 54367116, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with balloon pump, ICD // compare with prior

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no change is seen in position of the ECG leads and of the monitoring and support devices, including the aortic balloon pump. Moderate cardiomegaly persists. No pulmonary edema.


SubjectID: 13537167, StudyID: 58357745, Comparison: None

FINAL REPORT

HISTORY: Hypoxia, for VAD position.

FINDINGS: In comparison with the earlier study of this date, there is little change in the appearance of the left IJ Swan-Ganz catheter and the pacemaker device. Retrocardiac opacification persists, consistent with volume loss in the left lower lobe and pleural effusion. The atelectatic changes at the right base have improved.


SubjectID: 13537167, StudyID: 56576901, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p Heartmate placement // interval change

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The patient is now extubated and the nasogastric tube has been removed. The lung volumes have barely changed. The Swan-Ganz catheter and the cardiac assist device are in unchanged position. Unchanged is a retrocardiac atelectasis as well as a small left pleural effusion. No change in appearance of the normal looking right lung   Keywords: no change.


SubjectID: 13537167, StudyID: 56355188, Comparison: same

WET READ: ___ ___ ___ 1:39 AM Stable appearance of potential right basilar pneumothorax.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p LVAD // eval for rigth basilar ptx

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the aortic balloon pump has been removed. A Swan-Ganz catheter has been placed via the left internal jugular vein access. The tip of the catheter is in the right pulmonary artery, the catheter should be pulled back by approximately 3 cm. The venous introduction sheet on the right has been removed. The other monitoring and support devices are constant. Unchanged appearance of the lung parenchyma   Keywords: unchanged appearance. . Moderate cardiomegaly persists. In unchanged manner, there is an unusually sharp delineation of the right hemidiaphragm, which could be interpreted as an indirect sign for the presence of free pleural air on the right. No apical pneumothorax is visualized.


SubjectID: 13537167, StudyID: 54426740, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p LVAD // eval for efussions, PTX

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the left pleural effusion is unchanged. Minimally increasing atelectasis at the right lung bases. Otherwise unchanged appearance of the lung parenchyma, the heart and the monitoring and support devices.


SubjectID: 13537167, StudyID: 51347306, Comparison: same

FINAL REPORT

HISTORY: Chest tube removal.

FINDINGS: In comparison with the study of ___, there is little interval change   Keywords: little interval change. Specifically, there is no evidence of pneumothorax.


SubjectID: 13537167, StudyID: 51106531, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p VAD // follow up swan position, effusion

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. In particular, the position of the Swan-Ganz catheter is constant. Moderate cardiomegaly. Unchanged position of the cardiac assist device. No evidence of pulmonary edema or larger pleural effusions.


SubjectID: 13537167, StudyID: 57325545, Comparison: same

FINAL REPORT

STUDY: PA and lateral chest, ___. CLINICAL

HISTORY: ___-year-old man with CHF and new nausea.

FINDINGS: Comparison is made to previous study from ___ at 12:41 p.m. There is a single-lead left AICD. The lead is intact. The heart size is enlarged, but stable. Lungs are clear. There are no pneumothoraces. There has been no interval change   Keywords: no interval change.


SubjectID: 13537167, StudyID: 55687141, Comparison: None

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old man with cardiogenic shock. Status post placement of Swan-Ganz catheter and aortic balloon pump.

FINDINGS: Comparison is made to previous study from ___. There is a Swan-Ganz catheter with distal tip is at the main pulmonary outflow tract. There is an intra-aortic balloon pump whose distal tip is in the aortic knob. This could be pulled back approximately 1 cm for more optimal placement. The heart size is enlarged. Lungs are clear. There are again seen calcifications within the lateral aspect of the left heart. No pneumothoraces are seen. There is an unchanged left-sided AICD generator.


SubjectID: 13537167, StudyID: 53444553, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old man with congestive heart failure and new nausea.

FINDINGS: Comparison is made to prior study from ___. There has been removal of the right IJ central line. The left-sided pacemaker is unchanged in position as is the lead. There is cardiomegaly which is stable. Lungs are clear without focal consolidation. Calcifications along the left ventricle lateral wall are again present. No pneumothoraces are seen.


SubjectID: 13537167, StudyID: 52255697, Comparison: None

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old man with congestive heart failure and placement of PA catheter and intra-aortic balloon pump.

FINDINGS: The Swan-Ganz catheter with the distal tip is at the main pulmonary outflow tract. There is also a left AICD with intact leads. There is intra-aortic balloon pump whose proximal tip is just below the aortic knob appropriately sited. There is cardiomegaly. Lungs are clear. There are no pneumothoraces.


SubjectID: 13537167, StudyID: 55775659, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with ___ ___ // ___ position

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Swan-Ganz catheter tip is at the level of the right main pulmonary artery. The intra-aortic balloon pump has been removed. The pacemaker defibrillator (terminating in the same location as on the previous radiograph) is noted. Cardiomegaly is severe. Calcifications of the on anterior lateral wall of the left ventricle are consistent with left ventricular calcified aneurysm. Lungs are clear and there is no pleural effusion or pneumothorax.


SubjectID: 13552058, StudyID: 59926584, Comparison: 0.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with fungemia, cardiac sarcoid, CHF, prior pneumonia with septic shock this hospitalization with worsening hypoxia and leukocytosis // ?consolidation, effusion, edema. concern for pneumonia

IMPRESSION: In comparison to prior radiograph of ___, cardiomegaly is accompanied by worsening pulmonary vascular congestion and mild edema as well as slight increase in size of small bilateral pleural effusions and adjacent bibasilar atelectasis   Keywords: worse, increase. No other relevant changes   Keywords: no other relevant change.


SubjectID: 13552058, StudyID: 55263603, Comparison: better

FINAL REPORT

INDICATION: ___ year old woman with resp distress, sCHF s/p diuresis eval for interval change // eval for interval change

TECHNIQUE: Portable semi-upright AP chest

COMPARISON: Chest radiographs ___ through ___. CT chest ___.

FINDINGS: Left chest wall pacer has leads in the right atrium, right ventricle and projecting over the left ventricle in stable position. Enteric tube courses into the stomach and beyond the field of view. Lung volumes remain low with mild pulmonary edema slightly improved from prior   Keywords: improve. Mild atelectasis at the left base is unchanged. There is no pneumothorax.

IMPRESSION: Mild pulmonary edema is slightly improved since the study of ___   Keywords: improve.


SubjectID: 13552058, StudyID: 59877338, Comparison: same

FINAL REPORT

EXAMINATION: CHEST PA AND LATERAL

INDICATION: ___ year old woman with new biV pacemaker upgrade. Evaluate for pneumothorax and lead placement.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiographs from ___, ___, and ___.

FINDINGS: Compared to the prior radiograph, no change in the lead positioning   Keywords: no change. One lead projects over the right atrium, the other over the right ventricle, and the other in the coronary sinus. Lung volumes have decreased but there is no pneumothorax. Moderate cardiomegaly is stable. Bibasilar atelectasis is noted.

IMPRESSION: 1. Continuous pacemaker leads terminate in the right atrium, right ventricle, and coronary sinus. 2. No pneumothorax.


SubjectID: 13552058, StudyID: 52367826, Comparison: None

WET READ: ___ ___ ___ 9:18 AM Biventricular pacer leads in appropriate position. No pneumothorax. Mild interstitial pulmonary edema. D/w Dr. ___ at approximately 5:55 p.m..

WET READ VERSION #___ ___ ___ ___ 6:08 PM Biventricular pacer leads in appropriate position. No pneumothorax. Mild interstitial pulmonary edema. D/w Dr. ___ at approximately 5:55 p.m.. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with new Biv pacemaker upgrade // pneumothorax and lead placement

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the leads of the pacemaker have been changed. There is now 1 lead projecting over the right atrium, 1 over the right ventricle and 1 in the coronary sinus. Lung volumes have decreased. No pneumothorax. Moderate cardiomegaly without pulmonary edema. No pleural effusions.


SubjectID: 13552058, StudyID: 59748021, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with sarcoid, acute onset hypoxia, abdominal pain // Pulmonary edema

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Severe cardiomegaly is stable. Pacer leads are in standard position. Diffuse consolidations in the left lung are grossly unchanged. Right perihilar opacities are minimally increased   Keywords: increase. The mediastinum is widened and there is no pneumothorax there is no pleural effusion


SubjectID: 13552058, StudyID: 58363746, Comparison: None

WET READ: ___ ___ ___ 3:16 PM Left upper lobe consolidation compatible with pneumonia. Followup after treatment suggested to document resolution. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___F with cough, fever // eval for pna

TECHNIQUE: Frontal and lateral views of the chest.

COMPARISON: ___.

FINDINGS: There is patchy consolidation in the left upper lobe which is new since prior. Elsewhere, lungs are clear. Left chest wall triple lead pacing device is noted. Moderate cardiomegaly is similar in appearance. No acute osseous abnormalities, hypertrophic changes seen the spine.

IMPRESSION: Left upper lobe consolidation compatible with pneumonia. Followup after treatment suggested to document resolution.


SubjectID: 13552058, StudyID: 51280843, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with a history of h/o HFrEF(EF ___% on TTE in ___), 2:1 heart block s/p pacemakerCAD, sarcoidosis with likely cardiac involvement (on ___ mg prednisone), and IDDM who presents for fever, chills, and cough found to have LUL pneumonia. Now extubated and s/p bronchoscopy today. // Eval for interval change Eval for interval change

IMPRESSION: Left upper lobe consolidation continues to be increasing. Findings are again concerning for left upper lobe extensive pneumonia. The rest of the findings including cardiomediastinal silhouette, tubes and lines, pacemaker leads is unchanged.


SubjectID: 13552058, StudyID: 50248817, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with HF EF ___%, DM, sarcoid admitted with fever, cough suspected PNA but also volume overload with continued increased work of breathing now intubated // eval location of ET tube, eval for pulm edema vs. PNA

TECHNIQUE: Single frontal view of the chest

COMPARISON: Study performed 6 hours earlier

IMPRESSION: Right perihilar opacities have increased   Keywords: increase. Multifocal consolidations in the left lung are grossly unchanged. Cardiomegaly is a stable, pacer leads are in standard position. ET tube is in standard position. NG tube tip is in the stomach. There is no evident pneumothorax


SubjectID: 13552058, StudyID: 59503638, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with swan pulled back // eval for swan placement eval for swan placement

IMPRESSION: In comparison with the earlier study of this date, there is mild improvement in the appearance of the Swan-Ganz catheter, which still projects well beyond the outer aspect of the mediastinum on the right. The catheter could be pulled back approximately 4 cm for more optimal positioning.


SubjectID: 13552058, StudyID: 55835808, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with acute on chronic systolic heart failure, now with PA catheter in place. // Eval for interval change. Eval for interval change.

IMPRESSION: In comparison with the study of ___, there has been placement of a right jugular Swan-Ganz catheter that extends well beyond the mediastinal border in the right pulmonary artery system. The tube could be pulled back approximately 6 cm to be in a more optimal position. Continued enlargement of the cardiac silhouette with mild elevation of pulmonary venous pressure.

NOTIFICATION: This information was conveyed to Dr. ___.


SubjectID: 13552058, StudyID: 50116144, Comparison: 1.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with sCHF admitted with decompensation eval for pulm edema, interval change // eval for pulm edema

IMPRESSION: As compared to prior radiograph from 1 day earlier, congestive heart failure has slightly worsened with increasing pulmonary edema and apparent slight increase in size of bilateral pleural effusions and adjacent basilar atelectasis   Keywords: worse, increasing. No other relevant change   Keywords: no other relevant change.


SubjectID: 13552058, StudyID: 56908677, Comparison: better

FINAL REPORT

INDICATION: ___ year old woman with fever evaluate for possible PNA // please evaluate

TECHNIQUE: Chest PA and lateral

COMPARISON: ___

FINDINGS: In comparison with the study of ___, there is interval improvement of the previously described interstitial pulmonary edema   Keywords: improve. The cardiopericardial silhouette remains enlarged. A triple lead pacer wires remains in expected position. No pleural effusion or pneumothorax.

IMPRESSION: Interval improvement in the mild interstitial pulmonary edema   Keywords: improve


SubjectID: 13552058, StudyID: 52872297, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with sCHF // ___ year old woman with sCHF, eval for possible pulmonary edema ___ year old woman with sCHF, eval for possible pulmonary ___

IMPRESSION: In comparison with the study of ___, there is some worsening of the previously described elevation of pulmonary venous pressure. Continued enlargement of the cardiac silhouette with biventricular pacer leads in good position.


SubjectID: 13552058, StudyID: 50665069, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hypoxemia, tachypnea // eval for pulm edema

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: Lines and tubes are stable in position. Again, the right-sided PICC continues to terminate in the right atrium. Consider withdrawal by approximately 3 cm. Enlargement of the cardiac and mediastinal silhouettes is grossly stable. Increased perihilar opacities and interstitial opacities suggest moderate pulmonary edema   Keywords: increase.


SubjectID: 13552058, StudyID: 55477854, Comparison: None

FINAL REPORT

HISTORY: Patient with left-sided pacemaker, eval lead placement.

COMPARISON: ___.

FINDINGS: Frontal and lateral chest radiographs were obtained. A left chest pacemaker has leads terminating in the right atrium and right ventricle. There is no pneumothorax. The lungs are fully expanded and clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. There is no pleural effusion.

IMPRESSION: Satisfactory position of dual-chamber pacemaker leads in the right atrium and right ventricle without complication.


SubjectID: 13552058, StudyID: 52947623, Comparison: same

FINAL REPORT

HISTORY: To assess for hilar adenopathy.

FINDINGS: In comparison with the study of ___, allowing for the AP portable technique, there is probably little overall change   Keywords: little overall change. Cardiac silhouette is within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia.


SubjectID: 13552058, StudyID: 54399983, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___F with sCHF ef ___% presenting with worsening dyspnea // evidence of pulm edema vs infection

COMPARISON: ___

FINDINGS: PA and lateral views of the chest provided. Tripolar pacer again seen unchanged in position. Heart is mildly enlarged. The lungs are clear without focal consolidation, effusion or pneumothorax. Mild congestion difficult to exclude without convincing signs of edema. Mediastinal contour is normal. Bony structures are intact.

IMPRESSION: Stable cardiomegaly with possible mild congestion.


SubjectID: 13552058, StudyID: 50478005, Comparison: worse

WET READ: ___ ___ ___ 7:47 AM Severe cardiomegaly with mild pulmonary vascular congestion and interstitial edema. No focal consolidation.

WET READ VERSION #1 ___ ___ ___ 7:07 PM Severe cardiomegaly with mild pulmonary vascular congestion and interstitial edema. No focal consolidation. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with pacemaker induced cardiomyopathy, LVEF ___%, BiV pacer, recent PVC ablation (___), HTN and HLD who presents with one day of dyspnea and palpitations, in decompensationd sCHF, febrile Tmax ___.6. // PNA? PNA?

IMPRESSION: In comparison with the study of ___, there is again substantial enlargement of the cardiac silhouette in a patient with a triple -channel pacer with leads in good position. There is increasing indistinctness of pulmonary vessels, consistent with elevated pulmonary venous pressure   Keywords: increasing. No evidence of acute focal pneumonia.


SubjectID: 13560084, StudyID: 59472193, Comparison: -1.0

FINAL REPORT

PORTABLE CHEST OF ___

COMPARISON: Radiograph of earlier the same date.

FINDINGS: Cardiac silhouette remains enlarged and is accompanied by pulmonary vascular congestion and mild interstitial edema   Keywords: remains. Overall, the degree of edema has slightly worsened compared to the recent study   Keywords: worse.


SubjectID: 13560084, StudyID: 56216336, Comparison: worse

FINAL REPORT

HISTORY: Dyspnea

COMPARISON: ___

FINDINGS: Two views were obtained of the chest. The lungs are well expanded with slight interval increase in interstitial pulmonary edema   Keywords: increase. Small bilateral pleural effusions on the previous examination have decreased in size. Moderate cardiomegaly is unchanged with normal mediastinal and hilar contours.

IMPRESSION: Interstitial pulmonary edema with small bilateral effusions.


SubjectID: 13560084, StudyID: 50858094, Comparison: None

FINAL REPORT

INDICATION: ___M with generalized weakness // eval for infection

TECHNIQUE: PA and lateral views of the chest.

COMPARISON: ___.

FINDINGS: The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 13560084, StudyID: 50535915, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with h/o ESRD, IDDM, HFpEF, progressive dementia who p/w fall. Now ? decreased breath sounds. // ?pneumonia

COMPARISON: Radiographs from ___

IMPRESSION: Support lines and tubes are unchanged in position. Cardiomediastinal silhouette is within normal limits. There are slightly low lung volumes without focal consolidations, pleural effusion, or pulmonary edema. There are no pneumothoraces.


SubjectID: 13581631, StudyID: 58565212, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: Mr. ___ is a ___ M with h/o dCHF (EF >___%), HTN, CAD, Afib (on Apixaban), hx of lung CA with two recent hospitalizations for pneumonia and acute exacerbation of heart failure, with findings of ?cavitary lesion on L lung // better characterize the equivocal ?cavitary lesion of l lung better characterize the equivocal ?cavitary lesion of l lung

IMPRESSION: In comparison with the earlier study of this date, there again is an area of opacification in the left mid zone with apparent cavitation, which CT could show to better advantage if clinically warranted. Extensive opacification at the left base is consistent with pleural fluid, some of which may be loculated. Extensive opacification at the right base is consistent with pleural fluid with underlying volume loss in the right lower and middle lobes.

RECOMMENDATION(S): CT would be of value if further assessment of the various abnormalities is clinically warranted.


SubjectID: 13581631, StudyID: 56188125, Comparison: None

WET READ: ___ ___ ___ 8:16 AM 1. Multifocal airspace opacities are most consistent with a multifocal infectious process. 2. A vague area of lucency within the left mid lung is equivocal for a cavitary lesion. Repeat PA and lateral chest radiographs could be performed for further evaluation.

WET READ VERSION #1 ___ ___ ___ 1:05 AM 1. Multifocal airspace opacities are most consistent with a multifocal infectious process. 2. Mild to moderate pulmonary edema. ______________________________________________________________________________

FINAL REPORT

INDICATION: History: ___M with hyperk // eval for fluid overload

TECHNIQUE: Portable semi-upright chest radiograph.

COMPARISON: Chest radiographs dated ___ through ___.

FINDINGS: There are low lung volumes, which results in bronchovascular crowding. Multifocal airspace opacities are present. A vague area of lucency within the left mid lung is equivocal for a cavitary lesion. Bilateral pleural effusions are small. The heart is enlarged. No pneumothorax.

IMPRESSION: 1. Multifocal airspace opacities are most consistent with a multifocal infectious process. 2. A vague area of lucency within the left mid lung is equivocal for a cavitary lesion. Repeat PA and lateral chest radiographs could be performed for further evaluation, with further characterization by CT confirmed radiographically.

RECOMMENDATION(S): A vague area of lucency within the left mid lung is equivocal for a cavitary lesion. Repeat PA and lateral chest radiographs could be performed for further evaluation.

NOTIFICATION: Updated impression and recommendations were discussed with Dr. ___ by Dr. ___ ___ telephone at 08:14 on ___, approximately ___ min after discovery.


SubjectID: 13595028, StudyID: 59181116, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with dyspnea // evidence of worsening fluid overload

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___ and 01:40

FINDINGS: The patient is rotated to the left. The patient is status post median sternotomy. There is moderate pulmonary edema. More confluent opacity at the right lung base may relate to vascular congestion however a a consolidation due to pneumonia is not excluded. No large pleural effusion is seen. There is no evidence of pneumothorax. The cardiac silhouette is enlarged. The aorta is calcified and tortuous.


SubjectID: 13595028, StudyID: 58288297, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF exacerbation, intermittent BiPAP. Pulmonary edema, pleural effusion, interval change?

TECHNIQUE: Single portable AP view of the chest.

COMPARISON: Chest radiographs from ___.

FINDINGS: Compared with the prior film, there is new worsening pulmonary edema, right greater than left, evidenced by alveolar opacities and indistinctness of the pulmonary vessels   Keywords: worse, new. Patient is slightly rotated to the left. No effusions are seen. Stable enlargement of the cardiac silhouette with intact median sternotomy wires and mediastinal clips. Scoliosis of the thoracolumbar spine again seen.

IMPRESSION: Interval worsening of pulmonary edema, without effusions   Keywords: worse.


SubjectID: 13595028, StudyID: 53583757, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hypoxia. Evaluate for acute interval changes.

TECHNIQUE: Single portable AP view of the chest.

COMPARISON: Chest radiograph from earlier on the same date and ___.

FINDINGS: Compared with the radiograph from 4 hr prior, there is continued pulmonary edema without pleural effusions   Keywords: continue. Stable enlargement of the cardiac silhouette. No new focal consolidation or pneumothorax. Unchanged median sternotomy wires, mediastinal clips and aortic valve replacement.

IMPRESSION: Continued pulmonary edema without new effusions or focal consolidations   Keywords: new. No pneumothorax.


SubjectID: 13595620, StudyID: 59171253, Comparison: None

FINAL REPORT

INDICATION: History: ___F intubated // acute process?

COMPARISON: None.

TECHNIQUE: Single frontal view of the chest.

FINDINGS: Endotracheal tube terminates 3.4 cm above the carina. NG tube terminates below the diaphragm. Pacer leads terminate in the right atrium and right ventricle. Aortic valve replacement appears in appropriate position. There is widespread heterogeneous hazy opacification of the right lung. No substantial pleural effusion or pneumothorax.

IMPRESSION: 1. Widespread heterogeneous hazy opacification of the right lung. Findings are nonspecific and may represent infection or asymmetric pulmonary edema. 2. Endotracheal tube terminates 3.4 cm above the carina.


SubjectID: 13595620, StudyID: 58420151, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with DYSPNEA, CHF exacerbation, intubated // evaluate volume status, ETT placement

TECHNIQUE: Portable AP radiograph of the chest.

COMPARISON: ___.

FINDINGS: A newly placed endotracheal tube terminates at the level of the clavicles. A newly placed NG tube terminates in the stomach. A new left IJ central venous catheter terminates in the brachiocephalic vein. The patient has had prior to TAVR. A right pectoral pacemaker sends leads to the right atrium and right ventricle. Retrocardiac opacification has like has increased, most likely due to atelectasis. There is a new small right pleural effusion. Moderate cardiomegaly despite the projection is unchanged.

IMPRESSION: Newly placed left IJ central venous catheter terminates in the brachiocephalic vein. Other lines and tubes in optimal position. Increased left basilar subsegmental atelectasis. New small right pleural effusion.


SubjectID: 13595620, StudyID: 57190570, Comparison: None

FINAL REPORT

INDICATION: History: ___F with shock noew line placement // ? left ij placement, ptx?

COMPARISON: Same-day chest radiographs.

TECHNIQUE: Single frontal view of the chest.

FINDINGS: The endotracheal tube cough appear slightly over distended and forms an impression on the trachea. New left internal jugular venous catheter terminates at the junction of the left brachiocephalic vein and the superior vena cava. No pneumothorax. Heterogeneous opacities in the right lung appear slightly improved compared to the exam ___ min prior but there has been interval development of retrocardiac opacity consistent with left lower lobe atelectasis.

IMPRESSION: 1. Overinflated ETT cuff. 2. New left IJ catheter terminates at the junction of left brachiocephalic vein and the superior vena cava. No pneumothorax. 3. New left lower lobe atelectasis with minimally improved heterogeneous right lung opacities.


SubjectID: 13595620, StudyID: 58014558, Comparison: None

FINAL REPORT

HISTORY: Pacemaker placement.

FINDINGS: In comparison with study of ___, little overall change in the small-to-moderate right apical pneumothorax. No definite pneumopericardium is seen. The new pacer device has leads in appropriate position. No definite vascular congestion. Blunting of the left costophrenic angle persists.


SubjectID: 13600112, StudyID: 55188220, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with SOB // PNA?

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the pre-existing pulmonary edema has decreased in extent and severity   Keywords: decrease. There is no evidence of pneumonia but the relatively extensive left retrocardiac atelectasis. No larger pleural effusions. A rounded density at the left lung bases new and likely caused by overlaying soft tissues.


SubjectID: 13600112, StudyID: 51393620, Comparison: None

FINAL REPORT

EXAMINATION: Portable AP semi upright chest radiograph

INDICATION: ___ year old man with concern for lower PNA on previous CT. // PNA?

COMPARISON: Chest radiographs dated ___ at ___ and 523h.

FINDINGS: Malpositioned right internal jugular catheter traversing into the right subclavian vein is unchanged from the most recent exam (tip about 7.5 cm from the origin of the right subclavian vein). Right infrahilar opacity suspected to be pneumonia on the prior exam is not as conspicuous, while still could be present is definitely not worse. The heart is top-normal in size. Mild-to-moderate pulmonary edema is likely. No pneumothorax or pleural effusion.

IMPRESSION: 1. Malpositioned right internal jugular catheter. 2. Mild-to-moderate congestive heart failure. 3. Right infrahilar suspected pneumonia is not worse.


SubjectID: 13600112, StudyID: 50622787, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man with shortness of breath evaluate for pneumonia.

COMPARISON: Comparison is made to chest radiograph from ___ and ___.

TECHNIQUE AP and lateral view of the chest.

FINDINGS: Cardiac silhouette is normal. There is tortuosity of the thoracic aorta. There is no focal lung consolidation. There is no overt pulmonary edema. There is no pleural effusion or pneumothorax.

IMPRESSION: No radiographic evidence of pneumonia.


SubjectID: 13602379, StudyID: 59400798, Comparison: None

FINAL REPORT

HISTORY: Hypoxia and tachycardia status post Pleurx catheter placement.

COMPARISON: ___ through ___.

FINDINGS: A single upright chest radiograph was obtained. The Pleurx catheter is in stable position in the right basilar pleural space. There is minimal, if any, residual pleural effusion. A moderate right basilar atelectasis is unchanged. Left effusion and pleural calcifications changes are stable. Severe cardiomegaly is unchanged. A massive hiatal hernia is again seen.

IMPRESSION: Persistent moderate right basilar pneumothorax after Pleurx catheter placement. The right lung has not fully re-expanded.


SubjectID: 13602379, StudyID: 56016361, Comparison: None

FINAL REPORT

HISTORY: Pleurex catheter clamped for 4 hours.

COMPARISON: Chest CT ___. Chest radiographs ___ through ___.

FINDINGS: A right basilar pneumothorax has been partially obscured by increased opacity at the right lung base since clamping of the Pleurex tube. Extensive left pleural calcifications and cardiomegaly are similar.

IMPRESSION: Increasing opacity at the right base may be fluid within the loculated air collection or projecting onto the air collection on this single frontal view. If clinically indicated, CT may be helpful to delineate. Findings discussed with Dr ___ ___ phone at ___ on ___.


SubjectID: 13602379, StudyID: 55999757, Comparison: worse

FINAL REPORT

PORTABLE CHEST, ___ AT 4:49 CLINICAL

INDICATION: ___-year-old with Pleurx catheter placed on ___ with concern for pneumothorax versus trapped lung, assess for interval change. Comparison is made to the patient's previous studies dated ___ at 15:47. A portable semi-upright chest film, ___ at 4:49 is submitted.

IMPRESSION: 1. There continues to be a right apical lateral and likely basilar pneumothorax with a right pleural catheter remaining in place. Overall, there is increasing opacification at the right mid and lower thorax. If trapped lung remains of clinical concern, further imaging evaluation with CT would be helpful. There is persistent opacity at the left base, particularly retrocardiac, which could reflect partial lower lobe atelectasis in the setting of a layering effusion. There is increased fullness of the perihilar vasculature and indistinctness of the interstitium, which suggest a superimposed component of pulmonary edema at the present time   Keywords: increase. Left pleural calcifications are again seen. Overall, cardiac and mediastinal contours are likely stable, although difficult to assess due to the airspace process.


SubjectID: 13602379, StudyID: 59061551, Comparison: same

FINAL REPORT

HISTORY: Right pleural effusion post-thoracentesis.

FINDINGS: In comparison with the study of ___, there has been a thoracentesis on the right with removal of a substantial amount of free fluid. Specifically, no evidence of pneumothorax. Some residual opacification persists at both bases   Keywords: persists.


SubjectID: 13602379, StudyID: 51661925, Comparison: None

FINAL REPORT

CHEST, TWO VIEWS: ___.

HISTORY: ___-year-old male with shortness of breath.

FINDINGS: Frontal and lateral views of the chest are compared to previous x-ray from ___ and CTA chest from ___. Large right-sided pleural effusion is unchanged. Large hiatal hernia is better characterized on the current exam due to air within the stomach. Left-sided pleural calcification is again noted. Superiorly, the lungs remain clear without focal consolidation. Cardiomediastinal silhouette is difficult to assess but grossly unchanged. Multiple old bilateral rib fractures are again noted.

IMPRESSION: No significant interval change in large right pleural effusion and left calcified pleural plaques. No definite acute cardiopulmonary process.


SubjectID: 13602379, StudyID: 50709916, Comparison: None

FINAL REPORT

INDICATION: Chest pain and shortness of breath.

COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: Left lateral and basilar calcified pleural plaque is redemonstrated, which limits assessment of the underlying lung parenchyma. There is a large hiatal hernia redemonstrated, and this obscures the size of the cardiac silhouette, which is likely mildly enlarged. The aortic knob is calcified. There is no pulmonary vascular congestion. Since the prior study, there is a new right basilar opacity which llikely reflects a combination of a moderate pleural effusion and atelectasis, though infection or aspiration is not excluded. Patchy opacity in left lung base may also be present, but again this area is not well assessed given the presence of overlying pleural plaques. There is biapical pleural thickening and scarring. Old rib deformities are noted bilaterally. There is no pneumothorax.

IMPRESSION: New opacity within the right lung base which likely represents a combination of a moderate sized pleural effusion with associated atelectasis though infection or aspiration cannot be excluded. Calcified pleural plaque in the left lung base somewhat limits evaluation of the underlying lung parenchyma, and a left basilar process cannot be completely excluded. Large hiatal hernia.


SubjectID: 13606683, StudyID: 59371598, Comparison: better

FINAL REPORT

PORTABLE CHEST FILM, ___ AT 8:16 A.M. CLINICAL

INDICATION: ___-year-old with CHF requiring IABP, new intubation. Comparison is made to the patient's prior study of ___ at 1:18 a.m. A portable semi-erect chest film ___ at 8:16 is submitted.

IMPRESSION: 1. Interval placement of an intraaortic balloon pump, which has its tip within the aortic knob. Pullback by approximately 3 cm would be recommended to place the tip in the proximal descending aorta. The patient's nurse, ___, was notified of this recommendation by phone on ___ at 12:10pm. Endotracheal tube, right internal jugular Swan-Ganz catheter, right internal jugular central line, right-sided pacemaker, and nasogastric tube are unchanged in position. The patient is status post median sternotomy with aortic valve replacement and the heart remains stably enlarged. There has been interval improvement in bilateral pulmonary edema with residual mild-to-moderate edema and layering bilateral effusions   Keywords: improve. There is retrocardiac opacity likely representing partial lower lobe atelectasis. No pneumothorax is appreciated.


SubjectID: 13606683, StudyID: 58789863, Comparison: same

WET READ: ___ ___ ___ 6:03 PM 1. Left intra-aortic balloon pump has been slightly withdrawn now in the proximal descending aorta. Other support devices remain in stable position. 2. Stable chest. Persistent bilateral pleural effusions and left retrocardiac opacities similar to the study earlier today. ______________________________________________________________________________

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph of earlier the same date.

FINDINGS: Interval repositioning of left intra-aortic balloon pump, with tip now terminating 3.8 cm below the superior aspect of the aortic knob. Swan-Ganz catheter terminates within the right hilar region, likely in the distal interlobar pulmonary artery. This could be withdrawn a few centimeters for standard positioning. Other indwelling devices are in standard position. Stable cardiomegaly, accompanied by pulmonary vascular congestion and moderate edema with a mid and lower lung predominance in this patient with known upper lobe predominant emphysema   Keywords: stable. Bilateral moderate pleural effusions are present, with interval increase in size on the left.


SubjectID: 13606683, StudyID: 58039737, Comparison: None

FINAL REPORT

PORTABLE CHEST FILM ___ AT ___ CLINICAL

INDICATION: ___-year-old with CHF. Evaluate for change. Comparison is made to prior study dated ___. Portable upright chest film ___ at ___ is submitted.

IMPRESSION: 1. Interval appearance of bilateral layering pleural effusions and associated airspace opacity which most likely reflects compressive atelectasis, although a pneumonia or aspiration should also be considered. No evidence of pulmonary edema. Status post median sternotomy with stable postoperative cardiac and mediastinal contours. Right-sided pacer in place. No pneumothorax. Relative paucity of vasculature in the apices suggests a component of underlying emphysema.


SubjectID: 13606683, StudyID: 57077344, Comparison: None

FINAL REPORT

PORTABLE AP CHEST FILM, ___ AT 1:18 A.M. CLINICAL

INDICATION: ___-year-old with advanced heart failure, admitted for CHF exacerbation, placement of endotracheal tube. Comparison is made to the patient's previous study dated ___ at 22:04. AP semi-upright chest film ___ at 1:18 a.m. is submitted.

IMPRESSION: 1. Interval placement of a right internal jugular Swan-Ganz catheter which has its tip in the right interlobar artery. There has been interval placement of a nasogastric tube which courses below the diaphragm with the tip not identified. Interval placement of an endotracheal tube, which has its tip approximately 3 cm above the carina. Heart remains enlarged, which most likely reflects cardiomegaly, although pericardial effusion cannot be excluded. The mediastinum appears widened but this is likely related to patient rotation. There are bilateral layering effusions with retrocardiac consolidation likely reflecting partial lower lobe atelectasis. In addition, there has been interval appearance of moderate pulmonary and interstitial edema. No large pneumothorax is seen. The patient is status post median sternotomy with an aortic valve replacement. A right-sided pacer remains in place. Right internal jugular central line also is unchanged in position.


SubjectID: 13606683, StudyID: 51871239, Comparison: better

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph of ___.

FINDINGS: Tip of intra-aortic balloon pump terminates about 5 cm below the superior aspect of the aortic knob, and a Swan-Ganz catheter continues to terminate in the region of the distal right interlobar pulmonary artery. Other indwelling devices are in standard and unchanged position. Persistent cardiomegaly accompanied by pulmonary vascular congestion and improving asymmetrical pulmonary edema   Keywords: improving. Bilateral pleural effusions have also decreased in size. Apparent moderate elevation of left hemidiaphragm could potentially represent a subpulmonic component of left pleural effusion. Consider a left lateral decubitus radiograph if warranted clinically.


SubjectID: 13620449, StudyID: 59037372, Comparison: better

FINAL REPORT

INDICATION: ___ year old man with esrd, chf // any pulmonary edema

FINDINGS: As compared to the previous radiograph from ___, interval improvement in mild pulmonary edema   Keywords: improve. Moderate cardiomegaly persists. The single lead left pectoral pacemaker is in constant position. A hemodialysis catheter is placed in the right internal jugular vein.

IMPRESSION: Interval improvement in mild pulmonary edema   Keywords: improve.


SubjectID: 13620449, StudyID: 58831775, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with renal failure, CHF, and Vtach s/p multiple shocks // assess for pulmonary edema assess for pulmonary edema

IMPRESSION: As compared to the previous radiograph from ___, the patient has developed mild to moderate pulmonary edema, predominantly interstitial   Keywords: develop. Moderate cardiomegaly persists. The single lead left pectoral pacemaker is in constant position. A hemodialysis catheter is placed in the right internal jugular vein.


SubjectID: 13620449, StudyID: 57475578, Comparison: worse

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old man with PMH anterior MI and recurrent VT presenting with sustained VT. // Please assess for pulmonary edema

TECHNIQUE: Portable chest

COMPARISON: Portable chest radiograph dated ___

FINDINGS: In comparison to the chest radiograph obtained 1 day prior, mild pulmonary edema has increased the right-sided IJ central venous catheter has been removed   Keywords: increase. Moderate cardiomegaly is unchanged. Pleural effusions small, if any. Lungs are otherwise clear without focal consolidation. A single pacemaker/defibrillator lead is unchanged in position within the right ventricle.

IMPRESSION: Increased, mild pulmonary edema   Keywords: increase.


SubjectID: 13620449, StudyID: 58477717, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with VT and CHF exacerbation // interval change interval change

IMPRESSION: In comparison with the study of ___, there is again substantial enlargement of the cardiac silhouette. Mild indistinctness of pulmonary vessels suggests increasing pulmonary venous pressure   Keywords: increasing. Otherwise little change in the appearance of the heart and lungs.


SubjectID: 13620449, StudyID: 53948351, Comparison: None

WET READ: ___ ___ ___ 8:18 AM No opacity concerning for pneumonia. ___ ___ 22:36.

WET READ VERSION #1 ___ ___ ___ 10:39 PM No opacity concerning for pneumonia. ___ ___ 22:36. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man pw from OSH with VT, ?PNA at OSH // ?PNA, acute processes ?PNA, acute processes

IMPRESSION: In comparison with the study of ___, there is again enlargement of the cardiac silhouette with tortuosity of the aorta in a patient with a single -lead pacer device extending to the apex of the right ventricle. No evidence of appreciable vascular congestion or acute focal pneumonia or pleural effusion.


SubjectID: 13620449, StudyID: 57878057, Comparison: None

WET READ: ___ ___ 10:00 PM interval placement of single lead ICD. top normal cardiac silhouette. no definite ptx. ______________________________________________________________________________

FINAL REPORT

HISTORY: ICD, to assess for pneumothorax.

FINDINGS: In comparison with study of ___, there has been placement of a single-lead ICD that extends to the apex of the right ventricle. No evidence of pneumothorax. The patient has taken a much better inspiration.


SubjectID: 13620449, StudyID: 56632904, Comparison: same

FINAL REPORT

HISTORY: Lead position.

FINDINGS: In comparison with study of ___, there is no change in the appearance of the position of the ICD lead, with its tip in the region of the apex of the right ventricle. Continued enlargement of the cardiac silhouette without vascular congestion or acute focal pneumonia   Keywords: continue.


SubjectID: 13620449, StudyID: 55341601, Comparison: worse

WET READ: ___ ___ ___ 1:43 AM Left chest wall defibrillator has a single lead terminating in the right ventricle. Endotracheal tube terminates 2.4 cm from the carina. Enteric tube courses below the left hemidiaphragm and beyond the field of view. There are hazy bilateral opacities suggesting pulmonary edema not significantly changed from the study of ___. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with CHF presenting with volume overload, VT // e/o pulm edema e/o pulm edema

COMPARISON: Chest radiographs ___.

IMPRESSION: Mild pulmonary edema has not cleared. Opacification has developed at both lung bases consistent with combination of dependent edema and atelectasis than pneumonia is not excluded   Keywords: develop. Severe cardiomegaly is long-standing. Pleural effusions are presumed, but not large. No pneumothorax. Left subclavian right ventricular defibrillator in standard placement. ET tube, 2.5 cm from the carina with the chin down is acceptable. Nasogastric drainage tube passes into the stomach and out of view.


SubjectID: 13620449, StudyID: 51587717, Comparison: None

FINAL REPORT

INDICATION: History: ___M with hypoxia // eval heart and lungs

TECHNIQUE: Chest PA and lateral

COMPARISON: Multiple prior radiographs most recent on ___.

FINDINGS: A left pectoral pacemaker/ defibrillator is in unchanged position. The cardiomediastinal and hilar contours are stable demonstrating mild cardiomegaly. There is mild to moderate pulmonary vascular congestion and interstitial pulmonary edema. Small pleural effusions.

IMPRESSION: Congestive heart failure with moderate interstitial edema and small pleural effusions.


SubjectID: 13620449, StudyID: 54229128, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cardiogenic, acute decomp heart failure, CVL in place // CVL positioning, e/o pulm edema CVL positioning, e/o pulm edema

COMPARISON: ___

IMPRESSION: Cardiomegaly is severe, unchanged. Swan-Ganz catheter tip is at the level of the right lower lobe pulmonary artery. Pacemaker defibrillator lead terminates in the right ventricle. There is no pulmonary edema. There is right basal opacity that appears to be overall similar to previous examination. No interval increase in pleural effusion or development of pneumothorax is seen.


SubjectID: 13620449, StudyID: 53189415, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with s/p intubation now with fever // eval for pna vs. aspiration eval for pna vs. aspiration

IMPRESSION: In comparison with the study of ___, the endotracheal tube and nasogastric tube have been removed. The right IJ catheter is been transformed into a Swan-Ganz catheter, with its tip in the right pulmonary artery extending beyond the mediastinal contours. It could be pulled back approximately 4-5 cm to be in better position. There is suggestion of some increasing opacification at the right base which could represent a developing pneumonia.

NOTIFICATION: This information was telephoned to ___, a nurse in the ICU.


SubjectID: 13620449, StudyID: 51070392, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with VT, hypotensive episode, pulmonary edema // Interval change Interval change

IMPRESSION: In comparison with the study of ___, the right Swan-Ganz catheter has been replaced with an IJ sheath. Continued substantial enlargement of the cardiac silhouette with some pulmonary vascular congestion. The opacification at the right base is less prominent than on the previous study.


SubjectID: 13620449, StudyID: 50688149, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p VT arrest now intubated // ? interval change ? interval change

IMPRESSION: In comparison with the earlier study of this date, the monitoring and support devices are essentially unchanged. Again there is some increased opacification at the right base. At this time the appearance is more suggestive of atelectasis, though in the appropriate clinical setting superimposed pneumonia would have to be considered. The tip of the Swan-Ganz catheter again extends several cm beyond the mediastinal border. Otherwise little change   Keywords: little change.


SubjectID: 13620449, StudyID: 50009377, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF exacerbation // CVL positioning, e/o pulm edema or other acute process

TECHNIQUE: Single portable AP view of the chest was obtained

COMPARISON: ___, ___, and multiple images from ___

FINDINGS: The cardiac silhouette is stably enlarged. Again noted is mild central pulmonary vascular congestion   Keywords: again. The previously seen right internal jugular sheath is no longer noted. There is no pneumothorax or definite pleural effusion. No consolidation is identified. Increased conspicuity of opacity is seen at the right lung base, which may represent atelectasis, though consolidation is not excluded. An AICD is in appropriate, unchanged position.

IMPRESSION: Increased prominence of right basilar opacity may represent developing consolidation.


SubjectID: 13628670, StudyID: 55046028, Comparison: None

FINAL REPORT

INDICATION: Shortness of breath. Evaluate for fluid overload.

COMPARISON: Multiple prior chest radiographs, most recent on ___.

TECHNIQUE: PA and lateral chest radiograph.

FINDINGS: Lung volumes are low. There are bilateral interstitial opacities with a perihilar distribution, with associated bilateral hilar engorgement and small pleural effusions. Slightly increased right basial opacity is also seen. There is no pneumothorax. Moderate cardiomegaly is unchanged from prior. A bicameral pacemaker is re-identified with the leads in unchanged position. Sternotomy wires are intact.

IMPRESSION: Pulmonary edema with moderate cardiomegaly. Increased right basilar opacity at the right lung base may represent atelectasis, although infection cannot be excluded.


SubjectID: 13628670, StudyID: 50941143, Comparison: better

WET READ: ___ ___ 9:54 PM No significant change compared to prior ______________________________________________________________________________

FINAL REPORT

HISTORY: ___-year-old male with CHF exacerbation, continuing O2 requirement despite diuresis. Evaluation for interval change.

COMPARISON: Comparison is made to numerous prior radiographs including most recent from ___.

FINDINGS: Low lung volumes persist although the degree of interstitial edema is improved since the prior study   Keywords: improve. Calcified lymphnodes are present along the left hilus, as before. Moderate cardiomegaly is unchanged. Stable small bilateral pleural effusions and bibasilar atelctasis.

IMPRESSION: Improved interstitial edema   Keywords: improve. Stable small bilateral pleural effusions and bibasilar atelectasis.


SubjectID: 13628670, StudyID: 54207060, Comparison: same

FINAL REPORT

PATIENT

HISTORY: ___ years old man with flash pulmonary edema

INDICATION: Interval changes.

TECHNIQUE: Portable AP single-view chest x-ray in semi-upright position.

COMPARISON: Exam is compared to ___.

FINDINGS: All the monitoring devices are unchanged. The moderate-to-severe bilateral pulmonary edema is stable   Keywords: stable. There is no new consolidation. There is no new pleural effusion or pneumothorax. Cardiomediastinal silhouette is unchanged.

IMPRESSION: Status quo.


SubjectID: 13628670, StudyID: 53446393, Comparison: worse

WET READ: ___ ___ ___ 9:17 PM Acute pulmonary edema. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Worsening respiratory distress, concerning pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is substantial progression of the already moderate pulmonary edema seen on the previous film   Keywords: progression. The edema is centralized in distribution and affects both the left and the right lung. Extent of the pre-existing pleural effusions that are limited to the costophrenic areas, is constant. Unchanged moderate cardiomegaly with shape of the cardiac silhouette, potentially indicating a small pericardial effusion. Unchanged position of the left pectoral pacemaker.


SubjectID: 13628670, StudyID: 52375169, Comparison: worse

FINAL REPORT

AP CHEST, 8:18 A.M., ___

HISTORY: ___-year-old man with flash pulmonary edema and possible pneumonia. Assess improvement.

IMPRESSION: AP chest compared to ___: Sequence of changes starting ___, 2:15 p.m., showed rapidly worsening moderate-to-severe pulmonary edema over a six-hour period, mild improvement over the next 5 hours into ___, and continued mild improvement a little over a day later today   Keywords: worse. Residual edema is asymmetric, favoring the right lung, but not so unbalanced as to raise concern about pneumonia, although of course it cannot be excluded. Heart is normal size. Pleural effusions are presumed, but not substantial. The transvenous right atrioventricular pacer leads are in standard placements. There is no pneumothorax.


SubjectID: 13628670, StudyID: 52071612, Comparison: None

WET READ: ___ ___ ___ 3:25 PM Bilateral parenchymal opacities and small effusions may be due to pulmonary edema. Alternatively this could be from atypical infection. Clinical correlation suggested. ______________________________________________________________________________

FINAL REPORT

HISTORY: ___-year-old male with shortness of breath.

COMPARISON: ___.

FINDINGS: Frontal and lateral views of the chest. There are multi focal regions of opacity specifically in the bilateral perihilar region and bilateral costophrenic angles, overall worse on the right compared to the left. Blunting of the posterior costophrenic angles may be due to small superimposed pleural effusions. The cardiomediastinal silhouette is within normal limits. Dual lead pacing device is seen with leads in stable position. Median sternotomy wires again noted. Dense atherosclerotic calcifications again seen at the aortic arch. Probable calcified mediastinal nodes are seen.

IMPRESSION: Bilateral parenchymal opacities and small effusions may be due to pulmonary edema. Alternatively this could be from atypical infection. Clinical correlation suggested.


SubjectID: 13636434, StudyID: 56331328, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with multifocal PNA // Eval for interval progression

COMPARISON: ___.

IMPRESSION: As compared to the previous image, no relevant change is seen   Keywords: no relevant change. Known multifocal pneumonia with diffuse bilateral multifocal parenchymal opacities. Stable severity and distribution of the opacities   Keywords: stable. Stable moderate cardiomegaly. Unchanged position of the pacemaker is. No larger pleural effusions.


SubjectID: 13636434, StudyID: 52626516, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with shortness of breath // evaluate for CHF

COMPARISON: ___ and ___.

FINDINGS: AP portable upright view of the chest. Dual lead pacer is again seen with leads extending to the region the right antrum and right ventricle. The heart is stably enlarged. Scattered airspace opacities remain concerning for pneumonia. Bilateral pleural effusions are likely small in size. As compared with the recent chest CT from ___, there is slight interval progression in the overall extent of airspace opacity within the left mid and right upper lungs. Mild pulmonary vascular congestion/ edema likely present as well.

IMPRESSION: Multifocal pneumonia, appears progressed from prior imaging studies. Small bilateral pleural effusions. Stable mild cardiomegaly. Mild pulmonary edema.


SubjectID: 13643894, StudyID: 57340373, Comparison: worse

WET READ: ___ ___ ___ 9:04 AM Worsening pulmonary edema.

WET READ VERSION #1 ___ ___ ___ 9:28 PM Worsening pulmonary edema. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with elevated lactate, ACS, // r/o pulm edema, pna r/o pulm edema, pna

IMPRESSION: In comparison with the study of ___, there is worsening enlargement of the cardiac silhouette and pulmonary edema with bilateral pleural effusions and compressive basilar atelectasis   Keywords: worse.


SubjectID: 13643894, StudyID: 50955198, Comparison: None

FINAL REPORT

INDICATION: ___M with worsening dyspnea // ? acute cardiopulm process

TECHNIQUE: AP and lateral views of the chest.

COMPARISON: ___.

FINDINGS: Small bilateral pleural effusions have slightly increased. Cardiomegaly is again noted. There is mild pulmonary edema. There is no focal consolidation Hypertrophic changes seen in the spine.

IMPRESSION: Slightly increased size of small bilateral effusions and mild pulmonary edema


SubjectID: 13647967, StudyID: 58875996, Comparison: same

WET READ: ___ ___ ___ 9:00 AM Improved positioning of right pigtail catheter with decrease in size of moderate right pleural effusion Stable mild vascular congestion with mild cardiomegaly   Keywords: stable.

WET READ VERSION #1 ___ ___ ___ 1:22 AM Improved positioning of right pigtail catheter with decrease in size of moderate right pleural effusion Stable mild vascular congestion with mild cardiomegaly. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with right chest tube that was malpositioned, replaced. // confirm proper placement.

TECHNIQUE: Chest single view

COMPARISON: ___ at 13:26

IMPRESSION: Improved positioning of right pigtail catheter, which is now projecting over the right lower chest, with decrease in size of moderate right pleural effusion. Stable mild vascular congestion with mild cardiomegaly


SubjectID: 13647967, StudyID: 56451020, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with right pleural effusion s/o chest tube placement // evaluate for PTX, tube placement. At ___ AM.

TECHNIQUE: Portable chest

COMPARISON: ___ at 18:09

FINDINGS: Right-sided chest tube is again visualized. There has been interval decrease in the right pleural effusion which is now small. There is a small amount of volume loss in both lower lungs. The heart is mildly enlarged. There is mild pulmonary vascular redistribution.

IMPRESSION: Decreased size of right pleural effusion


SubjectID: 13647967, StudyID: 50880821, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with right pleural effusion s/o chest tube placement // evaluate for PTX, tube placement

COMPARISON: None.

FINDINGS: Compared with ___, the right chest tube has been placed. However, the tip overlies the lateral right chest wall at the level of the right mid chest, in the region of the right sixth and seventh ribs. It does not appear to extend beyond the chest wall into the pleural space. No pneumothorax is detected. Again seen is opacity at the right lung base with obscuration of the right hemidiaphragm, slightly improved. There is upper zone redistribution and mild diffuse vascular blurring, consistent with CHF. This is also probably slightly improved. There is minimal atelectasis at the left base, slightly improved. No left-sided effusion.

IMPRESSION: 1. New right-sided chest tube does not appear to cross the chest wall. No pneumothorax detected. 2. Right base opacity is slightly improved. CHF findings and left base atelectasis also slightly improved   Keywords: improve.

NOTIFICATION: Positioning of the right chest tube discussed by Dr. ___ with Dr. ___ ___ at ___:16 on ___. By report, the chest tube did successfully drain some fluid, which might account for improvement at the right lung base, question interval retraction.


SubjectID: 13647967, StudyID: 55693511, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with desatting // consolidation consolidation

IMPRESSION: In comparison with the study of ___, the more tenting a or EO however ___ there are lower lung volumes with continued enlargement of the cardiac silhouette and probable worsening vascular congestion   Keywords: worse. Hazy opacification of the bases is consistent with bilateral pleural effusions and compressive atelectasis. The retrocardiac region shows substantial opacification consistent with volume loss in the lower lobe. Marked obliquity of the patient makes it difficult to assess for the possibility of mediastinal shift. No evidence of pneumothorax. Monitoring and support devices remain in good position.


SubjectID: 13647967, StudyID: 52114627, Comparison: better

WET READ: ___ ___ 8:45 PM NG tube coursing below the diaphragm with the tip terminating in the proximal stomach. The side-port is at the level of the diaphragm and could be advanced further for optimal positioning. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with replaced NGT // assess for coiling of ngt in esophagus

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: The NG tube tip is in the stomach with the proximal port at the GE junction. There small bilateral pleural effusions. There is cardiomegaly. There is volume loss at both bases an early infiltrates. However, the alveolar edema has improved compared to the study from the prior day the right IJ line tip is in the distal SVC   Keywords: improve

IMPRESSION: NG tube in proximal stomach. This could be advanced


SubjectID: 13647967, StudyID: 55200448, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with fever 101.9, s/p renal transplant, chf exacerbatn // evaluate for interval change

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen with regard to the bilateral pleural effusions. The moderate cardiomegaly, the moderate pulmonary edema and the bilateral areas of atelectasis. No new parenchymal opacity.


SubjectID: 13647967, StudyID: 53119014, Comparison: worse

FINAL REPORT

INDICATION: ___F with low o2 sats // Eval for volume overload

TECHNIQUE: Portable upright view of the chest.

COMPARISON: Chest radiograph ___.

FINDINGS: New hilar and perihilar opacities with a small right pleural effusion are consistent with pulmonary edema   Keywords: new. Two round opacities in the peripheral mid and lower left lung may also reflect pulmonary edema, but superimposed infection is not excluded. Bibasilar atelectasis or consolidation is also present, given obscuration of both hemidiaphragms. The size of cardiac silhouette is difficult to assess given the prominent perihilar opacities.

IMPRESSION: Pulmonary edema with small right pleural effusion and bibasilar atelectasis. Superimposed infection is not excluded.


SubjectID: 13647967, StudyID: 50047749, Comparison: better

FINAL REPORT

INDICATION: Pulmonary edema.

COMPARISON: Chest radiograph from ___.

TECHNIQUE: Frontal chest radiograph.

FINDINGS: Mild cardiomegaly is unchanged. Moderate central pulmonary vascular congestion and pulmonary edema have slightly improved since ___   Keywords: improve. Small bilateral pleural effusions appear stable. There is no pneumothorax.

IMPRESSION: 1. Improved moderate pulmonary edema   Keywords: improve. 2. Mild cardiomegaly. 3. Unchanged small bilateral pleural effusions.


SubjectID: 13647967, StudyID: 52970151, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with sbo // ngt placement ngt placement

IMPRESSION: In comparison with the study of ___, this and placement of a nasogastric tube that extends to the mid body of the stomach. Allowing for the AP portable rather than PA upright view, there is probably little change in the appearance of the heart and lungs.


SubjectID: 13647967, StudyID: 52451833, Comparison: None

WET READ: ___ ___ ___ 9:09 AM Normal chest radiograph, no pneumonia. If symptoms persist, consider dedicated chest CT for further evaluation given immunocompromised state. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: Female status post renal transplant with cough. Assess for pneumonia.

COMPARISON: Chest radiograph ___, ___, ___.

FINDINGS: Frontal and lateral chest radiographdemonstrates well expanded and clear lungs.No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. Limited assessment of the upper abdomen is within normal limits.

IMPRESSION: Normal chest radiograph, no pneumonia. If symptoms persist, consider dedicated chest CT for further evaluation given immunocompromised state.


SubjectID: 13650934, StudyID: 57407831, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: Chest, PA and lateral.

INDICATION: ___-year-old female patient with complete heart block, status post dual-chamber pacemaker via left cephalic and axillary approach. Evaluate lead position.

FINDINGS: PA and lateral chest views were obtained with patient in upright position. Comparison is made with the next preceding AP portable chest examination of ___. Marked cardiomegaly and status post sternotomy with evidence of bypass surgery as before. In the interval, the patient has received a permanent pacer located in left anterior axillary position. Connection exists with two intracavitary electrodes, one of which terminates in a position compatible with the right atrial appendage, the second lead reaches the apical portion of the right ventricle. The patient was unable to elevate her arms for the lateral view, but still well penetrated image allows exclusion of any significant pleural effusion in the posterior pleural sinuses. The pulmonary vasculature demonstrates an upper zone redistribution pattern, but there is no evidence of interstitial or alveolar edema. No acute parenchymal infiltrates can be seen.

IMPRESSION: Permanent pacer placement with two intracavitary electrodes in appropriate position in the right atrium and the right ventricle. Stable cardiomegaly. No evidence of pneumothorax.


SubjectID: 13659269, StudyID: 59734696, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hx of dCHF who presents with respiratory distress // Interval change?

COMPARISON: ___

IMPRESSION: As compared to the previous image, no relevant change is seen   Keywords: no relevant change. Minimal atelectasis at the right lung bases. Moderate cardiomegaly. Moderate scoliosis. No overt pulmonary edema. No larger pleural effusions. A lateral radiograph would be helpful in determining the cause for a minimal increase in density surrounding the upper and lower aspects of the right hilus.


SubjectID: 13659269, StudyID: 54630884, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with DM, dCHF, p/w hypertesive urgency and decompensated CHF, CXR showed widened mediastium // eval if widen mediastium is indeed due to technique

TECHNIQUE: Chest PA and lateral

COMPARISON: ___ ___ and ___.

FINDINGS: Cardiomediastinal silhouette is unchanged with Cardiac size is top normal and stable appearance of the mediastinal and hilar contours. The upper lungs are clear. There is no pneumothorax . Small bilateral pleural effusions are associated with minimal adjacent atelectasis. There are moderate degenerative changes in the thoracic spine

IMPRESSION: Small bilateral effusions with adjacent atelectasis Stable cardiomediastinal silhouette.


SubjectID: 13659269, StudyID: 53620591, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with hx of chf with doe, sob today // eval sob

COMPARISON: ___.

FINDINGS: AP portable upright view of the chest. Underpenetration limits assessment to the lower lungs. Allowing for technical limitations, mild pulmonary edema is suspected with possible trace pleural effusions. The heart size is top-normal. The mediastinal contour is exaggerated due to technique. No definite pneumothorax is seen. Bony structures are intact.

IMPRESSION: Mild pulmonary edema, small bilateral pleural effusions and top-normal heart size.


SubjectID: 13659269, StudyID: 59516139, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old man with pulmonary edema and lower leg edema.

FINDINGS: Comparison is made to the prior study from ___. There are bilateral pleural effusions, left greater than right, which have increased since the previous study. There is decrease in the pulmonary interstitial prominence since the previous study. There is unchanged cardiomegaly. There are no pneumothoraces.


SubjectID: 13659269, StudyID: 58393614, Comparison: None

FINAL REPORT

INDICATION: Crackles in the lung.

COMPARISON: ___.

FINDINGS: PA and lateral chest radiographs demonstrate small bilateral pleural effusions, greater on the left than right, and mild pulmonary edema. Additionally, more focal opacities in the right upper lobe and bilateral lung bases is concerning for multifocal pneumonia. The cardiac borders are not well visualized. There is no pneumothorax.

IMPRESSION: Multifocal pneumonia with superimposed mild pulmonary edema and small bilateral pleural effusions.


SubjectID: 13659269, StudyID: 57914767, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Dyspnea on exertion, edema, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is a mild decrease in extent and severity of the pre-existing parenchymal opacities. The heart continues to be large. There is ongoing blunting of the left costophrenic sinus, so that the presence of a minimal left pleural effusion cannot be excluded. No other changes   Keywords: no other change. Mild bilateral basal atelectasis.


SubjectID: 13659269, StudyID: 52836486, Comparison: None

WET READ: ___ ___ ___ 6:51 PM Multifocal parenchymal opacities are more pronounced than on the recent comparison. Given the short time course this likely reflects worsening of pulmonary edema superimposed on a background of multifocal pneumonia (though pulmonary hemorrhage can also evolve in a short time course). Small left pleural effusion is unchanged.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Hypoxia, pulmonary edema.

COMPARISON: ___.

FINDINGS: Compared to the previous radiograph, there is an increase in severity of the bilateral parenchymal opacities, with newly appeared consolidations in the retrocardiac lung areas that are likely atelectatic in nature. The size of the cardiac silhouette is unchanged. No pneumothorax.


SubjectID: 13663336, StudyID: 58060660, Comparison: None

FINAL REPORT

INDICATION: Tachycardia, confusion.

COMPARISON: None. UPRIGHT AP AND LATERAL VIEWS OF THE CHEST: The heart size appears mildly enlarged. The aorta is slightly unfolded. Hilar contours are not enlarged. Linear opacities within the right middle lobe are compatible with subsegmental atelectasis. While there is a suggestion of mild pulmonary vascular congestion, no frank pulmonary edema is seen. No large pleural effusion or pneumothorax is identified. There are multilevel degenerative changes in the thoracic spine with osteophyte formation.

IMPRESSION: Possible mild pulmonary vascular congestion, but no evidence for pneumonia.


SubjectID: 13686295, StudyID: 53995302, Comparison: 1.0

FINAL REPORT

EXAMINATION: Portable AP chest radiograph.

INDICATION:

HISTORY OF PRESENT ILLNESS: ___F h/o dementia, T2DM, HTN, DVT/PE on rivaroxaban, CVA, AV block s/p PPM presents with worsening malaise and SOB. - ___ (___) pt was in bed all day and did not eat. She had 6 episodes of urinary incontinence which was unusual and diarrhea. - ___, pt was feeling weak and unsteady. She had trouble getting up steps and trouble lifting legs, though she was able to walk with walker on flat ground ok. -nausea but no emesis. -fever to 102 on ___. On day of presentation, pt was noted to be breathing harder, so husband check O2 sats which were ___% on RA. She had

COMPARISON: Chest radiograph from earlier on the same day, dated ___ at 02:32.

FINDINGS: Slight interval improvement in left sided consolidation, likely reflecting resolving asymmetric edema   Keywords: resolving. Otherwise, no significant interval change   Keywords: no significant interval change. Lung volumes remain low. No change in by lateral atelectasis. Pleural effusion, if present, on the left is minimal. No right pleural effusion and no pneumothorax. Mild cardiomegaly is unchanged. Calcifications aortic knob are unchanged. Unchanged position of a single lead cardiac device. Surgical clips project over the right axilla supraclavicular region.

IMPRESSION: Slight interval improvement in left asymmetric edema   Keywords: improve. Otherwise, no significant change   Keywords: no significant change.


SubjectID: 13686295, StudyID: 53913046, Comparison: worse

FINAL REPORT

EXAMINATION: Portable AP chest radiograph.

INDICATION: ___ year old woman with acute resp distress; Evaluate for pulmonary edema or interval change.

COMPARISON: Chest radiograph dated ___.

FINDINGS: Lung volumes are lower. Slight interval increase in opacities, particularly in the left lung, suggesting asymmetric edema, although aspiration/pneumonia cannot be definitely excluded   Keywords: increase. Atelectasis is worse with slight elevation of the left hemidiaphragm. The heart is mildly enlarged, more so since yesterday. The mediastinal pulmonary vasculature is more prominent. No pneumothorax. Clips projecting over the right axilla and supraclavicular region are unchanged. Left single lead cardiac device is intact and unchanged in position, tip ending in the right ventricle. Aortic knob calcifications are unchanged. The thoracic aorta is slightly tortuous or ectatic, unchanged.

IMPRESSION: Interval worsening of probably asymmetric edema in the left lung and lower lung volumes   Keywords: worse.

RECOMMENDATION(S): Close interval follow-up with radiograph is advised to exclude aspiration/pneumonia in left lung.


SubjectID: 13686295, StudyID: 52461273, Comparison: None

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: History: ___F with sob and fever // eval pneumonia

TECHNIQUE: Chest: Frontal and Lateral

COMPARISON: None.

FINDINGS: There are low lung volumes and bibasilar atelectasis. No definite focal consolidation is seen. Cardiac silhouette is top-normal. The aorta is calcified and tortuous. Surgical clips are noted overlying the right axilla. Single lead left-sided pacer is seen with lead terminating in the expected location of the right ventricle.

IMPRESSION: Low lung volumes and bibasilar atelectasis. No definite focal consolidation.


SubjectID: 13687044, StudyID: 59456154, Comparison: None

FINAL REPORT

EXAM: Chest, AP upright portable view. CLINICAL INFORMATION: Respiratory distress, history of COPD, CHF.

COMPARISON: ___.

FINDINGS: Single AP upright portable view of the chest was obtained. There is a moderate right pleural effusion; underlying consolidation is not excluded. The left lung is grossly clear aside from possible mild pulmonary vascular congestion. The cardiac silhouette remains enlarged. There is no left pleural effusion or evidence of pneumothorax.

IMPRESSION: Moderate right pleural effusion, underlying consolidation is not excluded. Possible minimal pulmonary vascular congestion. Persistent cardiac silhouette enlargement.


SubjectID: 13687044, StudyID: 58563018, Comparison: None

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with ET tube, now with hypoxia, rule out acute process.

COMPARISON: ___ at 3:57 a.m.

FINDINGS: New ET tube ends 2.5 cm above the carina. Right moderate pleural effusion with passive atelectasis is unchanged. There is new collapse of the left lower lung. There is no pneumothorax. Increase in density of all the bones could raise the possibility of diffuse metastatic prostate cancer or renal insufficiency.

CONCLUSION 1. New ET tube is in adequate position. 2. New left lower lung collapse. 3. Unchanged diffuse increased density of the bones. The differential diagnostic is broad, but includes more frequently metastatic prostate cancer in male patients and renal osteodystrophy. Less frequently, it could be from hematologic or other rare metabolic disorders.


SubjectID: 13687044, StudyID: 58562383, Comparison: None

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: COPD, chronic heart failure, AFib, now on Coumadin, admitted to MICU, respiratory distress.

COMPARISON: ___.

FINDINGS: ET tube and right IJ tube are in adequate position. The distal end of the NG tube cannot be seen further from mid mediastinum. Yesterday's CT showed that it was in adequate position. Right moderate pleural effusion is unchanged. There is no pneumothorax.

CONCLUSION: 1. Tube and lines are in adequate position except for distal end of NG tube which cannot be seen. 2. Unchanged right moderate pleural effusion. 3. Stable generalized increased bone density for which the differential diagnostic was already given.


SubjectID: 13687044, StudyID: 55838092, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___.

COMPARISON: ___ radiograph.

FINDINGS: Moderate-to-large right pleural effusion has decreased in size with associated decrease in extent of adjacent atelectasis in the right lower lobe. Cardiac silhouette remains enlarged. Left lung and pleural surfaces are clear.


SubjectID: 13687044, StudyID: 54470875, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male patient status post left brachial vein catheter placement.

COMPARISON: Prior chest radiograph from ___, at 7:36.

TECHNIQUE: Portable supine AP chest radiograph.

FINDINGS: A left-sided PICC line tip crosses midline and is seen projecting over the right subclavian vein. There is no pneumothorax. Remaining support and monitoring devices are in unchanged position. Right moderate pleural effusion is unchanged. Diffuse increased bone density is stable.

IMPRESSION: Left-sided PICC line tip projects over the right subclavian vein. Repositioning is recommended. These findings were discussed with ___, RN by Dr. ___ via telephone on ___ at 11:45 a.m., at time of discovery.


SubjectID: 13687044, StudyID: 50243221, Comparison: None

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with hematemesis NG tube placement.

COMPARISON: ___ at 5:42 p.m.

FINDINGS: The distal end of the NG tube cannot be identified. It is seen until the mid mediastinum; however, subsequent CT will show that the NG tube is in adequate position. Right jugular line and ET tube are in adequate position. Left lower lobe atelectasis has recurred and is now mild. Right moderate pleural effusion with passive atelectasis is unchanged. Unchanged diffuse increased density of the bones.


SubjectID: 13687044, StudyID: 58564092, Comparison: None

FINAL REPORT

HISTORY: Diffuse alveolar hemorrhage and shock.

FINDINGS: In comparison with the study of ___, the monitoring and support devices remain in place. Right pigtail catheter remains in place and there has been no reaccumulation of pleural fluid. No pneumothorax is appreciated. There is some increasing opacification at the left base with poor definition of the hemidiaphragm. This is consistent with volume loss in the left lower lung and possible small effusion. Monitoring and support devices are otherwise unchanged.


SubjectID: 13687044, StudyID: 57913195, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male patient with GIB, pneumothorax, with new chest tube placement.

COMPARISON: Prior chest radiograph from ___, at 10:53.

TECHNIQUE: Supine portable AP chest radiograph.

FINDINGS: As compared to prior chest radiograph from ___, there has been interval placement of a right pigtail catheter which is seen in entering the lateral aspect of the right lower lung. There has been interval reexpansion of the right lung. Support and monitoring devices are unchanged in position. Left PICC line tip terminates at upper SVC.

IMPRESSION: Interval reexpansion of right lung with no evidence of pneumothorax.


SubjectID: 13687044, StudyID: 56440148, Comparison: None

WET READ: ___ ___ ___ 7:30 PM PA catheter with tip that appears to terminate in the right lower lobe branch of the pulmonary artery. ______________________________________________________________________________

FINAL REPORT

HISTORY: PA catheter.

FINDINGS: In comparison with the earlier study of this date, there has been placement of a PA catheter that extends to a lower lobe branch of the right pulmonary artery. Little overall change in the appearance of the heart and lungs.


SubjectID: 13687044, StudyID: 56404456, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___:

COMPARISON: Prior exam from earlier today. CLINICAL

HISTORY: Diffuse alveolar hemorrhage status post PICC line, assess PICC position.

FINDINGS: Portable supine AP view of the chest was provided. There is a small right pneumothorax, which is slightly more conspicuous compared with prior exam. There is no evidence of tension. This finding was discussed with Dr. ___ at approximately 11:15 a.m. on date of exam. There is an unchanged right pleural effusion which is overall small to moderate in size. Diffuse ground-glass opacity within the right lung is compatible with known alveolar hemorrhage. There is left lower lobe atelectasis. The heart is top normal in size. The left PICC line has been retracted with its tip now well situated at the level of the upper SVC. A right IJ central venous catheter tip is seen in the mid SVC. The endotracheal tube tip appears low in the trachea with its tip at the level of the carina. Retraction is advised by at least 2 cm. The enterostomy tube is not well visualized due to underpenetrated technique.

IMPRESSION: 1. Small right pneumothorax, slightly increased from prior exam. Followup advised. Findings discussed with Dr. ___ in MICU at the time of this dictation. 2. Low-lying endotracheal tube with its tip at the level of the carina. Retraction by at least 2 cm is advised. This recommendation was made with Dr. ___ at the time of this dictation. 3. Improved position of left PICC line with its tip residing in the upper SVC.


SubjectID: 13687044, StudyID: 54184668, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male patient with dCHF and hypotension. Study requested for interval change and evaluation of pneumonia.

COMPARISON: Prior chest radiograph from ___.

TECHNIQUE: Portable supine chest radiograph.

FINDINGS: A right central venous catheter is seen terminating in the right internal jugular vein or right brachiocephalic vein. As compared to prior chest radiograph from ___, patient is slightly rotated. There is a possible pleural reflection evident along the mid-upper portion of the right lung, concerning for a small right pneumothorax. There is right-sided pleural effusion with compressive atelectasis at the right lower lung base. The left hemidiaphragm is somewhat better visualized and demonstrates mild left lobe atelectasis.

IMPRESSION: 1. Pleural reflection along mid upper portion of the right lung, concerning for a small right pneumothorax. 2. Right sided pleural effusion with compressive atelectasis and mild left lobe atelectasis.


SubjectID: 13687044, StudyID: 52288926, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Respiratory failure, intubation.

COMPARISON: ___, 11:29 a.m.

FINDINGS: As compared to the previous radiograph, the right lung shows no relevant change   Keywords: no relevant change. On the left, there is increasing atelectasis, notably at the left lung bases and, potentially, occurrence of a small left pleural effusion. The tip of the left PICC line is difficult to visualize but could still be malpositioned. The re-position is required. The other monitoring and support devices are constant. The overall size of the cardiac silhouette is also unchanged. There is no evidence of pneumothorax.


SubjectID: 13687044, StudyID: 57651715, Comparison: same

FINAL REPORT

CLINICAL

HISTORY: ___-year-old man with shock, intubated and sedated, check endotracheal tube placement. CHEST, SEMI-ERECT: The patient is significantly rotated. The tip of the endotracheal tube lies 4.5 cm from the carinal angle and remains in satisfactory position. The position of the tip of the Swan-Ganz catheter is also unchanged as is that of the right IJ line. Opacification of the left base is again noted, probably unchanged. A pigtail catheter is present at the right base, unchanged in position since the previous chest. No pneumothorax is identified on this side.

IMPRESSION: No change since prior chest x-ray   Keywords: no change.


SubjectID: 13687044, StudyID: 54091915, Comparison: None

FINAL REPORT

AP CHEST, 4:29 A.M., ___

HISTORY: ___-year-old man with diffuse alveolar hemorrhage, shock and right ventricular failure.

IMPRESSION: AP chest compared to ___: No appreciable right pleural effusion with pigtail pleural catheter still present at the base of the right lung. No pneumothorax. Right basal consolidation which developed during the course of ___ has improved, probably due to resolution of a component of atelectasis. There is worsening opacification at the base of the left lung, either pneumonia or hemorrhage. Moderate cardiomegaly is longstanding. No pneumothorax. Course of the transjugular Swan-Ganz catheter is little uncertain, but it probably ends in a small branch of the right descending pulmonary artery, no less than 4 cm beyond standard positioning. Right jugular introducer ends low in the SVC. Left PIC line can be traced as far as the left brachiocephalic vein, but the tip is indistinct. ET tube in standard placement. MICU housestaff notified by telephone at 9 a.m.


SubjectID: 13687044, StudyID: 52199324, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Pulmonary hypertension, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The monitoring and support devices are constant, with the exception of the Swan-Ganz catheter that has been removed. The right pleural pigtail catheter is in unchanged position. Unchanged moderate cardiomegaly without signs of overt pulmonary edema   Keywords: unchanged. No pleural effusions. No pneumonia.


SubjectID: 13687044, StudyID: 56738306, Comparison: None

FINAL REPORT

AP CHEST, 10:05 A.M., ___

HISTORY: ___-year-old man with respiratory failure and a chest tube on the right. Evaluate interval change.

IMPRESSION: AP chest compared to ___ through ___: No right pleural effusion or pneumothorax, pigtail pleural catheter still present at the lateral aspect of the base of the right hemithorax. Previous left lower lobe consolidation has improved. The overall pattern looks more like mild pulmonary edema. Moderate cardiomegaly is chronic. ET tube in standard position. Right jugular line ends in the upper SVC. An upper enteric tube can be traced as far as the mid esophagus, but I do not see the tip and it may not extend into the stomach. Clinical correlation advised. Left PIC line ends in the upper SVC. No pneumothorax or appreciable pleural effusion.


SubjectID: 13687044, StudyID: 51773730, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Respiratory failure, chest tube on the right, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The monitoring and support devices are in constant position. The right chest tube is also unchanged. There is no evidence of pneumothorax. Unchanged size of the cardiac silhouette. A minimally increased radiodensity of the left lung base is due to patient rotation. No pleural effusions.


SubjectID: 13687044, StudyID: 50102370, Comparison: None

FINAL REPORT

HISTORY: Pneumonia and volume abnormality.

FINDINGS: In comparison with the study of ___, there is continued enlargement of the cardiac silhouette with ill-defined pulmonary vessels consistent with some elevation of pulmonary venous pressure. The area of opacification at the left base appears somewhat less prominent, consistent with slow clearing of an infectious process. Monitoring and support devices remain in place. No definite pneumothorax with the right pigtail catheter in place.


SubjectID: 13687044, StudyID: 56353212, Comparison: worse

FINAL REPORT

CLINICAL

HISTORY: ___-year-old man with CHF and dyspnea. Evaluate for CHF.

COMPARISON: ___ and ___.

FINDINGS: A frontal upright view of the chest was obtained portably. Low lung volumes result in bronchovascular crowding. Increased perihilar opacity with pulmonary vascular engorgement in the setting of cardiac enlargement is likely due to mild congestive heart failure   Keywords: increase. There is no substantial pleural effusion. No pneumothorax. Increased opacity at the left lung base may represent asymmetric edema, but supervening infection cannot be excluded. Degenerative change at the acromioclavicular joint on the left is noted with joint space narrowing.

IMPRESSION: Findings compatible with mild congestive heart failure. Recommend followup after treatment to evaluate for underlying infection.


SubjectID: 13687044, StudyID: 50345407, Comparison: better

FINAL REPORT

AP CHEST 5:22 A.M. ___

HISTORY: ___-year-old man with CHF, COPD, and short of breath.

IMPRESSION: AP chest compared to ___: Pulmonary vascular engorgement has improved and previous opacification in the lingula has cleared   Keywords: improve. Perhaps this was aspiration. There is no edema or pneumonia currently. Mild cardiomegaly is stable. Pleural abnormality is minimal if any.


SubjectID: 13687044, StudyID: 54865778, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Nasogastric tube placement. Evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has received a nasogastric tube but was extubated. The tip of the tube is not included on the image, but the course of the tube appears unremarkable. The right internal jugular vein catheter and the right pigtail catheter and the pleural spaces are in unchanged position. Unchanged appearance of the bones, the heart and the lung parenchyma.


SubjectID: 13687044, StudyID: 54057736, Comparison: None

FINAL REPORT

PORTABLE CHEST ___

COMPARISON: ___ radiograph.

FINDINGS: Indwelling support and monitoring devices are unchanged in position. Right pigtail pleural catheter remains in place in the lower right hemithorax with a probable small right pleural effusion. Unusually sharp appearance of right hemidiaphragm is unchanged, and may reflect a basilar pneumothorax. Within the left lung, an area of consolidation in the left lung base has slightly worsened, with new partial obscuration of the left hemidiaphragm. This finding probably represents an area of infectious pneumonia given clinical history of this diagnosis.


SubjectID: 13688683, StudyID: 59740052, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Septic shock, status post CoreValve.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The monitoring and support devices, including the external pacemaker are in constant position. There is constant appearance of the cardiac silhouette, with a left basal combination of effusion and parenchymal consolidation. Minimal fluid overload is present on today's image. On the right and in the left apex, there is no evidence of pathologic opacities. No pneumothorax.


SubjectID: 13688683, StudyID: 56038163, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Mechanical ventilation, septic shock, new left internal jugular vein catheter and nasogastric tube placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has received a nasogastric tube. The course of the tube is unremarkable, the tip of the tube projects over the middle parts of the stomach. The other monitoring and support devices, including the temporal pacemaker, are constant. The pre-existing opacity at the left lung bases likely multifactorial in origin, is unchanged. Unchanged size of the cardiac silhouette. Minimally improved ventilation at the right lung base.


SubjectID: 13688683, StudyID: 54701156, Comparison: None

WET READ: ___ ___ 8:47 PM ETT is low, can be withdrawn 2-3 cm. LSC at the confluence of the brachiocephalic veins. Aortic valve prosthesis noted. LLL atelectasis is likely increased. ___ d/w ___ ___ at the time of discovery who advised he had already withdrawn the tube.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: History of chronic heart failure, ETT placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, patient has been intubated. The tip of the endotracheal tube projects above the carina. The tube should be pulled back by approximately 2 cm. The left internal jugular vein catheter shows a normal course. The tip positioned relatively high in the superior vena cava. The size of the cardiac silhouette is unchanged. Unchanged position of the aortic valve replacement. Newly appeared retrocardiac atelectasis. In addition, there is a zone of increased opacity at the left lung base, potentially reflecting the left border of the moderately enlarged cardiac silhouette. No evidence of pulmonary edema. No pneumothorax.


SubjectID: 13688683, StudyID: 56223484, Comparison: better

FINAL REPORT

TYPE OF

EXAMINATION: Chest AP portable single view.

INDICATION: ___-year-old male patient status post CoreValve placement, evaluate for pulmonary edema.

FINDINGS: AP single view of the chest has been obtained with patient in semi-erect position. Comparison is made with the next preceding similar study obtained on the morning of the preceding day ___. On the present portable examination, the patient is more rotated to the right as on the preceding examination. Again noted is significant cardiac enlargement and presence of surgical clips in the left-sided mediastinal structures compatible with previous bypass surgery. Absence of the usual sternal wires is noted. The grid-shaped structures of a CoreValve device are again identified and occupy the area of the left ventricular outflow tract and the root of the aorta. These structures are in unchanged position in comparison with the previous study. Comparison of pulmonary vasculature suggests that vascular distention and perivascular haze is less marked than it was on the preceding study. Again noted are relatively high positioned diaphragms indicative of poor inspirational mechanics. No pneumothorax can be seen.

IMPRESSION: Comparison of portable chest examination suggests some improvement of pulmonary vascular congestion   Keywords: improve.


SubjectID: 13688683, StudyID: 51620787, Comparison: worse

FINAL REPORT

INDICATION: Evaluation for interval change in a patient status post core valve.

COMPARISON: ___ through ___.

FINDINGS: Portable AP semi-upright view of the chest is reviewed and compared to the prior study. An aortic core valve projects over the heart and a transvenous right internal jugular pacer follows the expected course and is unchanged in position. Interstitial abnormality is unchanged since ___, but increased since ___, probably due to edema, exaggerated by low post operatived lung volumes   Keywords: increase. There is no significant pleural effusion or pneumothorax. The cardiomediastinal silhouette, reflecting mild cardiomegaly, are unchanged. Elevation of the left hemidiaphragm is chronic.

IMPRESSION: 1. Mild interstitial edema stable since ___, increased since ___   Keywords: increase.


SubjectID: 13695016, StudyID: 57866465, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with sepsis, AF, colitis // acute process, pleural effusion change

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Moderate cardiomegaly. Small to moderate right pleural effusion with subsequent atelectasis at the right lung bases. No change in appearance of the left lung   Keywords: no change. Unchanged position of the right internal jugular vein catheter.


SubjectID: 13695016, StudyID: 54994909, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with septic shock // Interval change, infiltrate, pulmonary edema

IMPRESSION: As compared to ___ radiograph, the appearance of the chest is remarkable for slight worsening of moderate right pleural effusion with adjacent right middle and right lower lobe atelectasis. No other relevant


SubjectID: 13695016, StudyID: 52917142, Comparison: None

WET READ: ___ ___ ___ 9:21 AM Right internal jugular venous catheter terminates in low SVC. Increased right lung base opacity may represent increased moderate right pleural effusion . Increased mild left lung base opacity is probably secondary to atelectasis, however pneumonia is possible in correct clinical setting.

WET READ VERSION #1 ___ ___ ___ 3:57 AM Right internal jugular venous catheter terminates in low SVC. Increased right lung base opacity may represent increased moderate right pleural effusion . Increased mild left lung base opacity is probably secondary to atelectasis, however pneumonia is possible in correct clinical setting. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with septic shock // eval line placement, eval for pna

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the patient has received a right internal jugular vein catheter. The tip of the catheter projects over the right atrium. Unchanged evidence of low lung volumes. Moderate cardiomegaly and a right pleural effusion, combines to a right basal parenchymal opacity. No complications, notably no pneumothorax.


SubjectID: 13695016, StudyID: 56590554, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with known effusions now with more SOB // progression of effusion/pulmonary edema progression of effusion/pulmonary edema

IMPRESSION: Comparison to ___. No relevant change   Keywords: no relevant change. The extent of the bilateral pleural effusions is constant. No new focal parenchymal opacities   Keywords: new. Unchanged size of the cardiac silhouette.


SubjectID: 13695016, StudyID: 51248300, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___ year old man s/p dual chamber ICD. // assess lead placement and r/o PTx.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph dated ___.

FINDINGS: The newly placed left pacemaker defibrillator has 1 tip in the right atrium the other in the expected region of right ventricle. A right IJ catheter tip projects over the expected region of the proximal right atrium, unchanged. Lung volumes remain low. A large right pleural effusion with compressive atelectasis has slightly increased in the interim. Left pleural effusion with compressive atelectasis appears to increased in the interim. There may be a tiny right apical pneumothorax. No evidence of tension. Cardiomegaly, unchanged.

IMPRESSION: 1. Satisfactory placement of new left ICD. 2. Interval increase in large, right greater than left, pleural effusions and atelectasis. 3. Tiny right apical pneumothorax without evidence of tension.


SubjectID: 13695016, StudyID: 54637981, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with rib pain, r/o fx // ___ year old man with rib pain, r/o fx ___ year old man with rib pain, r/o fx

IMPRESSION: Minimal interval decrease of a pre-existing right pleural effusion. Stable extent of a previously existing left pleural effusion. The areas of pre-existing bilateral parenchymal atelectasis are proportional to the extent of the effusions. No new focal parenchymal abnormalities. No pneumothorax. No convincing evidence for the presence of a rib fracture. If rib fractures are suspected, a dedicated rib series should be performed.


SubjectID: 13695016, StudyID: 51079994, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CP // Eval for cardiopulmonary prcoess

IMPRESSION: Compared to ___ chest radiograph, a moderate right pleural effusion has increased in size with adjacent worsening right mid and lower lung opacity. Additionally, a previously present small left pleural effusion is now moderate in size with adjacent worsening left retrocardiac atelectasis or consolidation. No other relevant changes   Keywords: no other relevant change.


SubjectID: 13696494, StudyID: 56771891, Comparison: 0.0

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Acute decompensation, evaluation for pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is substantial improvement of the pre-existing pulmonary edema, with reduction in size of the pulmonary vessels and reduction of the pre-existing peribronchial cuffing   Keywords: improve. However, signs of mild-to-moderate pulmonary edema still present   Keywords: still. Lung volumes remain low. No pleural effusions, moderate cardiomegaly.


SubjectID: 13696494, StudyID: 52076008, Comparison: same

FINAL REPORT

INDICATION: History of decompensated heart failure. Please evaluate for interval change in pulmonary edema.

COMPARISONS: None.

TECHNIQUE: Single AP portable exam of the chest.

FINDINGS: Again seen is mild cardiomegaly. The hilar and mediastinal contour is unremarkable. Again noted are left perihilar and bibasilar opacities, overall unchanged compared to the prior exam. There are small bilateral pleural effusions. There is no pneumothorax. The visualized osseous structures are unremarkable.

IMPRESSION: Stable left perihilar and bibasilar alveolar opacities concerning for moderate bilateral pulmonary edema   Keywords: stable.


SubjectID: 13696494, StudyID: 50093445, Comparison: better

FINAL REPORT

HISTORY: ___-year-old male with congestive heart failure, evaluate improvement in pulmonary edema.

TECHNIQUE: Portable erect AP chest radiographs obtained.

COMPARISON: Chest radiograph from ___.

FINDINGS: Mild pulmonary edema continues to be seen, but interval improvement is noted   Keywords: improve. Heart size has decreased in size but continues to be mildly enlarged. No consolidation, pneumothorax or pleural effusion is seen.

IMPRESSION: Interval improvement in pulmonary edema   Keywords: improve.


SubjectID: 13700088, StudyID: 59542064, Comparison: None

FINAL REPORT

INDICATION: Hypoxia.

COMPARISON: ___. SEMI-UPRIGHT AP VIEW OF THE CHEST: The heart size appears moderately enlarged. The mediastinum demonstrates tortuosity of the thoracic aorta. There is perihilar haziness with vascular indistinctness, compatible with mild pulmonary edema. Hazy opacities in both lung bases likely reflect small layering bilateral pleural effusions with associated bibasilar atelectasis. No large pneumothorax is identified. There are no acute osseous abnormalities.

IMPRESSION: Mild pulmonary edema with small bilateral pleural effusions and bibasilar atelectasis.


SubjectID: 13700088, StudyID: 53970354, Comparison: worse

FINAL REPORT

AP CHEST, 6:05 A.M., ___

HISTORY: Intubated for hypercarbia. Mild pulmonary edema.

IMPRESSION: An AP chest performed with the patient rotated severely to the right, excludes lateral right lower chest. It shows moderate left pleural effusion stable or increased since ___, but improvement in pulmonary vascular engorgement and mild edema   Keywords: increase. Severe right lower lobe atelectasis is presumed and the volume of right pleural effusion cannot be assessed. There is no pneumothorax seen along the imaged pleural surfaces. ET tube is in standard placement. Right central venous line ends low in the SVC and a nasogastric tube passes below the diaphragm and out of view. Heart is not appreciably enlarged, but difficult to compare with prior images.


SubjectID: 13700088, StudyID: 55908245, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: ___. CLINICAL

HISTORY: Pulmonary disease with altered mental status, assess for pneumonia.

FINDINGS: PA and lateral views of the chest are obtained. There is mild interstitial pulmonary edema without focal consolidation to suggest pneumonia. No large pleural effusion or pneumothorax is seen. Heart size is grossly stable. Central pulmonary vasculature appears engorged. Bony structures are intact.

IMPRESSION: Mild CHF. No signs of pneumonia.


SubjectID: 13700088, StudyID: 52081127, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: ETT placement.

COMPARISON: ___.

FINDINGS: In the interval, the patient has been intubated. The tip of the endotracheal tube projects approximately 4.5 cm above the carina. In addition, the patient has received a nasogastric tube. The course of the tube is unremarkable, the tip of the tube is not included in the image. There is no evidence of complications, notably no pneumothorax. Moderate cardiomegaly with signs of minimal fluid overload. No pleural effusions.


SubjectID: 13718173, StudyID: 59947715, Comparison: worse

FINAL REPORT

HISTORY: Severe AF from leukocytosis, question pulmonary edema, pneumonia. CHEST, TWO VIEWS. Compared with ___, there has been a marked change in the radiographic appearance. There are now diffuse interstitial and alveolar opacities in both lungs, with upper zone redistribution. No gross right and no definite left effusion. Left lower lobe collapse and/or consolidation is again seen. The patient is status post sternotomy, with cardiomegaly and a left ventricular configuration as well as a prosthetic valve. The cardiomediastinal silhouette may be very slightly more prominent, though likely also accentuated by differences in technique. A right-sided central line is present, tip over proximal SVC, unchanged.

IMPRESSION: 1. Interval development (over one day) of increased interstitial and alveolar opacities in both lungs with upper zone redistribution   Keywords: increase. This most likely represents CHF, given the rapidity of development   Keywords: development. 2. Continued left lower lobe collapse and/or consolidation. The possibility of a pneumonic infiltrate associated with this cannot be excluded. Findings were discussed with Dr. ___ at the time of discovery at 2:50 p.m. on the day of the exam (___, phone).


SubjectID: 13718173, StudyID: 59225026, Comparison: None

FINAL REPORT

HISTORY: History of CHF.

TECHNIQUE: Frontal view of the chest.

COMPARISON: Multiple chest radiographs the most recent on ___.

FINDINGS: An endotracheal tube and feeding tube have been removed since the prior study. The right internal jugular line tip is at the level of the mid SVC and unchanged. The right lung is clear. There is a retrocardiac opacity at the base of the left lung, which is similar in appearance to the prior study. The heart is enlarged and the hilar contours are normal. There is no evidence of pneumothorax. There is a very small left pleural effusion.

IMPRESSION: Large left lower lobe consolidation, persistent over 3 days, could represent pneumonia or lobar collapse.


SubjectID: 13718173, StudyID: 58862891, Comparison: None

FINAL REPORT

HISTORY: Post-AVR pleural effusions.

FINDINGS: In comparison with study of ___, there is substantial increase in the right pleural effusion with continued small left effusion. No evidence of mediastinal shift indicating some compensatory atelectasis at the right base. The central catheters have been removed. No definite evidence of pulmonary vascular congestion.


SubjectID: 13718173, StudyID: 54646077, Comparison: None

WET READ: ___ ___ ___ 8:18 PM chest tube projects over right hemithorax with interval decrease in right pleural effusion. there is a small right apical pneumothorax. small left pleural effusion with atelectasis, similar to prior. -___ d/w ___ by phone at 8:17pm on ___.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post right thoracocentesis, evaluation for pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has undergone right thoracocentesis. The chest tube projects over the right hemithorax, there is a marked decrease in extent of the right pleural effusion. Small right apical post-procedural pneumothorax. No evidence of tension. The appearance of the left hemithorax and of the heart is unchanged.


SubjectID: 13718173, StudyID: 51681368, Comparison: None

FINAL REPORT

HISTORY: Right-sided effusion and increasing shortness of breath.

COMPARISON: ___.

FINDINGS: Portable upright chest radiograph. Moderate to large right and small left pleural effusions are unchanged from 1 day prior, increased from ___. Aside from accompanying atelectasis, the lungs are clear without pneumothorax. The heart and mediastinal contours as well as postsurgical changes are unchanged.

IMPRESSION: Unchanged moderate-to-large right and small left pleural effusion from 1 day prior.


SubjectID: 13718173, StudyID: 57915409, Comparison: None

FINAL REPORT

PORTABLE CHEST FILM, ___ AT 7:13 CLINICAL

INDICATION: ___-year-old with mechanical AVR, left apical pneumothorax with chest tube on waterseal. Comparison to prior study dated ___ at 8:23 and ___ at 10:10.

IMPRESSION: A right internal jugular large-bore catheter and feeding tube are unchanged in position. A left basilar chest tube remains in place. A left subclavian introducer is also unchanged. There is a stable small left apicolateral pneumothorax. Overall cardiac and mediastinal contours are stable status post median sternotomy with CABG. There is blunting of the left costophrenic angle likely reflecting a small effusion and/or pleural thickening. Streaky patchy opacity in the retrocardiac region likely reflects resolving partial lower lobe atelectasis. There is no evidence of pulmonary edema.


SubjectID: 13718173, StudyID: 53373447, Comparison: None

WET READ: ___ ___ ___ 10:09 PM Newly placed left to is coiled in the expected position of the stomach. Remaining support devices are well positioned. Stable retrocardiac opacification ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post redo sternotomy. Evaluation for nasogastric tube placement.

COMPARISON: ___, 10:10 a.m.

FINDINGS: As compared to the previous radiograph, the patient has received a Dobbhoff catheter. The Dobbhoff catheter is in correct position. The tip is pointed towards the gastroesophageal junction and projects over the proximal parts of the stomach. The other monitoring and support devices are unchanged in appearance. The pre-described small left pneumothorax is not visible on the current image, given that the lung apices are not included.


SubjectID: 13718173, StudyID: 51305964, Comparison: None

FINAL REPORT

PORTABLE CHEST FILM, ___ AT 10:54 CLINICAL

INDICATION: ___-year-old with redo AVR, rule out pneumothorax, status post discontinuing of chest tube. Comparison to prior study of ___ at 7:13 a.m. A portable AP upright chest film ___ at 10:54 is submitted.

IMPRESSION: 1. Right internal jugular central line. Left subclavian introducer catheter and feeding tube are unchanged in position. There has been interval removal of the left basilar chest tube. There continues to be a small but stable left apical lateral pneumothorax given differences in positioning. The patient is status post median sternotomy with stable cardiac and mediastinal contours. There is blunting of the left costophrenic angle, which may reflect a small effusion or pleural thickening. No pulmonary edema. Patchy retrocardiac opacity likely reflects patchy atelectasis, although superimposed infectious process should also be considered.


SubjectID: 13718173, StudyID: 51269527, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post redo sternotomy, rule out pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the radiograph from ___, 10:10 a.m., the known left apical pneumothorax has minimally increased in extent. There is no evidence of tension, the left chest tube is in unchanged position. The Swan-Ganz catheter has been removed. The other monitoring and support devices are constant. In addition, the patient has received a Dobbhoff catheter, as noted on the previous exam. Minimal atelectasis at the left lung base persists. The right lung shows unchanged appearance   Keywords: unchanged appearance. The sternal wires are constant.


SubjectID: 13718173, StudyID: 57872919, Comparison: same

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiographs of two days earlier.

FINDINGS: Cardiomegaly is accompanied by persistent widespread interstitial edema   Keywords: persistent. More confluent opacities at the lung bases are present, and have markedly progressed in the left lower lobe in the interval. It is uncertain whether this represents dependent pulmonary edema or a superimposed process such as aspiration or developing infectious pneumonia. Followup radiographs after diuresis may be helpful in this regard. Moderate left pleural effusion has increased in size since the prior study. There is no visible pneumothorax.


SubjectID: 13718173, StudyID: 56042178, Comparison: None

FINAL REPORT

CLINICAL

HISTORY: Severe coronary artery disease, now with acute dyspnea. CHEST, AP:

COMPARISON: ___. There is diffuse pulmonary edema which was not present on the prior chest x-ray. Cardiac size is mildly enlarged.

IMPRESSION: Pulmonary edema.


SubjectID: 13718173, StudyID: 52843738, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Intubation, assessment.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has been intubated. The tip of the endotracheal tube projects 2 cm above the carina. A nasogastric tube is in normal position. The tip is not visualized on the image. Mild overinflation of the stomach. Right internal jugular vein catheter in correct position. As compared to the previous image, there is ongoing evidence of rather centralized pulmonary edema   Keywords: ongoing. Unchanged substantial retrocardiac atelectasis. No pneumothorax. Status post valvular repair and sternotomy.


SubjectID: 13718173, StudyID: 52822519, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Intubation, assessment for interval change.

COMPARISON: ___, 1:15 a.m.

FINDINGS: As compared to the previous radiograph, the lung volumes have improved, likely reflecting improved ventilation. The signs indicative of pulmonary edema have decreased   Keywords: decrease. There is persistent atelectasis at the left lung bases and in the retrocardiac areas. Unchanged appearance of the cardiac silhouette. No pneumonia, no pneumothorax. No larger pleural effusions. The monitoring and support devices are constant.


SubjectID: 13718173, StudyID: 57349269, Comparison: better

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph of one day earlier.

FINDINGS: Stable mild cardiomegaly but interval improvement in pulmonary vascular congestion and decreased extent of interstitial edema   Keywords: decrease, improve. A more confluent area of airspace opacification at the right lung base has also partially cleared. Small pleural effusions are present bilaterally. No detectable pneumothorax.


SubjectID: 13718173, StudyID: 53477994, Comparison: None

WET READ: ___ ___ 10:40 PM right pneumothorax is minimally smaller than on ___. new right basilar opacity may be reaccumulating pleural effusion vs atelectasis or aspiration. stable left pleural effusion

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

HISTORY: Thoracentesis with small residual pneumothorax.

FINDINGS: In comparison with the study of ___, there is little change in the appearance of the small right apical pneumothorax. However, there is increasing opacification at the right base, which could reflect any combination of increasing effusion, volume loss, or even supervening pneumonia.


SubjectID: 13721087, StudyID: 57740278, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, evaluation of pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is unchanged massive cardiomegaly with signs of moderate pulmonary edema   Keywords: unchanged. No pleural effusions. Atelectasis at both lung bases, but no evidence of pneumonia. Pacemaker and right hemodialysis catheter are in unchanged position.


SubjectID: 13721087, StudyID: 50939307, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Severe heart failure, multiple central lines, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is unchanged evidence of mild-to-moderate fluid overload and massive cardiomegaly   Keywords: unchanged. None of the two findings has further increased in extent and severity. Unchanged alignment of sternal wires, unchanged overall monitoring and support devices. No new parenchymal opacities   Keywords: new. No larger pleural effusions.


SubjectID: 13723259, StudyID: 58557612, Comparison: worse

FINAL REPORT

INDICATION: Acute kidney injury, on hemodialysis with severe aortic stenosis with increasing dyspnea on exertion.

COMPARISON: Chest radiographs ___, ___.

FINDINGS: The heart size remains normal. There has been reaccumulation of small bilateral pleural effusions with associated compressive atelectasis. Slight vascular congestion is present. There is no focal consolidation concerning for pneumonia.

IMPRESSION: New small bilateral pleural effusions with mild vascular congestion   Keywords: new.


SubjectID: 13723259, StudyID: 51384851, Comparison: better

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with new diagnosis of multiple myeloma, acute renal failure, interval change in pulmonary edema?

COMPARISON: ___.

FINDINGS: Significant improvement since ___ of the moderate pulmonary edema, which is now minimal   Keywords: improve. The bibasilar atelectasis has also improved. There are residual small bilateral pleural effusions. There is no pneumothorax and mediastinal and cardiac contours are normal.

CONCLUSION: 1. Significant improvement of pylmonary edema, which is now mild   Keywords: improve. 2. Residual small bilateral pleural effusions.


SubjectID: 13723709, StudyID: 59451183, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is improved ventilation of the upper and mid lung zones. The pre-existing opacities in these lung regions have almost completely resolved. Relatively minor opacities persist at both lung bases and are likely atelectatic in origin. Moderate cardiomegaly. The monitoring and support devices are constant in appearance.


SubjectID: 13723709, StudyID: 55950861, Comparison: worse

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph of one day earlier.

FINDINGS: Indwelling support and monitoring devices are in standard position. Stable cardiomegaly accompanied by pulmonary vascular congestion and worsening pulmonary edema as well as enlarging pleural effusions, now moderate in size bilaterally   Keywords: worse.


SubjectID: 13723709, StudyID: 50408499, Comparison: better

FINAL REPORT

PORTABLE AP CHEST FILM ___ AT 10:28 CLINICAL

INDICATION: ___-year-old intubated for respiratory failure, assess endotracheal tube position. Comparison is made to prior study of ___ at 4:09.

IMPRESSION: 1. Endotracheal tube continues to have its tip approximately 4 cm above the carina. The nasogastric tube is seen coursing below the diaphragm with the tip not identified. Right internal jugular central line has its tip in the mid SVC unchanged. There is a layering left effusion. Patchy bibasilar airspace opacities are now seen suggestive of atelectasis, although a superimposed infection cannot be excluded. There has been interval improvement in the mild perihilar edema   Keywords: improve. No pneumothorax is appreciated. Overall cardiac and mediastinal contours are stable.


SubjectID: 13723709, StudyID: 57743914, Comparison: None

FINAL REPORT

PORTABLE CHEST FILM ___ AT 4:04 A.M. CLINICAL

INDICATION: ___-year-old intubated for respiratory distress. Evaluate for interval change. Comparison is made to the patient's prior study of ___ at 17:38. A portable semi-erect chest film ___ at 4:04 is submitted.

IMPRESSION: 1. Endotracheal tube and nasogastric tube are likely unchanged in position. There continue to be bibasilar airspace opacities with likely associated pleural effusions suggestive of compressive atelectasis, although aspiration or pneumonia should also be considered. There is asymmetry in the perihilar vasculature, right being more pronounced than the left, which is of uncertain clinical significance, though could indicate a component of asymmetric perihilar edema. Followup imaging would be advised. No pneumothorax. Overall cardiac and mediastinal contours are likely unchanged given differences in positioning.


SubjectID: 13723709, StudyID: 56421977, Comparison: None

FINAL REPORT

PORTABLE AP CHEST FILM FROM ___ AT 4:09 CLINICAL

INDICATION: ___-year-old with severe respiratory distress. Comparison to prior study of ___ at 18:27. Portable AP upright chest film ___ at 4:09 is submitted.

IMPRESSION: 1. Endotracheal tube, nasogastric tube, and right internal jugular central line are likely unchanged in position. The lung volumes remain low and there are patchy bibasilar opacities with associated likely layering effusions suggestive of compressive atelectasis. Pneumonia cannot be excluded. Since the prior study, there has been interval appearance of superimposed mild pulmonary edema. No pneumothorax is seen. Overall cardiac and mediastinal contours are stably enlarged given patient rotation.


SubjectID: 13724584, StudyID: 59792939, Comparison: better

FINAL REPORT

HISTORY: Pneumonia and heart failure.

FINDINGS: In comparison with study of ___, there is some progressive decrease in the degree of pulmonary vascular congestion   Keywords: decrease. Areas of more coalescent opacification in the left perihilar region and the right base and mid zone may well reflect residual pneumonia. Pacer device remains in good position.


SubjectID: 13724584, StudyID: 54040628, Comparison: better

FINAL REPORT

HISTORY: CHF.

FINDINGS: In comparison with the study of ___, there may be mild decrease in the diffuse bilateral pulmonary opacifications, again most likely a combination of pulmonary edema and pneumonia   Keywords: decrease. Areas of opacification at the bases have reflected small pleural effusions, are less prominent, possibly related to change in patient position.


SubjectID: 13724584, StudyID: 54941633, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old woman with known CHF, with weakness and malaise.

COMPARISON: Chest radiograph done earlier today at 11:52 a.m. PORTABLE AP CHEST RADIOGRAPH: There is stable mild cardiomegaly. The hilar and mediastinal contours are stable, with moderate aortic calcification. Mild pulmonary edema is slightly worse since the earlier study done today at 11:52 a.m. There is increasing consolidation in the right lung base, consistent with pneumonia. Streaky opacities in the left lung base, likely represent atelectasis. No large pleural effusion or pneumothorax is seen. A left chest wall AICD device is seen with leads in expected position in the right atrium and right ventricle.

IMPRESSION: Worsening right lower lobe pneumonia and mild pulmonary edema   Keywords: worse.


SubjectID: 13724584, StudyID: 50357332, Comparison: worse

FINAL REPORT

PORTABLE CHEST OF ___

COMPARISON: ___ radiograph.

FINDINGS: Worsening multifocal areas of consolidation are present, including a dominant opacity in the right infrahilar region involving portions of the right lower and right middle lobes. Additionally, relatively symmetrical perihilar opacities have progressed in the interval as well as an area of opacity in the left retrocardiac region. Small pleural effusions have increased in size.

IMPRESSION: Worsening multifocal pulmonary opacities, likely a combination of pulmonary edema and pneumonia   Keywords: worse. Bilateral small pleural effusions.


SubjectID: 13739802, StudyID: 57039558, Comparison: worse

FINAL REPORT

HISTORY: Leukocytosis and cough.

TECHNIQUE: Single, AP, portable view of the chest with the patient in an upright position.

COMPARISON: Comparison is made to radiographs dated ___.

FINDINGS: As compared to the prior examination, there has been minimal interval change. Redemonstrated is severe emphysema with increased interstitial markings and several large bullae   Keywords: increase. There is no definitive consolidation, pleural effusion, pneumothorax, or pulmonary edema identified. Stable, mild cardiomegaly is noted. Mediastinal hilar contours are largely unchanged from prior examination.

IMPRESSION: Severe emphysema. Given the patient's baseline chronic lung disease, is difficult to exclude a superimposed acute process in the appropriate clinical setting.


SubjectID: 13739802, StudyID: 52530038, Comparison: None

FINAL REPORT

HISTORY: ___-year-old male status-post fall 1 week prior with several rib fractures on the left. Evaluation for pneumothorax.

COMPARISON: Comparison is made to radiograph of the chest from ___. This study is read in conjunction with CT of the chest from ___ and CT of the abdomen and pelvis from 3 hours prior.

FINDINGS: PA and lateral views of the chest demonstrate relative flattening of the bilateral hemidiaphragms and multiple bullae, consistent with severe emphysema. There is no evidence of pleural effusion, pulmonary edema, or pneumothorax. No focal consolidation is identified. The cardiomediastinal silhouette is stable and the aorta is somewhat tortuous. Left-sided rib deformities are again seen, consistent with healed fractures.

IMPRESSION: 1. No evidence of pneumothorax or other acute cardiopulmonary process. 2. Severe emphysema.


SubjectID: 13745545, StudyID: 59152994, Comparison: better

FINAL REPORT

INDICATION: ___-year-old male status post history of COPD, DCHF and interstitial lung disease, status post recent biopsy of right lower lobe lesion.

COMPARISON: Chest radiograph ___ and a chest CT ___. PA AND LATERAL CHEST RADIOGRAPHS: The cardiomediastinal and hilar contours are normal. Subtle opacity in the right lower lobe, likely represents post-biopsy changes. Known right lower lobe consolidation is not visualized in the current study. Again seen is heterogeneous opacification of the retrocardiac left lower lobe, slightly improved since the prior study, suggestive of improving edema. A stable small right pleural effusion and mild increase in a small left pleural effusion is noted. No new consolidation or pneumothorax is detected. Dense calcifications of the pericardium are noted. Left chest wall AICD device is seen with leads in the expected position of the right atrium and right ventricle.

IMPRESSION: 1. Improving left lower lobe changes, likely represent improving edema   Keywords: improving. 2. Hazy opacity in the right lower lobe, likely represents post-biopsy changes. 3. Emphysema and bilateral small pleural effusions.


SubjectID: 13745545, StudyID: 53908730, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old man with lung mass. Status post right lung biopsy. Evaluate for pneumothorax.

FINDINGS: Comparison is made to prior study from ___. There is a dual-lead left-sided pacemaker with lead tips in the right atrium and right ventricle. Cardiac silhouette is enlarged but unchanged. There are again seen opacities within the lung bases as well as bilateral pleural effusions. No pneumothoraces are seen on either side. There is a focus of calcification adjacent to the right humeral head consistent calcific tendinitis.


SubjectID: 13745545, StudyID: 51276270, Comparison: None

FINAL REPORT

CHEST, TWO VIEWS ON ___

HISTORY: Bronchiolitis obliterans with increased dyspnea. REFERENCE EXAM: ___.

FINDINGS: Again seen is severe cardiomegaly and a dual-lead pacemaker. There are bilateral pleural effusions, left greater than right. However, the aeration in the lower lobes is slightly improved compared to the study from one week prior. There continues to be patchy bilateral lower lobe infiltrates and an underlying infectious infiltrate cannot be excluded. Overall, the previously described lung nodules are better visualized on the CT from ___ and diffuse increase in lung markings consistent with the patient's history of chronic lung disease are again seen.


SubjectID: 13745545, StudyID: 50437966, Comparison: worse

FINAL REPORT

CHEST

HISTORY: Pulmonary hypertension and severe AS with increasing dyspnea. REFERENCE EXAM: ___.

FINDINGS: Compared to the film from the prior day, the heart is slightly larger. The left effusion is larger and the pulmonary vascular redistribution is worse. Alveolar infiltrate in the right lower lobe is also slightly worse. The overall impression is that of CHF which is worsened in the interval   Keywords: worse. The dual-lead pacemaker is unchanged.


SubjectID: 13757356, StudyID: 59087176, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p AVR // eval for line placement and pneumo eval for line placement and pneumo

IMPRESSION: Comparison 2 ___, 14:11. All chest tubes and mediastinal drains have been removed. There currently is no evidence for the presence of a pneumothorax. The venous introduction sheet in the right internal jugular vein has been replaced by a right internal jugular vein access line, the tip projects over the upper to mid SVC. No complications. Unchanged moderate cardiomegaly with mild retrocardiac atelectasis but no overt pulmonary edema. No pleural effusions.


SubjectID: 13757356, StudyID: 53861311, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with as above // s/p CABG w/dropping HCT r/o effusion

IMPRESSION: Compared to ___, cardiomediastinal contours are stable. With moderate right and small left pleural effusions have apparently slightly increased in size in the interval with adjacent worsening bibasilar atelectasis and or consolidation. No pneumothorax.


SubjectID: 13757356, StudyID: 51974105, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with as above // s/p CABG w/increased drainage from chest tube sites r/o effusion s/p CABG w/increased drainage from chest tube sites r/o effusion

IMPRESSION: As compared to the previous radiograph from ___, the patient has developed bilateral small pleural effusions, blunting the costophrenic sinuses. In addition, areas of atelectasis at both the left and the right lung bases have newly appeared. No evidence of pneumonia. No pneumothorax. The alignment of the sternal wires continues to be normal. Moderate cardiomegaly without pulmonary edema. Unchanged position of the right internal jugular vein catheter.


SubjectID: 13757356, StudyID: 51139543, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p AVR // eval for pneumo eval for pneumo

IMPRESSION: The patient is now extubated and the nasogastric tube was removed. Also removed is the Swan-Ganz catheter. The mediastinal drains and chest tubes are in unchanged position. No pneumothorax. No larger pleural effusions. Minimal retrocardiac atelectasis. No pulmonary edema. Normal appearance of the cardiac silhouette.


SubjectID: 13757356, StudyID: 57548987, Comparison: worse

WET READ: ___ ___ 10:03 PM There has been no significant interval change compared to the prior radiograph performed earlier on the same date. There is pulmonary vascular congestion, without over pulmonary edema. Bibasilar atelectasis, with likely a small right-sided pleural effusion. No pneumothorax. Heart size is normal. Median sternotomy wires are intact. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with aortic regurgitation and chest pain and now with acute onset hypoxia in the setting of elevated BPs // Flash pulmonary edema? Flash pulmonary edema?

COMPARISON: Chest radiographs ___.

IMPRESSION: Right pleural effusion developed between ___ and ___ comment and small bilateral pleural effusions were larger on ___. Small right pleural effusion remains, unchanged since ___. If there is any left pleural effusion it is not large. There is no pneumothorax. Borderline cardiomegaly is stable since ___ but mild interstitial edema and pulmonary vascular congestion have worsened   Keywords: worse.


SubjectID: 13757356, StudyID: 56366133, Comparison: None

FINAL REPORT

INDICATION: History: ___M with NSTEMI // ?pleural effusion?

TECHNIQUE: Upright AP chest

COMPARISON: Chest radiographs ___ through ___

FINDINGS: The lung volumes are slightly low. There is mild bibasilar atelectasis. Cardiomediastinal silhouette is stable. There is mild pulmonary vascular congestion without frank pulmonary edema. Small bilateral pleural effusions, right greater than left are unchanged. There is no pneumothorax.

IMPRESSION: Unchanged small bilateral pleural effusions, right greater than left. Pulmonary vascular congestion without frank pulmonary edema.


SubjectID: 13757356, StudyID: 53231174, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with severe aortic regurgitation in need of eval for cardiac surgery // surgical work up Surg: ___ (aortic valve replacement) surgical work up

IMPRESSION: As compared to ___, no relevant change is seen   Keywords: no relevant change. The sternal wires show correct alignment. Moderate cardiomegaly. Mild fluid overload but no overt pulmonary edema. The extent of the known right pleural effusion is constant.


SubjectID: 13757356, StudyID: 51580891, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man s/p Redo sternotomy AVR // eval for effusion eval for effusion

COMPARISON: ___

IMPRESSION: Right internal jugular line tip is at the level of superior SVC. Heart size and mediastinum are unchanged in position. Bilateral pleural effusions, right more than left in atelectasis are unchanged. No pneumothorax.


SubjectID: 13757356, StudyID: 51278957, Comparison: None

WET READ: ___ ___ ___ 6:47 PM Right-sided central venous catheter in unchanged position Likely persistent bilateral pleural effusions No significant change, given differences in technique, from study from 2 hours prior ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p redo AVR // eval for effusion eval for effusion

COMPARISON: ___ obtained at 16:22

IMPRESSION: Post sternotomy wires are unchanged. Bilateral pleural effusions appear to be increased since the prior study substantially and giving the repeat ___ of the change might potentially represent hemothorax. No pneumothorax is appreciated. Perihilar pulmonary edema is re- demonstrated. Right central venous line tip terminates at the level of superior SVC.


SubjectID: 13762124, StudyID: 58668356, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: CAD, intubation, respiratory failure, rule out pneumonia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The bilateral parenchymal opacities, left more than right, located at the lung bases, constant in appearance. Unchanged size of the cardiac silhouette. Absence of new parenchymal opacities   Keywords: new. The vertebral fixation devices are constant. In the interval, the patient has been extubated, but the right internal jugular vein catheter persists.


SubjectID: 13762124, StudyID: 55810633, Comparison: better

FINAL REPORT

HISTORY: Female with history of coronary artery disease, status post multiple PCIs, presents with CHF exacerbation. Assess for interval change.

COMPARISON: Chest radiographs, ___, ___, ___. CTA chest, ___.

TECHNIQUE: Single portable frontal chest radiograph.

FINDINGS: ET tube is 4 cm above the level of the carina and is in good position. NG tube extends into the proximal stomach and is out of view. Right IJ tip is in low SVC. Chronic reticular interstitial pattern at the lung bases appear unchanged. No interval change in mild pulmonary edema, however, has improved since ___   Keywords: improve. No interval change in mild bibasilar atelectasis and small bilateral pleural effusions. Heart is top normal in size with normal mediastinal and hilar contours. No pneumothorax.

IMPRESSION: 1. Minimal improvement in mild pulmonary edema on a scaffold of predominantly basal interstitial lung disease   Keywords: improve. 2. No interval change in mild bibasilar atelectasis and small pleural effusions.


SubjectID: 13762124, StudyID: 53910472, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure exacerbation, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the monitoring and support devices are in unchanged position. Unchanged bilateral reticular opacities, likely to reflect a combination of mild fibrosis and interstitial lung edema   Keywords: unchanged. Unchanged normal size of the cardiac silhouette. No new parenchymal opacities   Keywords: new.


SubjectID: 13762124, StudyID: 58546431, Comparison: None

FINAL REPORT

HISTORY: CHF exacerbation.

FINDINGS: In comparison with the study of ___, the monitoring and support devices are essentially unchanged. Nasogastric tube extends well into the stomach. Bibasilar opacifications persist, consistent with a combination of atelectasis and effusion. Endotracheal tube is now in place with its tip approximately 5 cm above the carina.


SubjectID: 13762124, StudyID: 54886008, Comparison: None

FINAL REPORT

HISTORY: CAD with CHF exacerbation.

FINDINGS: In comparison with the earlier study of this date, the aberrant NG tube has been removed. Little change in the appearance of the heart and lungs with bibasilar opacifications consistent with pleural effusion and atelectasis at the bases.


SubjectID: 13762124, StudyID: 54303987, Comparison: None

FINAL REPORT

HISTORY: NG placement.

FINDINGS: In comparison with the earlier study of this date, nasogastric tube has been placed into the left main stem bronchus. This was recognized by the clinical team and has been removed. Little change in the appearance of the heart and lungs.


SubjectID: 13762124, StudyID: 58315311, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH.

INDICATION: ARDS, evaluation for tubes and lines.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the monitoring and support devices are in unchanged position. This includes the Swan-Ganz catheter, pericardial drain, the endotracheal tube, the nasogastric tube and the cervical stabilization devices. The appearance of the lung parenchyma is not substantially changed as compared to the previous image. There is no pneumothorax. Constant appearance of the cardiac silhouette. No larger pleural effusions.


SubjectID: 13762124, StudyID: 53777706, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Intubation, pneumonia, questionable progression.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the opacities in the lung parenchyma have decreased in severity but are unchanged in extent   Keywords: decrease. In the interval, the patient has received a nasogastric tube and Swan-Ganz catheter. Swan-Ganz catheter is in correct position. There is no pneumothorax. Unchanged size of the cardiac silhouette.


SubjectID: 13762124, StudyID: 50861263, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: CHEST, AP PORTABLE SINGLE VIEW.

INDICATION: ___-year-old female patient with CHF, shortness of breath, pulmonary edema, hypoxia, evaluate for worsening of pulmonary edema, ? ARDS.

FINDINGS: AP single view of the chest has been obtained with patient in semi-upright position. Comparison is made with the next preceding similar examination obtained two hours earlier during the same day. The extensive bilateral multifocal patchy and confluenting parenchymal densities are similar to what has been described on the preceding examination. Comparison with findings on examination of ___ demonstrates progression of the patchy infiltrates. There is also blunting of the lateral pleural sinuses indicating at least moderate amount of pleural effusion. No pneumothorax is found. When comparison is extended to the next previous available chest examination of ___, there existed only small regional basal parenchymal densities mostly on the left side.

IMPRESSION: Advanced bilateral pulmonary opacities most likely related to aggressive infectious process. Pulmonary vascularity cannot be assessed as they are overshadowed by the infiltrates. As previously commented, significant cardiac enlargement cannot be identified on these portable chest examinations.


SubjectID: 13762124, StudyID: 50614159, Comparison: None

FINAL REPORT

PORTABLE CHEST RADIOGRAPH, ___.

COMPARISON: Radiograph of one day earlier.

FINDINGS: Widespread alveolar opacities have improved with partial clearing at the apices and residual ground-glass and reticular opacities in the mid and lower lung zones as well as some dependent consolidation at the bases. Pleural effusions have also decreased in size with residual small effusions remaining. Cardiomediastinal contours are stable, and indwelling support and monitoring devices are unchanged in position.


SubjectID: 13762124, StudyID: 57470003, Comparison: same

FINAL REPORT

EXAM: Chest, single frontal view. CLINICAL INFORMATION: Aspiration, intubated.

COMPARISON: ___.

FINDINGS: Endotracheal tube is seen, terminating approximately 6 cm above the level of the carina. Enteric tube is seen coursing below the level of the diaphragm, inferior aspect not included on the image. Left-sided subclavian central venous catheter terminates in the low SVC. Bibasilar opacities are again seen, grossly stable to possibly minimally improved   Keywords: again, stable. Small bilateral pleural effusions are stable. Cardiac and mediastinal silhouettes are stable.


SubjectID: 13762124, StudyID: 57454403, Comparison: None

FINAL REPORT

HISTORY: Female intubated in the MICU. Assess progression of lung opacities.

COMPARISON: Chest radiograph ___, ___, ___.

TECHNIQUE: Single portable frontal chest radiograph.

FINDINGS: ET tube is 4 cm above the level of the carina in correct position. NG tube enters the stomach and is out of view. Right IJ tip is in upper SVC. Unchanged small bilateral pleural effusions, left greater than right. Diffuse and focal opacities with air bronchograms suggestive of a predominantly alveolar component are unchanged. Heart size, mediastinal contour and hila are normal. No pneumothorax. Coronary stents noted in the right coronary artery, left anterior descending artery, and circumflex artery.

IMPRESSION: No interval change in small bilateral pleural effusions or bilateral diffuse opacities with air bronchograms suggestive of an alveolar process and likely represents ARDS.


SubjectID: 13762124, StudyID: 54257063, Comparison: better

FINAL REPORT

COMPARISON: Chest radiographs, ___, ___, ___, ___.

TECHNIQUE: Single Portable frontal chest radiograph.

HISTORY: Female with respiratory failure, on ventilation. Assess for interval change.

FINDINGS: ET tube tip is 4.5 cm above the level of the carina and is in appropriate position. NG tube with side port below the gastroesophageal junction enters into proximal stomach and is out of view. Swan-Ganz catheter with tip in proximal right pulmonary artery is unchanged. Left brachial line with tip at the junction of subclavian and axillary vein. Mild interval improvement in moderate diffuse bilateral heterogeneous opacities with both interstitial and parenchymal components   Keywords: improve. No pneumothorax or pleural effusion. Heart size, mediastinal contour and hila are normal.

IMPRESSION: 1. Right Swan-Ganz catheter tip is in the proximal right pulmonary artery and is unchanged. 2. Mild improvement in diffuse moderate bilateral heterogeneous opacities which may represent moderate pulmonary edema   Keywords: improve.


SubjectID: 13762124, StudyID: 53202224, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___ radiograph.

FINDINGS: Support and monitoring devices are in standard position. Interval decreased width of cardiomediastinal contours, as well as rapid improvement in the severity of diffuse bilateral alveolar opacities. This may have represented hydrostatic edema superimposed upon baseline changes of ARDS, which now appear similar to the previous radiograph of ___. There are small pleural effusions bilaterally, but no pneumothorax.


SubjectID: 13762124, StudyID: 53107564, Comparison: same

FINAL REPORT

PATIENT

HISTORY: ___ years old woman with congestive heart failure, arrhythmia, pneumonia, respiratory failure and intubated, assessment for interval changes.

COMPARISON: Exam is compared to chest x-ray of ___.

FINDINGS: Right jugular Swan-Ganz catheter head ends in right pulmonary artery. ET tube ends at 5 cm from carina. The sidehole of the NG tube is in mid gastric cavity. Moderate-to-severe pulmonary edema is unchanged since prior chest x-ray, although there is minimal improvement of lung bases ventilation for reduced bibasilar atelectasis and pleural effusion   Keywords: unchanged. Cardiomediastinal silhouette is unchanged. There is no pneumothorax.

IMPRESSION: Minimal improvement of lung base ventilation, but persistent moderate pulmonary edema   Keywords: persistent.


SubjectID: 13762124, StudyID: 50863971, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph of earlier the same date.

FINDINGS: On the initial radiograph, a feeding tube was coiled within the proximal thoracic esophagus, with tip directed cephalad, outside of the field of view. On the second radiograph, the feeding tube has been removed. On the third radiograph, a nasogastric tube is in place, with tip terminating within the stomach. Endotracheal tube and vascular sheath are in standard position on all three radiographs, and the appearances of the lungs and pleura are not appreciably changed since the recent study of earlier the same date.


SubjectID: 13762124, StudyID: 57064427, Comparison: same

FINAL REPORT

PORTABLE CHEST ___

COMPARISON: ___.

FINDINGS: As compared to the recent study, there has been no relevant short interval change in the appearance of the chest   Keywords: no relevant short interval change.


SubjectID: 13762124, StudyID: 56797150, Comparison: same

FINAL REPORT

PORTABLE SEMI-UPRIGHT CHEST, ___

COMPARISON: ___.

FINDINGS: As compared to the recent radiograph, there has been little change in the appearance of the chest except for slight improved aeration at the lung bases   Keywords: little change.


SubjectID: 13762124, StudyID: 57037511, Comparison: worse

FINAL REPORT

INDICATION: Pneumonia and congestive heart failure, here to evaluate for interval change.

COMPARISON: Chest radiograph performed on ___.

TECHNIQUE: Portable upright frontal radiograph of the chest.

FINDINGS: A right internal jugular central venous catheter is advanced from the prior study with the tip now terminating at the level of the cavoatrial junction. Anterior cervical spine fixation hardware is unchanged. Multiple coronary arterial stents are redemonstrated. There are increased bilateral lung opacities most pronounced at the bilateral lung bases from the most recent prior study   Keywords: increase. There is increased mild pulmonary vascular congestion   Keywords: increase. No pneumothorax is present. The cardiac silhouette is incompletely evaluated due to bibasilar opacities. The mediastinal and hilar contours are stable.

IMPRESSION: 1. Increased bilateral opacities most consistent with ARDS although a component of pulmonary edema and/or superimposed infection is not excluded   Keywords: increase. 2. Increased mild pulmonary vascular congestion from ___   Keywords: increase. 3. Interval advancement of right IJ catheter with tip at the cavoatrial junction.


SubjectID: 13762124, StudyID: 55970223, Comparison: better

FINAL REPORT

INDICATION: History of ARDS and pneumonia. Evaluate for interval change.

COMPARISONS: Chest radiograph, ___ and multiple chest radiographs dating to ___.

FINDINGS: In comparison to the prior radiograph obtained two days prior, there has been mild improvement in the aeration of the lower lobes of the lungs, particularly on the left. Bilateral diffuse patchy infiltrates persist, most consistent with ARDS. There is relative sparing of the apices. There is no definite pleural effusion. There is no pneumothorax. The cardiomediastinal silhouette is poorly evaluated due to adjacent opacities, although unchanged. The endotracheal tube is 5.3 cm from the carina. A right internal jugular central venous catheter terminates in the mid SVC. An NG tube courses below the diaphragm with the tip out of the field of view. Cervical hardware is partially imaged.

IMPRESSION: Slight improvement in the bilateral diffuse opacities which are most consistent with ARDS   Keywords: improve.


SubjectID: 13762124, StudyID: 55462851, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Tracheostomy tube, assessment.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the tracheostomy tube has been exchanged. The tip of the tube now projects 3 cm above the carina. The transparency of the lung parenchyma at the lung bases has increased; the pleural effusions and areas of opacities at the lung bases have decreased. Unchanged appearance of the cardiac silhouette, with pericardial drain in situ. No pneumothorax.


SubjectID: 13762124, StudyID: 54524063, Comparison: worse

FINAL REPORT

PATIENT

HISTORY: ___-year-old woman with aspiration pneumonia and atrial fibrillation with aberrancy with elevating white blood count. Assess for interval changes.

COMPARISON: Exam is compared to chest x-ray of ___.

FINDINGS: Tracheostomy tube and left PICC are unchanged since ___. Lung volume is reduced with increased bibasilar opacification due to mild pulmonary edema and new bilateral pleural effusion   Keywords: new, increase. Cardiomediastinal silhouette is unchanged. Multiple coronary stents are unchanged. There is no pneumothorax. Abdominal J-tube.

IMPRESSION: New mild pulmonary edema and bibasilar small pleural effusion   Keywords: new.


SubjectID: 13762124, StudyID: 54943662, Comparison: worse

FINAL REPORT

PORTABLE CHEST, ___.

COMPARISON: Radiograph of earlier the same date.

FINDINGS: No acute, displaced rib fractures are evident, but portable radiographs are relatively insensitive for detecting anterior rib fractures. Support and monitoring devices are unchanged in position, including a left PICC that terminates in the left axilla. Cardiomediastinal contours are stable. Diffuse heterogeneous pulmonary opacities have slightly worsened since the recent radiograph of several hours earlier, but they remain improved compared to the earlier study from ___   Keywords: worse. Bilateral pleural effusions are again demonstrated.


SubjectID: 13762124, StudyID: 50759251, Comparison: None

FINAL REPORT

PORTABLE CHEST FILM ___ AT 802 CLINICAL

INDICATION: ___-year-old with ARDS, any interval change? Comparison is made to the patient's prior study dated ___ at ___. A portable supine chest film ___ at 802 is submitted.

IMPRESSION: 1. Endotracheal tube, nasogastric tube and right internal jugular introducer are unchanged. A left PICC line terminates in the left axilla, unchanged. Several tubular structures are seen overlying the heart possibly representing calcificed coronary arteries or stents. Clinical correlation is advised. Cardiac and mediastinal contours cannot be assessed due to an interval worsening of the bilateral airspace process which likely reflects pulmonary edema superimposed on underlying ARDS.


SubjectID: 13762124, StudyID: 51597838, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___ radiograph.

FINDINGS: Tip of endotracheal tube terminates 4.2 cm above the carina, left PICC terminates in the lower superior vena cava, and a nasogastric tube terminates within the stomach. Cardiomediastinal contours are stable in appearance. Mild pulmonary vascular congestion is accompanied by heterogeneous opacities in the mid and lower lung regions, which are superimposed upon known basilar predominant interstitial fibrosis. Differential diagnosis includes pulmonary edema, diffuse infection, ARDS, and pulmonary hemorrhage. Small bilateral pleural effusions are present, but there is no visible pneumothorax.


SubjectID: 13762124, StudyID: 51053429, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Significant cardiac history, chronic heart failure, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the monitoring and support devices, including the endotracheal tube, the nasogastric tube, the left PICC line and the vertebral stabilization devices are in unchanged position. The patient continues to have bilateral pleural effusions and to show parenchymal opacities of alveolar morphology with air bronchograms. The opacities are symmetrical and bilateral, predominating in the middle and lower lung zones. No new parenchymal opacities   Keywords: new. No pneumothorax. Drain devices continue to project over the heart.


SubjectID: 13767558, StudyID: 53310138, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___M with CP // C/f PNA, possible extension of mets

COMPARISON: Chest x-ray from ___

FINDINGS: Probable background hyperinflation/COPD, though inspiratory volumes on the frontal view are slightly low. Again seen are sternotomy wires and multiple mediastinal clips, with linear radiodensities seen adjacent to the right mainstem bronchus, similar to the prior study. The cardiomediastinal silhouette is unchanged. No CHF or effusion. Subsegmental atelectasis is present at both lung bases. However, no focal consolidation is identified. Within the limits of plain film radiography, no hilar adenopathy or pulmonary nodules are identified. (Subtle abnormalities might not be apparent radiographically.) biapical pleural thickening is similar to the prior study. Again seen is slight accentuation of thoracic kyphosis, with minimal degenerative changes and slight nonacute wedging of multiple mid thoracic vertebral bodies. Relative increased density of the T12 vertebral body is compatible with previously described findings.

IMPRESSION: 1. Bibasilar atelectasis. Probable background COPD. 2. No CHF or focal consolidation identified. 3. No obvious pulmonary metastasis, though small nodules could be radiographically occult. 4. Sclerotic T12 vertebral body again noted, not fully evaluated.


SubjectID: 13767558, StudyID: 51038322, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CAD, ESRD s/p renal transplant here with chest pain, r/o PE // eval for pneumonia, effusion

COMPARISON: DEXA x-ray dated ___ at 17:31.

FINDINGS: Inspiratory volumes are at the lower limits of normal or minimally diminished. Cardiomediastinal silhouette is unchanged, with sternotomy wires and multiple mediastinal clips noted. Again seen is curvilinear density adjacent to the right heart border question related to prior surgery. No CHF. Minimal atelectasis at both lung bases is probably slightly improved. The possibility of minimal blunting of the costophrenic angles cannot be excluded, but no gross pleural effusion is identified. Biapical pleural thickening is again noted, similar to the prior film. No pneumothorax is detected.

IMPRESSION: 1. Status post sternotomy. Cardiomediastinal silhouette is unchanged. 2. No CHF, frank consolidation or gross effusion. 3. Minimal bibasilar atelectasis appears slightly improved.


SubjectID: 13771641, StudyID: 59668480, Comparison: None

FINAL REPORT

AP CHEST, 9:39 P.M., ___

HISTORY: Hypoxic respiratory distress.

IMPRESSION: AP chest compared to ___ and ___ at 10:20 a.m. Severe somewhat asymmetric pulmonary opacification, favoring the right lung has not changed appreciably over the past 11 hours. Patient has had median sternotomy and coronary bypass surgery and the heart is mildly-to-moderately enlarged. Pleural effusions if present are not large. The bulk of pulmonary findings are probably due to pulmonary edema. Alternatively there could have been initiating extensive pneumonia in the right lung leading to noncardiogenic edema, but cardiac causes or volume overload should be considered first. No pneumothorax.


SubjectID: 13771641, StudyID: 57796766, Comparison: worse

FINAL REPORT

HISTORY: Hypoxic respiratory failure, to assess for pneumonia or pulmonary edema.

FINDINGS: In comparison with the study of ___, the diffuse bilateral pulmonary opacification appears to have increased   Keywords: increase. In view of the previous cardiac surgery and enlargement of the cardiac silhouette, this could well represent diffuse pulmonary edema. However, widespread infection or even ARDS could present a similar appearance in the appropriate clinical setting.


SubjectID: 13771641, StudyID: 52713545, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: ___. CLINICAL

HISTORY: Low oxygen saturation, assess for pneumonia.

FINDINGS: AP semi-upright portable chest radiograph obtained. Midline sternotomy wires and mediastinal clips are again noted. There is diffuse pulmonary opacity, right greater than left which is intervally increased in extent concerning for pneumonia with probable superimposed pulmonary edema. Small effusions are present. Overall heart size appears grossly stable. Bony structures are unchanged.

IMPRESSION: Extensive pulmonary consolidation concerning for pneumonia and pulmonary edema.


SubjectID: 13786130, StudyID: 56446716, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman // eval for pneumo

COMPARISON: ___.

IMPRESSION: The patient has been extubated and the nasogastric tube has been removed. The left chest tube and the pericardial drain remain in situ. Also removed is the Swan-Ganz catheter. The lung volumes have slightly decreased and the signs indicative of fluid overload, notably on the left, have minimally increased   Keywords: increase. Moderate cardiomegaly persists. No pneumothorax. No larger pleural effusions.


SubjectID: 13786130, StudyID: 55385808, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman cabg/AVR // eval for pneumo s/p CT removal

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the mediastinal and the left chest tube have been removed. There is no evidence of pneumothorax. Moderate cardiomegaly and retrocardiac atelectasis as well as a small left pleural effusion persist. Unchanged normal alignment of the sternal wires, unchanged normal position of the right venous introduction sheet.


SubjectID: 13797527, StudyID: 59931129, Comparison: None

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: History: ___F with chest pain // eval for pneumothorax

TECHNIQUE: Chest: Frontal and Lateral

COMPARISON: ___

FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Gaseous distention of the stomach is incidentally noted.

IMPRESSION: No acute cardiopulmonary process. No evidence of pneumothorax.


SubjectID: 13797527, StudyID: 55032188, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with AFIb RVR, acute onset dyspnea, crackles and wheezes // assess for interval change

COMPARISON: Prior exam from earlier today

FINDINGS: AP portable upright view of the chest. There is interval development of mild pulmonary interstitial edema   Keywords: development. The heart remains moderately enlarged. No large effusion or pneumothorax.

IMPRESSION: Interval development of pulmonary interstitial edema   Keywords: development.


SubjectID: 13798658, StudyID: 57759230, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p CT removal // eval for pneumo

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: There has been interval removal of the ET tube, Swan-Ganz catheter, left-sided chest tube. There continues to be a left IJ Cordis and A2 right IJ line. There is volume loss in both lower lungs and hazy alveolar infiltrate in the left mid lung, similar to prior   Keywords: similar. There is a small left apical pneumothorax.

IMPRESSION: Small left apical pneumothorax.


SubjectID: 13798658, StudyID: 53004613, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p AVR, MVR // follow up infiltrates, effusion

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Substantial interval improvement in perihilar opacities is consistent with almost complete resolution of pulmonary edema but still present bibasal focal areas of increase consolidation that should be further more knee torn   Keywords: increase. Cardiomediastinal silhouette is stable as well as supporting devices. No pneumothorax is seen.


SubjectID: 13798658, StudyID: 53047516, Comparison: same

WET READ: ___ ___ ___ 6:52 PM 1. ET tube tip 8.2 cm from the carinal and should be advanced several cm. 2. Diffuse bilateral parenchymal opacities, potentially due to pulmonary edema, bilateral infection or ARDS. *** ED URGENT ATTENTION *** ______________________________________________________________________________

FINAL REPORT

INDICATION: ___M with s/p intubation, respiratory failure for ? PNA,ARDS,CHF // eval ETT

TECHNIQUE: Single portable view of the chest.

COMPARISON: Chest x-ray performed at___ from earlier the same day.

FINDINGS: ET tube is seen with tip approximately 8.2 cm from the carina. Diffuse bilateral parenchymal opacities are again noted, most dense in the left mid lung and in the retrocardiac region silhouette the descending thoracic aorta, new from prior   Keywords: again. Cardiac silhouette is enlarged likely exaggerated by portable technique and low lung volumes. No acute osseous abnormalities.

IMPRESSION: 1. ET tube tip 8.2 cm from the carinal and should be advanced several cm. 2. Diffuse bilateral parenchymal opacities, potentially due to pulmonary edema, bilateral infection or ARDS.


SubjectID: 13798658, StudyID: 52240617, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with endocarditis and shock; evaluate OG placement.

TECHNIQUE: Portable AP radiograph of the chest from ___.

COMPARISON: ___.

FINDINGS: A newly placed NG tube enters the stomach, tip not visualized. All support devices including a right IJ central venous catheter and endotracheal tubeare unchanged in position. Bilateral airspace opacities are slightly improved since the study of 1 day prior   Keywords: improve. Small bilateral layering pleural effusions are unchanged. The heart again appears enlarged despite the projection.

IMPRESSION: Newly placed NG tube courses below the hemidiaphragm, tip not visualized. Slightly improved bilateral airspace opacity which may be due to pulmonary edema or infection. Unchanged small bilateral layering pleural effusions. Stable cardiomegaly.


SubjectID: 13807179, StudyID: 57762672, Comparison: better

FINAL REPORT

HISTORY: ___-year-old female with flash pulmonary edema.

COMPARISON: ___.

FINDINGS: There has been significant interval improvement in pulmonary edema, which is nearly entirely resolved   Keywords: improve, resolve. Azygous venous distention remains. Bibasilar opacity remains, likely reflecting atelectasis. There is no pneumothorax. There are probably small bilateral pleural effusions. The cardiac silhouette remains mildly enlarged, the mediastinal contours are accentuated by portable technique.

IMPRESSION: Marked interval improvement in pulmonary edema, residual mild cardiac enlargement   Keywords: improve. There is bibasilar atelectasis, with probable small bilateral pleural effusions.


SubjectID: 13807179, StudyID: 50850039, Comparison: None

FINAL REPORT

INDICATION: Dyspnea, evaluate for pneumonia.

COMPARISONS: ___. SINGLE AP VIEW OF THE CHEST: There are bilateral interstitial opacities, right greater than left. There is no focal consolidation. There are likely bilateral pleural effusions. Heart size is enlarged. There is no pneumothorax.

IMPRESSION: Bilateral interstitial opacities with cardiomegaly and probable small pleural effusions compatible with either asymmetric moderate pulmonary edema versus infection. Repeat after treatment to document resolution.


SubjectID: 13832352, StudyID: 57937130, Comparison: None

FINAL REPORT

HISTORY: Coronary artery disease, chronic kidney disease, diabetes, hypertension.

TECHNIQUE: Upright AP and lateral views of the chest.

COMPARISON: ___.

FINDINGS: The heart remains mildly enlarged. Calcifications of the thoracic aorta are again noted, and the mediastinal and hilar contours are unchanged. Prominence of the pulmonary vasculature is present compatible with mild pulmonary edema, with a small right pleural effusion noted. Small amount of fluid is also noted within the right minor and major fissures. There is no pneumothorax or focal consolidation. No acute osseous abnormalities are visualized.

IMPRESSION: Mild pulmonary edema and small right pleural effusion.


SubjectID: 13832352, StudyID: 56347818, Comparison: None

FINAL REPORT

HISTORY: Dyspnea.

COMPARISON: ___.

FINDINGS: Portable AP upright chest radiograph was obtained. Vascular engorgement with ___ B-lines and fluid in the minor fissure are in keeping with mild to moderate pulmonary edema. Small dependent right pleural effusion is noted. There is no focal consolidation or pneumothorax. Enlarged pulmonary arteries may reflect pulmonary hypertension as a result of left sided failure. The heart is stably enlarged with tortuous and calcified aortic contour.

IMPRESSION: Mild to moderate pulmonary edema and small pleural effusion.


SubjectID: 13832352, StudyID: 50745861, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH:

INDICATION: Benign cough, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is a massive increase in opacities in both perihilar lung regions as well as at the right lung base   Keywords: increase. Infection must be suspected and close radiographic monitoring should be performed. Pleural effusions. Borderline size of the cardiac silhouette. At the time of observation and dictation, 8:27 a.m., on ___, the referring physician, ___. ___ was paged for notification.


SubjectID: 13839087, StudyID: 56679877, Comparison: None

FINAL REPORT

INDICATION: Dyspnea and evaluate for CHF or pneumonia.

COMPARISON: ___.

FINDINGS: PORTABLE AP UPRIGHT VIEW OF THE CHEST. There is mild cephalization of the vessels as well as mild pulmonary vascular engorgement but no overt pulmonary edema. Heart size is top normal. No pleural effusions or pneumothorax. No focal opacities concerning for pneumonia.

IMPRESSION: Mild elevation in pulmonary venous pressure with no overt pulmonary edema. No evidence of pneumonia.


SubjectID: 13839087, StudyID: 54948744, Comparison: None

FINAL REPORT

INDICATION: Chest pain and shortness of breath.

COMPARISON: None. PA AND LATERAL VIEWS OF THE CHEST: Cardiac silhouette size is top normal. The mediastinal contours are unremarkable. The hilar contours and mediastinal contours are unremarkable. Pulmonary vascularity is not engorged. There may be subtle reticulation within the lung bases, but no focal consolidation, pleural effusion or pneumothorax is present. There are minimal degenerative changes in the thoracic spine.

IMPRESSION: No focal consolidation to suggest pneumonia. Minimal reticulation of the lung bases may be due to chronic changes.


SubjectID: 13840464, StudyID: 57982294, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: Chest AP portable single view.

INDICATION: ___-year-old male patient status post TV (tricuspid valve?) repair. Post-operative.

FINDINGS: AP single view of the chest has been obtained with patient in supine position. The patient is now intubated, the ETT seen to terminate in the trachea 4 cm above the level of the carina. A right internal jugular vein sheath is noted to reach with its tip 1 cm below the lower edge of the clavicle. This is close to the junction of the jugular and subclavian veins. New row of midline sternal wires indicates recent cardiac surgery. Multiple external wires are overlying the chest. There is a semi-circular metallic structure in the expected area of the tricuspid valve and probably relates to an annuloplasty. Heart size remains enlarged with considerable prominence of the right atrial contour to the right. Pulmonary vasculature is slightly increased, but there is no evidence of large pleural effusions and no pneumothorax is seen in the apical area.

IMPRESSION: Satisfactory first post-operative chest findings.


SubjectID: 13840464, StudyID: 57425884, Comparison: None

FINAL REPORT

HISTORY: Possible pneumonia.

FINDINGS: In comparison with the earlier study of this date, the right IJ sheath has been removed. The patient has taken a better inspiration. Mild opacification at the bases is consistent with atelectatic change. Again, there is substantial enlargement of the cardiac silhouette without appreciable vascular congestion, suggesting underlying cardiomyopathy.


SubjectID: 13840464, StudyID: 50395181, Comparison: None

FINAL REPORT

HISTORY: Back surgery with dropping hematocrit.

FINDINGS: In comparison with the study of ___, there is a decrease in the hazy opacification at the right base consistent with pleural effusion. This may merely reflect a more upright position of the patient, though some decrease in effusion could have occurred. Mild elevation of pulmonary vascularity, though the discordancy with the substantial enlargement of the cardiac silhouette suggests underlying cardiomyopathy. Endotracheal tube has been removed.


SubjectID: 13840464, StudyID: 50129145, Comparison: same

FINAL REPORT

HISTORY: Cardiac surgery, to assess for widened mediastinum.

FINDINGS: In comparison with the study of ___, there is little change   Keywords: little change. No evidence of increasing widening of the mediastinum. Huge enlargement of the cardiac silhouette persists without appreciable vascular congestion, again suggesting underlying cardiomyopathy   Keywords: again, persists.


SubjectID: 13840464, StudyID: 54676262, Comparison: None

FINAL REPORT

HISTORY: Patient status post TV ring and Maze procedure, eval for effusion.

COMPARISON: ___.

FINDINGS: Frontal and lateral chest radiographs were obtained with the patient in upright position. A tricuspid annuloplasty ring is in a stable position. Median sternotomy wires are intact. Epicardial pacing wires are again visualized. There is marked cardiomediastinal widening. No focal consolidation, pneumothorax or pulmonary edema is seen. Small pleural effusions.

IMPRESSION: Stable postoperative cardiomediastinal widening. Small pleural effusions.


SubjectID: 13843083, StudyID: 59641358, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with pneumonia vs CHF // Evaluate for consolidation/effusion

COMPARISON: Radiographs from ___

IMPRESSION: Left-sided pacer and lead wires are unchanged. There are airspace opacities within the left lung more confluent within the left base. There are bilateral pleural effusions, left greater than right. There is unchanged cardiomegaly. No pneumothoraces are seen.


SubjectID: 13843083, StudyID: 58092093, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with respiratory distress with O2 sat maintained with non-rebreather // fluid status, any consolidation?

TECHNIQUE: Portable semi upright chest radiograph

COMPARISON: Multiple priors

IMPRESSION: The study is severely limited by patient rotation and overlying devices. Dual-chamber pacemaker is unchanged. Low lung volumes. Moderate left pleural effusion and interstitial edema appear similar   Keywords: similar. Recommend repeat radiograph for more meaningful evaluation.


SubjectID: 13843083, StudyID: 55289655, Comparison: worse

FINAL REPORT

INDICATION: ___ year old man with pneumonia, chronic effusion and volume overload from CHF // interval change

COMPARISON: Radiographs from ___

IMPRESSION: Left-sided pacemaker is unchanged position. There is again seen cardiomegaly as well as airspace opacities more confluent within the left lung. This is unchanged. Bilateral effusions are also present. There is mild prominence of the pulmonary markings on the right side suggestive of mild pulmonary edema which is worse than yesterday's radiograph   Keywords: worse.


SubjectID: 13843083, StudyID: 51642196, Comparison: None

FINAL REPORT

INDICATION: ___M with sob // eval for pna ptx

TECHNIQUE: Single portable view of the chest.

COMPARISON: ___.

FINDINGS: Exam is limited secondary to patient's positioning with his chin overlying is lung apices bilaterally. When compared to prior, there is increased opacity in the left hemi thorax. There is also probable right pleural effusion and pulmonary edema.

IMPRESSION: New increased opacity in the left hemi thorax likely in part due to underlying effusion with any combination of consolidation or atelectasis. Probable right pleural effusion with pulmonary edema.


SubjectID: 13843083, StudyID: 58343072, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with dementia, HCPA, pulm edema // Please eval for interval change

IMPRESSION: As compared to prior radiograph of ___, pulmonary edema has improved with residual asymmetrical interstitial edema involving the right lung to a greater degree than the left   Keywords: improve. Small to moderate right pleural effusion has also decreased in size with improving right basilar opacity, but small left pleural effusion is similar with adjacent worsening left retrocardiac atelectasis or consolidation.


SubjectID: 13843083, StudyID: 55688057, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with dementia, hypoxemia, HCAP, triggered for RR 44 // Please eval for acute pulmonary process

EXAMINATION: CHEST (PA AND LAT)

TECHNIQUE: Portable Chest radiograph, frontal view

COMPARISON: Chest radiograph ___

FINDINGS: There is moderate pleural effusion on the right and small pleural effusion on the left. There remains mild pulmonary edema   Keywords: remains. Slight improvement in bibasilar atelectasis. Pacemaker leads terminate in the right atrium and right ventricle. Hiatal hernia is noted.

IMPRESSION: Mild pulmonary edema, moderate right pleural effusion and small left pleural effusion are similar to ___. Slight improvement in adjacent bibasilar atelectasis.


SubjectID: 13843083, StudyID: 58265115, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pneumonia // interval changes interval changes

IMPRESSION: In comparison with the study of ___, there is again enlargement of the cardiac silhouette. By be lateral opacification is suggest elevated pulmonary venous pressure with a left-sided predominance. However, some coalescence of opacification in much of the left hemithorax an the right base could well be consistent with the pneumonia described in the clinical history. The lung apices are somewhat obscured by the chin of the patient.


SubjectID: 13843083, StudyID: 57001827, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with R-sided PNA, recently drained effusion // Interval change Interval change

IMPRESSION: In comparison with the study of ___, there again is enlargement of the cardiac silhouette with elevation of pulmonary venous pressure and tortuosity of the aorta. Little change in opacification at the right base and no evidence of pneumothorax. Retrocardiac opacification is again consistent with volume loss in the left lower lobe. The degree of pneumonia is difficult to assess, especially in the absence of a lateral view.


SubjectID: 13843083, StudyID: 51120619, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with PNA. S/p thoracentesis. // Eval for pneumothorax, interval change

COMPARISON: Radiographs from ___

IMPRESSION: Left-sided pacer with wires are intact. There is unchanged cardiomegaly. There has been improved aeration of the left lung consistent with the recent thoracentesis. There are bilateral pleural effusions. There is a left retrocardiac opacity, stable. No large pneumothoraces are seen; however, the lung apices are partially obscured by the patient's chin.


SubjectID: 13843083, StudyID: 57180887, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M w/ hx dementia and afib, contractures p/w 2 days SOB from home, AMS (normally answering yes no answers), found to have pneumonia. // interval change

TECHNIQUE: Portable chest

COMPARISON: ___.

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change.


SubjectID: 13843083, StudyID: 51947379, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M w/ hx dementia and afib, contractures p/w 2 days SOB from home, AMS (normally answering yes no answers), found to have pneumonia. // acute interval changes acute interval changes

IMPRESSION: In comparison with the study of ___, there are slightly lower lung volumes in this patient with enlargement of the cardiac silhouette and a dual-channel pacer device with leads in the right atrium and apex of the right ventricle. The degree of pulmonary vascular congestion has decreased   Keywords: decrease. The area of right basilar opacification has decreased. However, there is still substantial opacification in the left mid and lower lung zones. This probably represents some combination of pleural fluid and atelectasis with possible asymmetric pulmonary edema and, in the appropriate clinical setting, the even some superimposed consolidation.


SubjectID: 13843083, StudyID: 52943965, Comparison: worse

FINAL REPORT

INDICATION: ___ year old man with respiratory failure // interval changes

TECHNIQUE: Supine

FINDINGS: In comparison with the study of ___, the dual lead pacemaker are unchanged in standard position. There is continued enlargement of the cardiac silhouette, marked tracheal shift to the right and pulmonary vascular congestion. There is worsening left-sided moderate pleural effusion and persistent retrocardiac opacity. The right-sided pleural effusion and fluid along the fissure has marginally improved.

IMPRESSION: Reaccumulation of the moderate left-sided pleural effusion, and increasing interstitial edema   Keywords: increasing.


SubjectID: 13843083, StudyID: 53415931, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with difficulty breathing // Eval for effusions

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: Dual lead left-sided pacer device is stable in position. There are moderate to large bilateral pleural effusions with overlying atelectasis. Basilar consolidation is difficult to exclude. There is moderate pulmonary edema. Lucency projecting over the left lung base, retrocardiac, may relate to a hiatal hernia. The cardiac and mediastinal silhouettes remain enlarged.

IMPRESSION: Moderate to large bilateral pleural effusions with overlying atelectasis, basilar consolidation is not excluded. Moderate pulmonary edema. Persistent enlargement of the cardiac silhouette. Retrocardiac lucency projecting over the left lower hemi thorax could be due to a hiatal hernia


SubjectID: 13843083, StudyID: 50746018, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with dementia, b/l pleural effusions, admitted with hypoxic resp failure. // eval for interval change

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is noted   Keywords: no relevant change. Very low lung volumes. Moderate cardiomegaly with moderate pulmonary edema and bilateral pleural effusions. Retrocardiac atelectasis. The left pectoral pacemaker is constant in position.


SubjectID: 13843083, StudyID: 51075879, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with new cough, r/o pul edema vs. lung etiology // ___ year old man with new cough, r/o pul edema vs. lung etiology

IMPRESSION: As compared to previous radiograph of ___, lung volumes are slightly improved with associated slightly improved aeration at the lung bases. No other relevant changes   Keywords: no other relevant change.


SubjectID: 13843083, StudyID: 50900013, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with h/o e coli pneumonia // evaluate pna, worsening effusions

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Cardiomegaly is substantial. Mediastinal silhouette is substantial. Pacemaker leads terminate in right atrium right ventricle. There is interval development of pulmonary edema   Keywords: development. No substantial interval increase in pleural effusions demonstrated.


SubjectID: 13845034, StudyID: 59546191, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man with recurrent right pleural effusion, status post Pleurx placement on ___. Evaluate for pneumothorax.

COMPARISON: ___.

FINDINGS: Sternotomy wires are midline and intact. There is a right Pleurex catheter. There is no pneumothorax. There is improved aeration of bilateral lungs compared to ___. Right lung base opacity is unchanged and may represent atelectasis. Stable cardiomegaly. Subcutaneous air collections are noted.


SubjectID: 13845034, StudyID: 55485518, Comparison: worse

FINAL REPORT

INDICATION: Recurrent right-sided pleural effusion status post Pleurx catheter placement.

TECHNIQUE: Portable frontal chest radiograph.

COMPARISON: ___.

FINDINGS: There has been interval placement of a right Pleurx catheter with the tip at the right lung base with interval decrease in right pleural effusion and no evidence of pneumothorax. Associated right lung base opacity is unchanged. There has been interval increase of asymmetric left perihilar and basal opacities suggestive of asymmetric edema   Keywords: increase. Cardiac silhouette remains stable.

IMPRESSION: Placement of right Pleurx catheter with interval decrease in right effusion without evidence of pneumothorax. Increased left perihilar and basal opacity suggestive of asymmetric edema.


SubjectID: 13845034, StudyID: 54704827, Comparison: worse

FINAL REPORT

PORTABLE CHEST, ___.

COMPARISON: Radiograph of one day earlier.

FINDINGS: Cardiac silhouette remains enlarged. Worsening airspace opacities are present in the right middle and right lower lobes, possibly due to reexpansion pulmonary edema, but differential diagnosis includes an evolving infectious pneumonia in the appropriate clinical setting   Keywords: worse. Cardiac silhouette remains enlarged, but is stable in size allowing for patient rotation.


SubjectID: 13845034, StudyID: 52087725, Comparison: None

FINAL REPORT

HISTORY: Large right pleural effusion status post thoracentesis.

COMPARISON: ___, chest CT ___.

FINDINGS: Cardiac silhouette is significantly and stably enlarged. Mediastinal contour is widened with prominent vasculature as seen on prior CT, distended azygos and main pulmonary arteries. There has been near complete resolution of the large right pleural effusion with trace remaining fluid. Left lung is clear. There is no pneumothorax.

IMPRESSION: Trace remnant right pleural fluid status post thoracentesis without evidence of pneumothorax.


SubjectID: 13870748, StudyID: 54011474, Comparison: same

FINAL REPORT

INDICATION: Evaluate for interval change in a patient with shortness of breath, likely CHF exacerbation.

COMPARISON: Chest radiographs from ___, ___, ___, ___.

FINDINGS: Frontal and lateral chest radiographs demonstrate a left chest wall pacer device with leads overlying the right atrium and ventricle, unchanged. There is unchanged moderate cardiomegaly. Lung volumes are slightly improved compared to chest radiograph from the day prior, with unchanged bibasilar atelectasis and vascular congestion   Keywords: unchanged. There may be a small left pleural effusion. No pneumothorax is present. The visualized upper abdomen is unremarkable.

IMPRESSION: Unchanged chest radiograph, with moderate cardiomegaly, bibasilar atelectasis, and vascular congestion.


SubjectID: 13870748, StudyID: 50700834, Comparison: None

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: History: ___ with SOB // PNA?

TECHNIQUE: Chest: Frontal and Lateral

COMPARISON: ___

FINDINGS: The lateral view is suboptimal due to patient positioning. Dual lead left-sided pacer device is stable in position. Bibasilar opacities are seen which may be due to pleural effusions and overlying atelectasis but consolidations are not excluded. There is prominence indistinctness of the central pulmonary vasculature suggesting congestion. The cardiac silhouette is not well assessed but appears enlarged. Mediastinal contours are stable.

IMPRESSION: The lateral view is suboptimal due to patient positioning. Bibasilar opacities are seen which may be due to pleural effusions and overlying atelectasis but consolidations are not excluded. There is prominence indistinctness of the central pulmonary vasculature suggesting congestion. The cardiac silhouette is not well assessed but appears enlarged.


SubjectID: 13884765, StudyID: 53223318, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with likely CHF exacerbation // ?interval changes

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Cardiomegaly is substantial, unchanged. Post sternotomy wires are unchanged. Bilateral perihilar opacities are most likely consistent with interstitial pulmonary edema. Infectious process in particular in the left lower lobe cannot be excluded. Small bilateral pleural effusion is present.


SubjectID: 13884765, StudyID: 52782163, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF exacerbation // interval change

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___ obtained at 21:08

IMPRESSION: Interval additional progression of pulmonary edema is demonstrated currently moderate interstitial with some elements of alveolar opacities   Keywords: progression. Minimal amount of pleural effusion is present. Bibasal atelectasis present.


SubjectID: 13896515, StudyID: 59666373, Comparison: None

FINAL REPORT

HISTORY: CABG and pulmonary edema.

FINDINGS: In comparison with the study of ___, the monitoring and support devices remain in place. There is again substantial enlargement of the cardiac silhouette with congestive failure. Mild blunting of the left costophrenic angle.


SubjectID: 13896515, StudyID: 55693385, Comparison: same

FINAL REPORT

CXR PORTABLE SEMI-UPRIGHT FILM

HISTORY: Followup pneumothorax.

FINDINGS: Prior sternotomy. Since yesterday's examination, the Swan-Ganz catheter has been removed. ET tube and NG tube remain and are satisfactory. Right chest tube is also unchanged. No pneumothorax identified. No change in appearance of the lung fields   Keywords: no change.


SubjectID: 13896515, StudyID: 58469571, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF // ?worsening pulmonary edema

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the severity of the pre-existing pulmonary edema has slightly worsened   Keywords: worse. The lung volumes have decreased. There are no larger pleural effusions. Moderate cardiomegaly persists.


SubjectID: 13896515, StudyID: 58373469, Comparison: better

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old man with CHF, sepsis, bacteremia, tachypnea // ?Interval change

TECHNIQUE: Portable chest radiograph

COMPARISON: Several chest radiographs between ___ and ___.

FINDINGS: As compared to the prior radiograph performed yesterday morning, there has been slight interval improvement in extent of interstitial pulmonary edema   Keywords: improve. There are no large pleural effusions. There is no pneumothorax. Persistent moderate cardiomegaly. Median sternotomy wires are intact. Left pectoral pacemaker is unchanged in visualized.

IMPRESSION: Slight interval improvement in interstitial pulmonary edema   Keywords: improve.


SubjectID: 13896515, StudyID: 52607379, Comparison: worse

WET READ: ___ ___ ___ 9:13 AM Compared to prior radiographs from 09:05 this morning, there is increased pulmonary vascular congestion and interstitial pulmonary edema. Lung volumes are persistently low.

WET READ VERSION #1 ___ ___ 10:01 PM Compared to prior radiographs from 09:05 this morning, there is increased pulmonary vascular congestion and interstitial pulmonary edema. Lung volumes are persistently low. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF, post wrist washout with resp distress // ?pulm edema ?pulm edema

IMPRESSION: In comparison with the earlier study of this date, there again is enlargement of the cardiac silhouette with pulmonary edema, which appears to have slightly progressed   Keywords: progressed. Continued low lung volumes. Pacer device remains in place.


SubjectID: 13896515, StudyID: 51050206, Comparison: None

WET READ: ___ ___ 7:51 AM Compared to prior radiograph from 11:24, there is new mild interstitial pulmonary edema. There are no pleural effusions. No focal opacity suggestive of pneumonia. Preliminary findings were communicated to Dr. ___ by Dr. ___, ___ phone on ___ at 8:23 PM, 1 minute(s) after discovery.

WET READ VERSION #1 ___ ___ ___ 8:18 PM Compared to prior radiograph from 11:24, there is new mild interstitial pulmonary edema. There are no pleural effusions. No focal opacity suggestive of pneumonia. Preliminary findings were communicated to Dr. ___ by Dr. ___, ___ phone on ___ at 8:23 PM, 1 minute(s) after discovery. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF, s/p IVF now with SOB, hypoxia // ?aspiration or volume overload

COMPARISON: ___, 11:24

IMPRESSION: As compared to the previous image, the patient is now in moderate pulmonary edema. No pleural effusions. Unchanged cardiomegaly and low lung volumes. Unchanged left pectoral pacemaker position. No pneumonia.


SubjectID: 13896515, StudyID: 58088717, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with left pleural effusion s/p chest tube // tube position

TECHNIQUE: Frontal portable radiograph of the chest

COMPARISON: ___

FINDINGS: The left chest wall pacemaker generator obscures portions of the left hemi thorax. No left chest tube is definitively visualized. Lung volumes are lower with persistent retrocardiac opacity likely reflecting combination of effusion and atelectasis/consolidation. Mild pulmonary edema appears stable   Keywords: stable.

IMPRESSION: No chest tube visualized in the left hemithorax, possibly obscured by the pacemaker generator.

RECOMMENDATION(S): Consider repeat radiograph with PA and lateral technique.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 2:14 PM, 20 minutes after discovery of the findings.


SubjectID: 13896515, StudyID: 50433627, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with s/p chest tube for pleural effusion not seen on portable // placement placement

IMPRESSION: Comparison to ___. The patient has received a left chest tube, the left pleural effusion has minimally decreased but is still present. Subsequent atelectasis on the left is unchanged. Moderate pulmonary edema persist in almost unchanged manner   Keywords: unchanged. Stable borderline size of the cardiac silhouette.


SubjectID: 13896515, StudyID: 57580196, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man s/p BiV ICD ___ -- previous xray not interpretable // assess for effusion, wire placement

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, there is slightly improved visualization of the leads. 2 leads project over the right ventricle, 1 lead projects over the right atrium. No evidence of complications such as pneumothorax. Otherwise unchanged radiograph   Keywords: unchanged radiograph.


SubjectID: 13896515, StudyID: 53789660, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with new CS lead // evaluate for lead placement and pneumothorax evaluate for lead placement and pneumothorax

IMPRESSION: In comparison with the study of ___, there has been placement of a pacer lead extending into the coronary sinus system. There is continued enlargement of the cardiac silhouette with increasing pulmonary vascular congestion   Keywords: increasing. Retrocardiac opacification is consistent with volume loss in the left lower lobe and probable small pleural effusion.


SubjectID: 13896515, StudyID: 51579601, Comparison: 1.0

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with new CS lead // evalaute for lead placement and pneumothorax

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, there is a marked improvement the lung volumes have increased, reflecting improved ventilation. The signs indicative of fluid overload have overall decreased   Keywords: decrease. A potentially pre-existing small left pleural effusion combined to an area of retrocardiac atelectasis has completely resolved. The size and border of the cardiac silhouette can be better determined than previously. No new opacities   Keywords: new. Unchanged course and position of the pacemaker leads. The sternal wires are constant.


SubjectID: 13896515, StudyID: 50498379, Comparison: better

FINAL REPORT

EXAMINATION: Chest radiograph PA and lateral

INDICATION: ___ year old man with new BiVICD implant // evaluate for lead placement and pneumothorax

TECHNIQUE: Chest PA and lateral

COMPARISON: Portable chest x-ray most recently performed ___

FINDINGS: Appearance of the median sternotomy wires are unchanged. Again noted is the biventricular ICD implant; one lead is seen in the right atrium, a second lead within the right ventricle but the tip of the third lead is not well visualized. There is slight improvement of underlying pulmonary edema compared to ___   Keywords: improve. Again noted is a small left pleural effusion. The heart is enlarged. No evidence of pneumothorax.

IMPRESSION: 1. Interval biventricular ICD placement. No evidence of pneumothorax. 2. Slight improvement in pulmonary edema   Keywords: improve.


SubjectID: 13896515, StudyID: 50464024, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___.

FINDINGS: Interval placement of ICD pacing device, with ICD lead in the right ventricle, additional leads overlying the expected location of the right atrium and a lead for biventricular pacing. PA and lateral chest radiographs would be helpful to confirm appropriate lead positioning when the patient's condition allows. There is no evidence of pneumothorax. Cardiomegaly is accompanied by pulmonary vascular congestion and apparent asymmetrical pattern of pulmonary edema, left greater than right. Moderate left pleural effusion is also demonstrated. This may be reevaluated at the time of standard PA and lateral chest exam.


SubjectID: 13896515, StudyID: 56199247, Comparison: worse

FINAL REPORT

PORTABLE CHEST ___

COMPARISON: ___ chest radiograph.

FINDINGS: Following removal of a right-sided chest tube, there is no visible pneumothorax. Remaining indwelling devices are unchanged in position, and there is stable cardiomegaly. Pulmonary vascular congestion has worsened in the interval with increasing predominantly interstitial edema   Keywords: increasing, worse. Bibasilar patchy atelectasis is also noted.

IMPRESSION: 1. No pneumothorax following tube removal. 2. Worsening pulmonary edema   Keywords: worse.


SubjectID: 13896515, StudyID: 52605645, Comparison: better

FINAL REPORT

PORTABLE CHEST FROM ___ AT 8:49 CLINICAL

INDICATION: ___-year-old status post CABG, question effusion. Comparison to previous studies dated ___ at 13:21. Single portable AP upright chest film ___ at 8:49 is submitted.

IMPRESSION: 1. Stable cardiac enlargement, status post median sternotomy for CABG. Interval removal of the gastric tube, endotracheal tube and left internal jugular central line. Persistent streaky opacities in both lungs which may reflect subsegmental atelectasis. In addition, there is perihilar vasculature indistinctness, which likely reflects persistent but improving perihilar edema   Keywords: improving. No large effusions. No evidence of pneumothorax.


SubjectID: 13896515, StudyID: 54879730, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with new O2 requirment and agitation. Eval for pulmonary edema, pna.

TECHNIQUE: Single portable AP view of the chest.

COMPARISON: Chest x-ray from ___, ___, and ___.

FINDINGS: Compared with the recent radiographs, there has been interval improvement in the degree of pulmonary edema   Keywords: improve. The heart remains enlarged. No focal consolidation or pleural effusion. Left-sided pacemaker remains in place.

IMPRESSION: Continued improvement/resolution of pulmonary edema   Keywords: improve. No focal consolidation concerning for pneumonia.


SubjectID: 13896515, StudyID: 53943549, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with developing edema vs. pna. Interval change.

TECHNIQUE: Single AP portable view of the chest.

COMPARISON: Chest radiographs from ___, ___, and ___.

FINDINGS: The endotracheal tube, left IJ line, and transvenous right atrial biventricular pacer leads are unchanged in position. Mild cardiomegaly, mild pulmonary edema, and low lung volumes are stable   Keywords: stable. No new pneumothorax or pleural effusion.

IMPRESSION: No significant change since the radiograph from the prior day   Keywords: no significant change.


SubjectID: 13921768, StudyID: 59679445, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with flash pulmoanry edema // ? interval change ? interval change

IMPRESSION: In comparison with the study of ___, there is some improved inspiration. Continued enlargement of cardiac silhouette with tortuosity of the a or a ___. Mild elevation of pulmonary venous pressure with small bilateral pleural effusions and bibasilar atelectasis. Pacer leads are in good position and there again are surgical clips in the left axillary region.


SubjectID: 13921768, StudyID: 58798180, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with acute SOB, hx of flash pulm edema and bad COPD // ? pulm edema ? pulm edema

IMPRESSION: In comparison with the study of ___, there are lower lung volumes. Pacer device is essentially unchanged. Continued prominence of the cardiac silhouette with elevation of pulmonary venous pressure. Small bilateral pleural effusions with bibasilar atelectasis.


SubjectID: 13921768, StudyID: 53004850, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with COPD, CHF with SOB // eval for fluid overload, other causes of SOB eval for fluid overload, other causes of SOB

IMPRESSION: In comparison with the earlier study of this date, there is little change in the appearance of the heart and lungs and the pacer device.


SubjectID: 13921768, StudyID: 50877377, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with COPD, CHF with SOB // volume overload infiltrates

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Cardiomegaly is stable. Pacer leads are in standard position. Mild vascular congestion is stable, asymmetric worse on the right   Keywords: worse. Small bilateral effusions are unchanged. Sternal wires are aligned. Patient is status post CABG


SubjectID: 13921768, StudyID: 50966773, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with SOB/CHF // r/o pulm edema, pna

COMPARISON: Chest radiograph ___

FINDINGS: Single AP view of the chest provided. A right atrioventricular pacemaker appears unchanged. The right lung is hypoinflated in relation to the left lung. There is mild vascular congestion consistent with fluid overload. No pneumothorax. Small, bilateral pleural effusions are seen with associated bibasilar atelectasis. Hilar contours are normal. The aorta is tortuous. Severe S-shaped is unchanged.

IMPRESSION: 1. There is mild vascular congestion consistent with mild fluid overload. 2. Opacification of the right upper lung could be due to asymmetric pulmonary edema, scapula projecting over the lung or in the appropriate clinical setting pneumonia. 3. Small, bilateral pleural effusions and associated bibasilar atelectasis.


SubjectID: 13921768, StudyID: 50259315, Comparison: worse

WET READ: ___ ___ ___ 7:51 PM Pacer leads, median sternotomy wires, mediastinal clips unchanged from same day radiograph. Cardiac silhouette stably enlarged. Mild increased interstitial markings, primarily on the right, compatible with worsening interstitial edema   Keywords: increase, worse. There are small bilateral pleural effusions, with bibasilar atelectasis. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with dyspnea and increased O___ s/p c cath this afternoon // ? increased pulmonary edema

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Pacer leads, median sternotomy wires, mediastinal clips unchanged from same day radiograph. Cardiac silhouette stably enlarged. Mild increased interstitial markings, primarily on the right, compatible with worsening interstitial edema. There are small bilateral pleural effusions, with bibasilar atelectasis.


SubjectID: 13950979, StudyID: 59781228, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with thorc // r/o ptx, s/p ct d/c r/o ptx, s/p ct d/c

IMPRESSION: In comparison with the earlier study of this date, the chest tube is been removed. There is some increase in the degree of small left apical pneumothorax. Otherwise little change   Keywords: little change.


SubjectID: 13950979, StudyID: 58396790, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with L thorc // r/o infiltrate r/o infiltrate

IMPRESSION: In comparison with the study of ___, there is increasing left pleural effusion with decreased aeration of the left hemithorax. Little change on the right   Keywords: little change. Monitoring and support devices remain in place.


SubjectID: 13950979, StudyID: 57309361, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p LV lead placement // eval for pleural effusions in

COMPARISON: ___

IMPRESSION: No relevant change as compared to the previous examination   Keywords: no relevant change. The pleural effusion on the left could have minimally increased. The areas of lateral pleural thickening are constant. Constant appearance of the large atelectatic lung portions in the retrocardiac region. Normal appearance of the right lung, without evidence of pleural effusions, pneumonia or pulmonary edema.


SubjectID: 13950979, StudyID: 56490715, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p lead placement with left effusion // eval for left effusion

COMPARISON: Chest radiograph from ___.

FINDINGS: AP portable upright view of the chest. A left thoracostomy tube is unchanged in position. Since the ___ examination there has been a slight increase in opacity throughout the left hemithorax, possibly representing slightly worsened effusion or worsening atelectasis. The right lung remains clear. A right IJ central venous catheter, left-sided pacemaker, and multiple intact sternal wires are unchanged in position. There is no right pneumothorax or right pleural effusion.

IMPRESSION: Interval increase in opacity throughout the left hemithorax since ___, possibly reflecting worsening atelectasis or increased fluid. No pneumothorax.


SubjectID: 13950979, StudyID: 56288479, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with L PTX // r/o ptx on water seal

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the left chest tube is now on water-seal. The small left pneumothorax, predominantly visible in the para aortic lung regions, has not increased in extent and is millimetric in ___. No other relevant changes   Keywords: no other relevant change.


SubjectID: 13950979, StudyID: 56208358, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p left thoracotomy ventricular pacer lead placement // chest tube position, ptx chest tube position, ptx

IMPRESSION: In comparison with the study of ___, there is been placement of a right IJ catheter that extends to the lower portion of the SVC. Pacemaker leads extend to the left atrium and apex of the right ventricle. Continued enlargement of the cardiac silhouette without definite vascular congestion or pleural effusion.


SubjectID: 13950979, StudyID: 50022341, Comparison: None

WET READ: ___ ___ ___ 11:12 AM Interval placement of left pleural drain with decrease in size of left pleural effusion and increased left lung aeration.

WET READ VERSION #1 ___ ___ 10:34 PM Interval placement of left pleural drain with decrease in size of left pleural effusion and increased left lung aeration. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with L thorc // s/p ct placement, check effusion

COMPARISON: Wet chest radiograph from ___ at 14:19

FINDINGS: AP portable upright view of the chest. A new left thoracostomy tube is present, resulting and improved aeration of the left lung and decreased left effusion. The right lung remains clear. There is no pneumothorax. Multiple intact sternal wires, prosthetic valve, and a left pacemaker generator pack projecting leads into the right ventricle and atrium remain unchanged. A right IJ catheter terminates at the cavoatrial junction.

IMPRESSION: New left thoracostomy tube, with interval decrease of a left pleural effusion and improved aeration of the left lung. No pneumothorax.


SubjectID: 13950979, StudyID: 59104051, Comparison: None

FINAL REPORT

CHEST X-RAY

INDICATION: Polytrauma, evaluation of interval changes, questionable pneumothorax and atelectasis from rib fractures.

COMPARISON: ___, 5:57 a.m.

FINDINGS: Unchanged appearance of right basolateral rib fractures. Presence of a minimal left pleural effusion cannot be excluded, but no right pneumothorax is visible. The extent of right lateral soft tissue air collection is constant. Constant size of the cardiac silhouette. Minimal retrocardiac atelectasis. Unchanged mediastinal and hilar contours. Sternal wires and valve replacement.


SubjectID: 13950979, StudyID: 59058567, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Rib fractures, pneumothorax, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Moderate cardiomegaly and low lung volumes. Mild peribronchial cuffing in the perihilar areas, potentially suggesting mild fluid overload. The soft tissue air collection in the right chest wall is constant. There is currently no indication for pneumothorax. The alignment of sternal wires after valvular replacement is constant.


SubjectID: 13950979, StudyID: 58666849, Comparison: None

FINAL REPORT

INDICATION: Status post fall, initial pneumothorax, evaluation for interval change.

COMPARISON: ___, 4:45 a.m.

FINDINGS: As compared to the previous radiograph, there is newly appeared slight pleural thickening at the level of the known right rib fractures. The air collection in the soft tissues has slightly decreased. There is no evidence of current pneumothorax. In unchanged manner, the diameter of the vascular structures suggests mild fluid overload. This is supported by a newly occurred subtle left pleural effusion. Unchanged size of the cardiac silhouette.


SubjectID: 13950979, StudyID: 57758602, Comparison: None

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with extensive rib fracture from fall from ladder, evaluation for change.

COMPARISON: ___.

FINDINGS: The endotracheal tube is in adequate position at 6.1 cm above the carina. The NG tube is in unchanged position. Worsening of the bilateral moderate pleural effusion. There is also an increase in the retrocardiac atelectasis. Patient with multiple right-sided rib fractures with adjacent mild hemothorax that is unchanged. There is also a right-sided scapular fracture as seen in the previous CT scan. Mediastinal and cardiac contour are unchanged with mild cardiomegaly. Patient with history of median sternotomy, mitral valve repair and CABG. There is no pneumothorax.

CONCLUSION: There is increase in the moderate bilateral pleural effusion and in the retrocardiac atelectasis.


SubjectID: 13950979, StudyID: 52242670, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Right rib fractures and pneumothorax, evaluation for interval change.

COMPARISON: Trauma chest x-ray from ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Unchanged displaced right basolateral rib fractures with gas inclusion in the soft tissues. The areas of parenchymal contusion and the small right pneumothorax, well documented on the CT torso examination from ___, are not appreciated on the current radiograph. Unchanged moderate cardiomegaly, unchanged normal appearance of the left lung. Unchanged normal alignment of the sternal wires.


SubjectID: 13950979, StudyID: 58734543, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p left thoracotomy-chest tube with small apical ptx // assess for left apical ptx

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The right internal jugular vein catheter as well as the ECG leads. , the areas of left pleural thickening and the blunting of the left costophrenic sinus are unchanged. Unchanged moderate cardiomegaly without overt pulmonary edema   Keywords: unchanged. Normal unchanged appearance of the right lung   Keywords: unchanged appearance.


SubjectID: 13950979, StudyID: 56995822, Comparison: better

WET READ: ___ ___ ___ 8:20 AM Status post removal of a left-sided chest tube, there may be a tiny left apical pneumothorax. Interval increase in small left-sided pleural effusion. Cardiomegaly, is accompanied by mild pulmonary vascular congestion however with slight interval improvement of pulmonary edema compared to the prior exam.

WET READ VERSION #1 ___ ___ ___ 8:17 AM Status post removal of a left-sided chest tube, there may be a tiny left apical pneumothorax. Interval increase in small left-sided pleural effusion. Cardiomegaly, is accompanied by mild pulmonary vascular congestion however with slight interval improvement of pulmonary edema compared to the prior exam. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___ year old man s/p chest tube removal // r/o ptx

TECHNIQUE: Single view at ___ 4:55 PM

COMPARISON: ___

FINDINGS: The left chest tube is been removed. The right internal jugular catheter terminates in the right atrium SVC junction. A pacemaker again is noted. Left-sided pleural disease is present. There is perhaps a tiny left apical pneumothorax not thought to be of importance. The pulmonary vasculature appears improved when compared to the previous study. The heart is enlarged. The patient has median sternotomy closures and mediastinal clips consistent with coronary artery bypass graft. . The osseous structures are normal for age.

IMPRESSION: The pulmonary vascular has improved   Keywords: improve. The left chest tube is removed. There remains left pleural disease. A tiny left apical pneumothorax is present.


SubjectID: 13950979, StudyID: 54801572, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p lead placement with sob, desatting // eval for effusion

COMPARISON: ___ and ___

IMPRESSION: Left chest tube remains in place, with interval improved aeration of left upper lobe and part of the lingula. Moderate, partially loculated left pleural effusion is again demonstrated, with probable component of small loculated hydro pneumothorax at the apex. Slight improvement in left retrocardiac opacification. Resolution of mild interstitial edema.


SubjectID: 13950979, StudyID: 51598486, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p lead placement // eval for left effusion

COMPARISON: ___

IMPRESSION: Left chest tube remains in place, with persistent moderate, loculated left pleural effusion. Further improved aeration of the left lung with residual left basilar atelectasis and or consolidation. Cardiomegaly is accompanied by pulmonary vascular congestion and worsening mild to moderate edema   Keywords: worse.


SubjectID: 13950979, StudyID: 51151273, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p lead placement with left effusion // eval for effusion

COMPARISON: Chest radiograph from ___.

FINDINGS: AP portable upright view of the chest. Multiple sternal wires, a prosthetic valve, and left-sided pacemaker are unchanged in position. A left thoracostomy tube is unchanged in position. There is no obvious pneumothorax. A diffuse left hemithoracic opacity is unchanged. There is new mild pulmonary vascular congestion and minimal edema within the right lung   Keywords: new. There is no right pleural effusion. A right-sided IJ central venous catheter terminates at the cavoatrial junction.

IMPRESSION: 1. Unchanged opacity across the left hemithorax . 2. Mild central pulmonary vascular congestion with minimal edema within the right lung.


SubjectID: 13950979, StudyID: 50675844, Comparison: None

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with injuries, interval change.

COMPARISON: ___.

FINDINGS: The right chest tube is lower in position than the previous exam and ends in the upper paramediastinal region. There is no visible pneumothorax. Increased in size in the mild bilateral pleural effusion with bibasilar atelectasis. The endotracheal tube is little bit high at the level of the clavicles at 7 cm above the carina. The mediastinal and cardiac contours are unchanged with history of median sternotomy for mitral valve repair and CABG.

CONCLUSION: 1. The right-sided chest tube is lower in position than the previous exam. There is no visible pneumothorax. 2. Mild increase in size of the bilateral mild pleural effusion with bibasilar atelectasis. 3. The ETT is slightly high.


SubjectID: 13950979, StudyID: 50123358, Comparison: same

FINAL REPORT

INDICATION: Patient with rib fractures, right pneumothorax, new desaturation. Lung pathology?

COMPARISON: ___ at 5:21 a.m.

FINDINGS: There is no visible pneumothorax. The right chest tube is in unchanged position. The endotracheal tube, the right jugular line and the NG tube are stable. The right lung base is better aerated. Stability of the left mild pleural effusion with compressive atelectasis. Stability of the mild right pleural thickening at the base, probably compatible with a hemothorax secondary to rib fractures. The mediastinal and cardiac contours are unchanged.

CONCLUSION: Except for a better aeration of the right lung base, there is no significant change since the previous exam   Keywords: no significant change.


SubjectID: 13950979, StudyID: 57647024, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF and left effusion s/p chest tube ___ // Assess for interval change in left pleural effusion and/or pneumothorax

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Cardiomegaly is unchanged. Replies far of are valve has unchanged. Pacemaker is are unchanged. Interval progression of pulmonary edema is demonstrated, mild to moderate   Keywords: progression.


SubjectID: 13950979, StudyID: 54050528, Comparison: None

WET READ: ___ ___ ___ 9:04 PM Small right effusion and moderate left effusion which appears partially loculated. Consolidation at the left lung base may represent atelectasis or superimposed infection. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___M with chest pain, SOB, cough // Please eval for pna

TECHNIQUE: PA and lateral views of the chest.

COMPARISON: ___.

FINDINGS: New compared to prior is left basilar opacity. Some of this opacity is peripheral likely due to loculated fluid although underlying parenchymal consolidation is also suspected. There is a small right effusion. Superiorly the lungs are clear. Left chest wall dual lead pacing device is noted. Median sternotomy seen aortic valve replacement are noted. No acute osseous abnormalities.

IMPRESSION: Small right effusion and moderate left effusion which appears partially loculated. Consolidation at the left lung base may represent atelectasis or superimposed infection.


SubjectID: 13950979, StudyID: 50316151, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p chest tube placement // evaluate for changes in effusion, ptx

TECHNIQUE: Chest PA and lateral

COMPARISON: Multiple priors most recent on ___

FINDINGS: A left-sided pacer and multiple leads are unchanged in position. Sternotomy wires are demonstrated. The heart is enlarged, but stable from the prior exam. A left pleural effusion is minimally decreased from the prior examination done yesterday. There is a layering right pleural effusion. No pneumothorax is identified. There is some parenchymal opacity at the left base, likely reflective of atelectasis. Left basal pigtail catheter is in place

IMPRESSION: Small bilateral pleural effusions. The left effusion is decreased in size from the prior examination.


SubjectID: 13950979, StudyID: 57044077, Comparison: None

WET READ: ___ ___ ___ 2:51 PM Stable appearance of the chest without evidence of acute cardiopulmonary process. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: PORTABLE CHEST RADIOGRAPH

INDICATION: ___-year-old man with dyspnea, here to evaluate for fluid overload, effusion or pneumonia.

TECHNIQUE: Portable upright frontal radiograph of the chest.

COMPARISON: Multiple prior chest radiographs, most recently dated ___.

FINDINGS: The patient is status post median sternotomy with intact appearing sternal wires. Multiple mediastinal surgical clips suggest prior CABG surgery. The patient is status post mitral valve replacement. A left pectoral pacemaker has dual leads terminating in the right atrium and right ventricle also with 2 epicardial leads. Multiple healed right-sided rib fractures are re demonstrated. There is no significant pleural effusion, focal consolidation or pneumothorax. Previously seen left-sided lateral pleural effusion has essentially resolved. The cardiomediastinal silhouette is top-normal in size but unchanged.

IMPRESSION: Stable appearance of the chest without evidence of acute cardiopulmonary process.


SubjectID: 13950979, StudyID: 53943808, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with CAD and mitral stenosis s/p CABG and mitral valve replacement in ___, AV block, CM, CHF, HTN, also recent ICD placement at complicated admission involving hemothorax and ___, p/w tachypnea and dyspnea.

TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position.

COMPARISON: Radiographs from ___, ___ and ___.

FINDINGS: The heart continues to be top normal in size, and the patient is status post median sternotomy and mitral valve replacement. Healed right-sided rib fractures are noted. A left-sided cardiac pacer has its leads terminating over the right atrium and right ventricle. The lungs are clear of focal consolidation or pneumothorax. There continues to be left pleural thickening, and there is no overt pulmonary edema.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 13950979, StudyID: 56644605, Comparison: None

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with ETT and NG placement. The patient reintubated.

COMPARISON: ___, at 5:18 a.m.

FINDINGS: The new ET tube is slightly too high at 8.9 cm above the carina; it could be advanced around 3 cm. Right-sided jugular line ends in the mid SVC and NG tube is in adequate position. Right chest tube is possibly fissural, but there is no pneumothorax. Left lower lobe collapse with mild pleural effusion is stable. Small right pleural effusion and mild lower lobe atelectasis is new. Multiple right rib fractures and right clavicle fracture are unchanged. Mediastinal and cardiac contour are normal.

CONCLUSION: 1. New endotracheal tube should be advanced 3 cm. 2. The right chest tube is possibly fissural; but there is no pneumothorax. 3. New, small, right pleural effusion and lower lobe atelectasis. ___, medical resident, has been verbally contacted for the results at 10:30 am.


SubjectID: 13950979, StudyID: 55805725, Comparison: None

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with acute dyspnea, intubated, evaluation for acute change.

COMPARISON: ___ and ___.

FINDINGS: ET tube ends 6.7 cm above carina. Right jugular line ends in mid SVC. The comparison of the lungs are difficult to prior study on ___ because of the rotation. The mediastinum and heart contour are improved compared to ___. Left pleural effusion that is moderate with atelectasis is unchanged since ___ but slightly increased since ___. Very mild right pleural effusion and atelectasis is worst since ___ but there are slightly better than ___. There is no pneumothorax. There is some increased densities in the left perihilar region that is clearly subtle that was not present on ___. Pneumonia or aspiration cannot be excluded.

CONCLUSION: 1. The tubes and lines are in adequate position. 2. New subtle left perihilar opacities that were not present ___. Pneumonia or aspiration has to be considered. 3. Improvement of mediastinal and cardiac size. 4. Bilateral pleural effusion and atelectasis. The medical team in the ICU has been verbally contacted at 9:58 a.m. The exam was done at 4:56 a.m. After discussion with the clinical team who understand that the patient is infected with Staph aureus and influenza.


SubjectID: 13950979, StudyID: 54023699, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Multiple fractures, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the pleural effusion on the left has minimally increased in extent and the pleural effusion on the right has minimally decreased in extent. Unchanged monitoring and support devices, including the right-sided chest tube. Unchanged size of the cardiac silhouette.


SubjectID: 13950979, StudyID: 51553858, Comparison: None

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with flail chest and respiratory compromise.

COMPARISON: ___.

FINDINGS: The endotracheal tube ends 7 cm above the carina in standard position. A right jugular line ends in the mid SVC. The NG tube is also in good position. The right chest tube could be fissural. There is no visible pneumothorax. The left lower lobe collapse and mild-to-moderate pleural effusion are stable. Less severe right base atelectasis has improved. Small pleural or extrapleural hematoma along right rib fractures and displacement of the right clavicle fracture are unchanged. The mediastinal and cardiac contours are normal.

IMPRESSION: 1. Stable left lower lobe collapse and moderate pleural effusion. 2. Right chest tube may be fissural; no visible pneumothorax. 3. Improving, moderate, right basal atelectasis.


SubjectID: 13950979, StudyID: 55481039, Comparison: None

FINAL REPORT

INDICATION: ___M with sob // eval for chf

TECHNIQUE: AP view of the chest.

COMPARISON: ___.

FINDINGS: Left chest wall dual lead pacing device is again seen. Median sternotomy wires are noted as well as a prosthetic valve. There is left basilar opacity both laterally and at the retrocardiac region medially, unchanged from prior. This could represent loculated effusion with possible superimposed parenchymal opacity. There is no large right pleural effusion. Superiorly, the lungs are clear.

IMPRESSION: Persistent left basilar opacity compared to prior, potentially a loculated effusion although superimposed consolidative process or underlying lesion or possible.


SubjectID: 13950979, StudyID: 55171990, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with COPD and CHF coming in w SOB, treated for COPD and CHF exacerbation with persistent cough. // ? pleaural effusion changes, consolidations

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Small right pleural effusion and adjacent atelectasis have decreased. Moderate left pleural effusion with adjacent atelectasis has minimally decreased. Severe cardiomegaly and tortuous aorta are stable. Pacer and epicardial leads are in standard position. There is no pneumothorax. There is no pulmonary edema. Patient has known COPD


SubjectID: 13952511, StudyID: 58611239, Comparison: same

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman status post replacement for pneumothorax. Status post chest tube removal.

FINDINGS: Comparison is made to previous study from ___. There are no pneumothoraces. There has been removal of the Swan-Ganz catheter. There is a right-sided PICC line with distal lead tip at the cavoatrial junction. This is a dual-lead left-sided AICD stable. There is persistent left sided pleural effusion and left retrocardiac opacity. There is mild pulmonary edema, stable   Keywords: stable.


SubjectID: 13952511, StudyID: 51544440, Comparison: worse

FINAL REPORT

AP CHEST, 10:59 A.M., ___

HISTORY: Left thoracotomy. Left ventricular lead placement.

IMPRESSION: AP chest compared to ___: Mild pulmonary edema has worsened   Keywords: worse. Previous left chest wall pacemaker has been replaced or repositioned. New epicardial leads project over the cardiac apex. No pneumothorax. ET tube in standard placement. Nasogastric tube ends in the upper stomach. Swan-Ganz catheter may be coiled in the right ventricular outflow tract. Transvenous right atrial and biventricular pacer defibrillator system unchanged in standard position. No pneumothorax. Tip of the right PIC line is obscured after it enters the mid SVC.


SubjectID: 13952511, StudyID: 58404097, Comparison: same

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman with VT shocks and pulmonary edema. Evaluate for interval change.

FINDINGS: Comparison is made to the prior study from ___. The pacemaker and right-sided PICC line are unchanged. There is unchanged cardiomegaly. There is improved aeration at the left lung base. There is persistent mild pulmonary edema, stable   Keywords: stable, persistent.


SubjectID: 13952511, StudyID: 51407251, Comparison: 1.0

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, pulmonary edema, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, a left pectoral pacemaker and the right PICC line are unchanged. Lung volumes have increased, likely reflecting improved ventilation. The pre-existing signs of fluid overload have decreased in severity   Keywords: decrease. However, there is unchanged moderate cardiomegaly with signs of retrocardiac atelectasis. No newly appeared focal parenchymal opacities   Keywords: new.


SubjectID: 13952511, StudyID: 57442822, Comparison: better

FINAL REPORT

HISTORY: Atrial fibrillation, to assess for pulmonary edema.

FINDINGS: In comparison with the study of ___, there has been some decrease in the degree of pulmonary vascular congestion   Keywords: decrease. Continued enlargement of the cardiac silhouette with dual-channel pacemaker device in place. The right subclavian lead is in unchanged position.

IMPRESSION: Some improvement in pulmonary vascular status   Keywords: improve.


SubjectID: 13952511, StudyID: 52651899, Comparison: None

WET READ: ___ ___ ___ 6:04 PM Right PICC now with tip in cavoatrial junction. dw Dr. ___ by ___ at 6p via phone on ___. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, line placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the right PICC line has been re-positioned. The tip of the line now projects over the cavoatrial junction. Otherwise, the image is unchanged. There is no evidence of pneumothorax or other complications.


SubjectID: 13972095, StudyID: 57232624, Comparison: None

FINAL REPORT

AP CHEST 6:40 A.M. ___

HISTORY: ARDS, sepsis ? acute pancreatitis.

IMPRESSION: AP chest compared to 1:34 a.m.: Endotracheal tube is in standard position, but the cuff is inflated to the extent that it distends the caliber of the trachea. This could be inadvertent or necessary if the patient has tracheomalacia. Previous borderline interstitial pulmonary edema has cleared. There is no pneumothorax. Lower lungs are minimally atelectatic. The heart is not enlarged. There is no pleural effusion or pneumothorax. Gaseous distention of the stomach may be a residual of intubation. If there is concern about pneumoperitoneum, an upright view should be obtained. Right internal jugular line ends in the region of the superior cavoatrial junction. Right atrial and two right ventricular pacer leads are in place.


SubjectID: 13972095, StudyID: 54360186, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: New fever, evaluation for pulmonary process.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has been extubated. As a consequence, the lung volumes have decreased. The right internal jugular vein catheter remains in situ. There is no evidence of pneumothorax or other complication. Borderline size of the cardiac silhouette. Mild bilateral areas of basal lung atelectasis.


SubjectID: 13972095, StudyID: 53949772, Comparison: worse

FINAL REPORT

HISTORY: New ET tube and OG tube in, evaluate placement.

COMPARISON: ___ at 00:43.

FINDINGS: ET tube ends 6.7 cm above the carina. New OG tube tip is below the diaphragm; however, side port above the diaphragm. Compared with the 30 minutes prior, lung volumes have increased, but the pulmonary vasculature is now indistinct compatible with pulmonary vascular congestion and mild pulmonary edema   Keywords: increase. No pleural effusion or pneumothorax is present. Normal cardiomediastinal silhouette.

IMPRESSION: 1. ET tube in satisfactory position. 2. OG tube with the side port above the GE junction, should be repositioned (this radiograph was read after the subsequent radiograph at 6:40 in which the OG tube has been removed so no call was made). 3. Mild pulmonary edema. No sufficient pulmonary abnormality to support a diagnosis of ARDS.


SubjectID: 13972095, StudyID: 53076320, Comparison: None

FINAL REPORT

HISTORY: Right IJ line placement.

COMPARISON: No prior chest radiographs available, in conjunction with chest CT from ___.

FINDINGS: Right internal jugular catheter ends at the cavoatrial junction. Right atrial and 2 right ventricular pacer leads are in place. Low lung volumes accentuate the interstitial markings; however, no focal consolidation is present. Bibasilar opacities likely represent atelectasis. No pleural effusion or pneumothorax.

IMPRESSION: 1. Right internal jugular catheter ends at the cavoatrial junction. 2. Bibasilar atelectasis and low lung volumes, but, otherwise, clear lungs.


SubjectID: 13976674, StudyID: 50405632, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Aortic stenosis.

COMPARISON: Pre-operative chest x-ray from ___.

FINDINGS: As compared to the previous radiograph, the patient has received a core valve. A newly placed Swan-Ganz catheter is in situ. There is newly developed mild-to-moderate pulmonary edema   Keywords: develop, new. The pre-existing right pleural effusion is unchanged. No other parenchymal opacities, except for retrocardiac atelectasis. The right-sided pacemaker leads are constant.


SubjectID: 13983282, StudyID: 59884447, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with CAD/CHF, DM, CKD, PAD, presenting with acute N/V, weakness, with preceding URI symptoms, SOB. // Please assess for intrapulmonary process/vascular congestion, evidence of acute heart failure.

TECHNIQUE: Portable upright AP view of the chest

COMPARISON: ___

FINDINGS: Moderate cardiomegaly is re- demonstrated. Mediastinal contours are unchanged with a moderate hiatal hernia again noted. Minimal atherosclerotic calcifications are seen at the aortic knob. Moderate pulmonary edema is present with perihilar haziness and vascular indistinctness. There are likely trace bilateral pleural effusions, with a small amount of fluid seen tracking in the minor fissure. Bibasilar opacities likely reflect areas of atelectasis. No pneumothorax is identified. There are no acute osseous abnormalities.

IMPRESSION: Moderate pulmonary edema with probable trace bilateral pleural effusions and bibasilar atelectasis.


SubjectID: 13983282, StudyID: 58321334, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with NSTEMI, productive cough, sepsis // ? pulm edema, developing infiltrates ? pulm edema, developing infiltrates

IMPRESSION: In comparison with the study of ___, there is little change in the appearance of heart and lungs   Keywords: little change. Again there is enlargement of the cardiac silhouette with significant pulmonary edema and possible small pleural effusions.


SubjectID: 13983282, StudyID: 50979462, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with h/o prod cough, NSTEMI // ? infiltrates, pulm edema

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Moderate pulmonary edema with interstitial component. Moderate cardiomegaly with retrocardiac atelectasis. Mild right pleural effusion. No evidence of pneumonia. No pneumothorax.


SubjectID: 13983282, StudyID: 59817096, Comparison: None

FINAL REPORT

AP CHEST, 7:50 A.M. ON ___

HISTORY: Shortness of breath. Hypoxia.

IMPRESSION: AP chest compared to ___ at 7:48 p.m.: Nasogastric tube has been removed. Right PIC line ends close to the superior cavoatrial junction. Widespread pulmonary opacification, has worsened appreciably, obscuring the margins were previously well defined lung nodules. Pleural effusions may also have increased and cardiomegaly worsened. No pneumothorax.


SubjectID: 13983282, StudyID: 51898951, Comparison: None

WET READ: ___ ___ ___ 12:11 AM D/w ___ at 8:23 pm on ___ by telephone - NG appears to be folded upon itself with the catheter coursing back up from the stomach - terminating in the mid esophagus - correlate clinically. Diffuse bilateral alveolar opacities are non-specific in appearance. Findings may reflect severe alveolar pulmonary edema or severe pneumonia. Probable small effusions. Mediastinal structures difficult to assess given the diffuse opaciteis. Small amount of fluid layering in the minor fissure. No pneumothorax. ___ p_________________________________________________________________________________

FINAL REPORT

AP CHEST, 7:48 P.M. ON ___.

HISTORY: New PIC line.

IMPRESSION: AP chest reviewed in the absence of prior chest radiographs: New right PIC line passes to the mid SVC, where the tip is partially obscured by a nasogastric tube that is looped in the stomach and ends at the level of the carina in the esophagus. Nasogastric tube was removed on subsequent radiograph available at the time of this dictation, so I made no attempt at position verification. Heart is moderately enlarged. Lungs are filled with multiple nodules and moderately severe pulmonary edema and/or consolidation. Right pleural effusion is small. No pneumothorax or appreciable left pleural effusion.


SubjectID: 13983282, StudyID: 58861211, Comparison: None

FINAL REPORT

HISTORY: Cough, to assess for pneumonia.

FINDINGS: In comparison with study of ___, there is again enlargement of the cardiac silhouette with diffuse bilateral pulmonary opacifications consistent with severe pulmonary edema. Retrocardiac opacification with poor definition of the hemidiaphragm suggests volume loss in the left lower lobe. Central catheter remains in place. On this and the most recent plain radiograph, there appears to be prominent sclerosis of the ribs. Although this could merely reflect overlying pulmonary changes, the possibility of metastatic disease should be considered and these structures should be carefully checked when the congestion improves. Another possibility would be hyperparathyroidism secondary to the patient's known chronic renal disease, but there is no evidence of the characteristic rugger-___ spine in the dorsal region.


SubjectID: 13983282, StudyID: 55776827, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old female with shortness of breath.

COMPARISON: ___.

TECHNIQUE: Single frontal chest radiograph was obtained with the patient in an upright position.

FINDINGS: Compared to prior exam, there is increased pulmonary edema, which is now moderate-to-severe   Keywords: increase. Subtle consolidation may be obscured by this edema. There is likely a left pleural effusion; retrocardiac opacity may be related to adjacent atelectasis but is incompletely evaluated on this single view. No pneumothorax is detected. Cardiomegaly persists.

IMPRESSION: Increased moderate-to-severe pulmonary edema   Keywords: increase. These findings were reported to Dr. ___ by Dr. ___ by telephone at 3:17 p.m. on ___.


SubjectID: 13983282, StudyID: 54737117, Comparison: 0.0

FINAL REPORT

INDICATION: ___-year-old female with shortness of breath and pulmonary edema.

COMPARISON: ___.

TECHNIQUE: Single frontal chest radiograph was obtained portably with the patient in an upright position.

FINDINGS: There is subtle increase in bibasilar opacities, suggestive of increased pleural effusions and mildly increased interstitial edema   Keywords: increase. No pneumothorax is detected. Heart and mediastinum appear stable with mild cardiomegaly. Right internal jugular catheter appears to be in similar position given differences in patient positioning.

IMPRESSION: Slightly increased pleural effusions, left greater than right, with persistent moderate interstitial pulmonary edema   Keywords: persistent.


SubjectID: 13983282, StudyID: 58835625, Comparison: better

FINAL REPORT

INDICATION: CHF. Evaluation for interval change.

TECHNIQUE: AP and lateral chest radiographs.

COMPARISON: Multiple priors, most recently ___.

FINDINGS: There is significant improvement in bibasilar opacities compared to ___   Keywords: improve. Cardiomegaly and moderate bilateral pleural effusions are essentially unchanged. There is no definite focal consolidation; however, underlying pneumonia cannot be excluded. There is no pneumothorax. The right internal jugular catheter has been removed.

IMPRESSION: Improved pulmonary edema   Keywords: improve.


SubjectID: 13983282, StudyID: 55295541, Comparison: worse

FINAL REPORT

HISTORY: CHF.

FINDINGS: In comparison with study of ___, there has been a substantial increase in the degree of pulmonary edema in this patient with enlargement of the cardiac silhouette   Keywords: increase. Probable bilateral pleural effusions. Although no definite effusion is appreciated, the possibility of supervening pneumonia should be considered in the appropriate clinical setting.


SubjectID: 13983282, StudyID: 57474987, Comparison: None

FINAL REPORT

INDICATION: ___F with abdominal pain/distention // evaluate for free air

TECHNIQUE: AP view of the chest.

COMPARISON: ___ at 11:18. ___.

FINDINGS: There is moderate pulmonary edema. There is silhouetting of the left hemidiaphragm medially likely partially due to suspected hiatal hernia. Superimposed atelectasis and/or effusion are also possible. There is no large effusion. Cardiac silhouette is enlarged but similar compared to prior. No visualized free intraperitoneal air.

IMPRESSION: Moderate pulmonary edema. No free intraperitoneal air.


SubjectID: 13983282, StudyID: 51268678, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with IDDM, CKD, sCHF, afib presenting with sCHF exacerbation and NSTEMI. // please eval for interval change, volume overload? please eval for interval change, volume overload?

IMPRESSION: Compared chest radiographs since ___ most recently ___. Moderate pulmonary edema has increased, along with moderate cardiomegaly and greater distention of mediastinal vasculature, indicating at biventricular cardiac decompensation   Keywords: increase. Opacification of the lung bases is greater than the upper lungs and this could be concurrent consolidation or alternatively a combination dependent edema atelectasis and overlying pleural effusion. Moderate size hiatus hernia noted. No pneumothorax.


SubjectID: 13983282, StudyID: 51238699, Comparison: same

FINAL REPORT

INDICATION: ___F with DM, CHF, CAD presents with vomiting, fluid overload // eval for pulmonary congestion, pleural effusion

TECHNIQUE: AP and lateral views of the chest.

COMPARISON: ___.

FINDINGS: Prior right PICC and enteric tube are no longer visualized. Mild to moderate pulmonary edema is similar when compared to previous exam   Keywords: similar. There is no confluent consolidation nor effusion. Degree of cardiomegaly is similar given differences in projection. No acute osseous abnormalities.

IMPRESSION: Pulmonary edema without effusion or consolidation.


SubjectID: 13983282, StudyID: 57291167, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with Rt PICC pulled back // Rt PICC pull back 6cm ___#___

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the left PICC line was pulled back. The tip now projects over the mid SVC. The course of the nasogastric tube is unchanged. Increasing size of the cardiac silhouette. Hiatal hernia and increasing evidence of pulmonary edema that is now mild to moderate in severity   Keywords: increasing. No pleural effusions. No pneumonia. No pneumothorax.


SubjectID: 13983282, StudyID: 56563861, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ yr. old woman with PMH of HTN, CAD S/P MI ___, ischemic cardiomyopathy, systolic CHF (EF ___%), DMII (dx ___, C/B neuropathy, retinopathy, nephropathy, gastroparesis), CKD stage III s/p cardiogenic shock c/b by shock liver and likely ATN, now on the floor, undergoing diuresis. // Please assess for interval change, evidence of volume overload.

TECHNIQUE: Portable AP radiograph of the chest.

COMPARISON: ___.

FINDINGS: The Swan-Ganz catheter has been removed. The nasogastric tube extends into the stomach, distal tip not visualized. A right-sided PICC line extends into the low right atrium. Retraction by 7-8 cm would position its tip in the low SVC. There is no pneumothorax. Retrocardiac airspace opacification has decreased, likely due to resolved atelectasis. The lungs are otherwise clear. Heart size is smaller, but magnified by the projection. A moderate hiatal hernia is unchanged.

IMPRESSION: Right-sided PICC line terminates in the right atrium. Retraction by 7-8 cm would reposition the tip in the low SVC. Resolved left basilar subsegmental atelectasis. Moderate hiatal hernia.


SubjectID: 13983282, StudyID: 53690041, Comparison: better

FINAL REPORT

HISTORY: NG tube placement.

FINDINGS: In comparison with the earlier study of this date, there is now a nasogastric tube in place. It extends well into the stomach, then coils back on itself so that the tip lies in the upper stomach, both below the esophagogastric junction. There is still significant pulmonary edema, though improved since the earlier study   Keywords: improve.


SubjectID: 13983282, StudyID: 54955278, Comparison: same

WET READ: ___ ___ ___ 7:57 AM 1. Nasogastric tube with the tip terminating over the vicinity of the gastroesophageal junction. 2. Low lung volumes, mild-moderate central vascular congestion/ interstitial pulmonary edema, and bibasilar atelectasis is relatively stable as compared to the prior examination.

WET READ VERSION #1 ___ ___ ___ 7:30 PM 1. Nasogastric tube with the tip terminating over the vicinity of the gastroesophageal junction. 2. Low lung volumes, mild-moderate central vascular congestion/ interstitial pulmonary edema, and bibasilar atelectasis is relatively stable as compared to the prior examination. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with emesis, gastroparesis // s/p NGT placement, please assess position

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the patient has received a nasogastric tube. The tip projects over the gastroesophageal junction, the tube needs to be advanced by at least 5-10 cm to be securely positioned in the stomach. Otherwise no relevant change is seen   Keywords: no relevant change. Moderate pulmonary edema. Moderate cardiomegaly. No larger pleural effusions. Minimal retrocardiac atelectasis.


SubjectID: 13983282, StudyID: 54072371, Comparison: None

WET READ: ___ ___ ___ 8:19 AM 1. Slight interval advancement of a nasogastric tube, with tip now projecting over the region of the proximal stomach. 2. Low lung volumes, mild-moderate central vascular congestion/ interstitial pulmonary edema, and bibasilar atelectasis is relatively stable as compared to the prior examination.

WET READ VERSION #1 ___ ___ ___ 7:12 PM 1. Slight interval advancement of a nasogastric tube, with tip now projecting over the region of the proximal stomach. 2. Low lung volumes, mild-moderate central vascular congestion/ interstitial pulmonary edema, and bibasilar atelectasis is relatively stable as compared to the prior examination. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with emesis // please assess NGT placement

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the nasogastric tube is in unchanged position. Its tip projects over the gastroesophageal junction. To be securely positioned in the stomach, the device needs to be advanced by approximately 5-10 cm. Bilateral areas of basilar atelectasis. Mild fluid overload but no overt pulmonary edema. Moderate cardiomegaly persists.


SubjectID: 13983282, StudyID: 52645685, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with cardiogenic shock, fever, and leukocytosis now intubated s/p impella removal // ?intervala changes

TECHNIQUE: Chest PA and lateral

COMPARISON: Multiple prior chest radiographs most recently from ___.

FINDINGS: Endotracheal tube, Swan-Ganz catheter and nasogastric tube are unchanged in position. TheSwan ___ catheter tip continues to be in the right main pulmonary artery and should be retracted. The appearance of the lung parenchyma is also unchanged with mild pulmonary edema   Keywords: unchanged. There is no new pneumothorax or pleural effusions.

IMPRESSION: 1. Stable mild pulmonary edema   Keywords: stable. No significant change since the prior study   Keywords: no significant change. 2. Swan-Ganz catheter tip remains in the right main pulmonary artery and should be pulled back for more optimal positioning.


SubjectID: 13983282, StudyID: 51561789, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with heart failure, respiratory failure // eval for interval changed, ETT and PA catheter placement

COMPARISON: Chest radiograph from ___.

FINDINGS: AP view of the chest provided. As compared to prior study, degree of pulmonary edema is not significantly changed   Keywords: not significantly changed. There is slight increase in retrocardiac atelectasis. No large pleural effusions are seen. Mild cardiomegaly remains stable. Swan-Ganz catheter has been retracted slight and terminates in right main pulmonary artery. Endotracheal tube is in appropriate position. Nasogastric tube courses towards the stomach and out of view.

IMPRESSION: Endotracheal and Swan-Ganz catheter in appropriate positions.


SubjectID: 13983282, StudyID: 52573949, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with heart failure // eval position of PA catheter

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Swan-Ganz catheter tip is at the level of the right main pulmonary artery. NG tube tip is in the stomach. Pulmonary edema appears to be even more pronounced than on the prior study, at least moderate.


SubjectID: 13983282, StudyID: 50355467, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman w hiatal hernia s/p NG tube plcaement // evaluate position

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: Cardiomegaly and widened mediastinum are is stable. NG tube tip is in the stomach. Swan-Ganz catheter tip is in the main right pulmonary artery. Vascular congestion is stable   Keywords: stable. There is no pneumothorax.

IMPRESSION: Stable vascular congestion and cardiomegaly   Keywords: stable.


SubjectID: 13983282, StudyID: 51969759, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with cardiogenic shock // assess for interval change and placement of PA catheter

COMPARISON: Chest x-ray from ___ at 10:31

FINDINGS: Again seen is a right IJ Swan-Ganz catheter, with tip overlying the proximal right pulmonary artery. There has been slight interval clearing of opacity at the left base and possible slight overall improvement in CHF findings   Keywords: improve. The cardiomediastinal silhouette is similar to the prior film. Probable small right effusion, unchanged.

IMPRESSION: As above..


SubjectID: 13987926, StudyID: 55913666, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with dyspnea. Evaluate for pneumonia.

TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position.

COMPARISON: Radiograph from ___, ___, ___ and ___

FINDINGS: There is continued elevation of the left hemidiaphragm. The lungs are clear of focal consolidation, pleural effusion or pneumothorax. The heart size is normal. The mediastinal contours are normal.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 13987926, StudyID: 50001064, Comparison: None

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPHS

INDICATION: Congestive heart failure.

TECHNIQUE: Chest, PA and lateral.

COMPARISON: ___.

FINDINGS: The cardiac, mediastinal and hilar contours appear stable. There is again moderate row the with elevation of the left hemidiaphragm with minor associated atelectasis. Elevation is primarily posterior and may reflect a diaphragmatic hernia. There is no pleural effusion or pneumothorax. The lungs appear clear. There has been no definite change.

IMPRESSION: Similar posterior elevation of the left hemidiaphragm which may reflect eventration or hernia. No evidence of acute cardiopulmonary disease including no evidence for pulmonary edema identified.


SubjectID: 13991458, StudyID: 56529679, Comparison: better

WET READ: ___ ___ ___ 6:46 PM 1. ET tube 5 cm above carina; NG tube in place; no additional unintended tubes noted. 2. minimal improvement in pulmonary edema/ARDS. ______________________________________________________________________________

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with hypoxic respiratory failure.

COMPARISON: Chest x-ray of ___, chest CT ___.

FINDINGS: On chest CT ___, bilateral consolidation and ground-glass opacities were mostly compatible with pneumonia. Severe widespread ground glass opacities and consolidations progressed on latest chest x-ray done today at 3:12 p.m. This chest x-ray was done two hours after the most recent prior and there is improvement of bilateral opacities   Keywords: improve. Considering the rapid evolution of these opacities, pulmonary edema is the most likely diagnosis. The residual pulmonary edema is moderate. Bibasilar consolidations as shown on CT are compatible with pneumonia. ET tube ends 5 cm above carina. NG tube is in the stomach. There is no pleural effusion or pneumothorax. Mediastinal and cardiac contours are normal.

CONCLUSION: 1. Bibasilar pulmonary consolidation shown on prior CT is compatible with pneumonia. 2. Rapid improvement of diffuse bilateral ground-glass and alveolar opacities is compatible with concurrent pulmonary edema   Keywords: improve.


SubjectID: 13991458, StudyID: 52093255, Comparison: worse

FINAL REPORT

HISTORY: Hypoxia, chest pain, dyspnea, question infiltrate. CHEST, SINGLE AP PORTABLE VIEW. No previous chest x-rays on PACS record for comparison. There is patchy opacity with air bronchograms at both lung bases, consistent with a pneumonic infiltrate. The differential diagnosis could include aspiration, but this is considered less likely. There do appear to be background increased interstitial markings which could be related to either acute or chronic lung disease. Cardiomediastinal silhouette is slightly prominent, but likely accentuated by low lung volumes. The right hemidiaphragm is elevated. Mild prominence of the azygos vein is likely also accentuated by low lung volumes.

IMPRESSION: Findings concerning for bilateral pneumonic infiltrates. Also diffusely increased interstitial markings, which may indicate a background acute or chronic process   Keywords: increase.


SubjectID: 13991458, StudyID: 50916903, Comparison: None

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with flash pulmonary edema, now intubated. Evaluation for change.

COMPARISON: ___. The patient was extubated since prior exam and the NG tube had been removed. After the extubation the lung volumes look lower with more proeminence of pulmonary vessel, heart and azygous vein. The patient is treated with pneumonia and bilateral opacities are unchanged. There is no pneumothorax or pleural effusion.

CONCLUSION: The patient has been extubated since prior exam, this causes lower lung volumes with increased volume load.


SubjectID: 13991458, StudyID: 50572935, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old male with new onset tachypnea.

COMPARISON: Comparison is made with chest radiographs from ___.

FINDINGS: Two frontal images of the chest demonstrate interval placement of NG tube and endotracheal tube. Another short tube appears overlying the trachea and recommend clinical correlation to identify. The cardiomediastinal silhouette is unremarkable. There is interval worsening of interstitial markings, likely representing pulmonary edema versus less likely ARDS   Keywords: worse.

IMPRESSION: Worsening pulmonary edema versus less likely ARDS   Keywords: worse. These findings were communicated to Dr. ___ at 4:45 p.m.


SubjectID: 13991458, StudyID: 53114173, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPHS

INDICATION: Severe respiratory distress.

TECHNIQUE: Chest, AP upright portable.

COMPARISON: Earlier on the same evening.

FINDINGS: The cardiac, mediastinal and hilar contours appear stable. This study suggests there may be at least trace pleural effusions. Parenchymal opacities have increased   Keywords: increase. Although these are somewhat more conspicuous in the right lower lung than elsewhere, likely etiology is pulmonary edema.

IMPRESSION: Worsening parenchymal opacities suggesting moderate pulmonary edema   Keywords: worse. Although less likely developing pneumonia at the right lung base is not excluded.


SubjectID: 13991458, StudyID: 52171960, Comparison: None

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPHS

INDICATION: Shortness of breath.

TECHNIQUE: Chest, PA and lateral.

COMPARISON: ___.

FINDINGS: The heart is again mild to moderately enlarged. Perihilar opacities in addition to a mild generalized interstitial abnormality are most consistent with mild pulmonary edema. Confirmatory is the presence ___ ___ B type lines at both lung bases, better seen in the right costophrenic angle than left. There is no definite pleural effusion or pneumothorax.

IMPRESSION: Findings consistent with mild pulmonary edema.


SubjectID: 13992004, StudyID: 59235778, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hypercarbic hypoxi resp failure from ?HCAP // infiltrate

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Moderate cardiomegaly, known right lower lobe parenchymal opacity and right pleural effusion. Signs of mild fluid overload are present in unchanged manner   Keywords: unchanged. No new parenchymal opacities   Keywords: new. No pneumothorax.


SubjectID: 13992004, StudyID: 54842450, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with resp failure // interval changes

COMPARISON: ___

IMPRESSION: As compared to the previous image, no relevant change is seen   Keywords: no relevant change. Moderate cardiomegaly, with the cardiac shape potentially suggesting pericardial effusion. Echocardiography could confirm this suspicion. The extent of the right basal parenchymal opacity and of the right pleural effusion is constant. No new parenchymal changes.


SubjectID: 13992004, StudyID: 52925060, Comparison: worse

FINAL REPORT

EXAMINATION: PORTABLE CHEST RADIOGRAPH

INDICATION: ___-year-old female with shortness of breath.

TECHNIQUE: Frontal upright chest radiograph

COMPARISON: Multiple prior chest radiographs, most recent on ___.

FINDINGS: Compared with the prior radiograph there is significant interval improvement of previously of lobular enlarged appearance of the heart. However there is new opacification of the right lower lung, likely combination of consolidation, atelectasis, and pleural effusion. There are also patchy opacities in the left upper lobe on the background of diffuse increased interstitial thickening and vascular congestion   Keywords: increase. The aorta is calcified as before. Cardiac size cannot be properly assessed in this AP exam. Severe mitral annular calcifications are present, unchanged.

IMPRESSION: 1. Right lower lobe pneumonia with associated right pleural effusion on the background of vascular congestion and interstitial pulmonary edema. 2. Significant interval improvement of previous enlarged globular appearance of the heart.


SubjectID: 14018526, StudyID: 59920399, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man sp TAVR // pls assess temp wire placement pls assess temp wire placement

IMPRESSION: In comparison with the study of ___, there has been placement of a right IJ temporary pacer device with extends to the region of the apex of the right ventricle. No evidence of pneumothorax. There is continued enlargement of the cardiac silhouette with increasing elevation of pulmonary venous pressure. Opacification at the left base silhouetting the hemidiaphragms consistent with volume loss in left lower lobe and pleural effusion.


SubjectID: 14018526, StudyID: 58738330, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with aortic stenosis s/p TAVR with temporary pacer in place // Temp pacer, pulmonary edema?

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, there is an increase in bilateral perihilar opacities and an increase in peribronchial cuffing, both changes reflecting an increase in severity of pulmonary edema   Keywords: increase. Small bilateral pleural effusions might have newly occurred. The external pacemaker is in unchanged position. Moderate cardiomegaly persists.


SubjectID: 14018526, StudyID: 58026725, Comparison: better

FINAL REPORT

INDICATION: ___ year old man with aortic stenosis and systolic heart failure s/p TAVR with decreasing UOP and crackles on exam // Pulmonary edema?

TECHNIQUE: Single view at ___ 4:35 AM

COMPARISON: ___ at 11:33

FINDINGS: When compared to the previous examination there is less parahilar haziness although some does persist. As before there is retrocardiac density likely representing pleural fluid and or parenchymal disease likely atelectasis. The heart is is grossly enlarged. An aortic valve replacement is noted. The transvenous pacemaker resides in the right ventricular apex.. Aortic arch calcification present. The osseous structures are normal for age. Monitor leads overlie the chest.

IMPRESSION: Partial improvement in the pulmonary edema pattern   Keywords: improve. Gross cardiomegaly


SubjectID: 14018526, StudyID: 52612242, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with history of dysphagia and concern for aspiration as well as pulmonary edema // please evaluate for aspiration vs. pulmonary edema

COMPARISON: ___, 07:56

IMPRESSION: As compared to the previous image, the pre-existing parenchymal opacities, predominating in the perihilar areas, have decreased in extent and severity   Keywords: decrease. The basal opacities, associated to bilateral pleural effusions, are unchanged. Moderate cardiomegaly persists. The external pacemaker has been removed in the interval.


SubjectID: 14018526, StudyID: 54603008, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with severe AS with R basilar crackles // PNA? Pleural effusions? edema?

IMPRESSION: In comparison with the study ___ ___, there is again enlargement of the cardiac silhouette with elevation of pulmonary venous pressure, bilateral pleural effusions, and compressive basilar atelectasis. There is a somewhat illl-defined area of increased opacification at the right base. Although this could merely reflect an area of vascular congestion, in the appropriate clinical setting superimposed pneumonia would have to be seriously considered.


SubjectID: 14018526, StudyID: 51675878, Comparison: None

FINAL REPORT

EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Aortic stenosis, presenting with weakness.

COMPARISON: ___.

FINDINGS: Frontal and lateral views of the chest were obtained. There are small bilateral pleural effusions with overlying atelectasis. Fluid is also seen tracking in the fissure. There is mild vascular congestion. The cardiac silhouette is enlarged. The aorta is calcified and tortuous. No pneumothorax is seen.

IMPRESSION: Small bilateral pleural effusions with overlying atelectasis. Left basilar opacity likely represents combination of pleural effusion and atelectasis, although underlying consolidation is not excluded. Vascular congestion. Cardiomegaly.


SubjectID: 14018526, StudyID: 58244573, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with SOB, wheeze, crackles on exam // eval for pulm edema

COMPARISON: ___

IMPRESSION: Cardiomegaly is accompanied by moderate to marked pulmonary edema with both alveolar and interstitial components. Moderate bilateral pleural effusions are also present, increased from the prior study, and associated with adjacent basilar atelectasis


SubjectID: 14018526, StudyID: 51417877, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with significant dysphagia, is NPO, on TF's only, now with new cough // eval for infiltrate, consolidation to exclude an aspiration PNA

COMPARISON: ___

IMPRESSION: Compared to the previous radiograph, there is a mild increase in extent of a pre-existing right pleural effusion. Also increased are the signs indicative of pulmonary edema that is now moderate in severity   Keywords: increase. Massive cardiomegaly persists. Status post aortic valve replacement. Bilateral areas of atelectasis are unchanged.


SubjectID: 14018526, StudyID: 57925309, Comparison: None

FINAL REPORT

HISTORY: Acute on chronic CHF with V-tach. CHEST, SINGLE AP PORTABLE VIEW. Compared with ___ at 16:01 p.m., there is little interval change. Right-sided PICC line tip overlies the proximal SVC. Again seen are moderately large right and moderate-sized left pleural effusions with underlying collapse and/or consolidation, with upper zone re-distribution, bronchial wall thickening, and vascular blurring, consistent with CHF and pulmonary edema. The cardiomediastinal silhouette, though partially obscured by parenchymal findings, again appears enlarged, but unchanged.

IMPRESSION: Cardiomegaly, CHF and pulmonary edema, with bilateral effusions and underlying collapse and/or consolidation, very similar to one day earlier. The right effusion may be slightly larger.


SubjectID: 14018526, StudyID: 54980370, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with acute on chronic heart failure. // ? interval in effusions.

COMPARISON: ___ and ___

IMPRESSION: Stable cardiomegaly accompanied by pulmonary vascular congestion and improving pulmonary edema   Keywords: improving. Moderate to large right and moderate left pleural effusions are associated with persistent lower lobe atelectasis and or consolidation.


SubjectID: 14018526, StudyID: 57414451, Comparison: None

FINAL REPORT

PORTABLE CHEST: ___

HISTORY: ___-year-old male with fever and hypoxia.

COMPARISON: None.

FINDINGS: Portable view of the chest. Moderate-to-severe cardiomegaly is noted. Bibasilar opacities are identified, right greater than left, which are likely in part due to layering effusions. Instinct pulmonary vascular markings are seen superiorly. Aortic CoreValve device is identified. Atherosclerotic calcifications noted at the aortic arch.

IMPRESSION: Moderate-to-severe cardiomegaly with findings suggesting moderate pulmonary edema and right greater than left effusions.


SubjectID: 14018526, StudyID: 57176912, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with concern for HCAP vs aspiration pneumonia // Please assess for worsening edema/infiltrates Please assess for worsening edema/infiltrates

COMPARISON: Comparison to ___ 08:44

FINDINGS: Portable semi-erect chest film ___ at 05:29 is submitted.

IMPRESSION: The heart remains enlarged. There are worsening perihilar and basilar opacities which given the symmetry, would favor worsening moderate to severe pulmonary edema rather than an infectious process   Keywords: worse. Clinical correlation is advised. No pneumothorax is seen. Patient is status post aortic valve replacement.


SubjectID: 14018526, StudyID: 56859345, Comparison: better

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old man with AS s/p tavr, CHF and history of aspiration recovering from respiratory distress. // Pulm edema?

TECHNIQUE: Portable chest radiograph

COMPARISON: Chest x-ray ___

FINDINGS: Compared to the prior radiograph performed yesterday morning, the pulmonary edema has slightly improved from severe to moderate/severe   Keywords: improve. There is better aeration of the lungs particularly in the upper lobes. No pneumothorax. Moderate calcification of the aortic arch. Patient is status post TAVR. Stable cardiomegaly. No acute osseous abnormalities demonstrated on this radiograph. Enteric tube extends into the stomach.

IMPRESSION: Slightly improving pulmonary edema, now moderate to severe   Keywords: improving.


SubjectID: 14018526, StudyID: 53628397, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with respiratory failure, eing diuresed // ? evolution of pulm edmea / effusions

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Moderate cardiomegaly. Moderate bilateral pleural effusions and perihilar parenchymal opacities are unchanged in extent and severity. The nasogastric tube is also unchanged. No new parenchymal opacities   Keywords: new. No pneumothorax.


SubjectID: 14018526, StudyID: 55907951, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with recent TAVR, admitted for SOB // pulm edema / effusions

TECHNIQUE: Single frontal view of the chest

COMPARISON: Study performed 3 hours earlier

IMPRESSION: Increasing opacities in the left hemi thorax are consistent with worsening large areas of atelectasis. Cardiomegaly cannot be assessed. NG tube tip is out of view below the diaphragm. Mild edema has minimally increased   Keywords: increase. Opacities in the right base are a combination of atelectasis and effusion.


SubjectID: 14018526, StudyID: 51471611, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with resp failure recent TAVR, admitted for SOB // pulm edema / effusions

TECHNIQUE: Single frontal view of the chest

COMPARISON: Study performed 9 hours earlier

IMPRESSION: Moderate to severe cardiomegaly is stable. Moderate to large bilateral effusions larger on the left are unchanged, allowing the difference in positioning of the patient. Improving opacities in the left mid hemi thorax are due to markedly improved aeration / prior large atelectasis. There are still atelectasis in the left base. Atelectasis in the right base have minimally improved. Moderate pulmonary edema is grossly unchanged   Keywords: unchanged. There is no pneumothorax. NG tube tip is out of view below the diaphragm. Aortic stent is in place.


SubjectID: 14018526, StudyID: 50670359, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with recent DHT tube placement. // Evaluate placement

COMPARISON: Chest x-ray from ___. 16:33

FINDINGS: Compared to the most recent prior film, Dobbhoff tube placement has been attempted. Allowing for slightly rotated positioning, the radiopaque portion of the Dobbhoff tube overlies the thoracic inlet/superior mediastinum. Because it does not pass distal to the carina, the Dobbhoff tube position in relation to the trachea cannot be confidently ascertained. Clinical correlation is therefore requested. Otherwise, I doubt significant interval change.

IMPRESSION: As above.


SubjectID: 14023270, StudyID: 59014242, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: Chest, AP portable single view.

INDICATION: ___-year-old male patient with respiratory failure, intubated, now with orogastric tube in place. Evaluate position.

FINDINGS: AP single view of the chest has been obtained with patient in semi-upright position. Comparison is made with the next preceding similar study obtained eight hours earlier during the same day. The patient remains intubated, the ETT in unchanged position. No pneumothorax can be identified. Similar as the most previously portable obtained chest films, the examination remains of limited quality in this apparently morbidly obese patient. Only with the knowledge of a new tube placement and manipulation of image density is one able to identify portions of an OG line overlying the left upper abdominal quadrant. Thus, there is evidence that the line has reached below the diaphragm. Position of side port cannot be evaluated.

IMPRESSION: Unchanged chest findings, OG tube reaches stomach.


SubjectID: 14023270, StudyID: 52551053, Comparison: worse

FINAL REPORT

HISTORY:

COMPARISON: ___ through ___ blind.

FINDINGS:

IMPRESSION: Mild to moderate pulmonary edema has not worsened since ___   Keywords: worse. Consolidation at the right lung base, more obvious, but not necessarily worsened, could be asymmetric edema or pneumonia   Keywords: worse. Left lower lobe is also airless, most commonly due to atelectasis, early in the setting of severe chronic cardiomegaly like this. Mediastinal venous distention indicates right heart component of CHF. Endotracheal tube in standard placement. An Upper enteric tube can be traced as far as the low esophagus but the tip is not distinct. There is no pneumothorax. Right PICC line ends at the origin of the SVC.


SubjectID: 14023270, StudyID: 58672712, Comparison: 1.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p CABG // eval for ptx s/p CT removal

IMPRESSION: Since the recent radiograph of earlier today, a left-sided chest tube has been removed, with no visible pneumothorax on this semi upright radiograph. Exam is otherwise remarkable for pulmonary vascular congestion accompanied by new asymmetrical edema   Keywords: new. No other relevant change   Keywords: no other relevant change.


SubjectID: 14023270, StudyID: 54675629, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p CABG now febrile // r/o pneumonia, effusion

IMPRESSION: In comparison to ___ chest radiograph, pulmonary vascular congestion has resolved   Keywords: resolve. The bibasilar atelectasis has worsened on the left and improved on the right. Bilateral pleural effusions have decreased in size.


SubjectID: 14023270, StudyID: 50031422, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p CABG // follow up s/p bronchoscopy follow up s/p bronchoscopy

IMPRESSION: In comparison with the earlier study of this date, there has been re-expansion of the right upper lobe following bronchoscopy. Otherwise no change   Keywords: no change.


SubjectID: 14023270, StudyID: 58194461, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Abdominal distention, status post nasogastric tube placement.

COMPARISON: ___.

FINDINGS: As compared to the previous images, there is minimal progression of the pre-existing pulmonary edema   Keywords: progression. The lung volumes remain low and the size of the cardiac silhouette is massively enlarged. The course of the previously re-positioned nasogastric tube now appears to be normal. There is no pneumothorax and there are no larger pleural effusions.


SubjectID: 14023270, StudyID: 55340162, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Self-extubation, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has been extubated. The nasogastric tube has been removed. The right PICC line is in unchanged position. Minimally increasing atelectasis at the right lung base, otherwise, unchanged appearance of the lung parenchyma with low lung volumes, moderate cardiomegaly and moderate pulmonary edema   Keywords: unchanged appearance.


SubjectID: 14023270, StudyID: 55273919, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Self extubation. Evaluation.

COMPARISON: ___.

FINDINGS: Limited image quality. The endotracheal tube can be followed down to the level of the carina, in the middle third of the esophagus. A more distal position of the tube cannot be confirmed. The right PICC line remains in place. No pneumothorax. Unchanged low lung volumes and moderate cardiomegaly.


SubjectID: 14023270, StudyID: 58164813, Comparison: -1.0

FINAL REPORT

PORTABLE CHEST X-RAY OF ___

COMPARISON: ___ radiograph.

FINDINGS: Tip of endotracheal tube terminates about 6.5 cm above the carina. Cardiac silhouette remains enlarged and is accompanied by pulmonary vascular congestion and slight worsening perihilar edema   Keywords: worse. Small to moderate left pleural effusion is unchanged, but small to moderate right pleural effusion has increased in size. Persistent bilateral retrocardiac opacities   Keywords: persistent. No visible pneumothorax.


SubjectID: 14023270, StudyID: 51584180, Comparison: same

FINAL REPORT

HISTORY: ___-year-old male with problems including diastolic CHF, COPD, morbid obesity, with worsening lower extremity edema and respiratory distress. Evaluate ET tube placement.

COMPARISON:

FINDINGS:

IMPRESSION: AP chest at 5:28 compared to ___: The diaphragmatic region is excluded from this examination. Severe cardiomegaly is unchanged during this hospitalization. Mild pulmonary edema is stable, but central vascular engorgement is more pronounced, and bibasilar atelectasis which worsened after ___ and ___, remains severe   Keywords: stable. Pleural effusions are present, but poorly depicted and not large. ET tube is in standard position. Right PICC line ends at the origin of the SVC. No pneumothorax.


SubjectID: 14023270, StudyID: 54228456, Comparison: worse

FINAL REPORT

INDICATION: PEA arrest with MSSA pneumonia and continued fevers.

COMPARISON: ___.

TECHNIQUE: Portable frontal chest radiograph.

FINDINGS: This is a highly limited study due to technique and patient body habitus. Cardiac silhouette is massively enlarged. Lung volumes are persistently low with diffuse bilateral opacities with probable improvement of retrocardiac densities with increased aeration but with persistent right-sided and left apical indistinct opacity   Keywords: increase.

IMPRESSION: Persistent scattered indistinct opacities with slightly improved aeration of the left lung base.


SubjectID: 14023270, StudyID: 50365892, Comparison: same

FINAL REPORT

INDICATION: Hypoxic respiratory distress, heart failure, pulled tube in the ICU. Status post endotracheal tube placement.

COMPARISON: ___, 5:19 a.m.

FINDINGS: There has been interval endotracheal tube placement with tip terminating 6.5 cm above the carina. There is, otherwise, no significant interval change compared to exam from three and a half hours prior   Keywords: no significant interval change.

IMPRESSION: Endotracheal tube in appropriate position 6.5 cm above the carina. Otherwise, no significant interval change compared to exam three and a half hours prior   Keywords: no significant interval change.


SubjectID: 14023270, StudyID: 54577557, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, exacerbation, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is progression of disease. Low lung volumes remain unchanged, the pre-existing cardiomegaly is constant. However, signs indicative of pulmonary edema have worsened   Keywords: worse. The predominant abnormality is an overall increased radiodensity of the lung as well as increased vascular diameters. There is no evidence of pleural effusion. No pneumothorax. The position of the endotracheal tube is constant.


SubjectID: 14023270, StudyID: 53112331, Comparison: same

FINAL REPORT

PORTABLE CHEST OF ___

COMPARISON: Comparison ___ radiograph.

FINDINGS: Persistent cardiomegaly, pulmonary vascular congestion and mild-to-moderate pulmonary edema   Keywords: persistent. Bibasilar opacities, left greater than right, are also unchanged, with adjacent pleural effusions, small to moderate on the left and small on the right.


SubjectID: 14025885, StudyID: 57119794, Comparison: None

FINAL REPORT

INDICATION: Hypoxia.

COMPARISON: None available.

FINDINGS: Evaluation was limited due to patient positioning. There is mild bibasilar atelectasis and mild pulmonary edema. Cardiomediastinal silhouette minimally enlarged. No acute fractures are identified.

IMPRESSION: Mild pulmonary edema and bibasilar atelectasis.


SubjectID: 14037995, StudyID: 59634185, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with hypoxia // PNA?

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: Right-sided PICC is seen,, distal aspect not well seen, may be terminating in the low SVC/proximal right atrium. The cardiac silhouette remains enlarged. Cardiac and mediastinal contours are stable. Aortic graft is incidentally noted. Patient is status post median sternotomy. Single lead left-sided pacer is stable in position. Patchy right base opacity may be due to summation of shadows or consolidation due to pneumonia. Dedicated PA and lateral views would be helpful for further evaluation. No pleural effusion or pneumothorax. No pulmonary edema.

IMPRESSION: Patchy right base opacity may be due to summation of shadows or consolidation due to pneumonia. Dedicated PA and lateral views would be helpful for further evaluation.


SubjectID: 14037995, StudyID: 57401250, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with heart failure, HTN who prsents with hypoxia thought to be consistent with fluid overload. Also with PICC line. // Please evaluate for PICC placement. Please evaluate for pulmonary edema, effusions, consolidation, acute processs.

COMPARISON: ___

FINDINGS: Unchanged position of the right PICC line. The line shows a normal course. The tip projects over the upper to mid SVC. Otherwise unchanged radiograph   Keywords: unchanged radiograph. No pneumothorax.


SubjectID: 14037995, StudyID: 52301213, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with new ETT and new OGT // assess position of ETT and OGT

TECHNIQUE: Portable chest

COMPARISON: ___.

FINDINGS: ET tube is 5.2 cm above the Carina. There is a feeding tube with the tip poorly visualized. As location cannot be determined there is volume loss at the bases the heart is moderately enlarged. There is retrocardiac opacity. There is pulmonary vascular redistribution and perihilar opacities

IMPRESSION: The position of the OG tube cannot be determined on this film. The ET tube is in satisfactory position.


SubjectID: 14037995, StudyID: 57539617, Comparison: worse

FINAL REPORT

PORTABLE CHEST, ___ AT 11:11. CLINICAL

INDICATION: ___-year-old with advancement of nasogastric tube, check position. Comparison to prior study of ___ at 6:10 a.m. Portable semi-supine AP chest film was obtained on ___ at 11:11.

IMPRESSION: 1. The nasogastric tube now courses below the diaphragm with the tip projecting over the stomach. Tracheostomy tube, left internal jugular central line and single lead left-sided pacer are unchanged in position. Overall cardiac and mediastinal contours are stably enlarged. There is increasing indistinctness of the pulmonary vascularity, likely representing worsening pulmonary edema   Keywords: increasing, worse. Persistent bibasilar patchy opacities with associated small effusions suggestive of compressive atelectasis. The tracheostomy tube is unchanged in position. The patient is status post median sternotomy with an aortic graft remaining in place.


SubjectID: 14037995, StudyID: 55183420, Comparison: None

FINAL REPORT

PORTABLE CHEST FILM, ___ AT 6:10 A.M. CLINICAL

INDICATION: ___-year-old with nasogastric tube placement, check position. Comparison is made to the patient's prior study of ___ at 16:47. Portable AP upright chest film ___ at 6:11 is submitted.

IMPRESSION: 1. Single lead left-sided pacer remains in place with the lead terminating over the expected location of the right ventricle. Tracheostomy tube remains in satisfactory position. Portion of nasogastric tube is seen with the tip projecting in the mid-distal esophagus. Repositioning would be recommended with advancement by at least 14cm. The patient is status post median sternotomy with an aortic graft in place. The heart remains enlarged. Lung volumes are low with patchy opacities at both bases likely reflecting areas of atelectasis. Probable small left effusion. Crowding of the vasculature with no overt pulmonary edema. No pneumothorax. Results were communicated to the patient's nurse ___ by phone on ___ at 10:02 a.m. at the time of discovery.


SubjectID: 14037995, StudyID: 52845027, Comparison: same

FINAL REPORT

HISTORY: Tube placement.

FINDINGS: In comparison with the study of ___, there has been placement of a nasogastric tube that extends well into the stomach, curving in the fundus and pointing downward. The endotracheal tube has been exchanged for a tracheostomy tube. Otherwise, little change   Keywords: little change.


SubjectID: 14037995, StudyID: 50509102, Comparison: None

FINAL REPORT

HISTORY: Increasing ventilation requirements.

FINDINGS: In comparison with the study of ___, there are slightly lower lung volumes. Continued substantial enlargement of the cardiac silhouette with evidence of elevated pulmonary venous pressure. Bibasilar opacifications are consistent with atelectasis, most prominent involving the left lower lobe. In the appropriate clinical setting, supervening pneumonia would have to be considered. Probable small left and possibly right pleural effusion. Tracheostomy tube is unchanged.


SubjectID: 14037995, StudyID: 52772479, Comparison: better

FINAL REPORT

HISTORY: Pulmonary contusions and left rib fracture. Question interval change. CHEST, SINGLE AP PORTABLE VIEW ET tube in satisfactory position, approximately 5 cm above the carina. NG tube not well visualized, but tip overlies the left upper quadrant. Again seen is a left IJ central line, the tip of which overlies the region of the aortic arch, and does not cross the midline. Compared to the prior film and allowing for differences in technique, there has probably been slight improvement in the CHF findings. Residual upper zone redistribution and mild interstitial edema remains present. There is continued left lower lobe collapse and/or consolidation. Cardiomegaly may be slightly improved. Prosthetic valve and aortic graft again noted. Pacemaker again noted. Multiple left-sided rib fractures with small left effusion again noted. No pneumothorax detected.

IMPRESSION: 1. Lines and tubes as described. Of note, there is an apparent left IJ line that does not cross to the right of the mediastinum. 2. Enlarged cardiomediastinal silhouette stable or slightly improved. 3. CHF findings have improved, but with residual interstitial edema, small left lower lobe collapse and/or consolidation, and small left effusion   Keywords: improve. 4. The patient apparently has known pulmonary contusions, but what component of the findings is represented by contusion is difficult to distinguish by radiograph. 4. Left-sided rib fractures again noted. No pneumothorax detected.


SubjectID: 14037995, StudyID: 50078159, Comparison: 0.0

FINAL REPORT

CHESTS RADIOGRAPH

INDICATION: Bilateral pulmonary contusions, status post aortic valve repair, evaluation for pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the radiographic signs of evocative of pulmonary edema have minimally decreased in severity   Keywords: decrease. Mild-to-moderate pulmonary edema, however, is still present   Keywords: still. Enlarged cardiac silhouette and slightly enlarged mediastinum with areas of paramediastinal atelectasis at the level of the right upper lobe and left lower lobe. The monitoring and support devices as well as the pacemaker are in constant position. No larger pleural effusions.


SubjectID: 14037995, StudyID: 56050632, Comparison: None

FINAL REPORT

PORTABLE SUPINE CHEST, ___

COMPARISON: Radiograph of earlier the same date.

FINDINGS: Since the recent radiograph of a few hours earlier, there has been interval improved aeration of the lungs, particularly in the left upper and left lower lobes. Heterogeneous opacities in the right lung show a lesser degree of improvement, and may be due to multifocal contusion or aspiration in the setting of recent trauma. Widening of mediastinum has been more fully assessed on recent CT from two hours earlier, which demonstrated an acute aortic injury. Left rib fractures are also more fully evaluated on that study.


SubjectID: 14037995, StudyID: 51114578, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Status post intubation.

COMPARISONS: Prior day.

TECHNIQUE: Chest, portable AP semi-upright.

FINDINGS: The patient remains intubated. The endotracheal tube terminates about 3 cm above the carina. An orogastric tube terminates in the stomach. An aortic stent graft projects from the arch through the lower part of the descending thoracic aorta, as before. A single-lead pacemaker device also appears unchanged. An internal central jugular venous catheter has been slightly retracted, now terminating over the left mediastinal border, presumably in the left brachiocephalic vein. Somewhat increased confluent left basilar and infrahilar opacification with air bronchograms is nonspecific, but most often would represent a combination of atelectasis, perhaps pneumonia, and possibly with a pleural effusion. The central pulmonary vasculature appears moderately engorged including enlargement of the main pulmonary artery.

IMPRESSION: Status post aortic valve and stent graft placements. Lines, tubes, and drains unchanged. Mild increased findings suggesting fluid overload   Keywords: increase. Left-sided opacification which could be seen with some combination of atelectasis, pleural effusion, and potentially pneumonia.


SubjectID: 14037995, StudyID: 50232626, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p ex lap, washout, closure for hemorrhage s/p lap chole, now w/ desats // check tubes lines, assess for consolidation/atelectasis

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: The ET tube is 5.5 cm above the Carina. The NG tube is poorly visualized. The tip may be at the GE junction IJ line tip is in the SVC. Pacemaker with single lead is again visualized. Endovascular repair of the aorta is again visualized. There is dense retrocardiac opacification. There is small bilateral effusions. Lung volumes are low. There is volume loss in the perihilar region

IMPRESSION: NG tube poorly visualized. It may be too high, at the GE junction.


SubjectID: 14056083, StudyID: 51664671, Comparison: better

FINAL REPORT

PORTABLE CHEST FROM ___ AT 21:39 CLINICAL

INDICATION: ___-year-old with shortness of breath, question CHF, question infection. Comparison is made to the patient's previous study dated ___ at 11:11. Portable AP upright chest film, ___ at 21:39 is submitted.

IMPRESSION: 1. Single-lead right-sided pacer remains in place with the tip projecting over the expected location of right ventricle. The heart remains stably enlarged, which may reflect cardiomegaly, although pericardial effusion could have this appearance. Mediastinal contours are unchanged. A patchy opacity in the right upper lobe persists and may represent an area of aspiration or pneumonia. There continues to be perihilar vascular fullness and some interstitial prominence which likely reflects improving, but persistent perihilar and interstitial edema   Keywords: improving. No large effusions. No evidence of pneumothorax.


SubjectID: 14061330, StudyID: 55034219, Comparison: same

FINAL REPORT

INDICATION: ___M h/o dementia, DM2, dCHF, CKD presents with weakness and ___ swelling; getting diuresis for volume overload ___ renal failure with SOB // evidence of pulm edema

TECHNIQUE: Single portable AP radiograph of the chest

COMPARISON: ___

FINDINGS: The lung volumes remain low with unchanged bilateral diffuse lung opacities   Keywords: unchanged, remain. There is unchanged cardiomegaly and bilateral pleural effusions right greater than left. No pneumothorax. No interval change in bony thorax   Keywords: no interval change.

IMPRESSION: No significant interval change in diffuse pulmonary edema   Keywords: no significant interval change. Superimposed infection cannot be entirely excluded.


SubjectID: 14061330, StudyID: 52074380, Comparison: worse

FINAL REPORT

INDICATION: ___M with dyspnea // eval pna, fluid overload

TECHNIQUE: Frontal and lateral views of the chest.

COMPARISON: ___.

FINDINGS: When compared to prior, the degree of pulmonary edema is worse   Keywords: worse. Somewhat more confluent regions of consolidation in the left mid lung and right upper lung are noted. There are small bilateral pleural effusions. Enlargement of the cardiac silhouette is similar compared to prior.

IMPRESSION: Pulmonary edema. Superimposed infection cannot be entirely excluded and repeat after diuresis is suggested.


SubjectID: 14068639, StudyID: 58237136, Comparison: None

FINAL REPORT

INDICATION: Heart failure.

COMPARISON: Chest radiograph from ___.

TECHNIQUE: Frontal chest radiograph.

IMPRESSION: A left intracardiac device is again seen. A Swan-Ganz catheter again demonstrates a loop likely within the main pulmonary artery, terminating deep within a right pulmonary artery. There is no pneumothorax, focal consolidation, or pleural effusion. The overall configuration is unchanged since the ___ 19:01 exam.


SubjectID: 14068639, StudyID: 52922827, Comparison: None

FINAL REPORT

INDICATION: Swan-Ganz positioning.

COMPARISON: Chest radiograph from ___ at 17:55.

TECHNIQUE: Frontal chest radiograph.

FINDINGS: A right IJ-approach Swan-Ganz catheter again terminates deep within a right pulmonary artery. A previously seen loop within the right ventricle has been resolved. There remains a smaller loop, likely coiled within the main pulmonary artery. A left-sided intracardiac device is unchanged in position. There is no pneumothorax. A left retrocardiac opacity is minimally changed, likely reflecting atelectasis.

IMPRESSION: A Swan-Ganz catheter again terminates deep within a right pulmonary artery. A ventricular loop has been resolved. There remains a smaller loop likely within the main pulmonary artery.


SubjectID: 14068639, StudyID: 51687583, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with heart failure and now with swan-___ catheter // please assess location of pulmonary artery catheter

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, there is unchanged looping of the Swan-Ganz catheter in the main pulmonary artery. The tip of the catheter projects over the right main pulmonary artery and is in slightly peripheral position. Neck device could be pulled back by approximately 2-3 cm. Otherwise unchanged radiograph   Keywords: unchanged radiograph. Minimal fluid overload. Low lung volumes. Moderate cardiomegaly. No pleural effusions. No pneumonia.


SubjectID: 14068639, StudyID: 50782452, Comparison: better

FINAL REPORT

INDICATION: CHF.

COMPARISON: Radiographs from ___.

FINDINGS: Mild cardiomegaly is unchanged. There is improved central pulmonary vascular congestion; pulmonary edema has resolved   Keywords: improve, resolve. Trace bilateral pleural effusions are nearly resolved. There is no pneumothorax. A left retrocardiac opacity has improved, reflecting improved atelectasis. A left-sided generator pack projects a single lead into the right ventricle.

TECHNIQUE: Frontal chest radiograph.

IMPRESSION: Resolved pulmonary edema   Keywords: resolve. Nearly resolved bilateral pleural effusions. Improved left lower lobe atelectasis.


SubjectID: 14068639, StudyID: 57525749, Comparison: None

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Shortness of breath.

COMPARISONS: ___.

TECHNIQUE: Chest, PA and lateral.

FINDINGS: There is a single-lead pacemaker device terminating in the right ventricle. The heart is mild to moderately enlarged with a left ventricular configuration, as before. The cardiac, mediastinal contours appear stable. The lung volumes are low. Patchy opacities at the lung bases are most consistent with minor atelectasis. There is a mildly prominent appearance of upper zone redistribution of pulmonary vasculature with instinct contours and peribronchial cuffing suggesting mild vascular congestion including ___ B lines at the lung bases. There is no definite pleural effusion or pneumothorax. Surgical clips project over the left upper quadrant.

IMPRESSION: Findings suggesting mild vascular congestion.


SubjectID: 14068639, StudyID: 51965194, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF now with worsening dyspnea // evaluate for interval change

TECHNIQUE: Portable chest

COMPARISON: ___.

FINDINGS: Lung volumes are low, limiting comparison. Given technique is no significant change   Keywords: no significant change

IMPRESSION: Low lung volumes.


SubjectID: 14068639, StudyID: 54197064, Comparison: None

FINAL REPORT

CLINICAL

INDICATION: Chest pain. Evaluate for infiltrate.

COMPARISON: Multiple prior chest radiographs, the most recent of ___. FRONTAL AND LATERAL VIEWS OF THE CHEST: A left pectoral defibrillator device has a single lead ending in the right ventricle. Compared to the most recent chest radiograph of ___, there has been little change. There are low lung volumes and bilateral linear opacities most likely represent atelectasis. There is no focal consolidation, pleural effusion or pneumothorax. The cardiac and mediastinal contours are stable. Clips are noted in the left upper quadrant of the abdomen. Multilevel moderate degenerative changes are seen in the thoracic spine.

IMPRESSION: No new focal opacity concerning for pneumonia.


SubjectID: 14081972, StudyID: 58601151, Comparison: better

FINAL REPORT

AP CHEST, 8:43 AM ON ___

HISTORY: ___-year-old man with recent MI and CHF, admitted with shortness of breath.

IMPRESSION: AP chest compared to ___: Pulmonary edema has almost resolved   Keywords: resolve. Heart is mildly-to-moderately enlarged. The thoracic aorta is generally large. When feasible, conventional radiographs should be obtained to see if there is any reason to be concerned about possibility of aortic dissection.


SubjectID: 14081972, StudyID: 56320056, Comparison: None

FINAL REPORT

AP CHEST, 10:38 P.M. ON ___

HISTORY: ___-year-old male with hypoxia.

IMPRESSION: AP chest reviewed in the absence of prior chest radiographs: Lungs are low in volume and severely affected by diffuse infiltrative abnormality which by virtue of its homogeneous distribution is more likely edema than anything else though not necessarily cardiogenic. Heart shadow is largely obscured, and pulmonary vessels cannot be assessed. Pleural effusions may be present but not large. Clinical service is aware of these findings.


SubjectID: 14081972, StudyID: 53690019, Comparison: same

FINAL REPORT

HISTORY: TIA versus seizures, now with lung crackles.

FINDINGS: In comparison with the study of ___, there is little change   Keywords: little change. Again there are relatively low lung volumes, which may accentuate the transverse diameter of the heart. The pacer wire again extends to the region of the apex of the right ventricle. There is no evidence of vascular congestion or acute focal pneumonia. Of incidental note is the old healed fracture of the mid portion of the right clavicle.


SubjectID: 14081972, StudyID: 53169495, Comparison: None

FINAL REPORT

HISTORY: Stroke with cardiac aneurysm, to assess for pneumonia.

FINDINGS: In comparison with study of ___, there again are low lung volumes. Cardiac silhouette is prominent, with some of the prominence of the transverse diameter of the heart, presumably related to the low lung volumes. There has been interval placement of a left subclavian pacer, with its tip in the region of the apex of the right ventricle. No definite vascular congestion or acute focal pneumonia. Of incidental note is an old healed fracture of the mid portion of the right clavicle.


SubjectID: 14092420, StudyID: 50922201, Comparison: None

FINAL REPORT

PORTABLE AP CHEST FILM, ___ AT 8:07 CLINICAL

INDICATION: ___-year-old with mitral valve regurg and increased chest tube output, evaluate effusion. Comparison is made to the patient's previous study dated ___ at 14:08. A portable upright chest film ___ at 8:07 is submitted.

IMPRESSION: 1. Right internal jugular Swan-Ganz catheter has its tip in the left pulmonary artery. An endotracheal tube has its tip at the thoracic inlet. A nasogastric tube is seen coursing below the diaphragm with the tip not identified. Bibasilar chest tubes are unchanged in position. A left-sided pacer is again seen with the leads terminating over the expected location of the right atrium and right ventricle respectively. The patient is status post median sternotomy with mitral valve replacement. Heart remains stably enlarged. The previously seen pneumopericardium has nearly completely resolved. There is persistent retrocardiac opacity with a probable layering effusion suggestive of compressive atelectasis. The right lung is grossly clear. No large right effusion is appreciated. There is possibly a tiny right-sided pneumothorax as there is suggestion of an air-fluid level laterally in the region of the horizontal fissure; however, this may be positional rather than representing a true finding. No left-sided pneumothorax. No pulmonary edema.


SubjectID: 14108343, StudyID: 54871665, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior chest radiograph from ___ as well as a CTA chest from ___. CLINICAL

HISTORY: End-stage renal disease with increasing shortness of breath and cough, assess pulmonary edema.

FINDINGS: Portable AP upright chest radiograph obtained. A right subclavian venous stent is again noted. There are pleural effusions, right greater than left. There is hazy opacity obscuring the majority of the right mid-lower lung which is most compatible with pulmonary edema, though a component of the layering effusion is also possible. Pulmonary edema is less evident in the left lung. The heart size is difficult to assess but appears grossly stable. Atherosclerotic calcification along the thoracic aorta noted. Tracheobronchial tree calcification is also noted. Bony structures are intact. Clips in the upper abdomen noted.

IMPRESSION: Possible pulmonary edema with bilateral pleural effusions, right greater than left.


SubjectID: 14108343, StudyID: 52517209, Comparison: None

FINAL REPORT

HISTORY: Fluid overload, to assess for continued effusion.

FINDINGS: In comparison with study of ___, there has been removal of some pleural fluid from the right chest. The fluid collection in the minor fissure has essentially been eliminated. However, right lateral decubitus view shows a substantial amount of free pleural fluid layering out along the right chest wall. Remainder of the study is essentially unchanged.


SubjectID: 14108608, StudyID: 55378455, Comparison: worse

FINAL REPORT

HISTORY: Shortness of breath and hypoxia.

TECHNIQUE: PA and lateral views of the chest.

COMPARISON: ___ and ___.

FINDINGS: The heart is mildly enlarged but unchanged. The mediastinal contours are stable. Increased streaky opacities in the lung bases are new compared to the prior study   Keywords: new, increase. Small bilateral pleural effusions are also new. There is no pneumothorax. No acute osseous abnormality is visualized.

IMPRESSION: Increased streaky opacities in the lung bases likely reflect mild pulmonary edema with small bilateral pleural effusions   Keywords: increase.


SubjectID: 14108608, StudyID: 50850459, Comparison: better

FINAL REPORT

PA AND LATERAL CHEST OF ___

COMPARISON: ___ radiograph.

FINDINGS: Cardiac silhouette remains enlarged. Bilateral areas of septal thickening have resolved since the prior study, and slightly confluent opacities in the lower lobes centrally have also improved   Keywords: resolve, improve. Small pleural effusions are again demonstrated. No acute skeletal findings.

IMPRESSION: 1. Resolution of interstitial edema. Improving lower lobe opacities may reflect dependent edema and atelectasis but continued follow up radiographs may be helpful to ensure resolution given clinical concern for infection   Keywords: improving. 2. Persistent small pleural effusions.


SubjectID: 14120635, StudyID: 59893939, Comparison: same

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___ year old man with question of free air under diaphragm on AM CXR. // eval for free air under the diaphragm with CXR

TECHNIQUE: Portable, semi upright AP radiograph view of the chest

COMPARISON: Chest radiograph dated ___, earlier on the same day at 09:17.

FINDINGS: ETT in standard position. Right PICC tip again courses superiorly into the right IJ and its tip is beyond the scope of this image. Right IJ catheter tip projects in the expected region of the low SVC. Enteric tube traverses the diaphragm into the left upper quadrant and its tip is not seen. Metallic foreign body projecting over the bronchus is unchanged. No evidence of pneumoperitoneum under the right hemidiaphragm. No significant interval change   Keywords: no significant interval change. Retrocardiac opacity consistent with atelectasis is unchanged. Lung volumes remain low. No pneumothorax.

IMPRESSION: 1. No evidence of pneumoperitoneum. 2. Persistent right PICC tip coursing in the right IJ and its tip is not seen.


SubjectID: 14120635, StudyID: 57257884, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with intubated // PNA? PNA?

IMPRESSION: Comparison to ___. Monitoring and support devices are constant. Moderate cardiomegaly persists. Mild pulmonary edema is present. Retrocardiac atelectasis. A coexisting small left pleural effusion is stable.


SubjectID: 14120635, StudyID: 56496732, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man intubated // Interval change? Interval change?

IMPRESSION: Comparison to ___. No relevant change   Keywords: no relevant change. Monitoring and support devices are stable. Unchanged moderate cardiomegaly with mild fluid overload but no overt pulmonary edema   Keywords: unchanged. Unchanged left lower lobe atelectasis. No larger pleural effusions.


SubjectID: 14120635, StudyID: 52772223, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with new NG tube // please evaluate tube placement please evaluate tube placement

IMPRESSION: Comparison to ___. No relevant change   Keywords: no relevant change. Monitoring and support devices are constant. Moderate cardiomegaly with retrocardiac atelectasis. Mild fluid overload persists   Keywords: persists.


SubjectID: 14120635, StudyID: 51487032, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with IPH pulled out og tube // og tube ? NGT TUBE PLACEMENT

IMPRESSION: Comparison to ___, 03:32. The nasogastric tube is now visible in its entire length. The tip projects over the pre-pyloric parts of the stomach. No complications, notably no pneumothorax. Otherwise the radiograph is unchanged.


SubjectID: 14120635, StudyID: 59666950, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with iph, hygromas, difficult to extubate // pna pna

IMPRESSION: Comparison to ___. The endotracheal tube has been pulled back and is now 5.5 cm above the carina. The other monitoring and support devices are constant. Previously mild pulmonary edema has decreased in severity   Keywords: decrease. A mild to moderate left pleural effusion persists. Subsequent left lower lobe atelectasis is unchanged. No evidence of pneumonia.


SubjectID: 14120635, StudyID: 52865538, Comparison: worse

FINAL REPORT

EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 1 EXAM

INDICATION: ___ year old man with IPH, intubated, pulled at tube // location of the ET tube LOCATION OF THE ET TUBE NG TUBE

COMPARISON: ___

IMPRESSION: ET tube tip is 3.4 cm above the carinal. NG tube tip is in the stomach. Right internal jugular line tip is in the right atrium. Cardiomegaly is extensive but unchanged but there is interval progression of pulmonary edema currently severe   Keywords: progression.


SubjectID: 14120635, StudyID: 50477166, Comparison: better

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___ year old man with subdural hematom // intubated, interval change

TECHNIQUE: Portable AP radiograph view chest.

COMPARISON: Chest radiograph dated ___.

FINDINGS: The ETT in standard position. Right internal jugular venous catheter tip projects over the approximate region of the upper right atrium, unchanged. Enteric tube is in side port projected expected region of the stomach, also unchanged. Tiny round radiopaque material projecting of the left upper lobe bronchus is unchanged. Lung volumes remain low. Mild pulmonary vascular congestion is improved slightly in interim   Keywords: improve. Edema is moderate. Small pleural effusion and atelectasis on the left persists. Moderate cardiomegaly is overall unchanged. No right pleural effusion. No pneumothorax.

IMPRESSION: Low lung volumes with perhaps slight improvement in moderate edema   Keywords: improve. Persistent small left pleural effusion.


SubjectID: 14120635, StudyID: 58894824, Comparison: worse

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___ year old man with NGT advancement // NGT placement

TECHNIQUE: Chest PA and lateral

COMPARISON: Prior same day chest radiographs in ___

FINDINGS: Enteric feeding tube is seen with of the tip projecting over the stomach and continuing out of view. As mentioned previously, there is interval increase in pulmonary edema from ___   Keywords: increase. Cardiomegaly is unchanged. A right PIC line is seen with tip terminating at the the lower SVC. Tracheostomy tube is appropriately placed.

IMPRESSION: 1. Enteric feeding tube seen with tip projecting over the stomach and continuing out of view. 2. Other findings are unchanged from multiple same day prior radiographs.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ ___ on the telephoneon ___ at 5:13 PM, 10 minutes after discovery of the findings.


SubjectID: 14120635, StudyID: 52681239, Comparison: worse

FINAL REPORT

EXAMINATION: Portable AP chest radiograph

INDICATION: ___ year old man with NGT advancement // Please assess NGT placement

TECHNIQUE: AP chest radiograph

COMPARISON: Prior chest radiographs from ___, ___, ___

FINDINGS: Enteric feeding tube is seen with of the tip projecting over the region of the stomach. Compared to ___, there is interval increase in pulmonary edema with enlargement of hilar structures due to vascular congestion   Keywords: increase. Cardiomegaly is largely unchanged. A right PIC line is seen with tip terminating at the the lower SVC. Tracheostomy tube is appropriately placed.

IMPRESSION: 1. Enteric feeding tube seen with tip projecting over the region of the stomach, continuing out-of-view. 2. Interval increase in mild pulmonary edema compared to ___   Keywords: increase.. 3. Unchanged appearance of right PIC line and tracheostomy.


SubjectID: 14120635, StudyID: 58696310, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with new NG tube placement // Please evaluate for NG tube

TECHNIQUE: Single frontal view of the chest

COMPARISON: Study performed 8 hours earlier

IMPRESSION: Dobhoff tube tip isin the stomach, just distal to the EG junction. No other interval change from prior study   Keywords: no other interval change.


SubjectID: 14120635, StudyID: 52968797, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with history of liver transplant (on immunosuppression) and also on dialysis and also has tracheostomy. Presents with 1 time fever. // Please assess for PNA

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Severe cardiomegaly is stable. Tracheostomy tube is in standard position. Right PICC tip is in the lower SVC. NG tube tip is out of view below the diaphragm. There is no pneumothorax. Retrocardiac consolidation is unchanged. Vascular congestion has improved   Keywords: improve. Bilateral effusions are layering probably decreased in size


SubjectID: 14120635, StudyID: 55734005, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with intraparenchymal hemorrhage, currently intubated // Interval change?

TECHNIQUE: Single frontal view of the chest

COMPARISON: Portable chest x-ray ___

FINDINGS: Severe cardiomegaly is stable. There is mild bilateral pulmonary vascular congestion. There is no pneumothorax. Hilar and mediastinal contours are unchanged. The ET tube is appropriately positioned. The right IJ catheter ends in the rt atrium. The enteric tube terminates in the stomach.

IMPRESSION: Mild bilateral pulmonary vascular congestion. Severe cardiomegaly is stable.


SubjectID: 14120635, StudyID: 54691935, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with SAH now intubated // interval change, location of lines and tubes interval change, location of lines and tubes

IMPRESSION: Comparison to ___. Moderate cardiomegaly with retrocardiac atelectasis and mild pulmonary edema. The changes are stable in severity. The presence of a minimal left pleural effusion cannot be excluded. Stable correct position of the monitoring and support devices.


SubjectID: 14120635, StudyID: 55110064, Comparison: None

FINAL REPORT

INDICATION: ___M with intubated // confirm ETT placement

TECHNIQUE: Single portable view of the chest.

COMPARISON: None.

FINDINGS: Endotracheal tube tip is 5.5 cm from the carina. Lung volumes are relatively low with secondary crowding of the bronchovascular markings. There is superimposed pulmonary vascular congestion. Moderate cardiomegaly is noted. Bibasilar opacities, left greater than right may be due to layering effusions. Vascular stent projects over left upper extremity. Prominent gastric bubble is identified.


SubjectID: 14120635, StudyID: 54379695, Comparison: worse

WET READ: ___ ___ ___ 8:19 PM The newly placed enteric tube traverses the diaphragm and its tip and side-port project over the expected region of the stomach in the left upper quadrant. Newly placed ETT in standard position. Bilateral pleural effusions are small. Probable cardiomegaly, unchanged. Mild edema and moderate pulmonary central vascular congestion. Retrocardiac opacity may reflect atelectasis and/or a edema. Radiopaque density projecting just to the left of the mediastinum is unchanged. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with IPH and SAH, with ESRD on HD, currently intubated and sedated // Evaluation of OG tube placement Evaluation of OG tube placement

COMPARISON: ___ obtained at 08:36

IMPRESSION: ET tube tip is 4.9 cm above the carinal. NG tube tip is in the stomach. Cardiomegaly and mediastinal contours overall stable but there is interval progression of pulmonary edema and development of left lower lung atelectasis and bilateral pleural effusions appear to be increased since the prior study   Keywords: progression, development.


SubjectID: 14120635, StudyID: 53908869, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p liver transplant, with ESRD on HD with new dobhoff placed at bedside // please assess if dobhoff is post-pyloric

IMPRESSION: Radiographs obtained for assessment of a feeding tube demonstrate a Dobhoff tube coiling in the region of the junction of the distal stomach and duodenum. Appearance of the chest is similar to the recent radiograph from earlier the same date.


SubjectID: 14120635, StudyID: 53224853, Comparison: same

WET READ: ___ ___ ___ 8:24 AM RESIDENT

WET READ: 2 sequential images are provided. In the first imaged the tip of the top off tube is above the diaphragm. In the second imaged the tip of the Dobhoff tube has been advanced and now projects over the expected region of the stomach in the left upper quadrant. Otherwise, overall no significant interval change in the radiographic appearance of the chest and upper abdomen compared to 16:19 earlier today. CWei ___, 8 pm.

WET READ VERSION #1 ___ ___ ___ 8:03 PM RESIDENT

WET READ: 2 sequential images are provided. In the first imaged the tip of the top off tube is above the diaphragm. In the second imaged the tip of the Dobhoff tube has been advanced and now projects over the expected region of the stomach in the left upper quadrant. Otherwise, overall no significant interval change in the radiographic appearance of the chest and upper abdomen compared to 16:19 earlier today. CWei ___, 8 pm. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hbv cirrhosis, ESRD with new dobhoff // assess dobhoff location

IMPRESSION: Since a recent study from earlier the same date, a feeding tube has been replaced. Sequential images document advancement into the proximal stomach. No other relevant changes   Keywords: no other relevant change.


SubjectID: 14148978, StudyID: 59897666, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female with shortness of breath. STUDY: Portable AP upright chest radiograph.

COMPARISON: None.

FINDINGS: The heart size is within normal limits. The mediastinal contours show no widening and demonstrate calcified atherosclerotic disease at the aortic knob. The lungs are hyperinflated and demonstrate ill-defined airspace opacities affecting the left upper lung and probably the right lung base as well; areas of lucency in the right upper lung represent underlying emphysema. There is no large pleural effusion or pneumothorax. Minimal scoliosis is present in the thoracic spine.

IMPRESSION: Left upper and possible right lower lung airspace opacities in the setting of emphysema, concerning for pneumonia. Recommend follow-up to resolution.


SubjectID: 14148978, StudyID: 51921994, Comparison: same

FINAL REPORT

STUDY: Portable AP chest radiograph.

COMPARISON EXAM: Portable AP chest radiograph, ___, ___.

INDICATION: ___-year-old woman with severe AS and pulmonary opacifications.

FINDINGS: There has been interval improvement of a right-sided pleural effusion and the right basilar opacification. However, there is still opacification of the right lower and upper lungs as well as the left upper lung   Keywords: still. There is no pneumothorax. The cardiomediastinal and hilar contours are stable.

IMPRESSION: 1. Improved right pleural effusion. Continued opacification of the right lower and upper lung as well as the left upper lung consistent with pneumonia.


SubjectID: 14148978, StudyID: 50140525, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Probable pneumonia, critical aortic stenosis.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is a massive, newly appeared right lower lobe opacity as well as a newly appeared opacity at the bases of the right upper lobe. In addition, increasing interstitial markings are also seen at the left lung base. The parenchymal opacity in the right lung is accompanied by relatively extensive right pleural effusion. At the time of observation, 9:16 a.m., the referring physician, ___. ___, was paged for notification and the findings were subsequently discussed over the telephone on ___.


SubjectID: 14168528, StudyID: 58773435, Comparison: None

WET READ: ___ ___ ___ 5:49 PM Improved pulmonary edema from ___. No large pleural effusion. Mediastinal contours within normal limits on this repeat exam. Unchanged cardiomegaly.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with concerning final read on chest xray, persistent hypotension // ? reassess mediastinal widening, pleural effusion more

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the lung volumes have increased, likely reflecting improved ventilation. The cardiac silhouette continues to be enlarged. The wide mediastinum is likely the result from mild pulmonary edema. No pleural effusions are seen on the current radiograph. No pneumothorax.


SubjectID: 14168528, StudyID: 55776807, Comparison: None

WET READ: ___ ___ 11:40 PM Enlargement of the cardiac silhouette. Low lung volumes accentuate the pulmonary vascular markings; although, there may be an element of pulmonary vascular congestion and mild pulmonary edema, the exam is limited by overlying soft tissue. No large pleural effusions or pneumothorax. Discussed with Dr. ___ at 23:39 on ___. ___ ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ yo M with a history of HTN, DMII, obesity and prior gluteal fold abscess presenting with gluteal fold swelling. // r/o acute process

COMPARISON: None

IMPRESSION: Greater opacification of the right hemi thorax is probably due to a posteriorly layering moderate right pleural effusion. The very wide mediastinum. could be due to fatty infiltration and mediastinal venous engorgement, but I cannot exclude hematoma or adenopathy on this single view alone. Heart is moderately enlarged. Pulmonary edema is mild to moderate. No pneumothorax.


SubjectID: 14174955, StudyID: 59689588, Comparison: None

WET READ: ___ ___ ___ 4:37 AM No acute cardiopulmonary process. ______________________________________________________________________________

FINAL REPORT

INDICATION: History: ___F with sob // edema

TECHNIQUE: Portable chest radiograph.

COMPARISON: Chest radiographs dated ___ through ___.

FINDINGS: The lungs are well-expanded and clear. The cardiomediastinal and hilar contours are unchanged. The heart remains enlarged which may reflect cardiomegaly or pericardial effusion. A single lead pacemaker is present. No pneumothorax, pleural effusion, consolidation, or evidence of pulmonary edema.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 14174955, StudyID: 52113149, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with sCHF and SOB // evaluate for pulm edema evaluate for pulm edema

IMPRESSION: Comparison to ___. Moderate cardiomegaly persists. Increasing pulmonary edema that is now mild to moderate in severity   Keywords: increasing. The presence of a small right pleural effusion cannot be excluded. No pneumonia. Bilateral areas of atelectasis.


SubjectID: 14174955, StudyID: 59483749, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with GI bleed and recent self extubation.

COMPARISON: ___. Right IJ line remains in acceptable position, tip in the low SVC. The left IJ sheath has been removed. The patient has been extubated. Lungs remain well aerated, without appreciable effusion, and without pneumothorax or focal opacity to suggest pneumonia. Evaluation of the hilar and cardiomediastinal contours is limited by patient rotation, though they appear unchanged. There is no pulmonary vascular congestion or edema.

IMPRESSION: Status post extubation. Grossly clear lungs without acute cardiopulmonary process.


SubjectID: 14174955, StudyID: 57213919, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post intubation, evaluation of nasogastric tube placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has been intubated. The tip of the endotracheal tube projects approximately 4 cm above the carina. The tube could be advanced by 1 cm. Normal course of the nasogastric tube, the tip of the tube projects over the middle parts of the stomach. The pre-existing right internal jugular vein catheter is unchanged. No evidence of complications. Unchanged normal lung volumes with moderate cardiomegaly and minimal fluid overload, but no evidence of overt pulmonary edema. Minimal retrocardiac atelectasis. No pneumonia, no pleural effusions.


SubjectID: 14174955, StudyID: 56297155, Comparison: None

WET READ: ___ ___ 9:49 PM ETT 3.5 cm from carina, retract 1-2 cm. Also slightly angulated to R, near tracheal wall. Mod cardiomegaly.

WET READ VERSION #___ ___ ___ ___ 9:49 PM ETT 3.5 cm from carina, retract 1-2 cm. Also slightly angulated to R, near tracheal wall. ______________________________________________________________________________

FINAL REPORT

AP CHEST, 8:28 P.M., ___

HISTORY: Check ET tube.

IMPRESSION: AP chest compared to ___, 12:16 p.m.: Tip of the new endotracheal tube is at the upper margin of the clavicles, no less than 4 cm from the carina. Respiratory motion obscures fine anatomic detail in the lungs, but there is no pulmonary edema or large consolidation. Severe cardiomegaly has increased, now accompanied by small bilateral pleural effusion. Supraclavicular left internal jugular introducer ends at the junction of the brachiocephalic veins. No pneumothorax is evident, though pleural surfaces might be obscured by respiratory motion. Subsequent chest radiograph, 9:34 p.m., showed no pneumothorax.


SubjectID: 14174955, StudyID: 52771077, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Upper gastrointestinal bleeding, intubation, fevers and rising white blood cell count, rule out pneumonia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the monitoring and support devices are in unchanged position. There is a newly appeared right basal parenchymal opacity that could represent early pneumonia. The presence of a minimal right pleural effusion cannot be excluded. Unchanged moderate cardiomegaly and minimal fluid overload as well as tortuosity of the thoracic aorta   Keywords: unchanged. The referring physician, ___. ___ was paged for notification at the time of dictation, 9:50 a.m., on ___.


SubjectID: 14174955, StudyID: 50204011, Comparison: None

FINAL REPORT

INDICATION: ___-year-old woman with line placement.

COMPARISONS: Portable AP chest radiograph from ___.

FINDINGS: Portable AP views of the chest were provided. There is a central line sheath terminating at the brachiocephalic confluence. The heart size is moderately enlarged. There is no focal consolidation, pneumothorax or pleural effusion. There are no suspicious osseous lesions.

IMPRESSION: Central line terminating at the brachiocephalic confluence. No pneumothorax.


SubjectID: 14174955, StudyID: 59303941, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman now s/p bronch of Right side, and OG tube placement // interval change interval change

IMPRESSION: In comparison with the earlier study of this date, there is some further aeration of the right lung with some residual volume loss and pleural fluid at the base. Orogastric tube extends to the upper stomach. Continued enlargement of the cardiac silhouette with some element of elevated pulmonary venous pressure.


SubjectID: 14174955, StudyID: 58948180, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: This is a ___ yo F with hx of CAD, systolic CHF, COPD, DM, HTN, atrial fibrillation, bradycardia s/p PPM, GI bleed (both lower and upper) who presented to ___ on ___ with acute diverticulitis c/b cardiac arrest X 2 now s/p re-intubation. // evaluate interval change evaluate interval change

IMPRESSION: In comparison with the study ___, the monitoring and support devices are stable, as is the appearance of the heart and lungs.


SubjectID: 14174955, StudyID: 57254288, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman here with resp failure, intubated // evaluate interval change evaluate interval change

IMPRESSION: In comparison with the study ___ ___, the monitoring and support devices are unchanged, as is the appearance of the enlarged heart and tortuous aorta. Again there is no evidence of vascular congestion   Keywords: again. There is suggestion of some increasing opacification in the right upper lobe. However, this probably represents merely superimposition of the medial aspect of the scapula. The right costophrenic angle is more sharply seen. This could reflect decreasing pleural fluid, though it might merely be a manifestation of a more erect position of the patient.


SubjectID: 14174955, StudyID: 52142562, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p extubation, desatting to the 80s on NRB // e/o worsening pulm edema or other acute process e/o worsening pulm edema or other acute process

IMPRESSION: In comparison with the study ___ ___, the monitoring and support devices have been removed except for the right IJ catheter. There has been dramatic opacification of the right hemithorax, consistent with collapse of the right lung most likely due to a mucous plug. Left lung remains clear. The appearance is similar to a subsequent study dictated previously.


SubjectID: 14174955, StudyID: 52111983, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: This is a ___ yo F with hx of CAD, systolic CHF, COPD, DM, HTN, atrial fibrillation, bradycardia s/p PPM, GI bleed (both lower and upper) who presented to ___ on ___ with acute diverticulitis c/b cardiac arrest X 2. // evaluate interval change evaluate interval change

IMPRESSION: In comparison with the study of earlier in this date, there has been some aeration of the right mid and upper lung, suggesting partial removal of a mucous plug. The left lung remains essentially clear and the monitoring and support devices are unchanged.


SubjectID: 14174955, StudyID: 58781208, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: This is a ___ yo F with hx of CAD, systolic CHF, COPD, DM, HTN, atrial fibrillation, bradycardia s/p PPM, GI bleed (both lower and upper) who presented to ___ on ___ with acute diverticulitis c/b cardiac arrest X 2. // evaluate interval changes evaluate interval changes

IMPRESSION: In comparison with the study ___ ___, there again is substantial enlargement of the cardiac silhouette with pulmonary vascular congestion and bilateral layering effusions with compressive atelectasis at the bases. The enteric tube appears to have been pulled back so that the tip is in the upper stomach.


SubjectID: 14174955, StudyID: 56132122, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with respiratory failure, intubation // interval change

IMPRESSION: In comparison to ___ chest radiograph, there remains marked enlargement of the cardiac silhouette accompanied by pulmonary vascular congestion and improved edema   Keywords: improve. Interval decrease in size of right pleural effusion with residual small effusion remaining. Small to moderate left pleural effusion is also evident as well as persistent bibasilar atelectasis and or consolidation.


SubjectID: 14174955, StudyID: 54364093, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with history of cardiac arrest, s/p intubation, volume overloaded // PNA PNA

IMPRESSION: Compared to chest radiographs ___ through ___:26. Moderate right pleural effusion is probably smaller. Previous pulmonary vascular congestion has improved   Keywords: improve. Left lung is clear. There is no left pleural abnormality. Moderate enlargement of cardiac silhouette is improved, but the heart still obscures the right lower lobe, which is largely atelectatic or consolidated. No pneumothorax. ET tube and other cardiopulmonary support devices in standard placements.


SubjectID: 14174955, StudyID: 58617913, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with respiratory failure and desat after trach placement // Please eval for edema vs. infiltrate vs. atelectasis

TECHNIQUE: Portable chest

COMPARISON: ___ at 11:00

FINDINGS: Compared to the prior study there is decreased free air under the left hemidiaphragm but otherwise, no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change.


SubjectID: 14174955, StudyID: 55253392, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p trach/PEG on ___, now with new fever // ? pneumonia ? pneumonia

IMPRESSION: Tracheostomy is in place. Right PICC line tip is at the cavoatrial junction. Cardiomegaly is substantial. Mild vascular congestion is present. There is pneumoperitoneum potentially related to recent pack placement No definitive new consolidation to suggest interval development of infection demonstrated.


SubjectID: 14174955, StudyID: 51247502, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with diverticulitis s/p cardiac arrest, hx of limb ischemia, s/p trach and PEG with new SOB. // evaluate for changes explaining SOB

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change.


SubjectID: 14174955, StudyID: 51193319, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with respiratory failure and desat after trach placement // please eval for interval chyange

TECHNIQUE: Portable chest

COMPARISON: ___.

FINDINGS: The heart continues to be severely enlarged. There is pulmonary vascular redistribution and hazy bilateral alveolar infiltrate. There are bilateral pleural effusions that have slightly increased compared to the prior exam. The pacemaker and the PICC line are unchanged

IMPRESSION: Worsened fluid overload   Keywords: worse.


SubjectID: 14174955, StudyID: 58557487, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with history of PEA arrest, now cooled // interval change in pneumothorax interval change

IMPRESSION: Comparison to ___. No relevant change is noted   Keywords: no relevant change. Monitoring and support devices continue to be correctly position. Moderate cardiomegaly with mild to moderate bilateral pleural effusions and signs of mild to moderate pulmonary edema are visualized. Relatively extensive left and right basal areas of atelectasis.


SubjectID: 14174955, StudyID: 58192531, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: This is a ___ yo F with hx of CAD, systolic CHF, COPD, DM, HTN, atrial fibrillation, bradycardia s/p PPM, GI bleed (both lower and upper) who presented to ___ on ___ with acute diverticulitis c/b cardiac arrest X 2. // evaluate interval change evaluate interval change

IMPRESSION: Compared to chest radiographs since ___, most recently ___. Severe cardiomegaly may have increased since ___:00 last night, and there is new more pulmonary and mediastinal vascular congestion so that the hazy opacification in right upper and lower lungs can be attributed to asymmetric could of pulmonary edema   Keywords: new. Small right pleural effusion is likely. No pneumothorax. Cardiopulmonary support devices in standard placements.


SubjectID: 14174955, StudyID: 57937759, Comparison: same

FINAL REPORT

EXAMINATION: Portable chest radiographs

INDICATION: This is a ___ yo F with hx of CAD, systolic CHF, COPD, DM, HTN, atrial fibrillation, bradycardia s/p PPM, GI bleed (both lower and upper) who presented to ___ on ___ with acute diverticulitis c/b cardiac arrest X 2. // evaluate interval change

TECHNIQUE: Chest PA and lateral

COMPARISON: Multiple same day chest radiographs

FINDINGS: Compared to 30 minutes prior, no significant changes   Keywords: no significant change. The recently placed enteric tube terminates superior to the GE junction with a side-port in the distal esophagus.

IMPRESSION: An enteric tube terminates above the GE junction with a side-port in the distal esophagus. Recommend advancing by 15 cm. No other significant change   Keywords: no other significant change.

NOTIFICATION: The findings were discussed with ___, M.D. by ___ ___, M.D. on the telephone on ___ at 4:54 PM, approximately 30 minutes after discovery of the findings.


SubjectID: 14174955, StudyID: 57028763, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p arrest // r/o pneumo r/o pneumo

IMPRESSION: In comparison with the study performed 1 hr previously, there is little change   Keywords: little change. Monitoring support devices are unchanged. Continued substantial enlargement of the cardiac silhouette without appreciable vascular congestion.


SubjectID: 14174955, StudyID: 56705664, Comparison: same

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old woman with new NGT // NGT placement

TECHNIQUE: Portable AP chest

COMPARISON: Earlier same day chest radiograph

FINDINGS: Compared to 9 hours prior, interval placement of an enteric tube which is extensively coiled in the hypopharynx. Increased opacification over the left hemithorax may be due to a layering pleural effusion. Otherwise, lines, tubes, and supportive devices are unchanged in position. Severe cardiomegaly and mild pulmonary vascular congestion are unchanged   Keywords: unchanged.

IMPRESSION: New enteric tube is extensively coiled in the hypopharynx.

NOTIFICATION: The findings were discussed with ___, M.D. by ___, M.D. on the telephone on ___ at 1:08 PM, at the timing of finding discovery.


SubjectID: 14174955, StudyID: 55644817, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with intubation, pea arrest // interval change interval change

IMPRESSION: Comparison to ___. Stable appearance of the chest radiograph. The monitoring and support devices continue to be in correct position. The stomach is mildly over distended, so the placement of a feeding tube could be beneficial. Moderate cardiomegaly persists. Small bilateral pleural effusions with subsequent areas of atelectasis. New focal parenchymal opacities   Keywords: new.


SubjectID: 14174955, StudyID: 55044090, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with history of PEA arrest, now cooled // interval change interval change

IMPRESSION: In comparison with the earlier study of this date, the monitoring and support devices are unchanged. Again there is severe cardiomegaly, though the pulmonary vascular congestion has decreased   Keywords: decrease.


SubjectID: 14174955, StudyID: 52947573, Comparison: same

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old woman with diverticulitis, A-fib, diastolic CHF, s/p V-fib arrest, now intubated. // please assess location of ET tube

TECHNIQUE: Portable AP chest

COMPARISON: ___ portable chest radiograph ___ portable chest radiograph

FINDINGS: Interval intubation with an endotracheal tube which terminates 2.3 cm above the carina and placement of a right IJ central venous catheter which terminates near the cavoatrial junction. Severe cardiomegaly is unchanged. Apparent mediastinal widening is likely exaggerated by patient rotation, unchanged compared to ___. Mild pulmonary vascular congestion. No focal airspace opacity. No pleural effusion. No pneumothorax. A left pectoralis single chamber cardiac pacemaker is again noted with a lead that terminates likely within the right ventricle. Mild thoracic levoscoliosis is noted. Prominent gaseous distention of the stomach should not be mistaken for free air under the diaphragm.

IMPRESSION: An endotracheal tube terminates 2.3 cm above the carina. Severe cardiomegaly and mild pulmonary vascular congestion are unchanged   Keywords: unchanged.


SubjectID: 14174955, StudyID: 52308530, Comparison: same

FINAL REPORT

EXAMINATION: Portable chest radiographs

INDICATION: ___ year old woman intubated s/p OG // evaluate placement of OG

TECHNIQUE: Portable AP chest

COMPARISON: Multiple same day chest radiographs

FINDINGS: Compared to 4 hours prior, there is interval placement of an enteric tube, which terminates near, but probably superior to the level of the GE junction. No other significant change   Keywords: no other significant change.

IMPRESSION: An enteric tube terminates near, but probably superior to the level of the GE junction. No other significant change compared to 4 hours prior   Keywords: no other significant change.

NOTIFICATION: The findings were discussed with ___, M.D. by ___ ___, M.D. on the telephone on ___ at 4:53 PM, approximately 30 minutes after discovery of the findings.


SubjectID: 14174955, StudyID: 50314172, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p PEA arrest, intubated // eval interval change eval interval change

IMPRESSION: Compared to chest radiographs ___ through ___. ET TUBE IN STANDARD PLACEMENT. RIGHT INTERNAL JUGULAR LINE ENDS IN THE REGION OF THE SUPERIOR CAVOATRIAL JUNCTION. LEFT TRANS SUBCLAVIAN RIGHT VENTRICULAR PACER LEAD CONTINUOUS FROM THE PECTORAL GENERATOR. A MEDIASTINAL VENOUS ENGORGEMENT HAS WORSENED. LARGE LEFT AND SMALLER RIGHT PLEURAL EFFUSIONS, ACCOMPANIED BY SUBSTANTIAL BIBASILAR ATELECTASIS, STABLE ON THE LEFT, INCREASED ON THE RIGHT. NO PNEUMOTHORAX. MILD PULMONARY EDEMA IS LIKELY.


SubjectID: 14174955, StudyID: 57797235, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF, GIB and ?PE. // Interval change? Interval change?

IMPRESSION: Comparison to ___. The lung volumes are low. Moderate cardiomegaly persists. Mild to moderate pulmonary edema is present. Potential minimal right pleural effusion. No new parenchymal opacities   Keywords: new.


SubjectID: 14174955, StudyID: 53627098, Comparison: better

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old woman with copd found to be ___%RA // eval for pulm edema

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: As compared to chest radiograph from 1 day prior, mild-to-moderate pulmonary edema is slightly improved   Keywords: improve. Mild to moderate bilateral pleural effusions with bibasal opacities have not significantly changed given for differences in technique. Moderate to severe cardiomegaly.

IMPRESSION: Mild to moderate pulmonary edema, has slightly improved   Keywords: improve. Bilateral pleural effusions and bibasal opacities are unchanged.


SubjectID: 14174955, StudyID: 57486678, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: This is a ___ yo F with hx of CAD, systolic CHF, COPD, DM, HTN, atrial fibrillation, bradycardia s/p PPM, GI bleed (both lower and upper) who presented to ___ on ___ with acute diverticulitis c/b cardiac arrest X 2. // interval change; evaluate pneumothorax seen previously

COMPARISON: None.

FINDINGS: An ET tube remains present, tip approximately 3.5 cm of a above the carina. An orogastric type tube is present, tip extending beneath diaphragm, off film. Right IJ central line tip overlies the right atrium. A left subclavian a left-sided single lead pacemaker, with lead tip over right ventricle. No pneumothorax is detected. Marked enlargement of the cardiomediastinal silhouette is again seen, similar to prior. Today's examination is obtained with less oblique positioning. Rounded density projecting lateral to the aortic arch is noted. , the appearance is similar to ___ at 15:46. This may reflect tortuosity and unfolding of the aorta with the patient still somewhat obliquely positioned. However, attention to this area on followup films is requested. New on today's exam, there is hazy opacity at in the right mid and lower zones, with obscuration of the right hemidiaphragm. The appearance is suggestive of a layering pleural effusion with underlying collapse and/or consolidation. Pleural fluid is now seen tracking along the right lung apex laterally. Increased retrocardiac density, with obscuration of left hemidiaphragm persists, compatible left lower lobe collapse and/or consolidation. A small left effusion cannot be entirely excluded. There is mild vascular and plethora and vascular blurring, consistent with interstitial edema.

IMPRESSION: New right effusion, with underlying collapse and/or consolidation. Persistent left lower lobe collapse and/or consolidation. Small left effusion cannot be excluded. CHF with interstitial edema. I suspect this is more pronounced than on the most recent prior film. Persistent marked cardiomegaly. Rounded opacity adjacent to the left aortic knob is similar to ___ and may reflect a tortuous on unfolded aorta. However, attention to this area on followup films is requested.


SubjectID: 14174955, StudyID: 54714931, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with history of PEA arrest, now cooled // interval change

COMPARISON: Chest x-ray from ___ at 02:59

FINDINGS: Markedly rotated positioning. An ET tube is present, tip approximately 3.1 cm above the carina. Left-sided pacemaker device overlies the left shoulder, with lead tip over right ventricle. Right IJ central line tip lies in the region of the cavoatrial junction or upper most right atrium. There is marked enlargement of the cardiomediastinal silhouette, as well as mediastinal venous engorgement, similar to the prior film. Hazy opacity in the left lung could represent atelectasis, possibly accentuated by small amount of layering left pleural fluid. Increased opacity at the right base is compatible with small effusion, with underlying collapse and/or consolidation, and is also similar to the prior study. Probable vascular plethora/mild edema similar to the prior study   Keywords: similar. Left lung apex is obscured by the device overlying the patient. No new right-sided pneumothorax is detected.

IMPRESSION: Overall similar to the study from ___ at 02:59


SubjectID: 14174955, StudyID: 53137216, Comparison: None

FINAL REPORT

HISTORY: Aspiration pneumonia versus VAP.

FINDINGS: In comparison with the study of ___, the monitoring and support devices remain in place. There is continued enlargement of the cardiac silhouette with tortuosity of the aorta. Mild elevation of pulmonary venous pressure persists. The area of increased opacification at the right base suggested on the previous study is somewhat difficult to appreciate due to obliquity of the patient. The hemidiaphragm is not sharply seen, suggesting some pleural effusion and atelectasis. A lateral view would be most helpful to determine whether there is a superimposed pneumonia.


SubjectID: 14174955, StudyID: 56740684, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the monitoring and support devices are in unchanged position. There is unchanged evidence of moderate-to-severe cardiomegaly with mild fluid overload   Keywords: unchanged. Bilateral pleural effusions are unchanged. Unchanged areas of basal atelectasis. Well-ventilated lung parenchyma shows no evidence of interval occurrence of pneumonia.


SubjectID: 14174955, StudyID: 54094634, Comparison: None

PROVISIONAL

FINDINGS

IMPRESSION (PFI): ___ ___ ___ 1:42 PM PFI: 1. Stable moderate bilateral pleural effusions and right infrahilar pneumonia. ______________________________________________________________________________

FINAL REPORT

INDICATION: GI bleed, pneumonia, altered mental status. Assess for interval change.

COMPARISONS: Multiple chest radiographs from ___ back to ___. Baseline radiograph from ___. PORTABLE SUPINE RADIOGRAPH OF THE CHEST: This study is not markedly changed from the preceding radiograph from the prior day. Moderate bilateral pleural effusions persist. An area of denser consolidation in the right infrahilar region is obscured by the heart on the prior study, but is stable since ___. The lungs are otherwise clear. Severe cardiomegaly is unchanged. The endotracheal tube, nasogastric tube, and right IJ central line are in appropriate and unchanged position. There is no pneumothorax. The hilar and upper mediastinal contours are normal.

IMPRESSION: Stable moderate bilateral pleural effusions and right infrahilar pneumonia.


SubjectID: 14174955, StudyID: 51391202, Comparison: 1.0

PROVISIONAL

FINDINGS

IMPRESSION (PFI): ___ ___ ___ 7:17 PM 1. Endotracheal tube in appropriate position, approximately 4 cm above the carina. 2. Interval improvement in pulmonary vascular congestion   Keywords: improve   Keywords: improve. 3. Otherwise, unchanged radiograph of the chest   Keywords: unchanged radiograph   Keywords: unchanged radiograph. ______________________________________________________________________________

FINAL REPORT

INDICATION: GI bleed, pneumonia, altered mental status. Evaluate endotracheal tube placement.

COMPARISON: Multiple chest radiographs from ___ at 06:07 dating back to ___. SEMI-UPRIGHT PORTABLE RADIOGRAPH OF THE CHEST: The endotracheal tube is in unchanged and appropriate position, approximately 4 cm above the carina. The right IJ central line and nasogastric tube are also well positioned. The lungs are better aerated than on the prior radiograph from earlier in the day. The severe cardiomegaly as well as bilateral pleural effusions and bibasilar atelectasis are unchanged. The lungs are otherwise clear. The tortuosity of the aorta is also stable. The pulmonary vascular congestion shows minimal improvement. There is no pneumothorax.

IMPRESSION: 1. Endotracheal tube in appropriate position, approximately 4 cm above the carina. 2. Interval improvement in pulmonary vascular congestion. 3. Otherwise, unchanged radiograph of the chest.


SubjectID: 14174955, StudyID: 52032968, Comparison: None

FINAL REPORT

PORTABLE CHEST ___

COMPARISON: ___.

FINDINGS: Indwelling support and monitoring devices are unchanged in position with endotracheal tube currently terminating 4.6 cm above the carina. Heart remains enlarged, and the aorta is diffusely tortuous. Rotation of the patient limits comparison of prior study, but there has been apparent decrease in size of a right pleural effusion and apparent increase in a small-to-moderate left effusion. There is no evidence of pulmonary edema.


SubjectID: 14179163, StudyID: 53495273, Comparison: same

FINAL REPORT

PORTABLE CHEST: ___

HISTORY: ___-year-old female, intubation for airway protection.

FINDINGS: Single portable view of the chest is correlated to CT torso and chest xray from earlier the same day. ET tube is seen with tip 6 cm from the carina. NG tube is seen off the inferior field of view, with the side port past the GE junction. Although indistinct pulmonary vascular markings are seen ther is no evidence of frank pulmonary edema. Cardiomediastinal silhouette is stable. Median sternotomy wires are again noted. Osseous and soft tissue structures are unremarkable.

IMPRESSION: Interval placement of endotracheal tube with tip approximately 6 cm from the carina. No other change   Keywords: no other change.


SubjectID: 14179163, StudyID: 52753295, Comparison: same

WET READ: ___ ___ ___ 7:42 PM T tube 5.5 cm above the carina. OG tube within the stomach. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Endotracheal tube position.

COMPARISON: ___, 12:51 p.m.

FINDINGS: The tip of the endotracheal tube projects 5.5 cm above the carina. Tip of the orogastric tube is in the stomach. No complications. Otherwise, unchanged appearance of the radiograph   Keywords: unchanged appearance.


SubjectID: 14186978, StudyID: 55516513, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p left subclavian placement ICD. // lead placement,PTX lead placement,PTX

IMPRESSION: No previous images. There is enlargement of the cardiac silhouette without appreciable vascular congestion, pleural effusion, or acute focal pneumonia. The single channel ICD lead extends to the apex of the right ventricle. No evidence of pneumothorax.


SubjectID: 14186978, StudyID: 52144328, Comparison: same

FINAL REPORT

HISTORY: Pacer lead.

FINDINGS: In comparison with study of ___, the ICD lead extends to the region of the apex of the right ventricle. No evidence of pneumothorax. Otherwise, little change   Keywords: little change.


SubjectID: 14219343, StudyID: 59460937, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with severe AS, home 2L O2 requirement, Afib , s/p PPM for SSS, HFpEF (EF >___%), presented w/ likely HCAP // Concern for aspiration PNA Concern for aspiration PNA

IMPRESSION: In comparison with the study of ___, there is again enlargement of the cardiac silhouette with somewhat improved pulmonary vascular congestion   Keywords: improve. Bilateral pleural effusions with basilar atelectasis are again seen. Dual-channel pacer device has leads in good position. No convincing evidence of superimposed pneumonia, though this would be difficult to exclude, especially in the absence of a lateral view.


SubjectID: 14219343, StudyID: 55059534, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF and admission for severe sepsis. // Evaluate for worsening effusions, pneumonia Evaluate for worsening effusions, pneumonia

IMPRESSION: In comparison with the study ___, there is little interval change   Keywords: little interval change. Again there is enlargement of the cardiac silhouette with only mild pulmonary vascular congestion in the full inspiration view. Again there are bilateral pleural effusions with compressive atelectasis at the bases. The dual-channel pacer device is again seen with leads in the right atrium and apex of the right ventricle. Again there is no definite superimposed pneumonia, though this would be difficult to completely exclude, especially in the retrocardiac region, in the absence of a lateral view.


SubjectID: 14219343, StudyID: 59064667, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF exacerbation // eval for interval change

IMPRESSION: As compared to recent radiograph of 1 day earlier, moderate pulmonary edema has slightly worsened but remains improved compared to the previous study of ___   Keywords: worse. Bilateral pleural effusions and adjacent basilar opacities are unchanged considering differences in positioning.


SubjectID: 14219343, StudyID: 51638271, Comparison: better

FINAL REPORT

INDICATION: ___F with dyspnea // evidence of effusion

TECHNIQUE: Single portable view of the chest.

COMPARISON: ___.

FINDINGS: There is moderate bilateral pulmonary edema which appears slightly improved since recent exam   Keywords: improve. Bibasilar opacities suggest superimposed layering effusions. Heart is enlarged. Left chest wall dual lead pacing device is again noted.

IMPRESSION: Persistent moderate pulmonary edema although improved since prior exam with probable moderate bilateral effusions   Keywords: improve.


SubjectID: 14219343, StudyID: 58635587, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with critical AS, HF, presenting with decompensated HF, productive cough concerning for HCAP. // focal infiltrate or consolidation to suggest PNA

TECHNIQUE: CHEST (PA AND LAT)

COMPARISON: ___

IMPRESSION: Cardiomegaly is unchanged. Mediastinum is unchanged. There is interval improvement, substantial, of pulmonary edema   Keywords: improve. Right opacity is unchanged and most likely represents a combination of pleural effusion and atelectasis but followup to complete resolution is required


SubjectID: 14219343, StudyID: 54793894, Comparison: None

FINAL REPORT

INDICATION: Respiratory distress. Evaluate for infiltration.

TECHNIQUE: Frontal chest radiograph.

COMPARISON: Chest radiograph ___.

FINDINGS: A left pectoral pacemaker is noted with leads in the standard position. There are bilateral basilar opacities, likely combination of small pleural effusions and atelectasis. Superimposed infection would be difficult to exclude. There is mild pulmonary edema. Heart size is probably enlarged but difficult to fully assess given the parenchymal abnormalities. No pneumothorax.

IMPRESSION: Mild pulmonary edema with bilateral small pleural effusions.


SubjectID: 14219343, StudyID: 52356583, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with worsening SOB // Please eval for PNA

IMPRESSION: As compared to ___ radiograph, cardiomegaly is accompanied by pulmonary vascular congestion and worsening edema   Keywords: worse. Asymmetrically distributed opacities involving the right lung to a greater degree than the left could reflect asymmetrical edema or coexisting pneumonia. Small left and moderate right pleural effusions have increased in size, with apparent partial loculation on the right.


SubjectID: 14219343, StudyID: 56178542, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with ?pulmonary infiltrate // interval change

COMPARISON: ___

IMPRESSION: Substantial decrease in extent and severity of the pre-existing pleural effusions. Moderate cardiomegaly persists. Unchanged position of the pacemaker leads. Retrocardiac atelectasis and right basilar atelectasis persist. Better seen than on the previous radiograph is a 1 cm nodular lesion at the right upper lobe basis. Comparison with a frontal and lateral radiograph to be taken within the next ___hrs should be performed to determine the validity of this observation.


SubjectID: 14219343, StudyID: 52817882, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF and +flu swab admitted for CHF exacerbation. Interval change.

TECHNIQUE: Single portable AP view of the chest.

COMPARISON: Chest radiographs from ___, ___, and ___.

FINDINGS: Compared with the prior radiograph, the severity pulmonary edema has improved   Keywords: improve. Moderate to severe cardiomegaly is stable. A persistent right lower lobe opacity concerning for pneumonia, given the improved edema   Keywords: improve. No pneumothorax. No change in the continuous left pacemaker leads terminating in the right atrium and right ventricle.

IMPRESSION: 1. Persistent right lower lobe opacity is concerning for pneumonia. 2. Improved pulmonary edema   Keywords: improve.


SubjectID: 14219343, StudyID: 53516714, Comparison: same

WET READ: ___ ___ ___ 7:57 AM Congestive heart failure with pulmonary edema. A superimposed infection cannot be excluded, and recommend followup imaging after diuresis.

WET READ VERSION #1 ___ ___ ___ 6:37 AM Congestive heart failure with pulmonary edema. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___ year old female with congestive heart failure and shortness of breath. Evaluate for edema.

TECHNIQUE: Frontal chest radiographs were obtained with the patient in the upright position.

COMPARISON: Chest radiograph from ___, ___ and ___.

FINDINGS: The heart continues to be enlarged with pulmonary edema   Keywords: continue. A cardiac device is in stable position with leads projecting over the right atrium and right ventricle. A superimposed infection cannot be excluded.

IMPRESSION: Congestive heart failure with pulmonary edema. A superimposed infection cannot be excluded, and recommend followup imaging after diuresis.


SubjectID: 14219343, StudyID: 51671686, Comparison: worse

FINAL REPORT

INDICATION: ___ yo F with severe AS, CAD, ___ on CKD with dyspnea // PNA vs worsening pulmonary edema

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph ___

FINDINGS: Since ___, there has been an increase in the now large right pleural effusion and small left pleural effusion. Moderate pulmonary interstitium edema is worse now   Keywords: worse. Moderate cardiomegaly is unchanged in size. Bibasilar atelectasis unchanged. Concurrent pneumonia cannot be ruled out. Pacer leads overlying right atrium and right ventricle.

IMPRESSION: Since ___, worsening pulmonary edema and worsening bilateral pleural effusions   Keywords: worse. Stable bibasilar atelectasis.


SubjectID: 14219343, StudyID: 51441125, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with respiratory distress // eval for acute process

COMPARISON: ___.

FINDINGS: AP portable upright view of the chest. Left chest wall pacer device is unchanged with leads extending to the region the right atrium and right ventricle. Bilateral pleural effusions persist with bibasilar atelectasis. Hilar congestion and mild pulmonary edema is again noted, slightly progressed in the interval   Keywords: progressed. Heart size is difficult to assess. Mediastinal contour is stable. Bony structures appear grossly intact.

IMPRESSION: Mild pulmonary edema with bilateral pleural effusions and basilar atelectasis. There has been mild interval progression.


SubjectID: 14246614, StudyID: 57881948, Comparison: same

FINAL REPORT

INDICATION: Extubated this morning, now reintubated. Evaluate ET tube.

COMPARISONS: Chest radiograph from ___. Chest radiograph from ___.

TECHNIQUE: A single AP supine view of the chest was obtained.

FINDINGS: The endotracheal tube is positioned low with the tip in the proximal right main stem bronchus. A right internal jugular catheter and a left hemodialysis catheter are in unchanged position with the tip near the cavoatrial junction. The lung volumes are persistently low. There is stable mild-to-moderate pulmonary edema and basilar opacities, likely atelectasis   Keywords: stable. The apices of lungs are clear. There are small bilateral pleural effusions, possibly slightly increased from the prior exam. The cardiomediastinal silhouette is unchanged with persistent severe cardiomegaly.

IMPRESSION: 1. Endotracheal tube in the right main stem bronchus. Recommend repositioning. 2. Small bilateral pleural effusions, slightly increased in size. 3. Stable mild-to-moderate pulmonary edema and severe cardiomegaly   Keywords: stable. Results were discussed with Dr. ___ at 2:35 p.m. on ___ via telephone by Dr. ___ at the time the findings were discovered.


SubjectID: 14246614, StudyID: 56292237, Comparison: -1.0

FINAL REPORT

INDICATION: Intubated with new fevers, query pneumonia.

COMPARISON: Chest radiograph ___; ___.

FINDINGS: ET tube terminates approximately 3.8 cm above the carina. Enteric tube is present with tip in the stomach. A right internal jugular line is present with tip in the right atrium. Left subclavian dialysis catheter remains with tip also in the right atrium. The heart remains enlarged. Mediastinal and hilar contours remain unchanged. Again seen are bilateral pleural effusions with bibasilar atelectasis, unchanged since the most recent prior. There is new mild pulmonary edema   Keywords: new.

IMPRESSION: No new parenchymal opacities   Keywords: new. Bibasilar atelectasis and bilateral pleural effusions, stable, with new mild pulmonary edema   Keywords: new.


SubjectID: 14246614, StudyID: 55042233, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Respiratory failure, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The endotracheal tube is still positioned too high and should be advanced by 1-2 cm. The lung is better ventilated than before, but pleural effusions and basal areas of atelectasis as well as signs of fluid overload are still present   Keywords: still. The patient shows no evidence of newly appeared parenchymal opacities in the interval. No pneumothorax.


SubjectID: 14246614, StudyID: 54266458, Comparison: worse

FINAL REPORT

HISTORY: Treated pneumonia, awaiting dialysis, interval change in pulmonary edema.

COMPARISON: ___ to ___.

TECHNIQUE: Portable frontal chest radiograph, single view.

FINDINGS: Lung volumes are persistently low. There has been interval increase in size of the cardiomediastinal silhouette consistent with increasing cardiomegaly or small pericardial effusion, although there is no radiographic evidence of tamponade. Mild pulmonary edema is increased from prior study   Keywords: increase. A small left-sided effusion is unchanged. There is no pneumothorax. A right internal jugular central venous catheter, left internal jugular dialysis catheter, endotracheal tube and upper enteric tube remain in unchanged position.

IMPRESSION: Increased size of the cardiac silhouette suggestive of pericardial effusion without radiographic evidence of tamponade. Mildly increased pulmonary edema   Keywords: increase.


SubjectID: 14246614, StudyID: 53456860, Comparison: same

FINAL REPORT

INDICATION: Evaluate endotracheal tube position after being pulled back 3 cm.

COMPARISONS: Chest radiograph from ___.

TECHNIQUE: A single AP supine view of the chest was obtained.

FINDINGS: The endotracheal tube has been repositioned, and is now in satisfactory position 3.2 cm from the carina. An orogastric tube courses below the diaphragm with the tip out of the field of view. A right internal jugular central venous catheter and left hemodialysis catheter are in unchanged position. Again, there is unchanged moderate pulmonary edema, small bilateral pleural effusions, and associated basilar atelectasis   Keywords: again, unchanged. There is no new opacity. There is no pneumothorax. The cardiomediastinal silhouette is unchanged, with persistent moderate cardiomegaly.

IMPRESSION: Satisfactory position of the endotracheal and orogastric tubes. Otherwise no significant change   Keywords: no significant change.


SubjectID: 14246614, StudyID: 51861742, Comparison: same

FINAL REPORT

PORTABLE CHEST X-___ ___ ___

COMPARISON: ___ radiograph.

FINDINGS: Tip of endotracheal tube terminates approximately 2.8 cm above the carina. Nasogastric tube terminates within the stomach, and right internal jugular central venous catheter terminates in the expected location of the right atrium. Allowing for patient's rotation, cardiomediastinal contours are stable compared to prior study. Persistent pulmonary vascular congestion, as well as unchanged left retrocardiac opacity and adjacent small left pleural effusion   Keywords: persistent, unchanged.


SubjectID: 14246614, StudyID: 57364660, Comparison: same

FINAL REPORT

HISTORY: Intubated with advancement of the endotracheal tube. Evaluate endotracheal tube position.

COMPARISON: ___, 3:02 a.m.

TECHNIQUE: Portable frontal chest radiograph.

FINDINGS: In comparison to same day earlier examination, the endotracheal tube has been advanced forward which now terminates 3.1 cm cranial to the carina and is in appropriate position. There is otherwise no significant change compared to earlier examination   Keywords: no significant change.

IMPRESSION: Appropriate positioning of endotracheal tube with tip positioned 3.1 cm cranial to the carina.


SubjectID: 14246614, StudyID: 55772647, Comparison: None

FINAL REPORT

HISTORY: Pneumonia, pulmonary edema. Worsening oxygenation. CHEST, SINGLE AP PORTABLE VIEW. An ET tube is present, tip in satisfactory position approximately 4.1 cm above the carina. A right IJ central line is present, tip in the upper SVC. An NG type tube is present, tip not well visualized but extending beneath the diaphragm, off the film. There are low inspiratory volumes. There appears to be considerable difference in the height of the diaphragms, elevated on the right. Cardiomediastinal silhouette is prominent, but probably unchanged. There is dense retrocardiac density, with obscuration of the left hemidiaphragm, consistent with left lower lobe collapse and/or consolidation. Progressive obscuration of the left hilum is noted, ? secondary to CHF. On the right, there is diffuse prominence of vascular markings, consistent with CHF, though this is likely accentuated by supine position and lower lung volume on the right. No frank consolidation or gross effusion on the right side.

IMPRESSION: 1) Lines and tubes as described. 2) Left lower lobe collapse and/or consolidation. 3) Prominence of the vessels and of the left hilum, suggesting CHF, though likely accentuated by supine positioning.


SubjectID: 14246614, StudyID: 52116476, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Intubation, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the lung volumes have increased, potentially due to increased ventilatory pressures. The size of the cardiac silhouette is still enlarged, but areas of bilateral basal parenchymal opacity have decreased in severity and extent. Minimal fluid overload is still present   Keywords: still. Remaining right lower lobe atelectasis. No larger pleural effusions. No newly appeared parenchymal changes.


SubjectID: 14246614, StudyID: 56521641, Comparison: same

FINAL REPORT

HISTORY: Intubated question interval change.

COMPARISON: ___.

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.


SubjectID: 14246614, StudyID: 55425544, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Intubation and pneumonia, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The position of the endotracheal tube, the right internal jugular vein catheter and the nasogastric tube are constant. Moderate cardiomegaly at low lung volume, moderate pulmonary edema with substantial atelectasis at both lung bases. No other relevant findings.


SubjectID: 14246614, StudyID: 55066462, Comparison: None

FINAL REPORT

HISTORY: Positive PPD; respiratory failure.

COMPARISON: ___ at 130

FINDINGS: Endotracheal tube is 3.3 cm above the carina. There continues to be dense retrocardiac opacity consistent volume loss/infiltrate/effusion. There is also hazy right lower lobe infiltrate. There is mild pulmonary vascular redistribution and moderate cardiomegaly. Compared to the study from 7 hours previous, the aeration in both lungs is slightly improved.

IMPRESSION: Improved aeration with continued retrocardiac opacity.


SubjectID: 14246614, StudyID: 52672561, Comparison: None

FINAL REPORT

HISTORY: Intubated OG tube placement.

COMPARISON: ___.

FINDINGS: The ETT is 4.5 cm above the carina. The NG tube is in the stomach. There continues to be mild cardiomegaly with dense retrocardiac opacity compatible with volume loss/infiltrate/effusion. There is mild pulmonary vascular redistribution.


SubjectID: 14246614, StudyID: 50657544, Comparison: None

FINAL REPORT

HISTORY: Tracheostomy, to assess for pulmonary edema.

FINDINGS: In comparison with the study of ___, the endotracheal tube has been removed and replaced with a tracheostomy tube. No complication is appreciated. Patient has taken a better inspiration. There is still continued enlargement of the cardiac silhouette with probable small pleural effusions, compressive atelectasis at the bases, and mild pulmonary edema. The other monitoring and support devices remain in place.


SubjectID: 14246614, StudyID: 54030823, Comparison: None

FINAL REPORT

HISTORY: Hypoxemia

COMPARISON: ___

FINDINGS: There is a new endotracheal tube with tip in the right mainstem bronchus. At the time of dictation this report on ___ at 10:25 a.m. the ET tube had already been withdrawn and was in a more appropriate position. There is moderate cardiomegaly right lower lung volume loss left retrocardiac opacity and pulmonary vascular redistribution.

IMPRESSION: Right mainstem bronchus intubation.


SubjectID: 14247006, StudyID: 54962366, Comparison: None

FINAL REPORT

HISTORY: ___M with hx CHF p/w dry cough, malaise.

COMPARISON: Multiple prior chest radiographs, the most recent of ___.

FINDINGS: Frontal and lateral views of the chest. A pacer defibrillator is seen with leads in the expected location of the right atrium, right ventricle and coronary. The lungs are clear without focal opacity, pleural effusion or pneumothorax. The cardiac silhouette has decreased in size since ___. There are mediastinal clips and a sternotomy ___. There is no free air beneath the right hemidiaphragm. No acute osseous abnormality is seen.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 14247006, StudyID: 50961442, Comparison: same

FINAL REPORT

HISTORY: Fever.

FINDINGS: In comparison with the study of ___, there is little overall change and no evidence of acute pneumonia, vascular congestion, or pleural effusion   Keywords: little overall change. Pacer device remains in place.


SubjectID: 14247006, StudyID: 53755406, Comparison: None

FINAL REPORT

HISTORY: ___-year-old male presenting with ventricular tachycardia.

COMPARISON: Chest radiograph from ___. AP PORTABLE FRONTAL CHEST RADIOGRAPH: There is increased opacity within the right upper to mid lung laterally, new from prior examination. Findings may reflect developing infection but are non-specific. The remainder of the lungs appear clear. There is no overt interstitial edema. No large pleural effusions are evident. Mediastinal and hilar contours are within normal limits. Moderate cardiomegaly is unchanged. An AICD generator and single lead appear in expected unchanged position terminating in the region of the right ventricle. Numerous mediastinal clips from prior CABG are noted.

IMPRESSION: New peripheral opacities in the right mid to upper lung may reflect developing infection. Recommend PA and lateral chest radiograph when patient is able for further assessment.


SubjectID: 14264182, StudyID: 57788962, Comparison: None

WET READ: ___ ___ 8:39 PM Small bilateral pleural effusions. Focal opacity projecting over the lateral aspect of the right lung base could potentially be due to overlying soft tissues given the well delineated margins, but should be reassessed with repeat PA view of the chest with the arms abducted. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___F with dyspnea on exertion

TECHNIQUE: Upright AP and lateral views of the chest

COMPARISON: ___ chest radiograph and ___ chest CTA

FINDINGS: Mild cardiomegaly is re- demonstrated. The aorta is tortuous and demonstrates diffuse atherosclerotic calcifications. Mediastinal and hilar contours are otherwise unremarkable. There is no pulmonary edema. Small bilateral pleural effusions are noted. Focal opacity with well delineated margins is noted projecting over the lateral aspect of the right lung base. Left lung is otherwise clear. No pneumothorax is identified. Diffuse demineralization of the osseous structures is again noted with compression deformities of at least ___ mid thoracic vertebral bodies. Remote fracture of the left humeral head is again noted.

IMPRESSION: Small bilateral pleural effusions. Focal opacity projecting over the lateral aspect of the right lung base could potentially be due to overlying soft tissues given the well delineated margins, but should be reassessed with repeat PA view of the chest with the arms abducted.


SubjectID: 14264182, StudyID: 52040177, Comparison: None

FINAL REPORT

INDICATION: Dyspnea.

COMPARISON: Chest radiograph from ___.

TECHNIQUE: Frontal and lateral chest radiographs.

FINDINGS: The heart size is top normal. Moderate atherosclerotic calcifications of the aortic arch are again seen. Trace pleural effusions are unchanged. A smooth opacity projecting over the lateral lower right lung base appears more pronounced since the ___ examination, and may represent a loculated effusion. There is no pneumothorax.

IMPRESSION: Right basal-lateral opacity appears slightly more prominent since ___, and may represent a loculated effusion.


SubjectID: 14271359, StudyID: 59643695, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: New dyspnea, evaluation for pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the signs indicative of pulmonary edema have almost completely resolved   Keywords: resolve. However, the cardiac silhouette remains enlarged. The hilar and mediastinal structures are unremarkable. There is no evidence of pleural effusion on the frontal and lateral views.


SubjectID: 14271359, StudyID: 54050907, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

COMPARISON: Prior exam from ___. CLINICAL

HISTORY: Short of breath, question CHF.

FINDINGS: PA and lateral views of the chest were provided. On the frontal view, patient is slightly rotated to the left, which somewhat limits the valuation. There is slight asymmetric opacity in the right lung relative to the left, which may in part be due to patient's rotation. The possibility of mild edema is not excluded. Top normal heart size. No effusion or pneumothorax. Bony structures are intact.

IMPRESSION: Limited due to rotation with possible mild edema.


SubjectID: 14271359, StudyID: 55932946, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Fever, hypoxia, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is unchanged evidence of lower lung volumes and moderate cardiomegaly with signs of minimal fluid overload. No pneumonia, no larger pleural effusions. No lung nodules or masses.


SubjectID: 14271359, StudyID: 54112193, Comparison: None

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Weakness and fatigue.

COMPARISONS: None.

TECHNIQUE: Chest, PA and lateral.

FINDINGS: The heart is at the upper limits of normal size. The mediastinal and hilar contours appear within normal limits. The frontal view is not symmetrical and difficult to evaluate, but there is a vague patchy opacity in the lingula, although most likely due to minor atelectasis. A nipple shadow is visualized on the right side. Hemidiaphragms appear flattened suggesting hyperinflation. There is no definite pleural effusion or pneumothorax. Bony structures are unremarkable.

IMPRESSION: Patchy opacity in the lingula, which is not specific as to etiology; pneumonia is not excluded, but the area is not well evaluated and opacity may be due to atelectasis. Noting the technical limitations of the film followup PA and lateral radiographs may be helpful if pulmonary symptoms were to persist.


SubjectID: 14283409, StudyID: 58281899, Comparison: None

FINAL REPORT

HISTORY: ___-year-old man with small bowel obstruction, going to the OR. NG tube in place. Pre-op chest x-ray.

COMPARISON:

FINDINGS:

IMPRESSION: AP chest at 6:45 compared to most recent prior chest radiograph from ___: Nasogastric tube ends in the upper portion of the moderately distended stomach. There is probably lungs are clear, size is normal. Mild leftward cardiac shift is a chronic future. Lungs are clear. No pleural effusion.


SubjectID: 14283409, StudyID: 51419829, Comparison: None

FINAL REPORT

HISTORY: NG tube placement.

COMPARISON: ___ 10:18.

IMPRESSION: NG tube has been replaced with the tip terminating in the mid gastric body. There is otherwise no short-term interval change compared to exam from 1 hour prior. Of note, a left internal jugular line remains in place and is likely at the junction of the left brachiocephalic vein and SVC, however, distinction between venous/arterial access cannot be made radiographically in this case. Results were discussed over the telephone with Dr. ___ by ___ at 12:58pm ___ at time of initial review.


SubjectID: 14286519, StudyID: 59415546, Comparison: worse

FINAL REPORT

EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Shortness of breath.

COMPARISON: ___.

FINDINGS: Frontal and lateral views of the chest were obtained. The patient is status post median sternotomy. Trace right pleural effusion may be present. There is vascular congestion, increased since the prior   Keywords: increase. There is also increase in opacity in the right mid-to-lower lung anteriorly, seen on both the frontal and lateral views. Fluid is seen tracking along the major fissure on the lateral view. The cardiac silhouette is mildly enlarged. Aortic knob is calcified.

IMPRESSION: 1. Pleural effusion, including tracking along major fissure. 2. Increase in opacity in the right mid-to-lower lung, nonspecific, but an underlying mass is not excluded. Recommend nonurgent chest CT for further evaluation. These findings were discussed with Dr. ___ at 8:15 p.m. on ___ in person 2 minutes after discovery.


SubjectID: 14286519, StudyID: 50452204, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: AFib, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The heart remains moderately enlarged, apical thickening continues to be seen bilaterally in a symmetrical distribution. No pleural effusions. No pulmonary edema. No pneumonia.


SubjectID: 14291723, StudyID: 59418907, Comparison: same

WET READ: ___ ___ ___ 8:53 AM Transesophageal tube courses below the diaphragm and out of view. Spoke with ___ at 1:30am

WET READ VERSION #1 ___ ___ ___ 1:36 AM Transesophageal tube courses below the diaphragm and out of view. Spoke with ___ at 1:30am ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with recent advancement of NG tube // assess ng placement

COMPARISON: ___.

IMPRESSION: The nasogastric tube has been advanced. The tip is not visualized on the current image. No other relevant changes   Keywords: no other relevant change.


SubjectID: 14291723, StudyID: 56875864, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with NGT in place with increased cough. // Please evaluate for misplacement of NGT tube.

COMPARISON: ___

IMPRESSION: On the current image, no nasogastric tube is visualized. The right PICC line is in unchanged position. Low lung volumes. Retrocardiac and right basilar atelectasis but no evidence of pneumonia. No pneumothorax. No pleural effusion.


SubjectID: 14291723, StudyID: 56504393, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with HCAP, seizure disorder with recent prolonged seizure who is now have fever. // evidence of aspiration pneumonitis vs PNA.

COMPARISON: ___.

IMPRESSION: No relevant change as compared to the previous examination   Keywords: no relevant change. Moderate pulmonary edema. Small left pleural effusion with subsequent atelectasis in the retrocardiac lung region. Moderate cardiomegaly persists. No new focal parenchymal opacities   Keywords: new. The right PICC line is in constant position. Constant course of the nasogastric tube.


SubjectID: 14291723, StudyID: 50944916, Comparison: None

WET READ: ___ ___ ___ 9:03 AM 1. NG tube terminates in mid esophagus. Consider advancing by 12 cm to reposition in the stomach. 2. Right PICC terminates in right atrium. Consider pulling back by 4 cm to reposition in low SVC. 3. Left lung base atelectasis is improved. Small left pleural effusion.

WET READ VERSION #1 ___ ___ ___ 1:06 AM 1. NG tube terminates in mid esophagus. Consider advancing by 12 cm to reposition in the stomach. 2. Right PICC terminates in right atrium. Consider pulling back by 4 cm to reposition in low SVC. 3. Left lung base atelectasis is improved. Small left pleural effusion. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with encephalopathy // NGT placement

COMPARISON: ___.

IMPRESSION: The nasogastric tube terminates in the mid esophagus, the device should be advanced by at least ___-15 cm. The right PICC line tip projects over the right atrium, to repositioned at the level of the cavoatrial junction and needs to be pulled back by about 4 cm. Improved left retrocardiac and lower lung atelectasis. Otherwise unchanged appearance of the lung parenchyma and the cardiac silhouette.


SubjectID: 14291723, StudyID: 57679464, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with AMS // Assess volume status, infiltrates, interval change.

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Low lung volumes. Mild fluid overload. Bilateral pleural effusions and moderate cardiomegaly are constant.


SubjectID: 14291723, StudyID: 52990001, Comparison: worse

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___-year-old man with HCAP. Evaluate for interval change.

TECHNIQUE: Portable AP chest radiograph

COMPARISON: Multiple prior chest radiographs, most recent from ___.

FINDINGS: Right PICC ends in the right atrium. Worsening interstitial edema, right greater than left   Keywords: worse. Increasing, moderate to large, bilateral pleural effusions. Stable, mild cardiomegaly.

IMPRESSION: Worsening interstitial edema, more pronounced on the right, and increasing, moderate to large, bilateral pleural effusions   Keywords: increasing, worse.


SubjectID: 14291723, StudyID: 52012949, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with seizures now s/p NGT advancement // ? NG tube placement

TECHNIQUE: AP view of the chest.

COMPARISON: Multiple chest radiographs, most recent prior from ___ at ___.

FINDINGS: There is interval placement of an NG tube combo with tip terminating in the proximal stomach. There is no significant additional interval change, with stable moderate cardiomegaly, left lower lobe collapse, left pleural effusion, and right basilar atelectasis with small pleural effusion. There is no pneumothorax.

IMPRESSION: Interval introduction of an NG tube, with tip terminating in the proximal stomach.


SubjectID: 14291723, StudyID: 51039563, Comparison: better

FINAL REPORT

INDICATION: ___ year old man with hx of seizure. // NG tube placement, interval change.

TECHNIQUE: AP view of the chest.

COMPARISON: Multiple chest radiographs, the most recent prior from ___ at 03:54.

FINDINGS: There is been interval improvement in her social edema, bed moderate pulmonary edema remains   Keywords: improve. There is persistent left lower lobe collapse with pleural effusion appear. Lung volumes are lingual, there is no new focal consolidation concerning for pneumonia. Moderate cardiomegaly is stable. No NG tube is visualized. A right PICC is present with tip not well visualized but seen at least to the mid SVC.

IMPRESSION: 1. Improvement in interstitial edema, with mild pulmonary edema remaining   Keywords: improve. 2. Persistent left lower lobe collapse. Small to moderate left pleural effusion. 3. No NG tube visualized.


SubjectID: 14291723, StudyID: 56061635, Comparison: None

WET READ: ___ ___ ___ 11:23 AM Endotracheal tube has been withdrawn so that it now terminates approximately 1.2 cm above the level of the carina. Recommend withdrawal by approximately 1-2 cm for more optimal positioning. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with s/p et // et location

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___ at 08:47

FINDINGS: Endotracheal tube has been withdrawn so that it now terminates approximately 1.2 cm above the level of the carina. Recommend withdrawal by approximately 1-2 cm for more optimal positioning. Enteric tube courses below the diaphragm, inferior aspect at out of the field of view. Low lung volumes persist. Bilateral perihilar opacities are seen suggesting pulmonary edema with possible underlying aspiration. Left base opacity may be due to combination of atelectasis, small pleural effusion not excluded.

IMPRESSION: Endotracheal tube has been withdrawn so that it now terminates approximately 1.2 cm above the level of the carina. Recommend withdrawal by approximately 1-2 cm for more optimal positioning. Low lung volumes persist. Bilateral perihilar opacities suggest pulmonary edema with possible underlying aspiration. Left base opacity may be due to atelectasis, small pleural effusion not excluded


SubjectID: 14291723, StudyID: 55767060, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with s/p intubation // s/p intubation

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___ at 08:51

FINDINGS: There has been interval placement of an endotracheal tube which is low in position, coursing into the right mainstem bronchus. Subsequent chest radiograph demonstrated withdrawal above the level of the carina. Enteric tube courses below the level of the diaphragm, inferior aspect out of the field of view. There are low lung volumes. There is increased perihilar opacities concerning for pulmonary edema and/ aspiration given the clinical scenario   Keywords: increase. The cardiac and mediastinal silhouettes are stable.

IMPRESSION: Endotracheal tube low in position, coursing into the right mainstem bronchus. Subsequent chest radiograph demonstrates withdrawal above the level of the carina. Enteric tube courses below the level of the diaphragm, inferior aspect data the field of view. The lung volumes. Increased perihilar opacities concerning for pulmonary edema and/or aspiration given clinical scenario   Keywords: increase.


SubjectID: 14291723, StudyID: 52849679, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with status epilepticus // infiltrate?

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: Patient is rotated to the left. Left perihilar opacities may relate to aspiration or asymmetric edema, however, underlying infectious process could be present. No large pleural effusion is seen although trace left pleural effusion is difficult to exclude. Lung volumes are low. The cardiac silhouette is top-normal to mildly enlarged. The aorta is calcified.

IMPRESSION: Patient rotated to the left and low lung volumes. Left mid to lower lung opacity may relate to aspiration or asymmetric pulmonary edema, but infection is not excluded in the appropriate clinical setting.


SubjectID: 14291723, StudyID: 52623437, Comparison: better

FINAL REPORT

INDICATION: ___ year old man with seizure and intubation for airway protection. // ? OG and ETT placement

TECHNIQUE: Portable

COMPARISON: ___

FINDINGS: The endotracheal tube has been pulled back with the tip now 4 cm from the carina. The tip of the nasogastric tube is in the body of the fundus in good position. Interval improvement of the mild interstitial edema   Keywords: improve. Persistent left retrocardiac opacity and effusion.

IMPRESSION: The ET tube is now in good position. Improvement of the mild interstitial edema   Keywords: improve. Left retrocardiac opacity and small pleural effusion are stable.


SubjectID: 14291723, StudyID: 52023204, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M w hx of CKD and seizure disorder on Keppra, now presenting with prolonged tonic clonic episode with intubation for airway protection. // acute processes, line placement

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: ET tube is in standard position. NG tube tip is out of view below the diaphragm. Cardiomegaly is stable. Worsening opacities in the left mid lung are worrisome for aspiration. Left lower lobe consolidation is unchanged. If any there is a small left effusion. There is no evident pneumothorax. Component of pulmonary edema has improved   Keywords: improve.


SubjectID: 14291723, StudyID: 53604970, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M w hx of CKD and seizure disorder on Keppra, now presenting with prolonged tonic clonic episode with intubation for airway protection. // interval change, line placement

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Cardiomegaly and tortuous aorta are unchanged. Multifocal opacities in the left lung worrisome for aspiration are grossly unchanged. Mild vascular congestion is stable   Keywords: stable. Small bilateral effusions larger on the left have mildly increased. ET tube is in standard position. NG tube tip is out of view below the diaphragm


SubjectID: 14295375, StudyID: 57113879, Comparison: better

FINAL REPORT

HISTORY: Shortness of breath, question edema or pneumonia.

COMPARISON: ___.

TECHNIQUE: PA and lateral views of the chest.

FINDINGS: The patient is status post median sternotomy. A dialysis line through the subclavian approach terminates in the right atrium. The heart size is again mildly enlarged. Previous pulmonary edema from ___ has improved   Keywords: improve. A left-sided pleural effusion as well as a probable right-sided pleural effusion is present on today's exam. The aortic knob is calcified.

IMPRESSION: Bilateral small pleural effusions. Mild pulmonary edema, improved since ___   Keywords: improve.


SubjectID: 14303271, StudyID: 59338195, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with SSS and AV block s/p dual-chamber pacemaker via R subclavian vein. // pneumothorax pneumothorax

IMPRESSION: In comparison with the study of ___, there is a placement of a right subclavian pacer device extends to the right atrium and apex of the right ventricle. Specifically, no evidence of pneumothorax.


SubjectID: 14303271, StudyID: 50251639, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with SSS and AV block s/p dual-chamber pacemaker via R subclavian vein. // lead position, pneumothorax

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Right pectoral pacemaker. No pneumothorax. The leads are in expected position. Mild cardiomegaly. No pulmonary edema.


SubjectID: 14307251, StudyID: 56330597, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with dyspnea

TECHNIQUE: Upright AP view of the chest

COMPARISON: ___

FINDINGS: Mild enlargement of the cardiac silhouette is unchanged. Atherosclerotic calcifications of the aortic knob are again present. Lung volumes are low with crowding of the bronchovascular structures. Diffuse increased interstitial opacities likely reflect chronic changes   Keywords: increase. Patchy opacity in the left lung base may reflect atelectasis but is nonspecific. No overt pulmonary edema or pneumothorax is present. There is no large pleural effusion. No acute osseous abnormality is visualized.

IMPRESSION: Low lung volumes with chronic interstitial changes. Patchy left basilar opacity may reflect atelectasis, but pneumonia is not excluded in the correct setting


SubjectID: 14307251, StudyID: 54670208, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF exacerbation, wheezing, cough // ?edema vs infiltrate s/p diuresis; please schedule ___ AM

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Mild to moderate cardiomegaly is stable. Opacities in the upper lungs have increased on the right, this could representatelectasis or pneumonia in the appropriate clinical setting. There is no overt pulmonary edema. Bilateral effusions are small. Patient's chin obscures the apices of the lungs.


SubjectID: 14349552, StudyID: 59791779, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___F with CHF, recurrent hypoxia // presence of acute process, pulmonary edema

TECHNIQUE: Chest PA and lateral

COMPARISON: AP and lateral views of the chest dated ___

FINDINGS: The cardiac silhouette is stably enlarged. There is stable prominence and indistinctness of the pulmonary vasculature   Keywords: stable. There are likely bilateral pleural effusions, larger on the left than on the right. Again seen is plate-like atelectasis in the left mid lung.

IMPRESSION: Stable cardiomegaly and edema   Keywords: stable.


SubjectID: 14349552, StudyID: 58399458, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (AP AND LAT)

INDICATION: ___F with chest pain

COMPARISON: ___.

FINDINGS: AP upright and lateral views of the chest provided. The heart is moderately enlarged with mitral annular calcification again noted. There is hilar congestion and mild pulmonary edema. Left mid lung linear density is most compatible with platelike atelectasis. No large pleural effusion or pneumothorax is seen. No convincing signs of pneumonia. The imaged bony structures are intact.

IMPRESSION: Cardiomegaly, mild congestion/ edema.


SubjectID: 14350079, StudyID: 58205328, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man with atrial fibrillation with rapid ventricular response and dyspnea for 7 days.

TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position.

COMPARISON: Radiographs from ___, ___, ___ and ___.

FINDINGS: The heart is mildly enlarged, and there is mild interstitial edema. No pleural effusions or pneumothorax is seen. No focal consolidation is seen.

IMPRESSION: Mild cardiomegaly with edema.


SubjectID: 14350079, StudyID: 55882985, Comparison: same

FINAL REPORT

INDICATION: ___M with AFib with RVR, worsening diaphoresis and tachypnea.

COMPARISON: Comparison is made to multiple chest radiographs dating back to ___.

TECHNIQUE Portable view of the chest.

FINDINGS: Compared to the same day chest radiograph, mild cardiomegaly is unchanged. The mediastinal contours normal. There is no pleural effusion or pneumothorax. Mild interstitial edema is unchanged   Keywords: unchanged. There is no focal lung consolidation.

IMPRESSION: Stable mild interstitial edema   Keywords: stable.


SubjectID: 14350079, StudyID: 54494974, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with AFib with RVR and dyspnea x 7 days // Evaluate for pulmonary edema

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: There is mild to moderate moderate pulmonary edema asymmetric worse on the right   Keywords: worse. Cardiomegaly is stable. There is no evident pneumothorax or enlarging effusions. .


SubjectID: 14350079, StudyID: 51496968, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with afib rvr, SOB. // pulm edema, infiltrates

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Moderate cardiomegaly is stable. Widened mediastinum is unchanged allowing the difference in technique. Mild to moderate pulmonary edema is unchanged   Keywords: unchanged. There is no pneumothorax or increasing effusions.


SubjectID: 14357860, StudyID: 59979745, Comparison: None

FINAL REPORT

EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Cough.

COMPARISON: ___.

FINDINGS: There is relative ___ of the left lower hemithorax, likely due to technique and patient body habitus, and this region is not well assessed. No obvious consolidation is seen. No large pleural effusion. The cardiac and mediastinal silhouettes are grossly stable. There are low lung volumes, but no overt pulmonary edema.

IMPRESSION: Suboptimal evaluation of the left lung base due to ___. No obvious consolidation seen.


SubjectID: 14357860, StudyID: 53678676, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: Prior exam from earlier today. CLINICAL

HISTORY: Hemoptysis, question pneumonia.

FINDINGS: PA and lateral views of the chest were provided. The heart appears mildly enlarged. There is no definite consolidation, effusion or pneumothorax. No signs of pulmonary edema or congestion. The mediastinal contour is stable. Bony structures are intact.

IMPRESSION: Mild cardiomegaly. No consolidation or findings to account for hemoptysis.


SubjectID: 14357860, StudyID: 59314753, Comparison: None

FINAL REPORT

INDICATION: Leukocytosis and acute kidney failure. Rule out pneumonia.

COMPARISON: Chest radiograph ___, ___.

FINDINGS: Single AP view of the chest was obtained. Cardiomediastinal and hilar contours are stable with moderate cardiomegaly. There is no pneumothorax. Again seen is a left retrocardiac opacity, which may represent atelectasis or pneumonia. The right lung is clear. Pulmonary vasculature is within normal limits.

IMPRESSION: Left basal atelectasis or pneumonia. A lateral view is recommended for better assessment.


SubjectID: 14357860, StudyID: 57451857, Comparison: None

FINAL REPORT

INDICATION: Acute kidney injury with acute mental status change. Rule out pneumonia or pulmonary edema, assess for interval change.

COMPARISON: Chest radiographs ___, ___.

FINDINGS: The cardiomediastinal and hilar contours remain stable with moderate cardiomegaly. Retrocardiac opacity remains stable compared to yesterday and may represent atelectasis or pneumonia. Lateral radiograph was not obtained for further assessment. There is no other focal consolidation concerning for pneumonia.

IMPRESSION: Stable left basilar atelectasis or pneumonia.


SubjectID: 14357860, StudyID: 55474557, Comparison: same

FINAL REPORT

HISTORY: Decreased O2 saturation. Assess for pneumonia or CHF exacerbation.

COMPARISON: ___.

FINDINGS: AP upright and lateral chest radiographs were obtained. The lungs are markedly low in volume, limiting assessment with at least mild pulmonary vascular congestion and upper zone redistribution. Given the low lung volumes assessment for edema is limited. The exam is further limited due to patient body habitus with the suggestion of a retrocardiac opacity which could reflect atelectasis. Pleural effusions would be difficult to exclude. Cardiomegaly is stable.

IMPRESSION: Limited examination due to low lung volumes and poor penetration with vascular congestion and unchanged cardiomegaly   Keywords: unchanged. Retrocardiac opacity, poorly assessed, may reflect atelectasis.


SubjectID: 14357860, StudyID: 51324621, Comparison: None

FINAL REPORT

INDICATION: ___-year-old with acute mental status change, wheeze and on treatment for hospital-acquired pneumonia, query interval change.

COMPARISON: Chest radiographs ___, ___, ___.

FINDINGS: Cardiomediastinal and hilar contours remain stable. There is no pleural effusion or pneumothorax. Left retrocardiac opacity is stable and likely represents minimal atelectasis. No new focal consolidation concerning for pneumonia.

IMPRESSION: Minimal atelectasis at the left lung base with no new findings.


SubjectID: 14360457, StudyID: 57978671, Comparison: worse

FINAL REPORT

INDICATION: Cough, assess for pneumonia.

COMPARISONS: ___.

FINDINGS: Frontal and lateral views of the chest demonstrate low lung volumes, which accentuate bronchovascular markings. There is widening of the right upper mediastinal contour which may reflect venous distention and less likely lymph node enlargement. Heart is mildly enlarged and has increased in size since the prior study. The right upper lobe opacities are also seen. Perihilar vascular congestion is noted as well as bilateral interstitial opacities. Multifocal patchy air space opacities are also demonstrated in the right upper lobe and both lower lobes. There is no pneumothorax. Small bilateral pleural effusions are present. There has been prior median sternotomy and CABG.

IMPRESSION: Bibasilar and right upper lung opacities, new since prior, which may represent asymmetrical edema in the setting of cardiomegaly but coexisting infection should be considered   Keywords: new. Short term follow-up radiographs are recommended to ensure resolution and to exclude a component of underlying chronic lung disease.


SubjectID: 14360457, StudyID: 56763063, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: CAD, immunocompromised patient. Evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the pre-existing parenchymal opacities, located in the right upper lobe and at both lung bases, have increased in severity and extent. Given that the lung volumes have not changed in the interval, the findings are strongly suggestive of pneumonia, as stated in the previous report. There is no evidence of pulmonary edema. No pleural effusions. Borderline size of the cardiac silhouette. Status post valvular replacement and sternotomy. Unchanged appearance of the mediastinal structures   Keywords: unchanged appearance. No pneumothorax.


SubjectID: 14362539, StudyID: 57910396, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Sepsis, assessment for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous examination, there might be minimal right and left pleural effusions as well as minimal fluid overload. The cardiac silhouette remains slightly enlarged. Retrocardiac atelectasis is present. The right central venous access line is constant in appearance.


SubjectID: 14362539, StudyID: 55613271, Comparison: None

FINAL REPORT

HISTORY: Central line placement.

FINDINGS: In comparison with the earlier study of this date, the right IJ catheter appears to extend to the right atrium. Extremely low lung volumes but otherwise little change in the appearance of the heart and lungs.


SubjectID: 14362539, StudyID: 54580768, Comparison: None

FINAL REPORT

INDICATION: Shortness of breath.

COMPARISON: Chest radiographs from ___ and ___ and chest CTA from ___.

TECHNIQUE: Frontal upright chest radiograph.

FINDINGS: The lungs are well expanded. There is a dense retrocardiac opacity, with obscuration of the margin of the left hemidiaphragm and descending thoracic aorta, suggestive of left basilar consolidation. Cardiac size is moderately enlarged, not significantly changed from prior exam. No large right pleural effusion or pneumothorax. Dense calcifications of the aorta are reidentified. Left deviation of the trachea and prominence of the upper mediastinum on the right is better assessed in prior CT and secondary to tortuosity of the vessels. Right upper quadrant surgical clips.

IMPRESSION: Dense retrocardiac opacity likely represents a combination of pleural effusion and lung consolidation due to atelectasis versus pneumonia.


SubjectID: 14362539, StudyID: 52415165, Comparison: same

FINAL REPORT

HISTORY: Congestive heart failure and hypotension requiring fluid boluses. Evaluate for pulmonary edema.

COMPARISON: ___ at 6:08 p.m.

FINDINGS: Frontal radiograph of the chest shows unchanged right internal jugular and left PICC lines. The right internal jugular central venous catheter persists in the high right atrium. Compared to prior radiograph, the cardiac silhouette is unchanged. There is no evidence of pulmonary vascular congestion or pleural effusions. The opacity that was seen at the left base has improved in the interim and was likely atelectasis. There is no acute consolidation.

IMPRESSION: 1. Right internal jugular catheter persists in the high right atrium. 2. Unchanged cardiac silhouette with no evidence of pulmonary edema   Keywords: unchanged. No pleural effusions.


SubjectID: 14365589, StudyID: 56509493, Comparison: better

FINAL REPORT

AP CHEST, 5:26 A.M., ___

HISTORY: ___-year-old man with fever. Evaluate for effusion or infiltrate.

IMPRESSION: AP chest compared to ___ through ___: Heterogeneous pulmonary opacification has returned, after showing substantial improvement between ___ and ___ indicating that the changes over the past 48 hours are due to the recurrence of pulmonary edema   Keywords: improve. Mediastinal widening, particularly in the right lower paratracheal region, is a longstanding finding previously documented as both adenopathy and azygous distention. Small left pleural effusion has increased. Heart size top normal. Some pneumonia, particularly atypical pneumonia could be present concurrently. Left internal jugular line follows the course of a tortuous left brachiocephalic vein, commonly seen in elderly patients, but I have discussed the possibility of arterial placement with the resident caring for this patient at the time of dictation.


SubjectID: 14365589, StudyID: 50621139, Comparison: None

FINAL REPORT

HISTORY: CHF with leukocytosis.

FINDINGS: In comparison with the study of ___, the patient has taken a slightly better inspiration. The central catheter remains in place. Mild enlargement of the cardiac silhouette persists with some elevation of pulmonary venous pressure. Bibasilar atelectatic changes are seen. Continued distention of the azygos vein is also consistent with volume overload.


SubjectID: 14365589, StudyID: 50003805, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old male with urosepsis, now resolved. Also with critical AS and systolic CHF, rule out pneumonia.

COMPARISON: Chest radiographs on ___, ___, and ___.

FINDINGS: PA and lateral views of the chest. Compared to most recent study on ___, the pulmonary edema has increased   Keywords: increase. A new heterogeneous opacity is seen in the anterior segment of the right upper lobe concerning for pneumonia. Small bilateral pleural effusions are unchanged. Heart size is top normal. Mediastinal widening, particularly in the right lower paratracheal region, is unchanged and previously documented as adenopathy and azygos distention. There has been interval removal of left internal jugular line. Sternotomy wires and clips in the upper mediastinum are seen.

IMPRESSION: 1. Increased pulmonary edema   Keywords: increase. 2. New opacification in anterior segment of right upper lobe concerning for pneumonia.


SubjectID: 14365589, StudyID: 54951350, Comparison: None

FINAL REPORT

EXAM: Chest single AP upright portable view. CLINICAL INFORMATION: ___-year-old male with history of shortness of breath.

COMPARISON: ___.

FINDINGS: Single AP upright portable view of the chest was obtained. The patient is status post median sternotomy. There are low lung volumes. Blunting of the right costophrenic angle may be due to a trace effusion. Subtle bilateral patchy opacities may relate to infection versus mild volume overload. Cardiac and mediastinal silhouettes are stable. No pneumothorax.


SubjectID: 14365589, StudyID: 51358141, Comparison: same

WET READ: ___ ___ ___ 11:21 PM Left apex not included in this view. Increased pulmonary edema and bilateral pleural effusions. Discussed with Dr. ___ by phone at 23:20 on ___. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Urosepsis, desaturations.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is ongoing evidence of slightly asymmetrical moderate-to-severe pulmonary edema, combined to bilateral pleural effusions and moderate cardiomegaly   Keywords: ongoing. The findings are minimally progressive as compared to the previous examination. A wet read was delivered at 11:20 on ___.


SubjectID: 14365589, StudyID: 50783190, Comparison: None

FINAL REPORT

HISTORY: CHF exacerbation.

FINDINGS: In comparison with the study of ___, there is again enlargement of the cardiac silhouette with substantial pulmonary edema and bilateral pleural effusions with compressive atelectasis at the bases.


SubjectID: 14367272, StudyID: 59746688, Comparison: better

FINAL REPORT

PATIENT

HISTORY: ___-year-old man with acute congestive failure, urinary symptoms, assess for pulmonary edema or pneumonia.

COMPARISON: Exam is compared to chest x-ray of ___.

FINDINGS: Triangular-shaped opacity in the right upper lobe is suspicious for pneumonia. Minimal interval improvement of vascular congestion   Keywords: improve. Patchy opacities at lung bases are likely due to atelectasis. Heart size is still enlarged. No pneumothorax or pleural effusion. Unchanged left axillary pacemaker with two leads following the expected course, ending in right atrium, right ventricle.

IMPRESSION: Right upper lobe opacity suspicious for pneumonia.


SubjectID: 14367272, StudyID: 58211559, Comparison: None

FINAL REPORT

HISTORY: Shortness of breath.

TECHNIQUE: PA and lateral views of the chest.

COMPARISON: None.

FINDINGS: Left-sided pacemaker device is noted with leads terminating in the right atrium and right ventricle. The heart size is mildly enlarged. The mediastinal contours are unremarkable. Patchy ill-defined opacities are noted within the upper lobes, right more so than left, which are nonspecific but may reflect areas of infection. Mild perihilar haziness as well as small bilateral pleural effusions is compatible with mild pulmonary vascular engorgement. No pneumothorax is seen. There are no acute osseous abnormalities.

IMPRESSION: Patchy opacities in the upper lobes, more so on the right, may reflect areas of infection. Mild pulmonary vascular congestion with small bilateral pleural effusions.


SubjectID: 14382425, StudyID: 58940496, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with Cardiogenic shock // Interval changes

COMPARISON: Chest x-ray from ___ at 17:29

FINDINGS: The lower left chest wall and left costophrenic angle are excluded from the film. The left base is somewhat obscured by overlying breast tissue. Again seen is a right IJ Swan-Ganz catheter. The tip is in similar position, overlying the distal right pulmonary artery, possibly an inferior lobe range. Better appreciated on the current exam, but unchanged, there is a loop of catheter overlying the right heart which appears represent a loop within the Swan-Ganz catheter. Again noted is a left-sided pacemaker with lead tips over the right atrium and right ventricle and additional leads overlying the upper left heart border. No pneumothorax detected. As before, there is marked cardiomegaly, with extreme left cardiac apex excluded from this film. Again seen is prominent upper zone redistribution and vascular plethora, which appears slightly improved compared with the prior film   Keywords: improve. There is retrocardiac density, similar to the prior study, possibly very slightly improved. No gross right effusion. Left costophrenic angle excluded from film. Incidental note is made of clips in the right upper quadrant of the abdomen.

IMPRESSION: 1. Right Swan-Ganz catheter tip positioned relatively distal. In addition, there appears to be looping of the catheter overlying the right heart. This appearance is similar to the most recent prior radiograph. Clinical correlation is requested regarding repositioning. (Note is made of fluoro spot views and radiographs obtained after these radiographs that demonstrate subsequent repositioning of the Swan-Ganz catheter.) 2. Marked cardiomegaly, unchanged. 3. Upper zone redistribution and vascular plethora, probably slightly improved   Keywords: improve. 4. Possible slight interval improvement in the retrocardiac collapse and/or consolidation.


SubjectID: 14382425, StudyID: 57996265, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with a history of severe non-ischemic cardiomyopathy EF ___% s/p recent biV ICD placement (___), s/p recent embolic Rt MCA CVA (___) w/Lt sided hemiparesis prior stroke ___ on Coumadin due to LV thrombus, MR, HTN, HLD, admitted to CCU from OSH w/worsening cardiogenic shock and possible VAD vs IABP placement. // Acute interval changes

FINDINGS: Marked cardiomegaly with prominent the main pulmonary artery and probable prominence of the right hilum is unchanged. Again seen is a multi lead pacemaker, unchanged in configuration. Also again seen is a right IJ Swan-Ganz catheter. On the current examination, the tip of the Swan-Ganz catheter lies quite distal, possibly near the origin of the lower lobe vessels. No obvious pneumothorax identified. In the right lung and left upper/ mid zones,there is upper zone redistribution mild vascular plethora, and diffuse vascular blurring. I suspect that some of the blurring reflects respiratory motion. Allowing for this, the distribution of these findings is similar. The right lung base remains grossly clear, without consolidation or effusion.

IMPRESSION: Swan-Ganz catheter tip lies relatively distal. Clinical correlation regarding retraction is requested no given the distal positioning. Possible increased vascular blurring, though I suspect that much of this this is artifact due to respiratory motion   Keywords: increase. Otherwise, doubt significant interval change.


SubjectID: 14382425, StudyID: 57241700, Comparison: None

WET READ: ___ ___ ___ 8:58 AM 1. There is a right IJ Swan-Ganz catheter which appears to enter the right pulmonary artery, requiring repositioning. 2. Left chest cardiac device with associated dual leads projecting over the right atrium and ventricle in grossly appropriate location. 3. Stable cardiomediastinal contours. 4. Pulmonary vascular congestion and likely mild to moderate pulmonary edema. 5. Left basilar atelectasis. 6. No pneumothorax or pleural effusion. The findings regarding malpositioned Swan-Ganz/PA catheter were already known to the CCU team at the time of this dictation.

WET READ VERSION #1 ___ ___ 1:19 AM 1. There is a right IJ Swan-Ganz catheter which appears to enter the right pulmonary artery, requiring repositioning. 2. Left chest cardiac device with associated dual leads projecting over the right atrium and ventricle in grossly appropriate location. 3. Stable cardiomediastinal contours. 4. Pulmonary vascular congestion and likely mild to moderate pulmonary edema. 5. Left basilar atelectasis. 6. No pneumothorax or pleural effusion. The findings regarding malpositioned Swan-Ganz/PA catheter were already known to the CCU team at the time of this dictation. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF, transferred from OSH w/ cardiogenic shock, has R ___ cath. // ___ cath positioning

COMPARISON: Chest x-ray from ___

FINDINGS: Right IJ Swan-Ganz catheter with tip overlying the right pulmonary artery -- as indicated in the wet reading, this is known to the covering team. Left chest cardiac device with leads projecting over the right atrium and ventricle; additional leads overlie the superior border of the left heart, unchanged compared with ___. There is marked cardiomegaly, unchanged. Also again seen is prominence of the main and? right pulmonary arteries. There is upper zone redistribution and diffuse vascular plethora and vascular blurring, consistent with CHF. This is increased compared with the prior film. There is bibasilar atelectasis. There is increased retrocardiac density consistent with left lower lobe collapse and/or consolidation, with obscuration of the left heart border. Allowing for this, no gross effusion is identified. No pneumothorax is detected. Clips noted in the right upper quadrant of the abdomen.

IMPRESSION: 1. Marked cardiomegaly, unchanged. 2. Vascular plethora consistent with CHF and left lower lobe collapse and/or consolidation. 3. Right IJ Swan-Ganz catheter tip overlying right pulmonary artery. Please see wet reading.

RECOMMENDATION(S): There is a right IJ Swan-Ganz catheter overlies the right pulmonary artery, requiring repositioning. The findings regarding malpositioned Swan-Ganz/PA catheter were already known to the CCU team at the time of the wet reading dictation.


SubjectID: 14382425, StudyID: 52418411, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with a history of severe non-ischemic cardiomyopathy EF ___% s/p recent biV ICD placement (___), s/p recent embolic Rt MCA CVA (___) w/Lt sided hemiparesis prior stroke ___ on Coumadin due to LV thrombus, MR, HTN, HLD, admitted to CCU from OSH w/worsening cardiogenic shock // Interval changes

IMPRESSION: As compared to prior radiograph of 1 day earlier, Swan-Ganz catheter has been slightly repositioned but distal tip remains in the interlobar portion of the right pulmonary artery and could be withdrawn a few cm for standard positioning. Persistent cardiomegaly and vascular engorgement accompanied by a mild to moderate edema and small left pleural effusion   Keywords: persistent.


SubjectID: 14382425, StudyID: 57726430, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ F non-ischemic CM LVEF ___%, s/p BiV ICD, LV thrombus s/p multiple cardioembolic CVAs w/ residual L sided hemiparalysis on coumadin, presents to OSH ___ w SOB, found to be in cardiogenic shock // interval change of pulmonary edema, Swan positioning

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Severe cardiomegaly is stable. Swan-Ganz catheter tip is in the intralobar portion of the right pulmonary artery as before and complete without withdrawn a few cm for more standard position. Moderate pulmonary edema has minimally improved   Keywords: improve. Pacer leads are in standard position. There is no evident pneumothorax. Presumed small effusions larger on the left are grossly unchanged


SubjectID: 14382425, StudyID: 57485462, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p pacer // Lead position

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Moderate cardiomegaly persists. Mild fluid overload but no overt pulmonary edema. No pleural effusions. No pneumonia.


SubjectID: 14382425, StudyID: 55312214, Comparison: -1.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with sCHF, recent pacemaker placement. Acutely dyspneic with new oxygen requirement? // Explanation for dyspnea and oxygen requirement? Pulm edema?

IMPRESSION: As compared to ___ at an earlier time, position of ICD pacing leads is unchanged and there remains no evidence of a pneumothorax. Marked cardiomegaly is accompanied by pulmonary vascular congestion and new interstitial edema as well as a possible small left pleural effusion   Keywords: new. No other relevant changes   Keywords: no other relevant change.


SubjectID: 14382425, StudyID: 57453119, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with f severe non-ischemic cardiomyopathy EF ___% s/p recent biV ICD placement (___), s/p recent embolic Rt MCA CVA (___) w/Lt sided hemiparesis prior stroke ___ on Coumadin due to LV thrombus, MR, HTN, HLD, admitted to CCU from OSH w/worsening cardiogenic shock // Interval change

TECHNIQUE: Portable AP chest radiograph.

COMPARISON: Chest radiograph ___

FINDINGS: The Swan-Ganz catheter and a dual lead pacemaker are unchanged in appearance compared to the prior study. There is severe cardiomegaly, unchanged. There is prominence of the pulmonary vasculature and bilateral hila consistent with congestive heart failure. Slightly increased airspace opacities bilaterally suggest mild pulmonary edema   Keywords: increase. No definite pleural effusion seen. No pneumothorax seen.

IMPRESSION: Congestive heart failure with slightly increased pulmonary edema   Keywords: increase.


SubjectID: 14382425, StudyID: 55262252, Comparison: None

WET READ: ___ ___ ___ 8:59 PM Interval retraction of the right IJ Swan-Ganz catheter, which is redundant in the right ventricle, and now terminates in the proximal right main pulmonary artery. Otherwise, no significant change. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with f severe non-ischemic cardiomyopathy EF ___% s/p recent biV ICD placement (___), s/p recent embolic Rt MCA CVA (___) w/Lt sided hemiparesis prior stroke ___ on Coumadin due to LV thrombus, MR, HTN, HLD, admitted to CCU from OSH w/worsening cardiogenic shock // ___ line placement?

TECHNIQUE: Portable AP chest radiograph.

COMPARISON: Chest radiograph obtained earlier on the same date. The Swan-Ganz catheter has been ridge retracted and is redundant, coiling in the right atrium. The tip terminates in the proximal right main pulmonary artery. There is persistent severe cardiomegaly, pulmonary vascular congestion and left lower lobe atelectasis. No definite pleural effusion or pneumothorax seen. A dual lead pacemaker is unchanged in position.

FINDINGS: The Swan-Ganz catheter has been withdrawn and now terminates in the expected location of the right main pulmonary artery. The catheter is redundant in the right atrium.


SubjectID: 14382425, StudyID: 53529314, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with tachypnea // please assess for pneumonia

COMPARISON: CHEST X-RAY FROM ___ AT 20:17

FINDINGS: Compared to the prior study, degree of distension of the esophagus may be somewhat less. Marked cardiomegaly is similar to the prior film. Increased retrocardiac density is also similar, though the left hemi diaphragm is very faintly visible on the current film. Again seen is upper zone redistribution and mild diffuse vascular blurring, consistent with CHF. On the right, there is some increased perihilar density, possibly an artifact of the cardiomegaly or esophageal distension -- otherwise, no focal consolidation on the right and no gross effusion. The pacemaker device and its leads are similar to the prior study. Slight difference in configuration of the right atrial lead is likely accounted for by differences in the patient rotation. On the current study, the left mainstem bronchus appears smaller in caliber than on the right, unchanged compared with the prior film. Again noted are multiple clips overlying the right upper abdomen.

IMPRESSION: 1. Left lower lobe collapse and/or consolidation, possibly slightly improved. The possibility of a pneumonic infiltrate in the left lower lobe cannot be excluded. 2. Marked cardiomegaly and mild CHF. 3. Pacemakers and leads probably unchanged -- please see comment above. 4. Degree of distention of the esophagus appears less. 5. Apparent smaller caliber of the left mainstem bronchus compared to the right, unchanged.


SubjectID: 14382425, StudyID: 50854259, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with sCHF s/p BiV placement pw/ rt MCA stroke. Now with SOB // Please assess for PNA vs CHF

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Status post pacer placement. No evidence of pneumothorax. Moderate to severe cardiomegaly but no evidence of pulmonary edema. Moderate retrocardiac atelectasis. Elongation of the descending aorta.


SubjectID: 14391494, StudyID: 56168717, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Shortness of breath, improvement of pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Mild-to-moderate pulmonary edema and cardiomegaly are still present   Keywords: still. Unchanged monitoring and support devices. No interval appearance of pneumonia.


SubjectID: 14391494, StudyID: 53367629, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the right hemodialysis catheter has been removed. The left central venous access line is in unchanged position. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No pleural effusions.


SubjectID: 14391494, StudyID: 50913286, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Congestive heart failure, on hemodialysis, with dyspnea, fever and chills.

COMPARISONS: None available. Prior radiographs from ___ have been fetched.

TECHNIQUE: Chest, semi-upright AP portable.

FINDINGS: A dialysis catheter terminates in the upper atrium. The heart is mildly enlarged. The aortic arch and left carotid artery appear calcified. There is mild interstitial abnormality suggesting slight congestion, but otherwise the lungs appear clear. There is no pleural effusion or pneumothorax.

IMPRESSION: Findings suggesting mild fluid overload or interstitial edema; no focal opacity demonstrated to suggest pneumonia.


SubjectID: 14391494, StudyID: 50677273, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Status post central line placement.

COMPARISONS: Earlier radiograph of the same day.

FINDINGS: A dialysis catheter terminates in the right atrium. There is a new left internal jugular central venous catheter terminating in the mid superior vena cava. There is no evidence for pneumothorax. Findings suggesting mild vascular congestion persist. There is no pleural effusion. The cardiac, mediastinal, and hilar contours appear unchanged including mild cardiac enlargement.

IMPRESSION: Status post placement of new central venous catheter without evidence for pneumothorax.


SubjectID: 14391494, StudyID: 55999891, Comparison: better

FINAL REPORT

INDICATION: ___F with cough, fever // eval pna

TECHNIQUE: Portable AP upright view of the chest

COMPARISON: Multiple prior radiographs, most recently ___

FINDINGS: There is interval development of heterogeneous airspace opacities in the right lower lung. Previously noted pulmonary vascular congestion has improved   Keywords: improve. Heart is top-normal size and mediastinal contour is within normal limits. Calcifications are present in the aortic arch. There is no large effusion or pneumothorax.

IMPRESSION: Interval development of heterogeneous airspace opacities in the right lower lung is consistent with pneumonia in the appropriate clinical context.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ ___ on the telephone on ___ at 3:03 PM, 3 minutes after discovery of the findings.


SubjectID: 14391494, StudyID: 51817784, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with afib and ESRD p/w pneumonia triggering for somnolence // eval for pulmonary edema eval for pulmonary edema

IMPRESSION: In comparison with the study of ___, there is more coalescence of opacification at the right base consistent with the clinical diagnosis of pneumonia. Enlargement of the cardiac silhouette and indistinctness of engorged pulmonary vessels is consistent with some degree of pulmonary edema.


SubjectID: 14395528, StudyID: 59999729, Comparison: None

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPH

INDICATION: ___ year old man with BiV PPM upgrade. // rule out pneumothorax and change lead position rule out pneumothorax and change lead position

TECHNIQUE: PA and lateral views of the chest.

COMPARISON: Chest radiograph from ___.

FINDINGS: A left-sided biventricular pacemaker remains in unchanged position. The heart is enlarged. There is unchanged right pleural thickening. No focal consolidation concerning for pneumonia. No pneumothorax.

IMPRESSION: Unchanged position of a left sided biventricular pacemaker. No acute cardiopulmonary process.


SubjectID: 14395528, StudyID: 54453410, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with BiV PPM upgrade. // rule out pneumothorax

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Cardiomegaly is substantial. There is interval placement of the left ventricular pacemaker lead. There is no evidence of pneumothorax. There is minimal amount of right pleural thickening, unchanged


SubjectID: 14443106, StudyID: 59142166, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___ Comparison with prior exam dated ___. CLINICAL

HISTORY: Dyspnea and weight gain.

FINDINGS: PA and lateral views of the chest were provided. A left chest wall AICD is again seen with leads extending into the region of the coronary sinus and right ventricle. The heart remains stably enlarged, and mild pulmonary interstitial edema is again noted   Keywords: remains, again. There is a small right pleural effusion again seen. Mediastinal contour is stable. No pneumothorax. Bony structures are intact.

IMPRESSION: No significant change with persistent cardiomegaly, mild edema and small right pleural effusion   Keywords: persistent, no significant change.


SubjectID: 14443106, StudyID: 57322827, Comparison: None

FINAL REPORT

INDICATION: History of increased dyspnea, occasional orthopnea. Rule out CHF or pneumonia.

COMPARISONS: Chest radiograph from ___.

FINDINGS: A left chest wall pacemaker is present with leads in the right ventricle and coronary sinus. There is no focal consolidation or pneumothorax. There is a small-to-moderate layering right pleural effusion. Mild upper zone redistribution is noted but there is no overt pulmonary edema. The heart is enlarged, as seen previously.

IMPRESSION: Small-to-moderate right pleural effusion.


SubjectID: 14443106, StudyID: 57366297, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF, afib, admit with pancreatitis, c/o chest discomfort // evaluate volume status, infiltrates evaluate volume status, infiltrates

IMPRESSION: Comparison to ___, 03:12. The current radiograph continues to show massive cardiomegaly. However, a small right pleural effusion has newly appeared an the patient also shows mild to moderate pulmonary edema. Unchanged retrocardiac atelectasis.


SubjectID: 14443106, StudyID: 56933091, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF and pancreatitis with tachypnea // C/f worsening pulmonary edema C/f worsening pulmonary edema

IMPRESSION: In comparison with the study of ___, there is little interval change   Keywords: little interval change. Again there is massive enlargement of the cardiac silhouette with moderate pulmonary edema and bibasilar opacifications consistent with pleural effusion and compressive basilar atelectasis, especially involving the left lower lobe. Pacer leads are unchanged.


SubjectID: 14443106, StudyID: 53329381, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with CHF EF ___%, afib on Coumadin, admit with pancreatitis and peripancreatic fluid collection. // Evaluate volume status

TECHNIQUE: Portable semi-upright AP chest

COMPARISON: Chest radiographs ___ through ___

FINDINGS: Massive cardiomegaly is unchanged. Left chest wall pacer-defibrillator has leads in stable position. The left retrocardiac region remains opacified with obscuration of left hemidiaphragm. The right lung is grossly clear. There is no pulmonary edema. The mediastinal and hilar contours are stable.

IMPRESSION: 1. Persistent left retrocardiac opacity obscuring the left hemidiaphragm unchanged since at least ___ may reflect persistent atelectasis or pleural effusion. 2. Persistent severe cardiomegaly.


SubjectID: 14443106, StudyID: 52753863, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M CHF EF ___%, afib on Coumadin, admitted with pancreatitis with large fluid collection. // evaluate volume status evaluate volume status

IMPRESSION: Comparison to ___. No relevant change   Keywords: no relevant change. Mild fluid overload. Massive enlargement of the cardiac silhouette. Unchanged position of the pacemaker leads.


SubjectID: 14443106, StudyID: 50814346, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with afib, CHF here with pancreatitis now with chest pain // c/f pulmonary edema c/f pulmonary edema

IMPRESSION: Comparison to ___. No relevant change   Keywords: no relevant change. Left pectoral pacemaker. Substantial increase in size of the cardiac silhouette. Subsequent blunting of the left costophrenic sinus. No pleural effusions. No pulmonary edema.


SubjectID: 14446098, StudyID: 56448057, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with respiratory distress new heart failure // r/o pulmonary edema

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the patient has developed mild interstitial lung edema   Keywords: develop. No evidence of pneumonia, no pleural effusions. Normal size of the cardiac silhouette.


SubjectID: 14446098, StudyID: 55990270, Comparison: None

FINAL REPORT

INDICATION: History: ___F with CHF, dyspnea // eval for pulm edema

TECHNIQUE: Chest PA and lateral

COMPARISON: Multiple prior chest radiographs dated ___ through ___..

FINDINGS: Frontal and lateral radiographs of the chest demonstrate well expanded, clear lungs. The cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 14447773, StudyID: 58865960, Comparison: nan

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ y/o female with h/o CHF (EF ___% on ___), CAD, mitral regurgitation due to rheumatic heart disease, and multiple sclerosis who presents with increasing low extremity edema and shortness of breath despite increasing diuretics. Triggered last night for AMS, portable CXR showing a consolidation in RLL. // Assess pneumonia

IMPRESSION: As compared to ___ radiograph from earlier the same date, interstitial edema has substantially improved   Keywords: improve. Heterogeneous opacification in the right lung base has partially cleared, and an adjacent small right pleural effusion is minimally decreased in size. No other relevant changes   Keywords: no other relevant change.


SubjectID: 14447773, StudyID: 52026692, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with ams // R/o pna

IMPRESSION: As compared to ___ radiograph, cardiomediastinal contours are stable. Heterogeneous opacification at the right lung base has slightly worsened, and could potentially be due to developing pneumonia given clinical suspicion for this entity. Adjacent small right pleural effusion. Other pleural and parenchymal abnormalities are unchanged.


SubjectID: 14450610, StudyID: 56517509, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with resp failure // eval for interval change to explain hypoxemia

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: ET tube tip is 5.2 cm above the carinal. NG tube tip is in the stomach. Cardiomegaly is substantial, unchanged. Slight interval improvement in interstitial pulmonary edema is demonstrated although still present, mild   Keywords: improve. Small bilateral pleural effusions are noted, potentially slightly increased since the prior study. Right central venous line tip is at the level of mid SVC. There is no evidence of pneumothorax.


SubjectID: 14450610, StudyID: 51538174, Comparison: None

FINAL REPORT

INDICATION: History of respiratory distress. Please evaluate for pneumonia.

COMPARISONS: None.

TECHNIQUE: Single AP portable radiograph of the chest.

FINDINGS: The heart size is moderately enlarged. There is pulmonary vascular congestion with diffuse bilateral moderate pulmonary edema. There are small bilateral pleural effusions. Adjacent opacities are likely secondary to atelectasis; however, an acute infectious process cannot be excluded. There is no evidence of a pneumothorax. The visualized osseous structures are grossly unremarkable.

IMPRESSION: 1. Moderate pulmonary edema. 2. Small bilateral pleural effusions with adjacent opacities likely secondary to atelectasis; however, an acute infectious process cannot be excluded.


SubjectID: 14450610, StudyID: 50694269, Comparison: None

FINAL REPORT

HISTORY: Acute respiratory failure, status post intubation, confirm ET tube. CHEST, SINGLE AP PORTABLE VIEW.

COMPARISON: Chest x-rays dated ___. On the current examination, an ET tube is present, the tip lies at the level of the mid clavicular heads approximately 5.5 cm above the carina. An NG-type tube is present. The tip lies beneath the diaphragm extending off the film. Equivocal site of the side port overlying the lower esophagus. This may also be an artifact, and therefore clinical correlation is requested. There is moderate cardiomegaly similar to the prior film. There is also upper zone re-distribution, diffuse vascular blurring and probable subtle areas of alveolar opacity in both lungs, consistent with CHF. There is increased opacity at both bases consistent with bibasilar collapse and/or consolidation. The possibility of small effusions would be difficult to exclude.

IMPRESSION: 1. ET tube in satisfactory position. 2. NG tube beneath diaphragm off film. Location of side port uncertain -- please see comment above. 3. CHF with interstitial and suspected alveolar edema. 4. Bibasilar collapse and/or consolidation. Small effusions cannot be excluded.


SubjectID: 14450610, StudyID: 53916963, Comparison: None

FINAL REPORT

INDICATION: History of asthma, presenting with hypoxemia, productive cough.

COMPARISON: None.

FINDINGS: AP chest radiograph. The heart is mildly enlarged and there is mild to moderate interstitial edema. The right heart border is obscured, likely due to atelectasis. There is no pneumothorax.

IMPRESSION: Mild to moderate interstitial pulmonary edema.


SubjectID: 14461680, StudyID: 59365417, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHB now w/ PPM and pericardial drain // position of pericardial drain, interval change in pleural effusions

TECHNIQUE: Plain film

COMPARISON: ___

FINDINGS: No new radiodense pericardial drain is visible and previously seen pigtail catheter had been removed before most recent prior study. Cardiac silhouette appears similar and central pulmonary vascular congestion, haziness and pleural fluid appear decreased   Keywords: decrease. Leads appear intact and unchanged in position.

IMPRESSION: No radiodense pericardial drain seen. Slight interval radiographic improvement in CHF   Keywords: improve


SubjectID: 14461680, StudyID: 56416727, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with complete heart block // assess for interval change and pacer lead placement

TECHNIQUE: Portable chest x-ray.

COMPARISON: Multiple prior radiographs of the chest dated ___ to ___.

FINDINGS: Portable semi upright radiograph of the chest demonstrates low lung volumes resulting in bronchovascular crowding. Again seen are small bilateral pleural effusions with adjacent atelectasis. However, superimposed infection could be considered in the appropriate clinical setting. There is evidence of mild pulmonary vascular congestion. A pacemaker is in place with the leads in the expected position in the right atrium and right ventricle. The cardiomediastinal contour is slightly improved. There is no pneumothorax. A pericardial drain projects over the cardiac silhouette.

IMPRESSION: 1. Small bilateral pleural effusions with adjacent atelectasis and pulmonary vascular congestion. 2. A pacemaker is in place with leads in the expected positions in the right atrium and right ventricle. The cardiomediastinal contour is slightly improved.


SubjectID: 14461680, StudyID: 52753562, Comparison: better

WET READ: ___ ___ ___ 12:36 AM A dual lead pacer has leads ending in the RA and RV. Bilateral airspace opacities have improved since the prior radiograph performed 10 hours prior. ___ ___ ___.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

INDICATION: ___ year old woman a/p RV lead revision // confirm lead placement

TECHNIQUE: AP upright portable with lateral

COMPARISON: ___

FINDINGS: Pacing leads are in unchanged position compared to yesterday's study on the AP view and a lateral view shows both leads extending anteriorly in expected locations. Bilateral hemidiaphragm obscuration and pulmonary vascular congestion are similar to slightly better radiographically pericardial lead has been removed   Keywords: better. No pneumopericardium is visible. And linear air density seen on lateral view is in uncertain location, not corresponding to and expected intra thoracic cavity

IMPRESSION: Interim removal of pericardial drain. Expected positions of leads


SubjectID: 14461680, StudyID: 57874244, Comparison: None

CLINICAL INFORMATION & QUESTIONS TO BE ANSWERED: ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with heart block requiring PPM // location of pacemaker wires?

IMPRESSION: In comparison with the study ___ ___, the endotracheal and nasogastric tubes have been removed. There are lower lung volumes which accentuate the appearance of the cardiac silhouette. Hazy opacifications bilaterally are consistent with pleural effusions and compressive atelectasis at the bases. In the appropriate clinical setting, superimposed pneumonia would have to be considered.


SubjectID: 14462350, StudyID: 54520511, Comparison: 1.0

FINAL REPORT

INDICATION: Pulmonary edema, status post aggressive Lasix diuresis.

COMPARISON: Chest radiographs dated ___, ___, ___ and ___.

TECHNIQUE: Portable semi-erect frontal radiograph of the chest.

FINDINGS: A left PICC is unchanged in position with the tip terminating in the proximal SVC. There is no significant interval change in the extent of pulmonary vascular congestion/interstitial edema from ___   Keywords: no significant interval change. Opacification at the left lung base is unchanged, likely reflecting a small-to-moderate left pleural effusion and underlying atelectasis. There is improved aeration of the right lung base. There is no pneumothorax. The cardiac silhouette remains enlarged, but stable. The mediastinal contours are prominent, but unchanged. There is partial calcification of the aortic knob.

IMPRESSION: Little change in pulmonary vascular congestions/interstitial edema from ___ with improved aeration at the right lung base   Keywords: improve.


SubjectID: 14462350, StudyID: 57896727, Comparison: 0.0

FINAL REPORT

HISTORY: ___-year-old female with pulmonary edema. Assess for interval change or pneumonia.

COMPARISON: Chest radiograph, ___, ___, ___.

TECHNIQUE: Single portable frontal chest radiograph.

FINDINGS: Left PICC tip is in upper SVC. Partial resolution of pulmonary edema with stable moderate sized right pleural effusion and perihilar haze, with minimal decrease in mediastinal vein dilatation and heart size   Keywords: decrease. Severe left lower lobe atelectasis. No pneumothorax or new focal opacity. Aortic arch calcifications noted.

IMPRESSION: 1. Partial resolution of mild pulmonary edema with stable moderate-sized right pleural effusion   Keywords: stable. 2. Unchanged severe left lower lobe atelectasis.


SubjectID: 14462350, StudyID: 51809752, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Pulmonary edema, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Moderate cardiomegaly, no pleural effusions. Atelectasis at the left lung bases. Minimal fluid overload.


SubjectID: 14462350, StudyID: 51263138, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Poorly visualized PICC line.

COMPARISON: ___.

FINDINGS: The appearance of the heart, the vascular structures and the lung parenchyma is unchanged. Barely visible is a left PICC line. The line can be followed centrally to the midline but is not visible beyond that. No evidence of pneumothorax.


SubjectID: 14464902, StudyID: 58282318, Comparison: same

FINAL REPORT

INDICATION: History of liver and kidney transplant with acute dyspnea and hypoxia.

COMPARISONS: Chest radiograph ___. Chest radiograph ___.

FINDINGS: Again seen is hazy opacification of the bilateral lungs, most likely representing pulmonary edema, although may be infection, ARDS, or pulmonary hemorrhage   Keywords: again. The cardiac silhouette is moderately enlarged and stable. Small bilateral effusions are unchanged. An opacification at the right base most likely represents atelectasis, although a developing infection cannot be excluded. There is no pneumothorax. Pacemaker electrodes are in standard position.

IMPRESSION: 1. Unchanged moderate pulmonary edema and pleural effusions   Keywords: unchanged. 2. Probable right basilar atelectasis although developing pneumonia cannot be excluded.


SubjectID: 14464902, StudyID: 54030621, Comparison: same

FINAL REPORT

INDICATION: History of kidney and liver failure with multidrug resistant UTI. New intubation.

COMPARISONS: Chest radiograph ___.

FINDINGS: An endotracheal tube ends approximately 3 cm from the carina. Mild pulmonary edema is unchanged from the prior study   Keywords: unchanged. Small stable bilateral pleural effusions are likely present. There is no consolidation or pneumothorax. The cardiac silhouette is moderately enlarged but unchanged from the prior exam. A pacemaker and its leads are in standard position.

IMPRESSION: 1. Endotracheal tube in proper position. 2. Stable mild edema and small bilateral pleural effusions   Keywords: stable.


SubjectID: 14464902, StudyID: 51022047, Comparison: better

FINAL REPORT

AP CHEST, 10:07 A.M., ___

HISTORY: Renal and hepatic transplant. Diastolic CHF. Tachypnea and hypoxemia.

IMPRESSION: AP chest compared to 3:29 a.m.: Moderately severe pulmonary edema has improved substantially since earlier in the day   Keywords: improve. Moderate cardiomegaly is stable. Small bilateral pleural effusions are presumed. No pneumothorax. Transvenous right atrial and right ventricular pacer leads noted. No endotracheal tube visible.


SubjectID: 14464902, StudyID: 57654508, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female with shortness of breath, chest pain.

COMPARISON: ___.

FINDINGS: Lung volumes remain adequate, there is no focal consolidation, pleural effusion or pneumothorax. The cardiac silhouette and mediastinal contours are normal. Previously noted bronchial wall thickening in the right upper and lower lobes is improved. A left chest pacemaker is unchanged in appearance.

IMPRESSION: No acute cardiopulmonary abnormality.


SubjectID: 14464902, StudyID: 57138333, Comparison: None

FINAL REPORT

HISTORY: ___-year-old woman with CHF, aortic stenosis and leukocytosis. Please evaluate volume status and rue out infiltrate.

COMPARISON: ___ as well as more remote radiographs.

TECHNIQUE: Single AP portable view of the chest.

FINDINGS: A left-sided battery pack with pacemaker leads terminating in the right atrium and right ventricle are in unchanged position. There is moderate-to-severe cardiomegaly with pulmonary vascular engorgement, SVC engorgement and bilateral pulmonary opacities consistent with pulmonary edema and biventricular heart failure. There are bilateral pleural effusions, left greater than right as well.

IMPRESSION: Cardiomegaly and pulmonary edema. No evidence of pneumonia.


SubjectID: 14464902, StudyID: 51445710, Comparison: same

FINAL REPORT

TYPE OF

EXAMINATION: Chest AP portable single view.

INDICATION: ___-year-old female patient with increasing oxygen requirements, evaluate volume status.

FINDINGS: AP single view of the chest has been obtained with patient in sitting semi-upright position. Analysis is performed in direct comparison with the next preceding similar study of ___. Marked cardiac enlargement unchanged. Unchanged position of previously described left-sided permanent pacer with dual intracavitary electrode system. The pulmonary congestive pattern persists and may even have increased. The lateral pleural sinuses are only mildly blunted but it is likely that the pleural effusions are layering posteriorly as the patient is in marked recumbent position. No pneumothorax identified.

IMPRESSION: Persistent cardiomegaly with pulmonary congestion close to pulmonary edema   Keywords: persistent.


SubjectID: 14464902, StudyID: 51503811, Comparison: 1.0

FINAL REPORT

HISTORY: ___-year-old woman with status post cardiac arrest, question infection.

COMPARISON: ___.

FINDINGS: In comparison with the prior exam, continued asymmetric resorption of the pulmonary edema has occurred   Keywords: continue. While opacities still exist, given the rate of resorption, it would be premature to call this pneumonia, although this is a possibility. No pleural effusion is present. Cardiac size is still enlarged. Pacemaker leads terminating in unchanged correct position.

IMPRESSION: Improvement in the previously mild pulmonary edema   Keywords: improve.


SubjectID: 14464902, StudyID: 51955786, Comparison: None

FINAL REPORT

HISTORY: Renal disease with cardiac arrest.

FINDINGS: In comparison with study of ___, there is again enlargement of the cardiac silhouette with evidence of congestive failure, though less prominent than on the previous study. Dual-channel pacemaker device remains in place. Poor definition of the left hemidiaphragm suggests volume loss as well as layering pleural effusion. Less prominent changes are seen at the right base. No evidence of pneumothorax or gross evidence of rib fracture.


SubjectID: 14464902, StudyID: 55486489, Comparison: same

FINAL REPORT

INDICATION: Recurrent multidrug resistant UTI. Evaluate endotracheal tube.

COMPARISON: Chest radiograph ___. Chest radiograph ___.

FINDINGS: An endotracheal tube is approximately 3 cm from the carina. A feeding tube is in the stomach with the tip of of view. Pacemaker leads are in the standard position. Mild pulmonary edema is stable   Keywords: stable. There is no consolidation. Small pleural effusions are presumed but not obvious. There is no pneumothorax. Moderate enlargement of the cardiomediastinal silhouette is stable.

IMPRESSION: Stable mild pulmonary edema and small pleural effusions   Keywords: stable.


SubjectID: 14464902, StudyID: 50036304, Comparison: None

FINAL REPORT

PORTABLE AP UPRIGHT CHEST FILM ___ AT 741 CLINICAL

INDICATION: ___-year-old with question volume overload, assess for pulmonary edema. Comparison is to prior study of ___ at ___. A single portable upright chest film ___ at 741 is submitted.

IMPRESSION: 1. Dual-lead left-sided pacemaker with its leads terminating over the expected location of the right atrium and right ventricle respectively. Left internal jugular central line has its tip in the proximal superior vena cava. Endotracheal tube continues to have its tip approximately 3 cm above the carina. Nasogastric tube seen coursing below the diaphragm with the tip not identified. 2. The heart remains mildly enlarged but unchanged. Mediastinal contours are within normal limits. Interval improvement in aeration with improving mild pulmonary and interstitial edema. Probable small layering right effusion. More patchy opacity at the left base may reflect a combination of compressive atelectasis and effusion, although pneumonia cannot be entirely excluded. Clinical correlation is advised. No evidence of pneumothorax.


SubjectID: 14480845, StudyID: 59797948, Comparison: None

FINAL REPORT

HISTORY: Chest pain. Evaluate for effusion.

COMPARISON: Multiple prior chest radiographs, most recently ___.

FINDINGS: Frontal portable views of the chest were obtained. Mild cardiomegaly is similar to prior, although exaggerated by low lung volumes. Lungs are clear without focal or diffuse abnormality. Blunting of the right costophrenic angle may represent an effusion although assessment is limited by soft tissue attenuation. No pneumothorax. Osseous structures are unremarkable. No radiopaque foreign body.

IMPRESSION: Mild cardiomegaly. Possible right pleural effusion, although assessment is limited. PA and lateral views with better inspiration could be obtained for further evaluation.


SubjectID: 14480845, StudyID: 55444095, Comparison: None

FINAL REPORT

HISTORY: COPD and CHF.

FINDINGS: In comparison with the earlier study of this date, the cardiac silhouette is within upper limits of normal in size. There is mild indistinctness of pulmonary vessels raising the possibility of some elevated pulmonary venous pressure. No evidence of pleural effusion or acute focal pneumonia.


SubjectID: 14489052, StudyID: 59947718, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Right lung collapse after bronchoscopy, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no change in extent and appearance of the collapsed right lung. The amount of air in the right pleural space is without substantial change. Clips over the right inferior aspects of the hilus are unchanged. The appearance of the cardiac silhouette, as well as the tortuosity of the thoracic aorta, are constant. Constant appearance of the left lung that shows no pathological changes.


SubjectID: 14489052, StudyID: 59460508, Comparison: None

FINAL REPORT

HISTORY: Status post right lower lobe lobectomy with recurrent right lung collapse now status post bronchoscopy with re-expansion and recollapse.

COMPARISON: Multiple prior chest radiographs, most recently dated ___.

FINDINGS: Single frontal view of the chest. There has been no substantial interval re-expansion of the collapsed right lung. Right sided pneumothorax and large right pleural effusion are similar to prior. The left lung is clear. The right heart border is obscured but the left heart border and mediastinal contours are stable.

IMPRESSION: Collapsed right lung with right-sided pneumothorax and large right pleural effusion, similar to prior.


SubjectID: 14489052, StudyID: 57046563, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female status post right lower lobectomy. Evaluate for interval change.

COMPARISON: Multiple prior radiographs of the chest dated ___ through ___.

FINDINGS: Frontal and lateral radiographs of the chest demonstrate a moderate-sized right apical pneumothorax with rightward shift of the mediastinum, which is likely due to prior surgery. There is substantial collapse of the remaining right lung with minimal pulmonic gas seen in the right lung field. Left lung is essentially clear. Heart size is normal.

IMPRESSION: Moderate right apical pneumothorax, with rightward shift of the mediastinum and substantial collapse of the remaining right lung, with only minimal aeration seen. COMMENTS: These findings were discussed with ___ (PA) by Dr. ___ ___ telephone at 11:40 a.m. on ___, 10 minutes after they were discovered.


SubjectID: 14489052, StudyID: 55752203, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Right lower lobectomy, right lung collapse, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the extent of the known right lung collapse is unchanged. There is minimal increase in pleural effusion in the right pleural space. The appearance of the heart and of the left lung are constant. Constant moderate tortuosity of the thoracic aorta.


SubjectID: 14489052, StudyID: 55207639, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female with recent right lower lobectomy. Evaluate for interval change.

COMPARISON: Multiple prior radiographs of the chest dated ___ through ___.

FINDINGS: Portable semi-upright radiograph of the chest demonstrates stable appearing partial collapse of the right lung and right-sided pneumothorax with large right pleural effusion. Left lung is clear. Cardiomediastinal and hilar contours are unchanged.

IMPRESSION: Stable appearing partial collapse of the right lung and right-sided pneumothorax with large right pleural effusion.


SubjectID: 14489052, StudyID: 54650541, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female with COPD status post right lower lobectomy. Evaluate for interval change.

COMPARISON: Multiple prior radiographs of the chest dated ___ through ___.

FINDINGS: Portable semi-upright radiograph of the chest demonstrates persistent collapse of the remaining portions of the right lung with stable large right pneumothorax and moderate pleural effusion. Cardiomediastinal contours are unchanged. Interval increase in the engorgement of pulmonary vessels in the left lung may represent high flow state. No left-sided pleural effusion.

IMPRESSION: Persistent collapse of the right lung and right-sided pneumothorax.


SubjectID: 14489052, StudyID: 51130837, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post multiple lobectomies, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the extent of the known right pneumothorax has increased. The collapsed lung is smaller than it was on the previous images. The basal pleural effusion on the right is constant. Constant size of the cardiac silhouette. However, lower lung volumes, there is more crowding of vascular structures at the left lung base. No left pleural effusion.


SubjectID: 14489052, StudyID: 59721346, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Right lower lobectomy, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, no relevant changes are seen   Keywords: no relevant change. Unchanged postoperative appearance of the right hemithorax, with relatively large pleural effusion and no visible expanded right lung parenchyma. The appearance of the left hemithorax is unchanged.


SubjectID: 14489052, StudyID: 59656277, Comparison: None

FINAL REPORT

HISTORY: Frequent collapse.

FINDINGS: In comparison with study of earlier in this date, there has been increased collapse with probable increased effusion and recurrent pneumothorax in the right apex. Left lung remains clear.


SubjectID: 14489052, StudyID: 59495275, Comparison: None

FINAL REPORT

PORTABLE CHEST FILM ___ AT 5:27 CLINICAL

INDICATION: History of COPD, assess for interval change. Comparison is made to the patient's prior study of ___ at ___. A portable upright chest film ___ at 5:27 is submitted.

IMPRESSION: 1. There is a right hydropneumothorax in this recently post-operative patient with collapse of the right lung. Left lung is grossly clear. Overall cardiac and mediastinal contours are difficult to assess given the abnormality within the right hemithorax and patient rotation. No evidence of pulmonary edema. No large left effusion.


SubjectID: 14489052, StudyID: 55916611, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post bronchoscopy, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has undergone bronchoscopy. There is improved expansion of the remaining right lung, with new appearance of air bronchograms. The pleural air collection after lobectomy persists at the level of the lung apex. Unchanged normal appearance of the left lung and of the heart.


SubjectID: 14489052, StudyID: 52652449, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female status post right lower lobectomy. Evaluate for interval change.

COMPARISON: Multiple prior radiographs of the chest dated ___ through ___.

FINDINGS: Frontal and lateral radiographs of the chest demonstrate large right-sided pleural effusion occupying greater than two-thirds of the right hemithorax with persistent moderate-sized right apical pneumothorax. The left lung is clear. The cardiomediastinal and hilar contours are unchanged.

IMPRESSION: Large right-sided hydropneumothorax, increased in size from the prior study.


SubjectID: 14489052, StudyID: 51503379, Comparison: None

FINAL REPORT

HISTORY: Pneumothorax.

FINDINGS: In comparison with study of ___, there has been some re-expansion of portions of the right lung with only a small residual apical pneumothorax. Post-surgical changes are again seen on the right. The left lung remains essentially clear.


SubjectID: 14489052, StudyID: 57573705, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post right lung surgery.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, after right lower lobectomy, there is newly appeared substantial pleural effusion. The previously partially collapsed remaining right lung shows signs of increasing collapse. The air collection in the pleura appears to have increased and now extends at the base of the right lung. The chest tube is in correct position. Unremarkable left lung. Unremarkable appearance of the cardiac silhouette.


SubjectID: 14489052, StudyID: 57037228, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female status post right lower lobectomy.

COMPARISON: Radiograph of the chest dated ___.

FINDINGS: Single portable semi-upright view of the chest demonstrates the patient in a very oblique position, making it difficult to evaluate the heart and lungs. Allowing for this limitation, there is cardiomediastinal widening. The left lung is clear. A chest tube projects over the right hemithorax. There is a moderate-sized pneumothorax at the right apex, which is expected postoperatively.

IMPRESSION: Moderate-sized pneumothorax at the right apex.


SubjectID: 14489052, StudyID: 55863132, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female status post right lower lobectomy. Evaluate for pneumothorax.

COMPARISON: Multiple prior chest radiographs of the chest dated ___ through ___.

FINDINGS: Frontal and lateral radiographs of the chest demonstrate a small apical right-sided pneumothorax. A chest tube is seen projecting over the right hemithorax. There is stable cardiomediastinal widening. The left lung is clear.

IMPRESSION: Small right-sided apical pneumothorax. COMMENTS: These findings were discussed with Dr. ___ ___ surgery) by Dr. ___ ___ telephone at 4:59pm on ___, 30 minutes after their discovery.


SubjectID: 14489052, StudyID: 54968318, Comparison: None

FINAL REPORT

HISTORY: Right lower lobectomy, to assess for change.

FINDINGS: In comparison with the study of ___, on these upright views, there is a gas filling the upper third of the right hemithorax. Chest tube is in place with a large amount of pleural fluid filling the lower two-thirds of the right hemithorax. The left lung remains essentially clear.


SubjectID: 14489052, StudyID: 53004509, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female status post right lower lobectomy. Evaluate for interval change.

COMPARISON: Prior radiographs dated ___ and ___.

FINDINGS: Portable semi-upright radiograph of the chest demonstrates the patient in a very oblique position, making it difficult to evaluate the heart and lungs. The right lung is less visualized on this radiograph, which may be secondary to positioning of the patient. An thoracostomy tube is seen projecting over the right hemithorax.

IMPRESSION: Obliquity of the patient makes interpretation difficult. There is decreased visualization of the right lung, which may be secondary to positioning.


SubjectID: 14489052, StudyID: 56814286, Comparison: None

FINAL REPORT

CLINICAL

HISTORY: Status post right upper lobectomy, evaluate for pneumothorax. CHEST The chest tube has been pulled. A moderate-sized apical pneumothorax is present, but there has been considerable re-expansion of the right lung since the prior chest x-ray of ___. Left lung remains clear.

IMPRESSION: Re-expanding lung, moderate apical pneumothorax.


SubjectID: 14489052, StudyID: 50124218, Comparison: None

FINAL REPORT

HISTORY: Lung collapse.

FINDINGS: In comparison with the chest CT of ___, there is again right hydropneumothorax with substantial collapse of the right upper and middle lobe. No pulmonic gas is seen. The left lung remains essentially clear.


SubjectID: 14494681, StudyID: 59131923, Comparison: worse

FINAL REPORT

AP CHEST, 11:39 P.M. ON ___

HISTORY: ___-year-old woman with new-onset atrial fibrillation and previous pulmonary edema.

IMPRESSION: AP chest compared to ___ and ___ at 1:01 a.m. Lung volumes are lower and there is greater opacification in the lungs, particularly the bases. The simplest explanation is worsening of pulmonary edema, but since the heart is not larger and mediastinal veins are not more dilated, the explanation could be something very different, depending upon whether the patient is febrile or having hemoptysis one would consider concurrent pneumonia or pulmonary hemorrhage   Keywords: worse. Pleural effusions could be present, but are not appreciable. There is no pneumothorax.


SubjectID: 14494681, StudyID: 55388449, Comparison: same

FINAL REPORT

INDICATION: Altered mental status.

COMPARISON: ___.

FINDINGS: Again seen is moderate cardiomegaly and mildly increased interstitial markings, little changed from ___. There is no pleural effusion or pneumothorax. The aorta is tortuous.

IMPRESSION: Mild pulmonary vascular congestion, little changed from ___   Keywords: little change.


SubjectID: 14494681, StudyID: 58787816, Comparison: worse

FINAL REPORT

HISTORY: ___-year-old female status post recent internal jugular line placement and ET tube repositioning.

COMPARISON: Chest radiograph from ___ at 22:22 and chest CT from ___ at 22:56. PORTABLE SUPINE FRONTAL CHEST RADIOGRAPH: The endotracheal tube has been repositioned, with the tip terminating 3.8 cm above the level of the carina. A new right internal jugular catheter terminates at the cavoatrial junction. No pneumothorax is evident. Increasing interstitial opacities suggest developing pulmonary edema especially given the moderate cardiomegaly and distension of the azygous vein. No large pleural effusions are evident. Consolidation within the left lung base has progressed, possibly due to progressive atelectasis, though pneumonia and aspiration are also within the differential. Apparent widening of the Mediastinal and hilar contours is likely secondary to the supine technique.

IMPRESSION: 1. Proximal repositioning of the endotracheal tube now in optimal position. 2. Interval placement of a right internal jugular central venous line terminating in the cavoatrial junction. No pneumothorax. 3. Progressive left lower lobe consolidation, possibly increasing atelectasis, though pneumonia and aspiration remain within the differential. 4. Developing mild pulmonary edema   Keywords: developing


SubjectID: 14494681, StudyID: 55795263, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with intubation, evaluate for tube placement.

COMPARISON: Multiple chest radiographs, the latest from ___. ONE VIEW OF THE CHEST: Evaluation of the radiograph is limited due to poor photon penetration. Within these limitations, the lungs are low in volume and show subtle retrocardiac lower lobe opacity. The cardiac silhouette is enlarged. The mediastinal silhouette and hilar contours are normal. An ET tube terminates at the carina and should be withdrawn by at least 3 cm for optimal position. An NG tube passes out of view below the diaphragm.

IMPRESSION: Subtle retrocardiac opacity could represent sequalae of aspiration or atelectasis. Low lying endotracheal tube terminates at the carina should be withdrawn by 3 cm for optimal position. These findings were communicated to ___ MD via telephone at 11:02 pm on ___.


SubjectID: 14494681, StudyID: 50060405, Comparison: None

FINAL REPORT

HISTORY: Altered mental status with intubation.

FINDINGS: In comparison with the study of ___, the monitoring and support devices are essentially unchanged. There is again enlargement of the cardiac silhouette with bilateral pulmonary opacifications most likely reflecting elevation of pulmonary venous pressure. The right hemidiaphragm is no longer sharply seen, consistent with layering effusion and atelectasis at the right base. The left base again shows mild obscuration of the hemidiaphragm. In the appropriate clinical setting, the possibility of superimposed pneumonia would have to be considered.


SubjectID: 14494681, StudyID: 51295248, Comparison: worse

FINAL REPORT

AP CHEST, 10:46 P.M., ___

HISTORY: Check ET tube placement.

IMPRESSION: AP chest compared to ___, ___:10 a.m.: Tip of the endotracheal tube is just below the upper margin of the clavicles, no less than 3 cm from the carina. Moderate bilateral pleural effusions, left greater than right and moderately severe pulmonary edema have all worsened   Keywords: worse. Cardiomegaly is severe, probably not appreciably changed. No pneumothorax. Right jugular line passes at least as far as the low SVC and possibly into the upper right atrium. No mediastinal widening or other evidence of complications.


SubjectID: 14494681, StudyID: 58240645, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female with cough and weakness

COMPARISON: Chest radiographs from ___ and ___, and chest CT from ___ AP AND LATERAL CHEST RADIOGRAPH: Diffuse increased density at the lung bases is likely secondary to overlying soft tissue attenuation. The lung apices are clear. No definite consolidation is identified on the lateral view. There is no overt pulmonary edema. Apparent enlargement of cardiomediastinal contours may be secondary to the AP technique.

IMPRESSION: Limited examination due to patient body habitus, though no definite pneumonia.


SubjectID: 14494681, StudyID: 53352924, Comparison: None

FINAL REPORT

HISTORY: Lethargy.

TECHNIQUE: Upright AP view of the chest.

COMPARISON: ___.

FINDINGS: Mild to moderate cardiomegaly is unchanged. The mediastinal contours are unremarkable. There is mild pulmonary vascular congestion. No focal consolidation, pleural effusion or pneumothorax is detected. There are no acute osseous abnormalities.

IMPRESSION: Mild pulmonary vascular congestion.


SubjectID: 14494681, StudyID: 57521389, Comparison: None

FINAL REPORT

PORTABLE CHEST ___

HISTORY: ___-year-old female with cough. Question pneumonia.

FINDINGS: Single portable view of the chest is compared to previous exam from ___. Exam is extremely limited secondary to portable technique and patient body habitus. There is no definite confluent consolidation identified. Cardiac silhouette is grossly stable.

IMPRESSION: Limited exam without definite large confluent consolidation; however, if clinically desired, repeat with two views could help for additional detail.


SubjectID: 14498233, StudyID: 58391150, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, evaluation for lung volumes.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the course of the nasogastric tube is unchanged. The tip of the tube projects 2-3 cm below the gastroesophageal junction and could be slightly advanced. The lung volumes continue to be low, and the cardiac silhouette is enlarged. Mild pulmonary edema is seen, and the image is not changed as compared to the previous comparison. Coronary stent is again visualized. No pleural effusions. No pneumonia, minimal atelectasis at the left lung bases.


SubjectID: 14498233, StudyID: 56615097, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with NGT, now ? pulled out // is NGT still in place?

TECHNIQUE: Portable chest

COMPARISON: ___.

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change. The NG tube is in a similar location compared to prior


SubjectID: 14498233, StudyID: 56694536, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: With multiple prior chest radiographs, the most recent of which is dated ___. CLINICAL

HISTORY: Chest pain, question interval change.

FINDINGS: PA and lateral views of the chest were provided. The heart remains moderately enlarged. There has been interval improvement in pulmonary edema, though mild edema persists   Keywords: improve. There are tiny bilateral pleural effusions, not significantly changed. No pneumothorax. Mediastinal contour is stable. Bony structures are intact.

IMPRESSION: Improved though persistent mild pulmonary edema, cardiomegaly   Keywords: improve.


SubjectID: 14498233, StudyID: 54028218, Comparison: same

FINAL REPORT

HISTORY: ___-year-old female with chest pain and cough. Evaluation for pneumonia.

COMPARISON: Comparison is made to radiographs of the chest from ___.

FINDINGS: PA and lateral views of the chest demonstrate severe cardiomegaly. Pulmonary vascular congestion persists, along with tiny bilateral pleural effusions   Keywords: persists. Old rib fractures are again noted. No pneumothorax is present. Subtle opacity anterior to the left oblique fissure, best seen on the lateral view, is possibly due to atelectasis.

IMPRESSION: Severe cardiomegaly with persistent pulmonary vascular congestion   Keywords: persistent. Opacity anterior to the left oblique fissure is possibly atelectasis, however underlying infection cannot be completely exluded. The above findings were communicated to Dr. ___ ___ ___) by Dr. ___ at 8:12 am via telephone, after attending review.


SubjectID: 14498233, StudyID: 52574901, Comparison: same

FINAL REPORT

HISTORY: Chest pain. Question pneumonia.

COMPARISON: Prior chest radiograph from ___.

TECHNIQUE: PA and lateral chest radiographs.

FINDINGS: As compared to prior chest radiograph from ___, there has been no significant change   Keywords: no significant change. Moderate cardiomegaly is stable and there is redemonstration of prominent pulmonary vascular markings, consistent with congestion. No overt pulmonary edema, pleural effusion or pneumothorax is identified. No focal consolidation concerning for pneumonia is seen.

IMPRESSION: Stable moderate cardiomegaly and pulmonary vascular congestion   Keywords: stable.


SubjectID: 14498233, StudyID: 50642372, Comparison: None

FINAL REPORT

HISTORY: Chest pain.

COMPARISON: Multiple prior chest radiographs, most recently ___.

FINDINGS: Frontal and lateral views of the chest. Moderate cardiomegaly and mediastinal contours are stable. Pulmonary vascular markings are prominent, consistent with congestion. No overt pulmonary edema, focal consolidation, or pneumothorax is appreciated. Chronic left rib fractures are again noted.

IMPRESSION: Moderate cardiomegaly and pulmonary vascular congestion.


SubjectID: 14501760, StudyID: 55475876, Comparison: None

FINAL REPORT

HISTORY: Critical AS with prior CHF after arrest.

FINDINGS: In comparison with the study of ___, there is an endotracheal tube in place with its tip approximately 2.2 cm above the carina. Obliquity of the patient makes it difficult to compare the mediastinal structures. Cardiac silhouette appears to be enlarged with tortuosity of the aorta. Some elevation of pulmonary venous pressure. The basilar regions are very difficult to assess due to overlying soft tissues. The hemidiaphragms are not well seen, suggesting a combination of volume loss and pleural effusions bilaterally. Repeat study could be helpful. A nasogastric tube extends to the stomach.


SubjectID: 14501760, StudyID: 52274255, Comparison: None

FINAL REPORT

INDICATION: ___-year-old woman status post cardiac arrest. Evaluate ET tube placement.

COMPARISON: Prior chest radiograph from ___.

TECHNIQUE: Semi-erect portable AP chest radiograph.

FINDINGS: An endotracheal tube terminates 2.6 cm above the carina. An enteric tube courses below the diaphragm, its tip terminates in the gastric fundus. As compared to prior chest radiograph, there is a an area of hyperlucency at the right lung base which likely represents a pneumothorax. The heart remains enlarged with tortuosity of the aorta. There are bibasilar opacities which likely reflect a combination of pleural fluid and volume loss, not significantly changed from prior examination. Multiple rib fractures are noted on the right and there is an area of soft tissue swelling overlying the lateral chest wall on the right.

IMPRESSION: 1. Increased lucency at right lung base likely represents a pneumothorax. 2. ET tube terminates 2.6 cm above the carina, withdrawal of at least 2 cm is recommeded for adequate positioning. These findings were discussed with Dr. ___ by Dr. ___ ___ telephone on ___ at 11:53 AM, time of discovery.


SubjectID: 14501760, StudyID: 54515405, Comparison: same

FINAL REPORT

HISTORY: Aortic valvuloplasty and arrest.

FINDINGS: In comparison with study of ___, the endotracheal tube is approximately 2 cm above the carina. There is a pneumothorax primarily seen at the lung base and laterally. Otherwise, little change   Keywords: little change.


SubjectID: 14504982, StudyID: 54130740, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with possible right pleural effusion and left-sided pleuritic chest pain. Evaluate effusions.

COMPARISONS: ___.

FINDINGS: Frontal and lateral views of the chest were obtained. The heart is of normal size with normal cardiomediastinal contours. The lungs are hyperinflated with flattened diaphragms, suggestive of COPD. No focal consolidation, pleural effusion, or pneumothorax is seen. Median sternotomy wires and mediastinal surgical clips are intact. Compression deformity of upper and mid-thoracic vertebral bodies are age-indeterminate.

IMPRESSION: 1. Hyperinflated lungs suggestive of COPD. No definite pleural effusion. 2. Age-indeterminate compression deformities of 2 thoracic vertebral bodies.


SubjectID: 14504982, StudyID: 53523552, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with chest pain.

COMPARISON: No relevant comparisons available. ONE VIEW OF THE CHEST: The lungs are hyper expanded and show mild blunting of the right costophrenic angle. The cardiomediastinal silhouette and hilar contours are normal. Clips and sternal sutures related to CABG are noted.

IMPRESSION: Mild blunting of the right costophrenic angle may be related to a small effusion. No focal consolidation. Hyperexpanded lungs could be related to COPD.


SubjectID: 14531257, StudyID: 56581723, Comparison: None

FINAL REPORT

HISTORY: ___ year old man with severe sepsis, oxygen requiremen Evaluation of pulmonary edema.

COMPARISON: Exam is compared with ___.

FINDINGS: Atelectasis of the right base has increased, with omolateral deviation of the trachea. The left base pleural fluid has increased. The heart is still moderately enlarged. There are no sign of pulmonary edema

IMPRESSION: The atelectasis of the right base is increased. The pleural fluid on the left base is increased.


SubjectID: 14531257, StudyID: 52668559, Comparison: None

FINAL REPORT

PORTABLE CHEST FROM ___ AT 4:14 A.M. CLINICAL

INDICATION: ___-year-old with heart failure and urosepsis. Assess for interval change. Comparison is made to prior study dated ___ at 3:07. A portable AP upright chest film, ___ at 4:16 is submitted.

IMPRESSION: 1. Status post median sternotomy for CABG with stable overall cardiac and mediastinal contours given lordotic technique on the current examination. There is an increasing patchy opacity at the right medial lung base, which could reflect worsening atelectasis or an evolving aspiration/pneumonia. In addition, there is a layering left effusion versus chronic pleural thickening. A 5-mm calcified nodule in the left mid lung is stable, consistent with a calcified granuloma. No evidence of overt pulmonary edema. No pneumothorax is seen.


SubjectID: 14531257, StudyID: 50162749, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is improved ventilation of the right lung bases with decrease of the pre-existing opacity. On the left, the accompanying pleural effusion as well as the calcified granuloma are unchanged. Unchanged moderate cardiomegaly with tortuosity of the thoracic aorta. No pneumothorax.


SubjectID: 14531257, StudyID: 50596955, Comparison: same

FINAL REPORT

INDICATION: Altered mental status.

COMPARISON: ___, ___. CT Abdomen/Pelvis, ___.

FINDINGS: PA and lateral chest radiographs. Median sternotomy wires are intact. Mild pulmonary vascular congestion is similar to ___, but bibasilar atelectasis is slightly worse   Keywords: similar. Small left pleural effusion is stable. Mild basilar bronchiectasis corresponds to prior CT. There is no pneumothorax. Mild cardiomegaly is unchanged.

IMPRESSION: Slightly worsened bibasilar atelectasis. Otherwise, no change from baseline   Keywords: no change.


SubjectID: 14544496, StudyID: 52907193, Comparison: same

WET READ: ___ ___ ___ 1:50 AM Moderate bilateral pleural effusions have redistributed with the patient supine but are not grossly changed. Underlying pneumonia cannot be excluded. The upper lungs are relatively clear. Moderate cardiomegaly is not appreciably changed. There may be minimal interstitial. pulmonary edema.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with worsening dyspnea and poor air movement // r/o worsening effusion

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the extent of the bilateral pleural effusions is unchanged. The effusions, however, distributed in a slightly different weight. Moderate cardiomegaly. Retrocardiac atelectasis and left lower lobe atelectasis. No new parenchymal opacities   Keywords: new. Mild fluid overload but no overt pulmonary edema.


SubjectID: 14544496, StudyID: 52599541, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female with dyspnea.

COMPARISON: Radiograph dated ___. PA and lateral chest radiographs demonstrate clear lungs with no focal consolidation. Increased since prior examination right greater than left. Obscuration of the left hemidiaphragm likely sequela of combination of pleural effusion and atelectasis. The cardiomediastinal and hilar contours are stable since prior examination dated ___. No evidence of overt pulmonary edema. There is no pneumothorax.

IMPRESSION: Bilateral pleural effusions with obscuration of the left hemidiaphragm most most typical of atelectasis.


SubjectID: 14565211, StudyID: 53278190, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with cough/chills // copd, cough and chills

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, mild pre-existing fluid overload has completely resolved   Keywords: resolve. There is unchanged evidence of mild bilateral apical thickening. Mild cardiomegaly persists. Elongation of the descending aorta. Severe scoliosis with subsequent asymmetry of the ribcage. No evidence of acute changes in the lung parenchyma, neither infectious or neoplastic. No pulmonary edema. No pleural effusions.


SubjectID: 14565211, StudyID: 53226980, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___F with shortness of breath

TECHNIQUE: Upright AP and lateral views of the chest

COMPARISON: ___ chest radiograph and ___ chest CTA

FINDINGS: Heart size is mildly enlarged. Tortuosity of the thoracic aorta and aortic knob calcifications are again demonstrated. The pulmonary vasculature is mildly engorged, new compared to the previous study. Lungs are hyperinflated with emphysematous changes again noted within the upper lobes. Patchy opacities are noted in the lung bases, likely atelectasis. No focal consolidation or pleural effusion is present. There are mild to moderate multilevel degenerative changes noted in the thoracic spine along with and S-shaped thoracolumbar scoliosis.

IMPRESSION: Mild pulmonary vascular congestion, new in the interval   Keywords: new. Emphysema.


SubjectID: 14566882, StudyID: 58647095, Comparison: None

FINAL REPORT

HISTORY: Dyspnea, assess for pulmonary edema.

COMPARISON: ___.

FINDINGS: 2 views were obtained of the chest. The lungs are well expanded with bilateral basal predominant interstitial abnormality and accompanying small pleural effusions which in the context of the patient's mild cardiomegaly reflects interstitial edema. There is no focal consolidation or pneumothorax. Tortuous aortic contour is noted.

IMPRESSION: Mild pulmonary edema.


SubjectID: 14566882, StudyID: 53724837, Comparison: None

FINAL REPORT

HISTORY: Fever.

COMPARISON: Multiple chest radiographs dating from ___, through ___.

TECHNIQUE: PA and lateral chest radiographs, two views.

FINDINGS: Moderate cardiomegaly with mild tortuosity of the thoracic aorta is unchanged since at least ___. Central pulmonary vascular congestion with associated interstitial edema is mild. Increased opacity at the right lung base is more pronounced compared to prior examinations. Pleural surfaces are clear without effusion or pneumothorax.

IMPRESSION: Moderate cardiomegaly with mild interstitial edema. Asymmetrically increased density at the right lung base is likely related edema, however, concurrent pneumonia is not excluded. Consider repeat imaging after diuresis to assess for improvement.


SubjectID: 14566882, StudyID: 52279857, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chest pain.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the signs evocative of pulmonary edema have almost completely disappeared. The size of the cardiac silhouette has also decreased. There are areas of mild atelectasis at the right and left lung bases, but no evidence of pneumonia, pneumothorax or other pathological change. Mild tortuosity of the thoracic aorta.


SubjectID: 14566882, StudyID: 53654129, Comparison: None

FINAL REPORT

PORTABLE CHEST FILM ___ AT 8:08 A.M. CLINICAL

INDICATION: ___-year-old with CHF, question interval change. Comparison is made to the patient's prior study of ___. Portable AP upright chest film ___ at 8:08 is submitted.

IMPRESSION: Heart remains enlarged. There is calcification in the aorta consistent with atherosclerosis. There is interstitial prominence which may reflect age-related changes or small airways disease. Overall, there is somewhat improved aeration at the right lung base where there are residual streaky opacities which may represent scarring or residual atelectasis. The previously described faint nodular opacity at the right base is not apparent on the current study. The left lung is grossly clear. There is no evidence of pulmonary edema. No pneumothorax.


SubjectID: 14566882, StudyID: 50774269, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: Prior exam from ___. CLINICAL

HISTORY: Shortness of breath and history of diastolic CHF, question fluid overload.

FINDINGS: PA and lateral views of the chest were provided. There is a small right pleural effusion with subtle nodular opacity in the right lower lung which is concerning for pneumonia. There is no pneumothorax. The heart is within normal limits of size with calcification of the mitral annulus, subtly visualized. The left lung appears clear. Bony structures appear intact though demineralized.

IMPRESSION: Small right pleural effusion with asymmetric nodular opacity in the right lower lung concerning for pneumonia.


SubjectID: 14584470, StudyID: 59204348, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post cardiac surgery, evaluation for pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The pre-existing minimal right pleural effusion distributes in a slightly different manner, but is overall unchanged in extent. The right lung parenchyma appears unchanged. In the interval, the patient has been extubated, nasogastric tube has been removed and the mediastinal drains have been removed. Unchanged postoperative mild cardiomegaly.


SubjectID: 14584470, StudyID: 53931156, Comparison: same

WET READ: ___ ___ ___ 12:54 AM No short interval change since preceding exam. - ___ ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Followup.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The monitoring and support devices are constant. Currently, there is no evidence of pneumothorax. No larger pleural effusions. Unchanged size of the cardiac silhouette.


SubjectID: 14584470, StudyID: 58313096, Comparison: worse

FINAL REPORT

INDICATION: ___ year old woman with PMH living unrelated donor kidney transplant ___, ___, afib, mech MVR, and COPD presents with ___ as well as fluid overload in the setting of newly worsened RV systolic dysfunction and tricuspid regurgitation, evaluate for pulmonary edema or pneumonia.

TECHNIQUE: Single upright AP chest radiograph

COMPARISON: Prior chest radiographs dating back to ___.

FINDINGS: Compared with the recent prior study of ___, there is new moderate pulmonary edema and worsened pulmonary vascular congestion   Keywords: worse, new. A right pleural effusion has increased. There is no focal consolidation or pneumothorax. Moderate to severe cardiomegaly and bihilar enlargement are unchanged. Median sternotomy wires and valve prostheses are stable.

IMPRESSION: New moderate pulmonary edema and enlarging right pleural effusion   Keywords: new. No focal consolidation to suggest pneumonia.


SubjectID: 14584470, StudyID: 51477149, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with PMH ESRD from HTN s/p R sided LURT in ___, dCHF, afib, mechanical MVR on warfarin, PVD s/p left superficial femoral artery stent in ___ for nonhealing ulceration who presents for ___ and fluid overload // evaluate for CHF exacerbation

TECHNIQUE: Chest PA and lateral

COMPARISON: Prior chest radiographs dating back to ___ and chest CT dated ___.

FINDINGS: Compared with the most recent prior study ___, moderate to severe cardiomegaly, hilar enlargement bilaterally, and moderate pulmonary vascular are unchanged, consistent with history of pulmonary hypertension. The previously multifocal nodular opacities in confluent right lower lobe consolidation have resolved. There is no pleural effusion, pneumothorax, or frank pulmonary edema. ___ intact median sternotomy wires and a mitral valve prosthesis are unchanged. A right IJ central venous catheter has been removed.

IMPRESSION: 1. Moderate to severe cardiomegaly with associated pulmonary vascular congestion and bihilar enlargement consistent with pulmonary arterial hypertension without frank edema. 2. No focal consolidation.

NOTIFICATION: The findings were discussed with ___, Medical Student by ___, M.D. on the telephone on ___ at 8:32 AM, 2 minutes after discovery of the findings.


SubjectID: 14584470, StudyID: 53373452, Comparison: None

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Congestive heart failure.

COMPARISONS: Prior radiographs from ___ and ___.

TECHNIQUE: Chest, PA and lateral.

FINDINGS: A right internal jugular venous catheter has been removed. The patient is status post apparently mitral valve replacement. The heart is moderately enlarged. The mediastinal and hilar contours are similar. There is persistent fluid in the minor fissure, but somewhat decreased. A small quantity of fluid is similar in the right major fissure. However, there is a new suspected small pleural effusion on the left with patchy associated basilar opacity and there is also increased opacification at the right lung base. There is no overt congestive heart failure. There is no pneumothorax. Bony structures are unremarkable.

IMPRESSION: New bibasilar opacification with a small new left-sided pleural effusion. These findings are not specific and could be seen with atelectasis but developing pulmonary infection is not excluded.


SubjectID: 14591184, StudyID: 58749517, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with sob // pna?

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph from ___.

FINDINGS: There are increased bibasilar opacities and prominent central pulmonary vasculature likely due to pulmonary edema   Keywords: increase. The costophrenic margins are indistinct bilaterally likely due to small bilateral pleural effusions. Heart size is mildly enlarged, however this may be technical due to the AP projection. There is no overt focal consolidation or pneumothorax. The imaged upper abdomen is unremarkable.

IMPRESSION: Findings compatible with pulmonary edema and small bilateral pleural effusions. Recommend repeat radiograph after diuresis to assess for any underlying abnormality.


SubjectID: 14591184, StudyID: 58570830, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with h/o COPD and OSA admitted for CHF exacerbation // pls eval for interval change pls eval for interval change

IMPRESSION: In comparison with the study of ___, the cardiac silhouette remains enlarged. The degree of pulmonary edema has decreased   Keywords: decrease. Bilateral pleural effusions with compressive atelectasis at the bases is again seen. No definite acute focal pneumonia .


SubjectID: 14591184, StudyID: 57052884, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pulmonary edema // ? interval change in edema ? interval change in edema

COMPARISON: Comparison to ___ at 07:41

FINDINGS: Portable AP upright chest film ___ at 08:05 is submitted.

IMPRESSION: Overall cardiac and mediastinal contours are stable. There are layering effusions, left greater right. More patchy retrocardiac opacity most likely reflects compressive atelectasis, although pneumonia or aspiration should also be considered. There is stable mild perihilar and interstitial edema   Keywords: stable. No pneumothorax.


SubjectID: 14593165, StudyID: 59159826, Comparison: better

FINAL REPORT

INDICATION: History of lupus with diffuse alveolar hemorrhage. Evaluate for change.

TECHNIQUE: Single upright AP view of the chest.

COMPARISON: Multiple chest radiographs, including the most recent from ___. CTA of the chest from ___.

FINDINGS: Since the prior exam, there has been continued improvement in the diffuse bilateral upper lung zone interstitial opacities, which may represent alveolar hemorrhage or edema. No new opacity is identified. The small right pleural effusion has improved. A tiny one is likely still present. There is no left pleural effusion. No pneumothorax identified. Enlargement of the cardiomediastinal silhouette has also lessened. Sternal wires are unchanged.

IMPRESSION: Continued improvement in the bilateral interstitial opacities, as described above   Keywords: improve.


SubjectID: 14593165, StudyID: 50357523, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with severe lupus with likely flair and sCHF now with increased O2 requirement from baseline // interval change

COMPARISON: Chest radiograph ___

FINDINGS: Single AP view of the chest provided. Cephalization and diffuse alveolar and interstitial opacities are consistent with moderate pulmonary edema. No pneumothorax. Small right pleural effusion is unchanged. Hilar contours are normal. Moderate cardiomegaly is mildly increased. A well-circumscribed sclerotic lesion in the humeral head has a nonaggressive appearance.

IMPRESSION: 1. Moderate pulmonary edema is unchanged from 1 day prior   Keywords: unchanged. 2. Small, right pleural effusion is unchanged.


SubjectID: 14593165, StudyID: 58042556, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (AP AND LATERAL)

INDICATION: History: ___F with shortness of breath

TECHNIQUE: Upright AP and lateral views of the chest

COMPARISON: ___

FINDINGS: The patient is status post median sternotomy and ascending thoracic aortic graft placement. Cardiac silhouette size remains mildly enlarged. Mediastinal contour is similar. New perihilar ill-defined alveolar opacities are demonstrated   Keywords: new. No pleural effusion or pneumothorax is identified. No acute osseous abnormalities seen.

IMPRESSION: New bilateral perihilar alveolar opacities, most likely reflective of moderate to severe pulmonary edema   Keywords: new. Pulmonary hemorrhage is not excluded.


SubjectID: 14593165, StudyID: 57769731, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with sob hypotension // widened mediastinum

IMPRESSION: As compared to recent radiograph of earlier the same date, cardiomediastinal contours are unchanged, with persistent cardiomegaly and widening of the mediastinum with configuration suggestive of tortuous and distended vessels. Pulmonary vascular congestion is accompanied by mild edema and small bilateral pleural effusions.


SubjectID: 14593165, StudyID: 56165836, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with respriatory failure and cardiogenic shock // eval for tube palcement

IMPRESSION: As compared to ___ chest radiograph, endotracheal tube is in place, with tip terminating 2 cm above the carinal. This could be withdrawn slightly for standard positioning. Cardiomegaly is stable, but pulmonary edema has increased in severity along with increasing small right pleural effusion   Keywords: increase.


SubjectID: 14593165, StudyID: 51422421, Comparison: better

FINAL REPORT

INDICATION: Shortness of breath. Evaluate for pneumonia or CHF.

COMPARISON: Chest radiographs from ___, ___, ___, and ___.

FINDINGS: Portable frontal chest radiographs again demonstrate an enlarged cardiac silhouette and bibasilar atelectasis. There has been interval improvement of right and left apical opacities   Keywords: improve. No focal consolidation, pleural effusion, or pneumothorax is identified. There may be mild vascular congestion and edema. The visualized upper abdomen is unremarkable.

IMPRESSION: 1. No new focal consolidation. 2. Mild vascular congestion and edema. 3. Interval improvement of bilateral apical opacities   Keywords: improve.


SubjectID: 14593165, StudyID: 57215162, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hx CHF and chronic CP with worsening SOB. // How does pulmonary edema look compared to yesterday?

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change.


SubjectID: 14593165, StudyID: 52582508, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CAD CHF and chest pain with increasing SOB // Is there evidence of volume overload, specifically increasing pulmonary edema or pleural effusions?

TECHNIQUE: AP view of the chest

COMPARISON: Priors most recent on ___

FINDINGS: Heart is mildly enlarged but stable. The cardiomediastinal contour is within normal limits. There is moderate pulmonary vascular congestion and mild interstitial edema. No focal consolidation or pneumothorax is identified. Likely small bilateral pleural effusions.

IMPRESSION: Moderate pulmonary vascular congestion and mild pulmonary edema. Likely small bilateral effusions.


SubjectID: 14593165, StudyID: 53196655, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___-year-old woman status post aortic valve replacement and tricuspid valve repair. Evaluate pneumothoraces.

TECHNIQUE: Chest PA and lateral

COMPARISON: Multiple prior chest radiographs, most recent from ___.

FINDINGS: Median sternotomy wires aligned and intact. Prosthetic aortic and tricuspid valves visualized. Stable widening of the mediastinum and cardiomegaly. Stable right lower lobe opacity. Increasing small right pleural effusion. Right apical pneumothorax is slightly smaller and left apical pneumothorax is stable. No definite osseous or soft tissue abnormalities.

IMPRESSION: Slightly smaller right apical pneumothorax and unchanged small left apical pneumothorax. Increased small right pleural effusion with adjacent basilar atelectasis.


SubjectID: 14593165, StudyID: 53184272, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with cabg // r/o ptx, s/p ct d/c

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: The endotracheal tube, Swan-Ganz catheter, chest tubes, and mediastinal drains have been removed. Prosthetic valves are visualized. Sternal wires present. The heart is mildly enlarged, larger than on the prior study. There patchy areas of opacity in the right upper lobe, right lower lobe, and retrocardiac region that could be due to volume loss or early infiltrate. There small bilateral pneumothoraces

IMPRESSION: Small bilateral pneumothoraces


SubjectID: 14606921, StudyID: 57498336, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with COPD, OSA, pulm fibrosis here for worsening hypoxemia at home // r/o pneumonia, pulmonary edema, new consolidation

TECHNIQUE: Portable AP radiograph of the chest.

COMPARISON: Plain chest radiograph dated ___. Chest CT dated ___.

FINDINGS: Coarse interstitial lung markings are not appreciably changed. There are no new consolidations or pleural effusions. There is no pneumothorax. Mild cardiomegaly despite the projection is unchanged.

IMPRESSION: No acute pulmonary disease.


SubjectID: 14606921, StudyID: 53276192, Comparison: 0.0

FINAL REPORT

INDICATION: ___F with h/o copd. now with fever, sob // eval for pna

TECHNIQUE: Single AP view of the chest.

COMPARISON: ___.

FINDINGS: Given differences in technique, there has been no significant interval change   Keywords: no significant interval change   Keywords: no significant interval change. Increased interstitial markings particularly at the lung bases is as seen on recent prior CT scan   Keywords: increase. Cardiac silhouette there is top-normal in size. Enlarged hila and increased soft tissue at the right paratracheal region are compatible with known adenopathy are compatible with patient's known adenopathy. Left shoulder arthroplasty changes and old right rib fractures are again noted.

IMPRESSION: Given differences in technique, there has been no significant interval change. Chronic changes in the lungs which could easily obscure subtle abnormality.


SubjectID: 14610106, StudyID: 58881503, Comparison: same

FINAL REPORT

HISTORY: CHF with increased oxygen requirement.

FINDINGS: In comparison with the study of ___, the degree of pulmonary edema is less prominent, though there is still evidence of substantial elevation of pulmonary venous pressure   Keywords: still. Moderate cardiomegaly persists. Mild left basilar atelectatic changes and blunting of the costophrenic angle are again seen.


SubjectID: 14610106, StudyID: 58605882, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, dyspnea.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the pre-existing signs indicative of pulmonary edema are unchanged in extent and severity   Keywords: unchanged. Also unchanged is the small retrocardiac atelectasis, the minimal left pleural effusion and a moderate cardiomegaly. No new parenchymal opacities   Keywords: new.


SubjectID: 14610106, StudyID: 50158746, Comparison: 1.0

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, exacerbation, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the signs indicative of pulmonary edema have minimally increased   Keywords: increase. The overall impression is one of mild progression. On the left, a small pleural effusion could be present. Increasing retrocardiac atelectasis. No other changes   Keywords: no other change.


SubjectID: 14610106, StudyID: 57622436, Comparison: 0.0

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: New onset of hypoxia, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the signs indicative of pulmonary edema have minimally improved   Keywords: improve. However, overt pulmonary edema is still clearly present   Keywords: still. Moderate cardiomegaly, in the presence of minimal left pleural effusion cannot be excluded. No pneumothorax.


SubjectID: 14610106, StudyID: 54917619, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: History of severe COPD, assessment for chronic heart failure.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is almost unchanged evidence of moderate-to-severe pulmonary edema   Keywords: unchanged. The extent and severity of the bilateral pre-existing parenchymal opacities is constant. Moreover, there is unchanged slight increase in diameter of the pulmonary artery on the left, potentially suggestive of pulmonary arterial hypertension. Moderate cardiomegaly, unchanged suggestion of a small left pleural effusion.


SubjectID: 14610106, StudyID: 55116312, Comparison: same

FINAL REPORT

HISTORY: COPD with CHF exacerbation.

FINDINGS: In comparison with the study of ___, there is little overall change in the enlargement of the cardiac silhouette and pulmonary edema   Keywords: little overall change. Once again, the costophrenic angles are not well seen due to scattered radiation related to the size of the patient.

IMPRESSION: Little overall change   Keywords: little overall change.


SubjectID: 14610106, StudyID: 53780868, Comparison: None

WET READ: ___ ___ ___ 11:12 PM Decreased pulmonary edema. ___ p_________________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: COPD, chronic heart failure, exacerbation, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change in extent and severity of the preexisting parenchymal opacities. The size of the cardiac silhouette is also unchanged. Presence of a minimal left pleural effusion cannot be excluded. On the right, no effusion is visible.


SubjectID: 14610106, StudyID: 53184734, Comparison: None

FINAL ADDENDUM There is enlargement of the main pulmonary artery suggesting underlying pulmonary hypertension. ______________________________________________________________________________

FINAL REPORT

EXAM: CHEST, SINGLE AP UPRIGHT PORTABLE VIEW. CLINICAL INFORMATION: Dyspnea, evaluate for fluid overload.

COMPARISON: ___.

FINDINGS: Single AP upright portable view of the chest was obtained. There is prominence of the perihilar vascular structures and interstitium consistent with moderate pulmonary edema. Hilar are mildly prominent. The costophrenic angles are not well seen due to patient's overlying soft tissues and underpenetration, although small pleural effusions cannot be excluded. The cardiac silhouette remains mildly enlarged. The aortic knob is calcified.

IMPRESSION: Findings consistent with moderate pulmonary edema. Recommend repeat after diuresis to exclude underlying infection in the appropriate clinical setting.


SubjectID: 14622418, StudyID: 57650281, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with IABP, evaluate IABP position

COMPARISON: Chest radiograph from ___.

FINDINGS: AP view of the chest provided. The intra-aortic balloon pump is approximately 6 cm below the upper most part of the aortic arch, advancement by 4 cm is recommended. Swan-Ganz catheter has been retracted, now terminating in the right ventricle. Lungs are otherwise clear.

IMPRESSION: 1. Low intra-aortic balloon pump, advancement by 4 cm is recommended. 2. Swan-Ganz catheter terminates in the right ventricle.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 11:09 AM, 10 minutes after discovery of the findings.


SubjectID: 14622418, StudyID: 56047364, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF, here with exacerbation // Please eval for PNA, edema Please eval for PNA, edema

IMPRESSION: In comparison with the study of ___, there is no change in the appearance of the heart and lungs and monitoring and support devices. The IABP remains ___ excessively high and should be pulled back approximately 2 cm for optimal positioning.


SubjectID: 14622418, StudyID: 53791792, Comparison: None

WET READ: ___ ___ 8:30 AM Tip of the PA catheter obscured by external wire. However it appears to project over the midline, probably in the distal main pulmonary artery.

WET READ VERSION #1 ___ ___ ___ 9:19 PM Tip of the PA catheter obscured by external wire. However it appears to project over the midline, probably in the distal main pulmonary artery. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with sCHF, now s/p IABP removal, concerns for incorrect PA catheter placement // eval for PA catheter placement

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the aortic balloon pump has been removed. A Swan-Ganz catheter has been advanced. The tip projects over the outflow tract of the right ventricle. No evidence of complications, notably no pneumothorax. Moderate cardiomegaly. Mild fluid overload but no overt pulmonary edema. No pleural effusions.


SubjectID: 14622418, StudyID: 52283112, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with IABP, repositioned back 2cm // location of IABP

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the monitoring and support devices are unchanged, except for the intra aortic balloon pump that has been pulled back and now shows its tip approximately 3.7 cm be low the upper most part of the aortic arch. Unchanged appearance of the lung parenchyma and the cardiac silhouette. No pneumothorax or other complication.


SubjectID: 14622418, StudyID: 51953175, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with swan - relook at line placement // line position line position

IMPRESSION: In comparison with the earlier study of this date, there is no change in the appearance of the Swan-Ganz catheter, which again appears to terminate in the rib right ventricle. The IABP tip may be slightly high air, though still more below the transverse arch of the aorta than normal. Little change in the appearance are and lungs   Keywords: little change.


SubjectID: 14622418, StudyID: 57396397, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with iabp for CM EF ___%, evaluate for placement of intra-aortic balloon pump.

TECHNIQUE: Single supine chest radiograph was obtained.

COMPARISON: Chest radiograph performed earlier on the same day at 16:41.

FINDINGS: The tip of the intra-aortic balloon pump terminates at the upper aortic arch. A Swan-Ganz catheter extends to the right pulmonary artery in unchanged position. There is moderate cardiomegaly. No focal consolidation, pleural effusion, or pneumothorax is identified.

IMPRESSION: Intra-aortic balloon pump terminates at the level of the upper aortic arch.

RECOMMENDATION(S): Withdrawing of the intra-aortic balloon pump by 2cm is recommended.

NOTIFICATION: Findings were discussed with Dr.___ by Dr.___ ___ telephone at 10:45am on ___, 10 minutes following discovery.


SubjectID: 14622418, StudyID: 51757676, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with dyspnea.

TECHNIQUE: Chest PA and lateral

COMPARISON: None available.

FINDINGS: PA and lateral chest radiograph demonstrates an enlarged heart. No evidence of pulmonary edema. Prominence of the left hilus is additionally noted. There is no pleural effusion or pneumothorax. No focal consolidation convincing for pneumonia is seen. There is no acute osseous abnormality.

IMPRESSION: Enlarged heart is identified which appears globular in shape. A pericardial effusion cannot be excluded. Prominence of the left hilus is noted, question adenopathy. Priors if made available would be helpful for comparison.


SubjectID: 14622418, StudyID: 56523632, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with swan // swan placement swan placement

IMPRESSION: Compared to prior chest radiographs since ___, most recently ___ through ___. Swan-Ganz catheter ends in the right pulmonary artery. Right ventricular pacer defibrillator lead unchanged in standard placement. No pneumothorax pleural effusion or mediastinal widening. Severe cardiomegaly and mild pulmonary vascular engorgement unchanged   Keywords: unchanged. No pulmonary edema.


SubjectID: 14622418, StudyID: 55057006, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with swan // swan placement swan placement

IMPRESSION: In comparison study of ___, the Swan-Ganz catheter has been advanced the tip lies in the midline in the right pulmonary artery. Otherwise, no change   Keywords: no change. Continued enlargement of the cardiac silhouette without vascular congestion or acute focal pneumonia   Keywords: continue.


SubjectID: 14622418, StudyID: 53064992, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with sCHF, eval for interval changes, PA catheter placement

COMPARISON: Chest radiographs since ___, most recently ___

FINDINGS: AP view of the chest provided. Compared to prior study from a day ago, there is less pulmonary vascular congestion. Heart size is still moderately enlarged. There is no pleural effusion. Swan-Ganz catheter is seen terminating in the right pulmonary artery.

IMPRESSION: 1. Slight improvement in pulmonary edema   Keywords: improve. 2. Swan-Ganz catheter in appropriate position.


SubjectID: 14622418, StudyID: 52339835, Comparison: None

WET READ: ___ ___ ___ 9:22 AM A Swan-Ganz catheter is unchanged in position, again terminating in the right pulmonary artery. Unchanged moderate cardiomegaly. No focal consolidation.

WET READ VERSION #1 ___ ___ ___ 8:44 PM A Swan-Ganz catheter is unchanged in position, again terminating in the right pulmonary artery. Unchanged moderate cardiomegaly. No focal consolidation. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cardiomyopathy ___ cocaine abuse with swan ganz catheter in place // assess proper placement of PA catheter assess proper placement of PA catheter

IMPRESSION: In comparison with the earlier study of this date, there is little change in the appearance of the Swan-Ganz catheter, which extends into the right pulmonary artery. Otherwise, no change in the appearance of the heart and lungs.


SubjectID: 14622418, StudyID: 52985206, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___M with PICC // eval PICC position.

TECHNIQUE: Chest PA and lateral

COMPARISON: ___ chest radiograph

FINDINGS: Right-sided PICC tip terminates in the mid SVC. Left-sided AICD device is noted with lead terminating in the right ventricle. Moderate cardiomegaly is re- demonstrated. Mediastinal contours are unchanged. There is mild pulmonary vascular congestion, improved from the previous study   Keywords: improve. No pleural effusion, focal consolidation or pneumothorax is seen. There are no acute osseous abnormalities.

IMPRESSION: 1. Right PICC tip in the mid SVC. 2. Moderate cardiomegaly with mild pulmonary vascular congestion, improved from the previous study   Keywords: improve.


SubjectID: 14622418, StudyID: 51910038, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with cocaine cardiomyopathy on chronic milrinone, s/p PICC replacement to LUE // Assess for PICC position Contact name: ___, ___: ___

TECHNIQUE: Single portable view of the chest. ___.

COMPARISON: Left chest wall single lead pacing device is again seen

FINDINGS: The left chest wall single lead pacing device is again noted. Left-sided PICC tip is in the lower SVC. There is pulmonary vascular congestion without edema. There is no focal consolidation or effusion. Moderate cardiomegaly is again noted.

IMPRESSION: Cardiomegaly without superimposed acute cardiopulmonary process.


SubjectID: 14637100, StudyID: 54487452, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old female patient with CHF and cough. Study requested for evaluation of pulmonary edema/infiltrate.

COMPARISON: Prior chest radiograph from ___.

TECHNIQUE: Portable upright AP chest radiograph.

FINDINGS: As compared to prior chest radiograph from ___, there has been slight worsening of moderate to severe pulmonary edema, with likely increased left pleural effusion   Keywords: worse, increase. The heart is enlarged. There are no new focal consolidations.

IMPRESSION: Slight worsening of moderate to severe pulmonary edema with no new focal consolidations   Keywords: new, worse.


SubjectID: 14637100, StudyID: 55042983, Comparison: None

FINAL REPORT

STUDY: Portable AP chest radiograph.

INDICATION: Query infectious process.

TECHNIQUE: Portable AP radiograph was obtained.

COMPARISON: ___. REPORT: AP portable radiograph, there is likely cardiomegaly. There is extensive congestive change with upper lobe blood venous diversion peribronchial cuffing. In addition, there is obscuration of the left hemidiaphragm and costophrenic sulcus. These findings suggest significant congestive change. Superimposed left lower lobe pneumonia cannot be immediately excluded. There is multilevel degenerative change in the thoracic spine with known mid thoracic fractures, visualized on prior chest x-ray dated ___ are not well seen.

CONCLUSION: Significant congestive changes as described.


SubjectID: 14637100, StudyID: 55017642, Comparison: worse

FINAL REPORT

AP CHEST 10:23 P.M. ON ___

HISTORY: CHF or nephrotic syndrome.

IMPRESSION: AP chest compared to ___ and ___: Moderately severe pulmonary edema has worsened   Keywords: worse. Bibasilar opacification in the lungs could be dependent edema and atelectasis or concurrent pneumonia. Severe enlargement of the cardiac silhouette is longstanding. Small bilateral pleural effusions are presumed. No pneumothorax.


SubjectID: 14637100, StudyID: 52854853, Comparison: better

FINAL REPORT

CHEST

HISTORY: CHF exacerbation. REFERENCE EXAM: ___.

FINDINGS: The heart continues to be severely enlarged and there is a small left pleural effusion with some mild pulmonary vascular redistribution. However, the alveolar edema has dramatically improved compared to the study from two days prior   Keywords: improve. There continues to be some bilateral lower lobe volume loss/consolidation.


SubjectID: 14637100, StudyID: 53152913, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Dyspnea and hypoxia, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Low lung volumes and moderate-to-severe pulmonary edema, associated with substantial cardiomegaly and the likely presence of a left pleural effusion. No new parenchymal opacities   Keywords: new. Unchanged valvular annulus calcification.


SubjectID: 14641474, StudyID: 58836797, Comparison: None

FINAL REPORT

AP CHEST, 2:24 A.M., ___:

HISTORY: A ___-year-old woman with pericardial effusion. Evaluate for cardiac size.

IMPRESSION: AP chest reviewed in the absence of prior chest radiographs: The patient is rotated to the right. Nevertheless, there is no appreciable cardiomegaly. Lungs are grossly clear, and pleural effusions are minimal, if any. Caliber of the mediastinum is difficult to assess, however, because of rotation. There could be distention of the azygos and other mediastinal veins. If that determination is important to make regarding the presence of pericardial effusion, then a repeat film should be obtained with careful attention to proper positioning.


SubjectID: 14641474, StudyID: 56168637, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Small pericardial effusion, evaluation for pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is a newly appeared small retrocardiac atelectasis. Small bilateral pleural effusions might also have newly occurred. No overt pulmonary edema. Unchanged appearance of the cardiac silhouette and the mediastinum.


SubjectID: 14641655, StudyID: 58170127, Comparison: None

FINAL REPORT

HISTORY: Shortness of breath and cough.

FINDINGS: In comparison with the study of ___, there is increasing opacification at the left base posteriorly, bounded anteriorly by the major fissure, consistent with left lower lobe pneumonia. Continued enlargement of the cardiac silhouette without substantial vascular congestion. This raises the possibility of cardiomyopathy or pericardial effusion.

IMPRESSION: Left lower lobe pneumonia. Information has been telephoned to Dr. ___.


SubjectID: 14641655, StudyID: 51461179, Comparison: None

FINAL REPORT

HISTORY: Fluid overload.

FINDINGS: In comparison with the study of ___, the left basilar opacification is again seen. Again, this is consistent with lower lobe pneumonia, though there is no lateral view on which the process was best visualized. Substantial enlargement of the cardiac silhouette persists with mild if any elevation of pulmonary venous pressure. Again, this raises the possibility of cardiomyopathy or pericardial effusion.


SubjectID: 14642114, StudyID: 57076046, Comparison: None

FINAL REPORT

INDICATION: ___-year-old woman with congestive heart failure, CAD and CKD, now presents with lethargy and fever, to rule out pneumonia.

COMPARISON: Chest radiograph, ___. PORTABLE AP CHEST RADIOGRAPHS: Moderate cardiomegaly is unchanged since the prior study. The hilar and mediastinal contours are stable, with multiple mediastinal surgical clips indicating CABG. A right internal jugular approach dialysis catheter ends in the right atrium. A right chest wall pacer ICD device is seen with the leads in expected position of the right atrium and right ventricle. The right lower lung fields are obscured by the pacer. Mild pulmonary edema is present. No consolidation, pleural effusion or pneumothorax is seen.

IMPRESSION: Moderate cardiomegaly and mild pulmonary edema. No evidence of pneumonia.


SubjectID: 14642114, StudyID: 56011062, Comparison: same

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with Staph bacteremia, question of pulmonary source, interval change.

COMPARISON: ___.

FINDINGS: There is no new lung consolidation. Patient had prior sternotomy for CABG and moderate-to-severe cardiomegaly. Right-sided atrioventricular pacemaker and right-sided hemodialysis catheter are in adequate position. Pulmonary edema is severe and stable   Keywords: stable. There is no significant pleural effusion.

CONCLUSION: There is no significant change since prior exam   Keywords: no significant change. There is no new lung consolidation. Pulmonary edema is severe.


SubjectID: 14657829, StudyID: 59648980, Comparison: None

FINAL REPORT

INDICATION: Patient with chest pain at the site of left pigtail catheter site.

COMPARISONS: Chest radiographs of ___, ___, ___.

FINDINGS: Frontal and lateral views of the chest demonstrate low lung volumes. Moderate right pleural effusion has increased in size since prior. A small left pleural effusion is unchanged. Bibasilar opacities most likely represent atelectasis. Heart is moderately enlarged. Hilar and mediastinal silhouettes are unremarkable. Calcified atherosclerotic disease at the arch is noted. There is no pulmonary edema. Partially imaged upper abdomen is unremarkable.

IMPRESSION: Right pleural effusion, increased in size since ___ exam. Small left pleural effusion and moderate cardiomegaly is stable.


SubjectID: 14657829, StudyID: 56032756, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: Chest AP portable single view.

INDICATION: ___-year-old female patient with pleural effusion, status post Pleurx catheter placement on the left side, evaluate for possible pneumothorax.

FINDINGS: AP single view of the chest has been obtained with patient in semi-upright position. Comparison is made with the next preceding PA and lateral chest examination of ___. AP single view of the chest has been obtained with patient in semi-upright position. Comparison is made with the next preceding PA and lateral chest examination of ___. During the interval, a left-sided small-caliber tube was placed on the left base entering lower lateral chest wall and progressing along the diaphragmatic contour towards the midline. Special high-contrast copy illustrates this finding in spite of the general increased basal soft tissue densities related to patient's sitting position. In comparison with the previous study, the amount of pleural density has decreased, indicating successful drainage. There is no evidence of pneumothorax in the apical area of the lungs. The previously present cardiomegaly persists and the pulmonary vascular pattern is compatible with chronic congestion. No new discrete parenchymal infiltrates can be identified.


SubjectID: 14657829, StudyID: 58075686, Comparison: None

FINAL REPORT

HISTORY: Left ventricular failure and diabetes with chest pain and possible worsening edema and effusion.

FINDINGS: In comparison with study of ___, there are continued large left and small right pleural effusions with mild vascular congestion in a patient with moderate cardiomegaly. The retrocardiac area cannot be properly evaluated in the absence of a lateral view.


SubjectID: 14657829, StudyID: 57206941, Comparison: None

FINAL REPORT

INDICATION: Shortness of breath and weight gain, evaluate for acute process.

COMPARISON: Chest radiograph from ___.

FINDINGS: PA and lateral views of the chest. The moderate-to-large left pleural effusion has increased. The small right pleural effusion is either unchanged or increased. There is mild pulmonary vascular congestion. Moderate cardiomegaly is likely unchanged. The mediastinal and hilar contours are stable. Underlying left lower lobe or right lower lobe opacity representing pneumonia cannot be ruled out.

IMPRESSION: 1. Increased moderate-to-large left pleural effusion and small right pleural effusion. 2. Left lower lobe or right lower lobe pneumonia cannot be ruled out.


SubjectID: 14657829, StudyID: 50337548, Comparison: same

WET READ: ___ ___ 9:00 PM L basilar chest tube w/ dec L effusion (now small), no PTX. Small R effusion. Unchanged mod cardiomegaly, venous congestion, and interstitial edema. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

TECHNIQUE: Portable erect chest view was read in comparison with prior chest radiograph from ___.

FINDINGS: Following left chest tube drain catheter, moderate left pleural effusion has substantially resolved. Small residual left pleural effusion persists. Mild-to-moderate right pleural effusion is unchanged. Heart size is mildly enlarged and stable. Mediastinal and hilar contours are normal. There are no new lung opacities of concern   Keywords: new.

IMPRESSION: Following left catheter placement, moderate left pleural effusion has substantially reduced, minimal residual effusion persist. Mild-to-moderate right pleural effusion and mildly enlarged heart size are unchanged.


SubjectID: 14657829, StudyID: 50295143, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH.

TECHNIQUE: PA and lateral chest views were reviewed in comparison with prior chest radiograph from ___.

FINDINGS: Moderate-to-large left pleural effusion and mild-to-moderate at right pleural effusions associated with adjacent lung atelectasis are unchanged. Mild pulmonary vascular congestion is similar   Keywords: similar. Moderate cardiomegaly is unchanged.

IMPRESSION: Moderate cardiomegaly, moderate-to-large left and mild-to-moderate right-sided pleural effusions and Mild pulmonary vascular congestion is unchanged   Keywords: unchanged.


SubjectID: 14657829, StudyID: 56583936, Comparison: None

FINAL REPORT

INDICATION: Pleural effusion. Please evaluate.

COMPARISON: Comparison is made to chest radiograph performed ___.

FINDINGS: Chest PA and lateral radiograph redemonstrates a large left pleural effusion, slightly decreased in size compared to prior study. The previously noted left lower lobe consolidation partially obscured by effusion is no longer apparent on current study. Mediastinal and hilar contours are unremarkable. Stable moderate cardiomegaly noted. No pneumothorax evident.

IMPRESSION: Slightly decreased large left pleural effusion.


SubjectID: 14657829, StudyID: 50671582, Comparison: None

FINAL REPORT

INDICATION: Left-sided pleural effusion status post thoracentesis.

COMPARISON: Radiographs available from ___ through ___ at 11:51 a.m. FRONTAL CHEST RADIOGRAPH: Since the 11:51 a.m. examination there has been interval near-complete drainage of a large left pleural effusion. No underlying consolidation is seen. The heart is moderately enlarged. There is no pneumothorax. Mild interstitial edema is unchanged. A small right pleural effusions is present.

IMPRESSION: Post drainage of large left pleural effusion. No pneumothorax.


SubjectID: 14677586, StudyID: 59976230, Comparison: None

WET READ: ___ ___ ___ 8:40 AM Swan-Ganz catheter is wedged in the right pulmonary arteries extending approximately 1 cm beyond the right hilar border. This should not be advanced any further. Left PICC line terminates in the mid SVC. Intra-aortic balloon pump terminates 3.5 cm from the superior aspect of the aortic arch and may be advanced 1-2 cm. There is no pneumothorax. Lung volumes remain low.

WET READ VERSION #___ ___ ___ 11:57 PM Swan-Ganz catheter is wedged in the right pulmonary arteries extending approximately 1 cm beyond the right hilar border. This should not be advanced any further. Left PICC line terminates in the mid SVC. Intra-aortic balloon pump terminates 3.5 cm from the superior aspect of the aortic arch and may be advanced 1-2 cm. There is no pneumothorax. Lung volumes remain low. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p swan placement // eval for line placement

TECHNIQUE: Chest single view

COMPARISON: ___ at ___

IMPRESSION: Swan-Ganz catheter is in the right main pulmonary artery. This should not be advanced any further. Left PICC line terminates in the mid SVC. Intra-aortic balloon pump terminates 3.5 cm from the superior aspect of the aortic arch and may be advanced 1-2 cm. There is no pneumothorax. Lung volumes remain low.


SubjectID: 14677586, StudyID: 50937550, Comparison: None

FINAL REPORT

EXAMINATION: Portable CXR

INDICATION: ___ year old woman s/p R AKA. Admitted with L PICC line, please confirm tip placement. // PICC line placement

TECHNIQUE: Portable CXR

COMPARISON: CXR ___

FINDINGS: Since the prior CXR, there has been interval resolution of large right pleural effusion. Small left effusion is stable. No pneumothorax or pulmonary edema. There is engorgement of the AP window, which is due to a large pulmonary artery and mediastinal lymphadenopathy; these findings are better demonstrated on CT chest ___.Stable mild/moderate cardiomegaly. Left PICC line terminates in the right atrium.

IMPRESSION: 1. Left PICC line is in the right atrium. Retracting it by 2cm would place the tip in the lower SVC. 2. Interval resolution of large right effusion. Stable small left effusion.


SubjectID: 14677586, StudyID: 58828953, Comparison: worse

FINAL REPORT

HISTORY: Shortness of breath.

FINDINGS: In comparison with the study of ___, the cardiac silhouette again is enlarged and there is evidence of pulmonary vascular congestion that may be increased from the previous study   Keywords: increase. Midline sternal wires are unchanged. Blunting of the left costophrenic angle is again noted.


SubjectID: 14677586, StudyID: 52764995, Comparison: worse

FINAL REPORT

INDICATION: ___ year old woman with shortness of breath, evaluate for pulmonary edema appear

TECHNIQUE: Portable chest radiograph.

COMPARISON: Chest radiographs from ___ through ___.

FINDINGS: Since prior, there has been slight worsening of vascular engorgement   Keywords: worse. Cardiac silhouette is stably enlarged. Blunting of the left costophrenic angle likely represents a small effusion. There is no pneumothorax. There is an abnormal bulging contour of the AP window new from ___. Left PICC ends in the low SVC.

IMPRESSION: 1. Mild worsening of pulmonary vascular engorgement   Keywords: worse. 2. Abnormal bulging contour at the AP window is new from ___, may represent acute aortic syndrome, a chest CT can be obtained for further evaluation.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 1:29 PM, 60 minutes after discovery of the findings.


SubjectID: 14677586, StudyID: 56518483, Comparison: None

WET READ: ___ ___ 12:42 AM No change from prior. No pneumothorax.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

HISTORY: Failed central line attempt, to assess for pneumothorax.

FINDINGS: In comparison with study of ___, there is little change in the appearance of the heart and lungs. Specifically, there is no evidence of pneumothorax after attempted central catheter placement.


SubjectID: 14677586, StudyID: 54040640, Comparison: None

FINAL REPORT

CLINICAL

INDICATION: Dyspnea and chills. Evaluate for pneumonia.

COMPARISON: Multiple prior chest radiographs, the most recent of ___. UPRIGHT FRONTAL VIEW OF THE CHEST: The patient is status post median sternotomy. The lung volumes are low, which causes crowding of the bronchovascular markings. The lungs are clear without focal consolidation, pleural effusion, or pneumothorax. Left pleural thickening and calcification is unchanged. The heart size is top normal. There is no pulmonary edema. There is no free air beneath the right hemidiaphragm.

IMPRESSION: No pneumonia.


SubjectID: 14679533, StudyID: 58242624, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: ICD, lead placement, evaluation for pleural effusions.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the external pacemaker lead that the patient has recently received is in unchanged position. Also unchanged is the left chest tube. The blunting of the left costophrenic sinus is less severe than on the previous image, this is likely reflecting a decrease in extent of pleural effusion. Mild cardiomegaly persists. No pneumonia, no pulmonary edema.


SubjectID: 14679533, StudyID: 56466580, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Epicardial pacemaker, questionable pneumothorax.

COMPARISON: Pre-interventional chest radiograph from ___.

FINDINGS: As compared to the previous radiograph, the patient has received an epicardial pacemaker. There is a left chest tube in situ. No pneumothorax is observed. Unchanged size of the cardiac silhouette. Overall, decreased lung volumes. No acute pulmonary edema. No pneumonia, no pleural effusions.


SubjectID: 14690648, StudyID: 59559032, Comparison: None

FINAL REPORT

CLINICAL

HISTORY: Acute dyspnea and hypoxia, history of COPD and CHF. CHEST, PA

COMPARISON: ___ at ___. Compared to the prior chest x-ray, there has been a marked increase in density, particularly on the right lung indicating acute cardiac failure.

IMPRESSION: Acute cardiac failure.


SubjectID: 14690648, StudyID: 56335795, Comparison: None

FINAL REPORT

CLINICAL

HISTORY: Status post intubation, check tube placement. The tip of the endotracheal tube lies 2.5 cm from the carinal angle and should be withdrawn to a better position. The degree of cardiac failure is essentially unchanged since the prior chest x-ray.

IMPRESSION: Endotracheal tube should be withdrawn to a better position.


SubjectID: 14690648, StudyID: 55030320, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Acute hypoxemic respiratory failure, evaluation for changes.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the tip of the endotracheal tube projects over the same level than on the previous image. There is moderate cardiomegaly, tortuosity of the thoracic aorta and areas of atelectasis at the lung bases. No overt pulmonary edema is present. No larger pleural effusions. No pneumothorax.


SubjectID: 14690648, StudyID: 54582649, Comparison: None

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Dyspnea on exertion after transfusion.

COMPARISONS: ___.

TECHNIQUE: Chest, AP view.

FINDINGS: The heart is mild to moderately enlarged. The aortic arch is calcified. Mild perihilar fullness and upper zone redistribution of pulmonary vascularity suggests pulmonary venous hypertension without frank pulmonary edema. Projecting over the right mid-to-lower lung is a nodular focus, probably a nipple shadow, not discernable on the prior study. Relative increased density projecting over the left retrocardiac area is probably due to soft tissue attenuation. There is no pleural effusion or pneumothorax.

IMPRESSION: Findings suggesting pulmonary venous hypertension without clear edema. Nodular focus projecting over the right mid lung, probably a nipple shadow. However, when clinically appropriate, confirmation using a repeat view with nipple markers is recommended.


SubjectID: 14690648, StudyID: 51139729, Comparison: None

FINAL REPORT

CLINICAL

HISTORY: Hypoxia, intubated and sedated with endotracheal tube. CHEST: The endotracheal tube lies 3.1 cm from the carinal angle. The position of the nasogastric tube cannot be determined. It can be seen as far as the middle esophagus, but I expect it extends further. Atelectasis in both lungs is present. The opacities present on the prior chest x-ray of ___ are significantly better.

IMPRESSION: Endotracheal tube in better position, clearing of right lung infiltrates.


SubjectID: 14690648, StudyID: 58406109, Comparison: None

FINAL REPORT

PORTABLE CHEST DATED ___

COMPARISON: ___ radiograph.

FINDINGS: Cardiac silhouette is enlarged and is accompanied by pulmonary vascular congestion and apparent area of asymmetrical edema in the right perihilar region. Differential diagnosis includes localized aspiration or early, developing pneumonia. Exam is otherwise remarkable for incidental calcified granulomas in the left lung and a small right pleural effusion.


SubjectID: 14710096, StudyID: 58981519, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with s/p AVR/MVr // eval postop changes

TECHNIQUE: PA and lateral chest radiographs

COMPARISON: ___

FINDINGS: Single lead pacemaker is unchanged. Left lower lobe collapse and small left pleural effusion are persistent. New subtle opacity at the right lung base may simply represent atelectasis. Small right pleural effusion. No pneumothorax. Stable post operative widening of the cardiac silhouette.

IMPRESSION: Unchanged left lower lobe collapse and left pleural effusion. New right basilar atelectasis and right pleural effusion.


SubjectID: 14710096, StudyID: 56509806, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with avr/mvrep // s/p ct d/c, r/o ptx

TECHNIQUE: Portable AP

COMPARISON: ___

FINDINGS: The chest tubes, Swan-Ganz catheter, nasogastric and endotracheal tubes have been removed. Stable position of the single lead pacemaker in the right ventricle. New left lower lobe and lingular opacity likely atelectasis. There is a new small left pleural effusion. The cardiac silhouette is enlarged. No interstitial pulmonary edema. No pneumothorax.

IMPRESSION: No pneumothorax. New left basal opacity and small pleural effusion.


SubjectID: 14710096, StudyID: 52233935, Comparison: None

FINAL REPORT

INDICATION: ___F with resp distress // r/o cardiopulm process

TECHNIQUE: Single portable view of the chest.

COMPARISON: ___

FINDINGS: Diffusely abnormal appearance of the lungs is again noted. Bilateral perihilar parenchymal opacities with more dense right upper lobe consolidation is noted. Blunting of the costophrenic angle suggests superimposed effusions. Mild cardiac enlargement and atherosclerotic calcifications of the arch are again noted. New left wall single lead pacing device seen with lead tip projecting over the right ventricle. Surgical clips in the right upper quadrant suggest prior cholecystectomy.

IMPRESSION: Bilateral parenchymal opacities potentially due to multi focal pneumonia and possible superimposed edema with effusions. Followup will be necessary after treatment.


SubjectID: 14710096, StudyID: 50956059, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with dyspnea, transfer from OSH for CHF vs ?ptx. No ptx on repeat scan here. + pulm edema and R lung consolidation. // pulm edema, consolidation change, pneumothorax, interval change pulm edema, consolidation change, pneumothorax, interval cha

IMPRESSION: In comparison with the study of ___, there has been substantial decrease in the diffuse bilateral pulmonary opacifications, most likely reflecting some decrease in pulmonary edema with continued multifocal pneumonia   Keywords: decrease. Pacer lead is unchanged.


SubjectID: 14717765, StudyID: 52499511, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with alcoholism, leg edema // evaluate interval changes

IMPRESSION: As compared to ___ chest radiograph, interval increase in pulmonary vascular congestion accompanied by interstitial edema   Keywords: increase. Development of a more confluent opacity in the right infrahilar region, which could be due to asymmetrical edema or a secondary process such as aspiration or developing infectious pneumonia. Small right pleural effusion is also demonstrated.


SubjectID: 14717765, StudyID: 51785065, Comparison: None

FINAL REPORT

INDICATION: Status post fall. Evaluate pneumothorax.

TECHNIQUE: Single AP supine view of the chest.

COMPARISON: Chest radiograph from ___.

FINDINGS: The trauma board somewhat obscures fine detail at the bases. Within the limitations, there is no focal consolidation. There is mild pulmonary edema. There are also emphysematous changes. There is no pleural effusion or pneumothorax. Allowing for positioning, the cardiomediastinal silhouette is normal. No fracture is identified on this limited supine view.

IMPRESSION: Emphysema and mild pulmonary edema. No evidence of a traumatic injury.


SubjectID: 14717859, StudyID: 56608146, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female with history of weakness and fatigue. STUDY: PA and lateral chest radiograph.

COMPARISON: none.

FINDINGS: The heart and mediastinal contours are within normal limits. There is nodular prominence of the right hilus which may represent engorgement of central pulmonary vessels. The lungs demonstrate diffuse edema with nodular opacities representing over the upper thoracic spine on lateral view as well as in the mid-to-lower right lateral lung. There is a trace right and small left pleural effusion. There is no pneumothorax.

IMPRESSION: Pulmonary edema with bilateral pleural effusions; prominent right hilus may represent engorged vasculature, but nodular opacities within the lung warrant chest CT after diuresis to assess the nodular opacities and right hilus.


SubjectID: 14718940, StudyID: 58993475, Comparison: better

FINAL REPORT

PORTABLE CHEST OF ___

COMPARISON: ___ radiograph.

FINDINGS: Persistent cardiomegaly accompanied by pulmonary vascular congestion and improving interstitial edema   Keywords: improving. Additional tubular-appearing opacity in right upper lobe may reflect prominent vasculature or an area of mucoid impaction. Attention to this region on followup PA and lateral radiograph would be helpful in this regard.


SubjectID: 14718940, StudyID: 58063981, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with dyspnea. Evaluate for pneumonia.

COMPARISON: ___.

TECHNIQUE: Frontal upright and lateral chest radiograph.

FINDINGS: There are bilateral diffuse interstitial thickening and upper vascular re-distribution compatible with interstitial edema. There are no focal opacities suggestive of pneumonia. Heart size is mildly enlarged, although assessment is limited in this AP projection. There is no pleural effusion or pneumothorax.

IMPRESSION: Interstitial pulmonary edema.


SubjectID: 14733367, StudyID: 53914361, Comparison: None

FINAL REPORT

STUDY: PA and lateral chest, ___. CLINICAL

HISTORY: ___-year-old man with congestive heart failure. Evaluate for pleural effusion or pneumonia.

FINDINGS: Comparison is made to the previous study from ___. Heart size is enlarged. There is elevation of the right hemidiaphragm. There is again seen an area of consolidation within the right base and infrahilar region, suspicious for pneumonia. There is also a right-sided pleural effusion. There are also opacities within the left lower lobe which can also be seen with pneumonia or aspiration. Pulmonary vascular markings are relatively preserved without overt signs for pulmonary edema. There are no pneumothoraces.


SubjectID: 14733367, StudyID: 51483035, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old male with increasing lethargy. Rule out pneumonia.

COMPARISONS: Multiple prior chest radiographs, most recently ___ ___.

FINDINGS: Frontal and lateral views of the chest were obtained. The heart is moderately enlarged, similar to prior. There is calcification of the aortic knob. A right lung opacity silhouettes the right heart border. Opacity is also seen at the left lung base. There are new bilateral small pleural effusions. Osseous structures are unremarkable. No radiopaque foreign body.

IMPRESSION: Bilateral parenchymal opacities, most prominent at right middle lobe, with new bilateral pleural effusions, compatible with edema or multifocal infection   Keywords: new.


SubjectID: 14761733, StudyID: 59474248, Comparison: better

FINAL REPORT

INDICATION: ___-year-old woman with AFib and congestive heart failure, assess for improvement in pulmonary edema.

COMPARISONS: ___. AP and lateral radiographs of the chest were obtained. Pulmonary edema has improved if not completely resolved. Small-to-moderate right greater than left pleural effusions are unchanged. Cardiomegaly persists.

IMPRESSION: Improvement to resolution of pulmonary edema with persistent right greater than left pleural effusions   Keywords: improve.


SubjectID: 14761733, StudyID: 56495647, Comparison: None

FINAL REPORT

INDICATION: Dyspnea.

COMPARISON: Chest radiograph from ___.

FINDINGS: Evaluation is somewhat limited due to low lung volumes. However, there are bibasilar opacities, likely representing a combination of atelectasis and pleural effusions. Additionally, there are bilateral interstitial opacities raising suspicions for mild pulmonary edema. The visualized portions of the upper cardiomediastinal silhouettes are normal. Lower cardiomediastinal silhouette is severely limited on evaluation. There is a lucent focus adjacent to the lower right heart border which may be suggestive of a herniated loop of bowel. Severe kyphosis of the thoracic spine is noted.

IMPRESSION: 1. Limited study due to patient positioning and low lung volumes demonstrate evidence of mild pulmonary edema as well as bibasilar opacities suggestive of atelectasis and pleural effusions. Pneumonia must be excluded in the proper clinical setting. 2. Lucent focus adjacent to the right heart border may be representative of a herniated loop of bowel.


SubjectID: 14766138, StudyID: 59551408, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with parapneumonic effusion // s/p chest tube left

IMPRESSION: Since the prior radiograph of ___, a left pigtail pleural catheter has been placed with slight decrease in size of left pleural effusion. With persistent adjacent left retrocardiac atelectasis and or consolidation. Questionable tiny left apical pneumothorax.


SubjectID: 14766138, StudyID: 57554528, Comparison: None

FINAL REPORT

INDICATION: Chest pain, rule out acute process

TECHNIQUE: Chest PA and lateral

COMPARISON: Multiple prior chest radiographs with direct comparison made to study from ___.

FINDINGS: There has been interval increase in the left pleural effusion, now moderate in size. There is obscuration of the left hemidiaphragm which likely due to a combination of pleural effusion and compressive atelectasis, although developing consolidation cannot be excluded. The right lung is clear. The cardiomediastinal silhouette and hilar contours are stable. There is no pneumothorax.

IMPRESSION: Interval increase in left pleural effusion, now moderate with likely compressive atelectasis, although a developing consolidation cannot be excluded at the left lung base.


SubjectID: 14766138, StudyID: 53078358, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with chest tube // eval for placement

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Left pigtail catheter is in place. No pneumothorax is seen. Left basal consolidation appears to be slightly improved in the interim most likely due to combination of decrease in pleural effusion and atelectasis.


SubjectID: 14766138, StudyID: 51446303, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old lady with HIV on HAART, HCV, ESRD on HD (___), and multiple myeloma who presents with left-sided chest pain with chest tube placed on ___ by IP // Please assess for interval change, position of chest tube, any evidence of worsening pleural effusion.

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The pleural fluid on the left has minimally increased in extent, the lung volumes are lower, likely caused by a lesser inspiratory effort. Subsequent crowding of the vascular and bronchial structures at both lung bases. No pneumothorax. Borderline size of the cardiac silhouette. No overt pulmonary edema. The position of the left pigtail catheter is constant.


SubjectID: 14766138, StudyID: 59533605, Comparison: None

WET READ: ___ ___ ___ 9:22 AM Left-sided pleural effusion may be minimally decreased in size from the prior examination done on ___. No other significant change from the prior exam.

WET READ VERSION #___ ___ ___ ___ 10:00 PM Left-sided pleural effusion may be minimally decreased in size from the prior examination done on ___. No other significant change from the prior exam. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with chest tube for parapneumonic effusion // interval change and tube placement

COMPARISON: ___

IMPRESSION: Unchanged position of the left chest tube. No pneumothorax. Minimal decrease of the left pleural fluid collection. Subsequent areas of left basilar atelectasis are constant. Unchanged appearance of the right lung and of the cardiac silhouette.


SubjectID: 14766138, StudyID: 58208666, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old lady with HIV on HAART, HCV, ESRD on HD (___), and multiple myeloma who presents with left-sided chest pain with chest tube placed on ___ by IP and 600cc of fluid drained. // Please assess for interval change in pleural effusion and chest tube placement.

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The extent of the right fluid collection, the subsequent areas of left basilar atelectasis and the position of the left pigtail catheter are constant. Minimal atelectasis at the right lung bases. Otherwise unchanged right lung parenchyma. Unchanged size of the cardiac silhouette.


SubjectID: 14766138, StudyID: 50400525, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old lady with HIV on HAART, HCV, ESRD on HD (___), and multiple myeloma who presents with left-sided chest pain with chest tube placed on ___ by IP and 600cc of fluid drained. // Please assess for interval change.

COMPARISON: ___

IMPRESSION: No relevant change as compared to the previous image   Keywords: no relevant change. Unchanged position of the left pleural drain. Unchanged extent of the left pleural effusion. Constant appearance of the right lung.


SubjectID: 14766138, StudyID: 59183513, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with chest tube for parapneumonic effusion. // Assess for interval change and tube placement Assess for interval change and tube placement

IMPRESSION: In comparison with the study of ___, there has been substantial increase in the left pleural effusion common despite the presence of a pigtail catheter. The right lung remains essentially clear.


SubjectID: 14766138, StudyID: 56028134, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old lady with HIV on HAART, HCV, ESRD on HD (___), and multiple myeloma who presents with left-sided chest pain with chest tube placed on ___ by IP and 600cc of fluid drained. Pain completely relieved. // Please assess for chest tube positioning.

COMPARISON: Chest x-ray from ___ at 11:36

FINDINGS: Compared to the prior study, the overall appearance is similar. Again seen is a chest tube at the left lung base. Also again seen is a small to moderate left effusion with underlying collapse and/or consolidation, similar to the prior study. No pneumothorax is detected. Atelectasis at the right base and minimal blunting of the right costophrenic angle is essentially unchanged. Doubt overt CHF.

IMPRESSION: Doubt significant interval change compared with ___. The left chest tube position and left base effusion are similar.


SubjectID: 14766138, StudyID: 50927657, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with chest tube for parapneumonic effusion // interval changes interval changes

IMPRESSION: In comparison with the study of ___, there is little overall change   Keywords: little overall change. Left chest tube remains in place and there is little difference in the appearance of the extent and severity of the left pleural fluid collection with underlying atelectatic change. The right lung is essentially clear. Cardiomediastinal silhouette is also unchanged.


SubjectID: 14766138, StudyID: 50531444, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with chest tube for parapneumonic effusion. // Interval change and chest tube placement

COMPARISON: ___.

IMPRESSION: The left chest tube is in unchanged position. Unchanged extent and severity of the left pleural fluid collection and the subsequent left atelectasis. Minimally improved ventilation of the right lung. No evidence of pneumothorax. Unchanged size of the cardiac silhouette.


SubjectID: 14766138, StudyID: 54919097, Comparison: same

FINAL REPORT

HISTORY: Shortness of breath with history of congestive failure.

FINDINGS: In comparison with the study of ___, there is little overall change   Keywords: little overall change. The pulmonary vasculature is essentially within normal limits and there is little change in the cardiomediastinal silhouette. Hemodialysis catheter again extends to the right atrium. No acute focal pneumonia.


SubjectID: 14766138, StudyID: 53146201, Comparison: None

WET READ: ___ ___ 10:22 PM Interval improvement in the degree of the pulmonary edema. No new focal opacities are identified. No pneumothorax or pleural effusion. ______________________________________________________________________________

FINAL REPORT

HISTORY: Hemodialysis, to assess degree of congestion.

FINDINGS: In comparison with study of earlier in this date, there has been essentially complete clearing of the elevated pulmonary vascular pressure. Cardiac silhouette remains enlarged. Hemodialysis catheter is again seen. No evidence of acute pneumonia.


SubjectID: 14766138, StudyID: 54122824, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with cough

TECHNIQUE: Portable upright AP view of the chest

COMPARISON: ___

FINDINGS: Heart size is normal. The mediastinal and hilar contours are unchanged. Mild pulmonary vascular congestion is new in the interval   Keywords: new. Retrocardiac opacification may reflect atelectasis though infection or aspiration cannot be excluded. Patchy right basilar opacity may also reflect atelectasis. A trace left pleural effusion also appears new in the interval. No pneumothorax is identified. Clips from prior cholecystectomy are seen in the right upper quadrant of the abdomen. No acute osseous abnormality is visualized.

IMPRESSION: Mild pulmonary vascular congestion and new retrocardiac opacity, potentially atelectasis though infection or aspiration are not excluded   Keywords: new. Small left pleural effusion, also new in the interval.


SubjectID: 14766138, StudyID: 51636608, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with HIV, ESRD on HD, here with sepsis from bloodstream infection and pneumonia - has new anemia and very mild report of hemoptysis (not on exam), rule out pulmonary hemorrhage // eval for change in left-sided opacity, eval for evidence of pulmonary hemorrhage ___ year old woman with HIV (CD4>800), ESRD, here with sepsis and bactermia, now with hemoptysis

COMPARISON: Chest radiograph from ___.

IMPRESSION:. . Left lower lobe pneumonia with adjacent small left pleural effusion. Coexisting interstitial process probably reflects interstitial edema in the setting of end-stage renal disease.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 10:04 AM, 10 minutes after the images were reviewed.

FINDINGS: There is increased opacity in the left lower lung, concerning for pneumonia. There is mild interstitial abnormality probably due to pulmonary edema. Small left and trace right pleural effusion is seen. The previously seen right middle lung nodular opacity is not well visualized in the study. Heart size is top normal. Mediastinal and hilar contours are normal.


SubjectID: 14767827, StudyID: 57668633, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with small apical pneumothorax on R side after chest tube placement. // evaluate for interval change of pneumothorax. Please do at 6 AM on ___.

IMPRESSION: In comparison to ___, a a very small right apical pneumothorax is a persistent finding. Cardiomegaly is accompanied by pulmonary vascular congestion and new mild to moderate pulmonary edema, accompanied by enlarging moderate sized pleural effusions, right greater than left   Keywords: new.


SubjectID: 14767827, StudyID: 54488688, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with recent removal of chest tubes, prior read of possible apical PTX. // evaluate for PTX or accumulation of fluid.

TECHNIQUE: Portable

FINDINGS: As compared to chest radiograph from earlier today, bilateral chest tubes have been removed. Tiny right apical pneumothorax is unchanged. No left pneumothorax. Moderate left effusion and adjacent opacity unchanged. Minimal right effusion and adjacent atelectasis.

IMPRESSION: Tiny right apical pneumothorax unchanged. No visualized left pneumothorax.


SubjectID: 14767827, StudyID: 54076353, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with diastolic CHF, HTN, AFib, DM2, HCV cirrhosis, HCC s/p RFA without recurrence, breast cancer, with b/l chest tubes placed for effusions. // evaluate chest tube placement evaluate chest tube placement

IMPRESSION: Heart size and mediastinum are unchanged including mild cardiomegaly. Left basal consolidation has developed in the interim and might be consistent with developing infection. Right pigtail catheter is in place. Left pigtail catheter is in place. Despite is present there is increase in pleural effusion Small right apical pneumothorax is unchanged. Minimal left apical pneumothorax is potentially present although it is not certain.


SubjectID: 14767827, StudyID: 50969414, Comparison: None

WET READ: ___ ___ ___ 8:05 AM Stable tiny right apical pneumothorax.

WET READ VERSION #1 ___ ___ ___ 1:31 AM Stable tiny right apical pneumothorax. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with small apical pneumothorax on R side after chest tube placement. // evaluate pneumothorax for interval change, please do at 6PM on ___.

IMPRESSION: In comparison to recent radiograph from several hr earlier, a tiny right apical pneumothorax persists. With us the exception of slight improved aeration at the lung bases, there has not been a relevant change in the appearance of the chest since recent exam.


SubjectID: 14767827, StudyID: 51057206, Comparison: None

FINAL REPORT

INDICATION: ___F w worsening dyspnea, chest pain since d/c 3 weeks ago, ___ exercise tolerance

TECHNIQUE: AP and lateral views of the chest.

COMPARISON: ___ chest x-ray and ___ chest CT.

FINDINGS: There is a moderate to large left and small right pleural effusion. It has demonstrated interval enlargement of the left effusion when compared to previous exam. There is pulmonary vascular congestion. Enlarged right hilum is unchanged from prior CT. Cardiac silhouette cannot be assessed. Dense atherosclerotic calcifications noted in the thoracic aorta. No acute osseous abnormalities.

IMPRESSION: Bilateral pleural effusions larger on the left than on the right with interval slight enlargement on the left since last month's exam.


SubjectID: 14774414, StudyID: 59248607, Comparison: same

WET READ: ___ ___ ___ 7:21 PM No change from radiograph from earlier the same day. No pulmonary edema.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, shortness of breath, evaluation for pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Right PICC line and left pacemaker are in unchanged position. Unchanged alignment of sternal wires. The heart continues to be moderately enlarged, the aorta shows moderate tortuosity. Currently, there is no evidence of pulmonary edema, pneumonia, or pleural effusion.


SubjectID: 14774414, StudyID: 58231518, Comparison: same

FINAL REPORT

HISTORY: COPD, assess for interval change.

TECHNIQUE: Single AP, portable view of the chest with the patient in upright position.

COMPARISON: Comparison is made to radiographs dated ___, ___, and ___.

IMPRESSION: As compared to previous exams, there has been no significant interval change   Keywords: no significant interval change. A right PICC line and left pacemaker are in unchanged position. There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema identified. The patient is status post CABG with median sternotomy wires noted to be well aligned and intact. Stable mild cardiomegaly and aortic tortuosity are noted.


SubjectID: 14774414, StudyID: 56252858, Comparison: same

FINAL REPORT

HISTORY: CHF, assess interval change.

TECHNIQUE: Single, AP, portable view of the chest with the patient in a upright position.

COMPARISON: Comparison is made to radiographs dated ___.

FINDINGS: As compared to the prior exam dated ___, there has been no significant interval change   Keywords: no significant interval change. The right PICC line and left pacemaker are in unchanged positions. There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The patient is status post CABG with sternotomy wires aligned and intact. Stable, mild to moderate cardiomegaly and tortuosity of the aorta are noted. Mediastinal hilar contours are otherwise unchanged.


SubjectID: 14792425, StudyID: 59452399, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Acute heart failure.

COMPARISON: ___, 8:11 a.m.

FINDINGS: As compared to the previous radiograph, the Swan-Ganz catheter has been removed. The right venous introduction sheath is in unchanged position. There is unchanged massive cardiomegaly, with shape of the cardiac silhouette, potentially indicative of pericardial effusion. The bilateral overall subtle but diffuse parenchymal opacities, indicative of pulmonary edema, are without relevant change   Keywords: without relevant change. No pleural effusions. No evidence of parenchymal bleeding. Minimal atelectasis at the right lung base persists.


SubjectID: 14792425, StudyID: 55431772, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Cardiomegaly with a shape of the cardiac silhouette potentially suggestive of pericardial effusion. Ultrasonography is recommended. The signs of mild-to-moderate pulmonary edema are constant. Constant areas of atelectasis at both lung bases. No new parenchymal opacities   Keywords: new. No pneumothorax. No larger pleural effusions. The venous introduction sheath in the right internal jugular vein catheter is unchanged.


SubjectID: 14792425, StudyID: 54893052, Comparison: better

FINAL REPORT

PATIENT

HISTORY: ___ years old woman with congestive heart failure and Swan-Ganz catheter placement. Assess line placement and pulmonary edema.

COMPARISON: Exam is compared to chest x-ray of ___.

FINDINGS: New Swan-Ganz catheter has been placed with tip ending in right distal pulmonary artery. It should be withdrawn at least 7 cm. Right jugular catheter has been removed. Bilateral pulmonary edema has improved, now mild   Keywords: improve. Heart size is still severely enlarged. There is no pleural effusion or pneumothorax.

IMPRESSION: Interval improvement of bilateral pulmonary edema, now mild   Keywords: improve. Right jugular catheter has been replaced by Swan-Ganz catheter which ends in distal right pulmonary artery and should be withdrawn at least 7 cm. Findings were paged to Dr ___ at 11:56 am by Dr ___


SubjectID: 14792425, StudyID: 54032322, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Decompensated chronic heart failure.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Venous introduction sheath in the right internal jugular vein. Moderate cardiomegaly, minimal atelectasis at the right lung base, moderate atelectasis in the retrocardiac lung areas. Mild pulmonary edema. No pneumothorax.


SubjectID: 14792425, StudyID: 51391164, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Venous introduction device in the right internal jugular vein. Low lung volumes. Cardiomegaly with retrocardiac atelectasis. Mild right lower lung atelectasis. Moderate pulmonary edema. No pneumothorax.


SubjectID: 14796314, StudyID: 58140031, Comparison: worse

FINAL REPORT

REASON FOR EXAM: ___ years old man with new ET tube placement.

COMPARISON: Exam is compared to chest x-ray of the same day at 11:13 a.m.

FINDINGS: New ET tube has been placed with tip ending at 3.5 cm from carina. Right IJ catheter is unchanged with tip ending in upper SVC. Bilateral multifocal opacity related to known pneumonia are unchanged, but with mild increase of pulmonary edema   Keywords: increase. There is no pneumothorax. Heart size still mildly enlarged.


SubjectID: 14796314, StudyID: 57442613, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Respiratory failure, likely pneumonia, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the lung volumes have increased, potentially as a result from increased ventilatory pressures. As a consequence, the parenchymal opacities are less widespread and minimally less severe   Keywords: less severe. Unchanged monitoring and support devices. Unchanged appearance of the cardiac silhouette. No pneumothorax.


SubjectID: 14796314, StudyID: 56904286, Comparison: None

FINAL REPORT

REASON FOR THE EXAM: ___ years old man with NG tube placement, please assess for NG tube.

COMPARISON: Exam is compared to chest x-ray of the same day at 1:20 p.m.

FINDINGS: AP single view portable chest x-ray show stable right IJ and ET tube devices unchanged in position since chest x-ray of 1:20 p.m. The NG tube is not visualized, probably coiling in the upper esophagus or in the mouth of the patient. The exam is otherwise unchanged since prior with multifocal pneumonia and mild pulmonary edema. Findings were reported to nursing care at 4:20 p.m. and paged to Dr ___ ___ by Dr. ___.


SubjectID: 14796314, StudyID: 52612855, Comparison: better

FINAL REPORT

REASON FOR THE EXAM: ___ years old man with fever and shortness of breath. Assess for pneumonia or pulmonary edema.

COMPARISON: Exam is compared to chest x-ray of ___.

FINDINGS: AP portable single view chest x-ray in upright position shows normal volume with stable bilateral patchy opacities already characterized in chest CT of ___ as multifocal pneumonia. Minimal improvement of left lung base opacity is likely due to reduced atelectasis but stable small pleural effusion. Mild pulmonary edema and central vein distention has improved   Keywords: improve. There is no pneumothorax.

IMPRESSION: Minimal improvement of pulmonary edema and central vein distention with stable bilateral multifocal opacity already characterized as multifocal pneumonia   Keywords: improve.


SubjectID: 14798385, StudyID: 57436549, Comparison: None

FINAL REPORT

CLINICAL

HISTORY: ___-year-old woman with dyspnea, lower extremity edema and anemia. Evaluate for congestive heart failure.

COMPARISON: No relevant comparisons available.

FINDINGS: A frontal upright view of the chest was obtained portably. Bibasilar opacities likely reflect a combination of pleural effusions and atelectasis. Pulmonary vasculature is enlarged, predominantly in the perihilar regions, in the setting of cardiomegaly. The upper lung zones are clear. No pneumothorax. Mediastinal silhouette is within normal limits. Degenerative change is seen at the right acromioclavicular joint.

IMPRESSION: Findings compatible with mild congestive heart failure.


SubjectID: 14798598, StudyID: 57971777, Comparison: None

FINAL REPORT

INDICATION: ___M with sob // effusion?

TECHNIQUE: PA and lateral views of the chest.

COMPARISON: ___.

FINDINGS: Moderate right-sided pleural effusion is seen, larger when compared to prior and likely partially loculated laterally. Associated atelectasis is noted at the right lung base. The left lung is clear, there is no effusion. The cardiomediastinal silhouette is stable. No acute osseous abnormalities.

IMPRESSION: Right-sided pleural effusion has increased in size and is likely partially loculated laterally.


SubjectID: 14798598, StudyID: 52112755, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with dyspnea, volum eoverload // interval resolution

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: Moderate cardiomegaly is a stable. Large right pleural effusion is stable. There is no evident pneumothorax. There is probably small left effusion. Vascular congestion has resolved   Keywords: resolve.

IMPRESSION: Stable loculated right pleural effusion. Resolved vascular congestion   Keywords: resolve


SubjectID: 14798598, StudyID: 57591524, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with R pleural effusion, s/p ___ ___ and pigtail aplcement // !!!!!please obtain at ___ am ___ please eval interval change pleural effusion!!!!! PLEASE DO AT 5 AM ___

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, there is a minimal increase in extent of the known right pleural effusion. Otherwise the radiograph is unchanged. Normal left lung. Moderate cardiomegaly.


SubjectID: 14798598, StudyID: 55516445, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with likely fluid overload, known ESRD, new hypoxia // r/o pulm edema, pna. please perform 200 pm (patient will be back on floor then from HD) r/o pulm edema, pna. please perform 200 pm (patient will b

IMPRESSION: In comparison with these study of ___, there is again enlargement of the cardiac silhouette with unchanged pulmonary vascular congestion and continued right pleural effusion with compressive basilar atelectasis   Keywords: continue, unchanged. Overall, little change   Keywords: little change.


SubjectID: 14798598, StudyID: 50983321, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with massive right effusion s/p pigtail placement // ? PTX ? PTX

IMPRESSION: In comparison with the study of ___, there has been removal of a moderate amount of free pleural fluid from the right hemithorax. Specifically, there is no evidence of appreciable pneumothorax. Otherwise little change   Keywords: little change.


SubjectID: 14798598, StudyID: 51450653, Comparison: None

FINAL REPORT

INDICATION: ___M ESRD on dialysis with SOB and evidence of fluid overload // please evaluate for pulmonary edema, effusion

TECHNIQUE: PA and lateral views of the chest

COMPARISON: ___

FINDINGS: There is interval development of a moderate-sized right pleural effusion and associated atelectasis at the right base. The left lung is clear. There is no overt pulmonary edema. The cardiac silhouette is partially obscured and difficult to evaluate. The mediastinal contour is otherwise unremarkable. There is no pneumothorax. Bones and the upper abdomen are grossly unremarkable.

IMPRESSION: Moderate size right pleural effusion and associated atelectasis. Superimposed consolidation cannot be excluded.


SubjectID: 14832062, StudyID: 59405663, Comparison: better

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Renal insufficiency, shortness of breath, hyponatremia and worsening renal failure.

COMPARISONS: None.

TECHNIQUE: Chest, PA and lateral.

FINDINGS: The heart is borderline enlarged. Allowing for technique, the mediastinal contours are within normal limits. There is a moderate interstitial abnormality suggesting pulmonary edema with small suspected pleural effusions, better suggested on the lateral view   Keywords: better. There is no pneumothorax. Superimposed are streaky opacities in the left mid lung, possibly coinciding atelectasis. Fissures are mildly thickened.

IMPRESSION: Findings most consistent with a mild-to-moderate pulmonary edema.


SubjectID: 14832062, StudyID: 51789425, Comparison: 1.0

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with pulmonary edema, interval change.

COMPARISON: ___.

FINDINGS: Moderate interstitial edema has worsened and is now moderate to severe   Keywords: worse. There is one focal area more confluent in right upper lobe. It could still be asymmetric edema, but close followup to this area is suggested to rule out developing pneumonia   Keywords: still. Bilateral small pleural effusions with atelectasis have either worsened or are new. Cardiac contour is moderately enlarged.

CONCLUSION: 1. Worsening of moderate to severe pulmonary edema   Keywords: worse. 2. Right upper lobe confluent opacification could still represent asymmetric pulmonary edema; however, close attention to this area in followup is suggested to rule out developing pneumonia   Keywords: still.


SubjectID: 14838068, StudyID: 57419371, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)

INDICATION: ___ year old woman with tachypnea, rales at bases. // Evaluate for pulmonary edema, any infiltrate/effusion?

COMPARISON: Chest radiographs since ___, most recently ___.

IMPRESSION: If edema was present previously it has improved   Keywords: improve. There is still substantial heterogeneous consolidation in the left lung and perhaps some of the right base due to either the asymmetric residual of edema or multi focal pneumonia. The heart is normal size. Pleural effusion is small on the right if any. No pneumothorax.


SubjectID: 14838068, StudyID: 52155075, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with tachypnea. // Evalaute for pulmonary edema, effusion?

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Cardiomegaly is unchanged as well as dilated mediastinum. Vascular upper zone re- distribution is noted, minimally different from the previous study. Bronchiectasis are bilateral in the lower lobes, unchanged. Overall no substantial change since previous examination demonstrated and no interval development of pulmonary edema seen   Keywords: development.


SubjectID: 14838068, StudyID: 52999816, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old female who was found down and hypoxia. Evaluate for acute process.

TECHNIQUE: Frontal radiograph of the chest was obtained.

COMPARISON: Chest CT from ___.

FINDINGS: The heart is moderately enlarged and there is pulmonary vascular redistribution that is increased compared to the prior study there is also patchy alveolar infiltrate in the right lower lobe that is increased. This is on the background of increased interstitial markings as seen on the prior CT   Keywords: increase

IMPRESSION: 1. Increased fluid overload   Keywords: increase.


SubjectID: 14838068, StudyID: 51359537, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with dypsnea // eval for interval change in pulmonary edema vs PNA, please perform at 7am

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: There has been interval increase in the right lower lobe infiltrate and also an increase in the volume loss in the right lower lobe. Left lower lobe also demonstrates increased alveolar infiltrate the cardiac silhouette sent chain

IMPRESSION: Increased bilateral lower lobe infiltrates.


SubjectID: 14838068, StudyID: 50845832, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (AP AND LATERAL)

INDICATION: History: ___F with shortness of breath

TECHNIQUE: Upright AP and lateral views of the chest

COMPARISON: Chest CTA ___ and chest radiograph ___

FINDINGS: Moderate enlargement of the cardiac silhouette is increased compared to the previous study. The aorta remains tortuous and calcified. There is no pulmonary edema. Lungs remain hyperinflated. Diffuse bronchiectasis is most pronounced in the lung bases with bronchial wall thickening re- demonstrated. No new focal consolidation, pleural effusion or pneumothorax is present. There are mild degenerative changes noted in the thoracic spine.

IMPRESSION: Moderate cardiac enlargement, increased compared to the previous study. Diffuse bronchiectasis, most severe in the lung bases, but not substantially changed in the interval.


SubjectID: 14841017, StudyID: 59405220, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___M with dyspnea

TECHNIQUE: Chest PA and lateral

COMPARISON: ___

FINDINGS: Patient is status post median sternotomy, CABG, and aortic valve replacement. Heart size remains mildly enlarged. Mediastinal and hilar contours are unchanged. Pulmonary vasculature is not engorged. Small bilateral pleural effusions are present, increased in size on the left, and similar in size on the right. Patchy opacities in the lung bases likely reflect areas of compressive atelectasis. Previously demonstrated left apical pneumothorax appears resolved. There are no acute osseous abnormalities.

IMPRESSION: Small bilateral pleural effusions, increased in size on the left, and unchanged on the right, with bibasilar atelectasis.


SubjectID: 14841017, StudyID: 50325506, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with s/p AVR/CABG/PFO closure // eval left pl.effusion

COMPARISON: ___.

IMPRESSION: No relevant change as compared to the previous image   Keywords: no relevant change. Minimal decrease of the bilateral pleural effusions with minimal improvement of the right basal lung ventilation. No pulmonary edema. Borderline size of the heart. Sternal wires are in unchanged position.


SubjectID: 14841017, StudyID: 53149596, Comparison: None

WET READ: ___ ___ ___ 9:47 AM 1. Interval removal of a left chest tube. No pneumothorax. 2. Improved aeration of the left lung base. 3. Likely trace right pleural effusion.

WET READ VERSION #1 ___ ___ 11:54 PM 1. Interval removal of a left chest tube. No pneumothorax. 2. Improved aeration of the left lung base. 3. Likely trace right pleural effusion. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___ year old man s/p CABG, AVR // predischarge eval, follow up for pneumothorax s/p CT removal

TECHNIQUE: Chest PA and lateral

COMPARISON: ___

FINDINGS: The chest tube has been removed. There is a trace left apical pneumothorax. There are small bilateral pleural effusions. The heart is enlarged. Median sternotomy wires are intact.

IMPRESSION: 1. Trace left apical pneumothorax. 2. Small bilateral pleural effusions.

NOTIFICATION: Findings discussed with ___ on ___ @ 9:50 am.


SubjectID: 14841017, StudyID: 52798151, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man POD___ s/p tissue AVR, CABG, now s/p CT clamping, evaluate for pneumothorax.

COMPARISON: Chest radiograph ___.

FINDINGS: AP view of the chest provided. Right sided pleural catheter has been removed. There is no pneumothorax. Lung volumes are low. There is interval increase in right pleural effusion,accompanied by atelectatic changes. Heart size is stably enlarged. Mediastinal drains are in unchanged positions. Endotracheal tube and swan ___ catheter have been removed.

IMPRESSION: No pneumothorax.


SubjectID: 14851458, StudyID: 59746828, Comparison: None

FINAL REPORT

STUDY: Chest radiograph.

INDICATION: Status post cardiac surgery. Evaluate for pneumothorax post-removal of chest tube. REPORT: The patient is status post median sternotomy. Abdominal epicardiac pacing leads are seen. A prosthetic valve is also identified. There is a right-sided central line in good position. There is some expected blunting of the left costophrenic sulcus with a small effusion and perhaps minimal increased density in the right lower lung zone. There is no evidence of pneumothorax.

CONCLUSION: No pneumothorax.


SubjectID: 14851458, StudyID: 51415155, Comparison: None

FINAL REPORT

INDICATION: Patient status post line change.

COMPARISONS: ___.

FINDINGS: Right internal jugular central venous catheter projects over mid SVC. There is no pneumothorax. Lung volumes remain low. There is blunting of the left costophrenic angle suggestive of pleural effusion. Trace right pleural effusion is likely. Perihilar vascular congestion is noted. Bibasilar opacities may represent atelectasis. The hilar and mediastinal silhouettes are unchanged. The heart is mildly enlarged. Partially imaged upper abdomen is unremarkable. Patient is status post medial sternotomy. Curvilinear densities projecting over the patient's mid abdomen are likely external to the patient.

IMPRESSION: Right internal jugular central venous catheter projects over mid SVC. No pneumothorax.


SubjectID: 14851532, StudyID: 59956491, Comparison: None

WET READ: ___ ___ ___ 8:24 AM 1. Hypoinflated lungs with stable mild pulmonary edema.

WET READ VERSION #1 ___ ___ ___ 10:20 PM 1. Hypoinflated lungs with stable mild pulmonary edema. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M s/p PEA and now s/p extubation w/tachypnea // interval changes interval changes

IMPRESSION: In comparison with the study of earlier in this date, the endotracheal tube has been removed, as has the nasogastric tube. Continued enlargement of the cardiac silhouette with some element of elevated pulmonary venous pressure. Opacification at the right base is consistent with collapse in the right middle and lower lobe with possible pleural effusion. Less prominent left basilar opacification is consistent with some volume loss in the left lower lobe and probable small effusion.


SubjectID: 14851532, StudyID: 58585627, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with complicated PMH and new OG tube. // OG tube placement OG tube placement

COMPARISON: ___ obtained at 07:41

IMPRESSION: Right internal jugular line tip terminates at the level of cavoatrial junction. NG tube tip is in the stomach. Cardiomediastinal silhouette is unchanged. Right pleural effusion is unchanged. Mild vascular congestion is present. No focal consolidations to suggest pneumonia.


SubjectID: 14851532, StudyID: 56151362, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with very reduced EF, s/p Respiratory and PEA arrest and intubation ___ now with OG tube. // interval changes

COMPARISON: Radiographs from ___

IMPRESSION: Support lines and tubes are unchanged in position. Heart size is enlarged. There has been atelectasis/collapse of the right lower lobe since prior. There is mild to moderate pulmonary edema and subsegmental atelectasis in the left lung. There are no pneumothoraces.


SubjectID: 14851532, StudyID: 54703104, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with recent OG tube advanced // check OG tube placement

FINDINGS: As compared to chest radiograph from the same day, nasogastric tube has been advanced with the first side port in the proximal stomach. Endotracheal tube is 2 cm from the carina. Right-sided IJ catheter in the low SVC. Overall no substantial change of the lungs with moderate right-sided effusion, small left effusion and moderate cardiomegaly. Mild pulmonary vascular congestion unchanged   Keywords: unchanged. Asymmetric opacity in the right lower lobe also may represent superimposed pneumonia.

IMPRESSION: Nasogastric tube has been advanced with the first side port in the body of the stomach. Overall no substantial change of the lungs.


SubjectID: 14851532, StudyID: 54414101, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with very reduced EF, s/p Respiratory and PEA arrest and intubation ___ now with OG tube. // interval changes interval changes

IMPRESSION: In comparison with the study of ___, there is again enlargement of the cardiac silhouette with elevation of pulmonary venous pressure. Opacification at the right base again is consistent with collapse of the right middle and lower lobes

RECOMMENDATION(S): . The tip of the right IJ catheter is in the mid to lower SVC.


SubjectID: 14851532, StudyID: 53685384, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M s/p PEA and now s/p extubation w/tachypnea // interval changes interval changes

COMPARISON: ___

IMPRESSION: NG tube tip is in the stomach. Right internal jugular line tip is at the level of lower SVC. Distended stomach bubble is present. Small to moderate right pleural effusion is present, unchanged. Mild interstitial pulmonary edema is unchanged the   Keywords: unchanged


SubjectID: 14851532, StudyID: 59794465, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M s/p PEA and now s/p extubation w/tachypnea // interval changes interval changes

IMPRESSION: Comparison to ___. Feeding tube and right internal jugular vein catheter are in correct position. Unchanged moderate cardiomegaly with moderate right pleural effusion and mild to moderate pulmonary edema. No new focal parenchymal opacities   Keywords: new. No pneumothorax.


SubjectID: 14851532, StudyID: 59215725, Comparison: None

FINAL REPORT

INDICATION: ___M s/p PEA and now s/p extubation w/tachypnea // please assess for interval changes

TECHNIQUE: Portable semi-upright AP chest

COMPARISON: Chest radiographs ___ through ___

FINDINGS: Right internal jugular central venous catheter terminates in the low SVC as before. Enteric tube courses into the stomach. Since the prior study the lungs appear better aerated bilaterally. Moderate right pleural effusion is slightly decreased. Left retrocardiac opacity is improving. The heart remains mildly enlarged. Mediastinal and hilar contours are stable. The aortic arch is calcified. There is no pneumothorax.

IMPRESSION: Improving lung aeration bilaterally with resolving left retrocardiac opacity and decreasing size of moderate right pleural effusion.


SubjectID: 14851532, StudyID: 56614061, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CAD, COPD, s/p PEA arrest, now with swan catheter // interval change interval change

IMPRESSION: No relevant change as compared to the previous examination, moderate cardiomegaly. Mild pulmonary edema. Swan-Ganz catheter in correct position. Small right pleural effusion.


SubjectID: 14851532, StudyID: 55060932, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with atrial fibrillation, hx of CAD and CABG, s/p PEA arrest // interval change

TECHNIQUE: Portable semi-upright AP chest

COMPARISON: Multiple chest radiographs on ___.

FINDINGS: Swan-Ganz catheter and enteric tube are not constant position. Moderate cardiomegaly persists. Lung volumes remain low. Right pleural effusion appears smaller although this may be due to more upright positioning. Worsening left retrocardiac opacity may reflect atelectasis or aspiration. The mediastinal and hilar contours are unchanged. There is no pneumothorax. The aortic arch is calcified.

IMPRESSION: 1. Persistent low lung volumes and small right pleural effusion 2. Worsening left retrocardiac opacity could reflect atelectasis or aspiration.


SubjectID: 14851532, StudyID: 59116935, Comparison: same

FINAL REPORT

INDICATION: ___M with R IJ // line palcement

TECHNIQUE: Single portable view of the chest.

COMPARISON: Prior exam from earlier the same day at 16:40.

FINDINGS: There is now a right IJ central venous catheter with tip projecting over the lower SVC. Remainder of the exam is unchanged noting bilateral parenchymal opacities   Keywords: unchanged. There is no pneumothorax.

IMPRESSION: Right IJ central venous catheter tip projecting over the lower SVC.


SubjectID: 14851532, StudyID: 56997833, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___M with epigastric pain, vomiting, fever and hypotension

TECHNIQUE: Chest PA and lateral

COMPARISON: ___ chest radiograph and ___ CT chest

FINDINGS: Cardiac silhouette size remains mildly enlarged and multiple mediastinal clips from prior CABG are again noted. The aorta remains tortuous and diffusely calcified. Pulmonary vasculature is not engorged. Hilar contours are similar. Ill-defined focal opacities are again noted within both upper lobes as well as within the left lower lobe, not substantially changed in the interval, and better assessed on the previous CT   Keywords: again. No new focal consolidation, pleural effusion or pneumothorax is present. No acute osseous abnormalities detected. Clips are noted within the midline upper abdomen.

IMPRESSION: Re- demonstration of multifocal parenchymal opacities compatible with adenocarcinoma, better assessed on the previous CT. No acute cardiopulmonary abnormality.


SubjectID: 14851532, StudyID: 54675277, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with right internal jugular central line placement

TECHNIQUE: Portable upright AP view of the chest

COMPARISON: ___ at 10:41

FINDINGS: The right internal jugular central venous catheter is malpositioned, coursing cephalad within the right internal jugular vein, tip off of the superior borders of the film. Remainder of the exam is unchanged.

IMPRESSION: Malposition right internal jugular central venous catheter coursing cephalad within the neck.


SubjectID: 14851532, StudyID: 50875682, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with sepsis, COPD, and CHF, likely from cholangitis, now febrile, tachypnic, and tachycardic. STAT exam as patient has substantial clinical change and looks ill // ?worsening pulmonary edema ?new infiltrates ?acute intra pulm process ?worsening pulmonary edema ?new infiltrates ?acute intra pulm process

COMPARISON: ___ obtained at 03:41

IMPRESSION: Heart size is enlarged. Mediastinum is stable. Multifocal opacities are present, overall similar to previous study but potentially minimally improved   Keywords: similar. No appreciable pneumothorax. Old rib fractures, unchanged.


SubjectID: 14851532, StudyID: 58000887, Comparison: worse

FINAL REPORT

INDICATION: ___ year old man with CHF with weight gain and dyspnea // evaluate for volume overload/pulm edema/effusion

TECHNIQUE: Chest PA and lateral

FINDINGS: As compared to ___, interval worsening moderate pulmonary edema   Keywords: worse. Right moderate pleural effusion has also slightly increased. Small left effusion persists. Left lower lobe parenchymal opacity in the superior segment is now obscured by increasing pulmonary edema   Keywords: increasing   Keywords: increasing. Moderate cardiomegaly. No pneumothorax.

IMPRESSION: Worsening moderate pulmonary edema as well as right moderate effusion   Keywords: worse. Left lower lobe parenchymal opacity in the superior segment is now obscured by increasing pulmonary edema.


SubjectID: 14851532, StudyID: 55544509, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ y/o male with CAD s/p CABG, sHF, transferred to ICU for Afib with RVR // eval interval change eval interval change

IMPRESSION: Comparison to ___. The lung volumes remain relatively low and the cardiac silhouette is still substantially enlarged. However, the lung parenchyma has increased in transparent see, notably due to a decrease in extent of the pre-existing right pleural effusion and basilar atelectasis as well as an increase in radiolucency of the left upper lobe. No other relevant change is noted   Keywords: no other relevant change.


SubjectID: 14851532, StudyID: 57629170, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluation for endotracheal tube.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient was intubated. Exact location of the ETT tip is difficult to determine, given overlay by multiple metallic devices at the level of the sternum. However, the approximate location above the carina is 4 cm. The other monitoring and support devices are constant. Constant appearance of the lung parenchyma, the pleura, with a known right pleural effusion as well as of the cardiac silhouette.


SubjectID: 14851532, StudyID: 55969579, Comparison: same

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Studies dating between ___ and ___.

FINDINGS: Endotracheal tube and other support and monitoring devices are in standard position. Status post removal of sternal wires. Mass-like opacity at left lung apex appears similar to previous studies and has been more fully evaluated by CT of ___. Pulmonary vascular congestion is again demonstrated as well as mild interstitial edema   Keywords: again. Moderate right and small left pleural effusions are similar with adjacent basilar lung opacities.


SubjectID: 14851532, StudyID: 54299422, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Coughing, status post unstable chest.

COMPARISON: ___, 10:30 a.m.

FINDINGS: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The lung volumes have slightly increased, likely reflecting improved ventilation. Otherwise, the appearance of the lung parenchyma, the mediastinum and the cardiac silhouette, including the monitoring and support devices as well as sternal fixations, is stable.


SubjectID: 14851532, StudyID: 54155919, Comparison: None

FINAL REPORT

PORTABLE CHEST ___

COMPARISON STUDY: ___ radiograph.

FINDINGS: Support and monitoring devices are in standard position, and cardiomediastinal contours are stable. Mass-like area of consolidation at left apex appears slightly less dense and has been more fully evaluated by recent CT. Moderate layering right pleural effusion and small left pleural effusion are similar, with adjacent bibasilar areas of atelectasis or consolidation.


SubjectID: 14851532, StudyID: 57089146, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with sepsis, likely ___ cholangitis, CHF, with worsening O2 requirement from baseline // tubes/lines, worsening edema, acute intrapulm process tubes/lines, worsening edema, acute intrapulm process

IMPRESSION: As compared to ___, the lung volumes have slightly decreased. The multiple pre-existing parenchymal opacities, notably at the right lung base and in the left perihilar areas, are constant in extent and severity. Moderate cardiomegaly. Mild elongation of the descending aorta. No overt pulmonary edema. No pleural effusions. The right internal jugular vein catheter continues to be in correct position.


SubjectID: 14851532, StudyID: 55657134, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CAD, COPD, s/p PEA arrest, now with swan catheter // interval changes interval changes

IMPRESSION: In comparison with study of ___, the patient has taken a better inspiration. The enlargement of the cardiac silhouette persists with mild to moderate pulmonary edema and right pleural effusion with volume loss in the right middle and probably right lower lobes   Keywords: persists. The Swan-Ganz catheter is unchanged, with the tip projecting beyond the mediastinal border. It could be pulled back approximately 4 cm for more optimal positioning.


SubjectID: 14851532, StudyID: 56249524, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___-year-old man with history of non-small cell carcinoma and pulmonary nodules, COPD, CHF, and a recent pneumonia. Evaluate for interval change.

COMPARISON: Chest radiograph dated ___. CT chest without contrast dated ___.

FINDINGS: Interval improvement in interstitial edema   Keywords: improve. Small bilateral effusions. Suture lines are noted in the region of the left upper hemithorax. The opacity in the right upper lobe corresponds to the mass demonstrated better on recent CT. No pleural effusion, pulmonary edema, or focal consolidation to suggest pneumonia. Stable cardiomediastinal silhouette. Incidental atherosclerosis in the left anterior descending artery. Stable post-sternotomy changes.

IMPRESSION: 1. Interval improvement interstitial edema   Keywords: improve. 2. Stable small bilateral effusions. 3. Stable chronic changes which are followed on CT.


SubjectID: 14851532, StudyID: 55116033, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF, COPD, CAD with dyspnea. // assess for interval change

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Cardiomediastinal silhouette is unchanged. Interstitial opacities are similar   Keywords: similar. There is no interval increase in pleural effusion or pneumothorax.


SubjectID: 14851532, StudyID: 55671568, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: This is a ___M with a PMHx significant for Stage IV NSCLC s/p wedge resection in ___, CAD s/p multiple PCIs and 2-vessel CABG, and moderate COPD who presetns with several days of worsening dyspnea and new-onset fever concerning for pneumonia. // eval for acute cardiopulmonary process

IMPRESSION: Stable cardiomegaly accompanied by pulmonary vascular congestion and worsening edema   Keywords: worse. A more confluent area of opacity in the right lower lobe could reflect a superimposed pneumonia given clinical suspicion for this entity. Small to moderate right and small left pleural effusion are present, but there is no visible pneumothorax.


SubjectID: 14851532, StudyID: 55077014, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Sternal rewire, evaluation for pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the lung volumes have decreased. As a consequence, the structures at the lung bases appear denser than on the previous image. However, there are no new parenchymal opacities or abnormalities noted   Keywords: new. Moderate cardiomegaly persists. The right chest tube has been removed.


SubjectID: 14851532, StudyID: 54726507, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH.

INDICATION: Sternal wires, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, no relevant change is seen of the sternal wiring   Keywords: no relevant change. Monitoring and support devices are constant in appearance. Constant low lung volumes with bilateral small pleural effusions and subsequent areas of atelectasis. Moderate cardiomegaly. No new parenchymal opacities   Keywords: new.


SubjectID: 14851532, StudyID: 53313689, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post sternal rib rewiring.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has undergone sternal rewiring. The patient is now extubated and the nasogastric tube and the Swan-Ganz catheter have been removed. The other monitoring and support devices are in unchanged position. Lung volumes have slightly decreased, and small bilateral pleural effusions as well as areas of atelectasis are still visible. No pneumothorax is visualized. The obviously postoperative opacity at the upper medial left aspects of the mediastinum is constant in appearance.


SubjectID: 14851532, StudyID: 53992179, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH FROM ___

HISTORY: Rule out pneumothorax after thoracentesis.

FINDINGS: Portable AP upright chest radiograph shows improved aeration at the right lung base, presumably status post right-sided thoracentesis. No pneumothorax is visible. The left hemidiaphragm remains obscured and there appears to be increased haziness of the mid and upper lung zone compared to the study from eight hours earlier   Keywords: increase. Some of this may be exaggerated because of increased rotation. Left-sided PICC line tubing may be slightly pulled back and now is at the level of the mid superior vena cava.

CONCLUSION: No visible pneumothorax status post thoracentesis (presumably on the right).


SubjectID: 14851532, StudyID: 50686747, Comparison: worse

FINAL REPORT

REASON FOR

EXAMINATION: Bilateral pleural effusions, followup. Portable AP radiograph of the chest was reviewed in comparison to ___. The left PICC line tip is at the level of mid SVC. Heart size is enlarged. Mediastinum is enlarged. Perihilar interstitial opacities are noted. Bilateral pleural effusion is present. Right pigtail catheter tip is in place. No pneumothorax is seen.

IMPRESSION: Since the prior study, there is substantial interval progression of pulmonary edema   Keywords: progression. The apical opacity on the left is unchanged.


SubjectID: 14851532, StudyID: 51373840, Comparison: better

WET READ: ___ ___ ___ 8:17 PM dobhoff tube is coiled in the stomach its tip in the proximal esophagus. pulmonary edema improved since prior. ___ ___ d/w nurse ___ at 8:10pm (tube removed)

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

PORTABLE CHEST RADIOGRAPH, ___

COMPARISON: Study of earlier the same date.

FINDINGS: Interval placement of feeding tube, which coils in the stomach, and subsequently courses cephalad with distal tip directed cephalad above the level of the clavicles within the proximal thoracic esophagus. Exam is otherwise remarkable for improving pulmonary edema and slight decrease in mass-like opacity at left apex which has been more fully evaluated by prior CT   Keywords: decrease, improving. Left retrocardiac opacity and bilateral pleural effusions appear similar. Nurse ___ was informed of the malposition of the feeding tube at 8:10 p.m. on ___ by telephone at the time of discovery.


SubjectID: 14851532, StudyID: 51478052, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post CABG, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the bilateral areas of atelectasis at the lung bases, left more than right, are present in unchanged manner. Minimal postoperative opacity at the left lung base that should receive attention on further followups. The right internal jugular vein catheter is unchanged. No overt pulmonary edema. No evidence of pneumothorax. Borderline size of the cardiac silhouette.


SubjectID: 14861926, StudyID: 58669809, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (AP AND LAT)

INDICATION: ___M with MDS presenting with acute onset dyspnea and peripheral edema

COMPARISON: ___

FINDINGS: AP upright and lateral views of the chest provided. Interstitial opacities within the lungs raise concern for mild edema. No large effusion or pneumothorax. Cardiomediastinal silhouette is stable. Bony structures are intact.

IMPRESSION: Mild interstitial edema.


SubjectID: 14861926, StudyID: 52766861, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with MDS/MM with anemia to 5.6, dyspnea and peripheral edema // eval for interval change eval for interval change

IMPRESSION: In comparison with the study of ___, the cardiac silhouette again is enlarged and there is evidence of some elevated pulmonary venous pressure. Atelectatic changes are seen at the bases, especially in the retrocardiac region on the left.


SubjectID: 14861926, StudyID: 56680295, Comparison: same

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPH

INDICATION: Fever and chills. Question pneumonia.

COMPARISON: ___.

TECHNIQUE: Chest, portable AP upright.

FINDINGS: The cardiac, mediastinal and hilar contours appear stable. There is a similar background interstitial abnormality   Keywords: similar. The previously noted opacity at the left lung base has cleared although there is mild residual more medial retrocardiac opacity, probably not new. The latter may be due to residual scarring or atelectasis. More clearly likely to represent active pneumonia, however, is a new vague opacity including nodular elements within the right upper lobe with some mild increase in background volume loss. There is no pleural effusion or pneumothorax.

IMPRESSION: Findings suggest pneumonia in the right upper lobe. Follow-up radiographs are recommended to show resolution within ___ weeks. Retrocardiac opacity, probable possibly scarring or atelectasis although an additional focus of active pneumonia is not excluded by this examination.


SubjectID: 14861926, StudyID: 51072032, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pneumonia // Interval change?

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, there is an increase in extent and severity of the pre-existing parenchymal opacities. These increase is most pronounced in the right upper lobe. Moderate cardiomegaly. No pulmonary edema. No pleural effusions.


SubjectID: 14866589, StudyID: 59568649, Comparison: -1.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with PNA with persistent fever // ?interval changes

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The lung volumes have slightly decreased, causing increased radiodensity of the pre-existing known diffuse parenchymal opacities   Keywords: increase. In addition, increased diameters of the vascular structures suggest overlying mild pulmonary edema. Unchanged mild cardiomegaly. The retrocardiac atelectasis is also constant. The hemodialysis catheter and the PICC line on the right are in constant position.


SubjectID: 14866589, StudyID: 54811738, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with progressive resp failure, pulled out HD several inches due to agitation // confirm placement of HD line

COMPARISON: ___, 04:38

IMPRESSION: As compared to the previous radiograph, the lung volumes have decreased. The patient is now intubated. The tip of the endotracheal tube projects 3 cm above the carinal. The patient has also received the nasogastric tube. The right hemodialysis catheter is in unchanged position. Low lung volumes. New focal parenchymal opacities at both the left and the right lung base, likely atelectatic in origin. The presence of minimal pleural effusions can no longer be excluded. The apical and midlung extensive parenchymal opacities are unchanged   Keywords: unchanged.


SubjectID: 14866589, StudyID: 53907858, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with AMS/new O2 requirement in setting of renal failure and PNA // evaluate for other causes of hypoxia

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is noted   Keywords: no relevant change. Extensive bilateral parenchymal opacities, caused by a combination of pneumonia and pulmonary edema. Moderate cardiomegaly. Unchanged monitoring and support devices. No new opacities   Keywords: new. No pleural effusions.


SubjectID: 14866589, StudyID: 53389597, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with multifocal PNA now with chest pain and dyspnea, evaluate for interval changes

COMPARISON: Chest radiograph from ___.

FINDINGS: AP view of the chest provided. Compared to prior study, right lung base opacity has cleared slightly but otherwise there is little change in the multifocal consolidation and edema   Keywords: little change. Minimal bilateral pleural effusions are again seen. Heart size is stably enlarged. Right sided PICC terminates in the distal SVC.

IMPRESSION: Slightly more clear right lung base compared to prior study 2 days ago, otherwise little change with respect to multifocal pneumonia and pulmonary edema   Keywords: little change.


SubjectID: 14866589, StudyID: 51001835, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with Type 1 DM with fever and ?ARDS // assess for interval change

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, there is a minimal decrease in extent and severity of the pre-existing extensive parenchymal opacities. Unchanged mild cardiomegaly with retrocardiac atelectasis. No pleural effusions. The monitoring and support devices are constant.


SubjectID: 14866589, StudyID: 59342348, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with respiratory failure, concern for infection // assess for interval change; ETT place

COMPARISON: Chest x-ray from ___ at 08:29

FINDINGS: ET and NG tube have been removed. Right IJ dual lumen catheter is unchanged. Left subclavian PICC line appears unchanged, with tip over right atrium. No pneumothorax detected. The cardiomediastinal silhouette is probably unchanged. There has been interval improvement in the diffuse bilateral opacities, likely reflecting interval improvement in CHF findings   Keywords: improve. Increased retrocardiac density has also improved. Mild residual increased opacity remains present. No gross effusion identified.

IMPRESSION: Interval removal of ET and NG tube and interval improvement in bilateral opacities   Keywords: improve. Mild residual opacity is seen bilaterally.


SubjectID: 14866589, StudyID: 58395650, Comparison: None

FINAL REPORT

EXAMINATION: Chest PA and lateral

INDICATION: ___F with complicated PMHx including T1DM, NSTEMI ___, PAD s/p L fem-posterior tib bypass, sCHF (EF40%) who presents with progressive cough, concern for fluid build up, and left leg pain. Evaluate for pneumonia.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest x-ray from ___ and ___.

FINDINGS: There is stable enlargement of the cardiac silhouette. There may be minimal elevation of pulmonary venous pressure. However, there is no focal consolidation, pleural effusion, or pneumothorax. The osseous structures are unremarkable.

IMPRESSION: 1. No evidence of pneumonia. 2. Stable enlargement of the heart with minimal elevation of pulmonary venous pressure.


SubjectID: 14866589, StudyID: 52047759, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with productive cough x several days, c/f volume overload as well // eval for pneumonia, pulmonary edema

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: Subtle patchy right mid and lower lung opacities are improved as compared to the prior study, however, unclear whether findings are residua of prior process or a new process. Suggest dedicated PA and lateral views, when patient able, for further assessment. No overt pulmonary edema is seen. No pleural effusion or pneumothorax. Cardiac silhouette is top-normal are unremarkable.

IMPRESSION: Subtle patchy right mid and lower lung opacities are improved as compared to the prior study, however, unclear whether findings on the current study are residua of prior process or a new process/infection. Suggest dedicated PA and lateral views, when patient able, for further evaluation. No overt pulmonary edema


SubjectID: 14866589, StudyID: 53350053, Comparison: worse

FINAL REPORT

HISTORY: Persistent low oxygen saturation. Evaluate for pulmonary edema or infection.

TECHNIQUE: Frontal view of the chest.

COMPARISON: Chest radiograph ___.

FINDINGS: There are bilateral perihilar opacities, worse from yesterday   Keywords: worse. There is a new small to moderate left pleural effusion. There is no pneumothorax. The cardiac silhouette is mildly enlarged. Mediastinal contours are normal. Two vague opacities are appreciated in the left upper lung. The more conspicuous of which measures 1.5 x 1.9 cm, while the other measures at least 3 cm.

IMPRESSION: 1. Worsened severe pulmonary edema with a new small to moderate left pleural effusion   Keywords: worse, new. 2. Vague opacities in the left upper lung for which repeat imaging after diuresis is required, possibly chest CT.


SubjectID: 14866589, StudyID: 58317976, Comparison: None

FINAL REPORT

PORTABLE CHEST FROM ___ AT 07:27 CLINICAL

INDICATION: ___-year-old with hypoxia, new fevers, assess for interval change. Comparison is made to prior study of ___ at 07:47. Portable AP upright chest from ___ at 07:27 is submitted.

IMPRESSION: 1. There continues to be bilateral diffuse interstitial and airspace disease with worsening consolidation in the right upper lobe, right hilar region and left lower lobe which is concerning for worsening pulmonary edema, although a superimposed infectious process cannot be entirely excluded. There is likely layering left effusion. Overall, cardiac and mediastinal contours are stable. No pneumothorax. Previously described vague opacities in left upper lobe are not well appreciated on the current study.


SubjectID: 14866589, StudyID: 58082872, Comparison: None

WET READ: ___ ___ ___ 10:53 AM New right basilar opacity may refelct atelectasis or underlying infection in the correct clinical setting. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with somnolence. Eval for acute pathology.

TECHNIQUE: Single portable AP view of the chest.

COMPARISON: Chest radiograph from ___, ___, and CT chest from ___.

FINDINGS: Since the prior chest x-ray, there has been removal of the left-sided PICC line. Lung volumes are low on the current study, causing bronchovascular crowding. Right basilar opacity, new since prior, may reflect atelectasis or underlying infection in the correct clinical setting. Streaky retrocardiac opacity may be atelectasis or scarring. No focal consolidation, pleural effusions, or pneumothorax.

IMPRESSION: New right basilar opacity may refelct atelectasis or underlying infection in the correct clinical setting.


SubjectID: 14866589, StudyID: 52799697, Comparison: worse

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___-year-old woman with chest pain and fever. Clinical concern for pneumonia and pulmonary edema.

TECHNIQUE: Portable AP chest radiograph

COMPARISON: Multiple prior chest radiographs, most recent from ___.

FINDINGS: Cardiomegaly with increased pulmonary vascular congestion   Keywords: increase. Increased opacity at the left lung base concerning for possible pneumonia. No pneumothorax.

IMPRESSION: Moderate pulmonary edema and possible left basilar pneumonia.

NOTIFICATION: Findings communicated to ___ at 18:34.


SubjectID: 14866589, StudyID: 51869904, Comparison: same

FINAL REPORT

INDICATION: CHF exacerbation. Evaluate for pulmonary edema.

TECHNIQUE: Single upright AP view of the chest.

COMPARISON: Chest radiographs from ___ and ___.

FINDINGS: There is mild pulmonary edema and vascular congestion, similar to the prior exam   Keywords: similar. There is no focal opacity to suggest pneumonia. There are small bilateral pleural effusions. No pneumothorax is identified. The mediastinal contours are normal. The heart is moderately enlarged, and unchanged. A right-sided PICC is present with the tip in the mid-to-low SVC.

IMPRESSION: Mild pulmonary edema, small pleural effusions, and moderate cardiomegaly.


SubjectID: 14866589, StudyID: 50909813, Comparison: 0.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with AMS, intubated // Eval for infiltrate

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the pre-existing parenchymal opacities have minimally decreased in extent and severity   Keywords: decrease. However, opacities are still seen in diffuse distribution throughout the lung   Keywords: still. Newly appeared retrocardiac atelectasis. Monitoring and support devices are stable. Moderate cardiomegaly persists.


SubjectID: 14866589, StudyID: 50378273, Comparison: worse

FINAL REPORT

INDICATION: Intubated, evaluate for ET tube placement.

TECHNIQUE: Bedside frontal chest radiograph.

COMPARISON: Chest radiograph 11:30 today.

FINDINGS: Endotracheal tube terminates 4.1 cm above the carina. An enteric tube courses into the stomach. There are diffuse bilateral interstitial opacities worse from 3 hr prior   Keywords: worse. ___ B-lines are noted. There is a developing left lower lobe consolidation. Heart is top normal in size but unchanged. There is no pneumothorax or definite pleural effusion.

IMPRESSION: 1. Endotracheal tube 4.1 cm above the carina. 2. Worsening bilateral opacities which may represent pulmonary edema, multifocal pneumonia and/or ARDS   Keywords: worse.


SubjectID: 14868074, StudyID: 57586184, Comparison: None

FINAL REPORT

CLINICAL

HISTORY: ___-year-old woman with chest pain. Evaluate for widened mediastinum.

COMPARISON: CT torso ___. SINGLE PORTABLE AP VIEW OF THE CHEST: The mediastinum on this AP radiograph is likely within normal limits with minimal calcification of the aortic arch. Cardiac silhouette is mildly enlarged. There is blunting of the costophrenic angles bilaterally suggestive of trace pleural effusions. Lung volumes are low leading to crowding of the bronchovascular structures and bibasilar atelectasis. There is likely mild pulmonary vascular congestion. Known thyroid goiter causes mild narrowing of the upper airway. The known left upper lobe mass is not well seen on the current exam.

IMPRESSION: Enlarged heart with mild pulmonary vascular congestion. Possible tiny bilateral pleural effusions. No widened mediastinum.


SubjectID: 14868074, StudyID: 54636349, Comparison: None

FINAL REPORT

CLINICAL

HISTORY: ___-year-old woman with CHF, question pleural effusions.

COMPARISON: ___, 14:58 chest radiograph. CT torso ___. PA AND LATERAL VIEWS OF THE CHEST: The cardiac and mediastinal contours are unchanged. There is mild pulmonary vascular congestion. Lung volumes are low leading to bibasilar atelectasis. No pleural effusions are noted, however the diaphgrams are flattened. The known posterior left upper lobe mass is visualized on the lateral view.

IMPRESSION: Mild pulmonary vascular congestion. No definite pleural effusions. Redemonstration of left upper lobe posterior mass.


SubjectID: 14871009, StudyID: 59882556, Comparison: 1.0

FINAL REPORT

EXAMINATION: PORTABLE CHEST RADIOGRAPH

INDICATION: ___-year-old female with fever and cough.

TECHNIQUE: Frontal upright chest radiograph.

COMPARISON: Multiple prior chest radiographs, most recent from ___ from as well as chest CT from ___.

FINDINGS: Assessment is limited due to poor positioning as well as the patient's body habitus. Allowing for these limitations: Compared with the previous exam there has been interval improvement of prior interstitial pulmonary edema as well as aeration of the left lower lobe   Keywords: improve. There is persistent prominence of the left hilum, likely a combination of a very tortuous aorta with an enlarged pulmonary artery, better demonstrated on prior CT. A small left-sided pleural effusion may be present although difficult to assess. There is no right-sided effusion. Significant rightward deviation of the trachea is also stable. A right femoral pacemaker is redemonstrated with leads in stable position. Assessment of cardiac size is limited although appears stable. Rotolevoscoliosis centered in the lower thoracic spine is also stable.

IMPRESSION: 1. Persistent left hilar engorgement may be related to superimposition of a tortuous aorta with an enlarged pulmonary artery   Keywords: persistent. Superimposed perihilar consolidation cannot be completely excluded, however. 2. Improved aeration of the left lower lobe compared with radiograph from ___. 3. Unchanged rotolevoscoliosis and rightward deviation of the trachea.


SubjectID: 14871009, StudyID: 53819658, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with pAFIB now with cough, fever // pneumonia pneumonia

IMPRESSION: In comparison with the study of ___, there is little change   Keywords: little change. Again severe scoliosis greatly obscures the study. No definite acute pneumonia is appreciated on this limited examination.


SubjectID: 14871009, StudyID: 57716973, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Asystolic arrest, confirmation of lead placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is substantially improved ventilation of the lungs, notably on the right. The size of the cardiac silhouette is still moderately-severely enlarged. The leads, as far as it is possible to judge on one projection image, are projecting over the right atrium and the right ventricle. The generator is in pectoral position. Mild fluid overload. Blunting of the left costophrenic sinus, potentially caused by a small left pleural effusion.


SubjectID: 14871009, StudyID: 52283884, Comparison: None

WET READ: ___ ___ ___ 8:36 PM no pneumothorax. slightly increased opacity in the RUL may be technical vs due to aspiration ______________________________________________________________________________

FINAL REPORT

INDICATION: Arrest.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has received a left pectoral pacemaker. The wires project their tips over the right atrium and the right ventricle. Low lung volumes with increased opacities in the right upper lobe. Presence of a small left pleural effusion cannot be excluded. No evidence of pneumothorax.


SubjectID: 14871009, StudyID: 51691671, Comparison: None

WET READ: ___ ___ 8:02 PM no change from ___. no new opacity. -___ d/w ___ ___ by phone at 8pm ___. ______________________________________________________________________________

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman with aortic stenosis, atrial fibrillation, now with acute shortness of breath.

FINDINGS: Comparison is made to prior study from ___. There is a right-sided PICC line whose distal tip is at least to the cavoatrial junction. The tip is partially obscured by the left-sided pacemaker wires. There is severe scoliosis. There is marked loss of volume due to poor inspiratory effort. There is left retrocardiac opacity. These findings are stable. There are no pneumothoraces.


SubjectID: 14871009, StudyID: 53065549, Comparison: same

FINAL REPORT

STUDY: Chest radiograph.

INDICATION: Cardiogenic shock, respiratory failure, status post diuresis. Evaluate for interval change.

TECHNIQUE: Portable AP radiograph was obtained.

COMPARISON: ___. Current radiograph is dated ___ timed at 8:09 a.m. REPORT: Even allowing for projection, there may be some cardiomegaly. There is unchanged thoracolumbar scoliosis. There is heavy tracheobronchial calcification and some deviation of the trachea to the right side. There is evidence of mild bilateral pleural effusions. There is a patchy type of change in the right mid zone. Similar change in left mid zone is seen but the distribution of these is unchanged. There is a left-sided central line noted. This demonstrates an unusual course, but its tip lies in the SVC.

CONCLUSION: Little change from prior study   Keywords: little change. Cardiomegaly with effusions and atelectasis.


SubjectID: 14871009, StudyID: 52522661, Comparison: None

FINAL REPORT

HISTORY: Arrest with respiratory distress.

FINDINGS: In comparison with the earlier study of this date, tracheal and nasogastric tubes have been removed. There are again extremely low lung volumes with continued enlargement of the cardiac silhouette and evidence of elevated pulmonary venous pressure, bilateral pleural effusions, and compressive basilar atelectasis.


SubjectID: 14871009, StudyID: 56773646, Comparison: None

FINAL REPORT

HISTORY: Respiratory distress with unsuccessful catheter placement, to assess for pneumothorax.

FINDINGS: In comparison with study of ___, there is no evidence of pneumothorax. Continued low lung volumes may accentuate the prominence of the transverse diameter of the heart. Opacification at the left base most likely reflects a combination of volume loss in the left lower lobe with pleural effusion, though in the appropriate clinical setting, supervening pneumonia would be difficult to exclude. Severe rotary scoliosis convexed to the left is again seen. The left IJ catheter has been removed.


SubjectID: 14871009, StudyID: 54557849, Comparison: None

FINAL REPORT

HISTORY: Cardiac arrest and pneumonia, on ventilator.

FINDINGS: In comparison with the study of ___, the endotracheal tube is at the orifice of the right main stem bronchus and must be pulled back. There are low lung volumes with continued enlargement of the cardiac silhouette and elevated pulmonary venous pressure with bilateral pleural effusions and compressive basilar atelectasis.

IMPRESSION: This information was noted at 8:40 a.m. and immediately telephoned to Dr. ___, who is covering for Dr. ___.


SubjectID: 14871428, StudyID: 57134836, Comparison: None

FINAL REPORT

PORTABLE CHEST ___

COMPARISON: ___ radiograph.

FINDINGS: Indwelling support and monitoring devices are unchanged in position. Stable cardiomediastinal contours in the post-operative period. Worsening patchy and linear atelectasis at both lung bases, as well as apparent small left pleural effusion.


SubjectID: 14871428, StudyID: 51910551, Comparison: None

WET READ: ___ ___ ___ 9:24 PM ETT tip 5.5 cm above carina. Swan Ganz in the MPA. Bilateral chest and mediastinal drains in place. Trace left apical pneumothorax. Bibasal atelectasis. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post CABG, rule out pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the tip of the endotracheal tube is projecting 5.5 cm above the carina. Swan-Ganz catheter in the main pulmonary artery. Bilateral pleural and mediastinal drains in situ. Millimetric left apical pneumothorax. Bibasilar areas of atelectasis. No evidence of tension.


SubjectID: 14871428, StudyID: 51057144, Comparison: None

FINAL REPORT

PORTABLE CHEST X-RAY, ___

COMPARISON: Study of earlier the same date.

FINDINGS: Following removal of left-sided chest tube, there is no evidence of pneumothorax. Focal atelectasis is present along the chest tube site as well as a persistent small left pleural effusion. Postoperative appearance of the cardiomediastinal contours is unchanged. Overall appearance of the chest is relatively similar to the prior study except for some improvement in degree of bibasilar atelectasis.


SubjectID: 14871428, StudyID: 50305707, Comparison: None

FINAL REPORT

HISTORY: CABG, to assess for pneumothorax.

FINDINGS: In comparison with the study of ___, there is no evidence of pneumothorax. The right IJ catheter has been removed and a nasogastric tube inserted with its tip extending at least to the upper stomach where it crosses the lower margin of the image. Little overall change in the appearance of the heart and lungs.


SubjectID: 14871428, StudyID: 58539342, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with chest pain, shortness of breath.

COMPARISON: None available.

FINDINGS: One portable supine AP view of the chest. This study is severely limited due to overpenetration. Within that limitation, there is no obvious pneumothorax, consolidation, or effusion. Cardiac, mediastinal and hilar contours appear within normal limits.

IMPRESSION: Severely limited study due to overpenetration. No obvious acute cardiopulmonary process.


SubjectID: 14871428, StudyID: 55307987, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with COPD exacerbation and pulled out NGT // position of NGT position of NGT

IMPRESSION: In comparison with the earlier study of this date, the nasogastric tube has been repositioned with the tip in the upper body of the stomach and the side port probably just distal to the esophagogastric junction. The tube should be pushed forward several cm if possible. Right IJ catheter extends to the lower portion of the SVC. The patient has taken a much better inspiration and there has been a substantial decrease in the atelectatic changes at the bases. Continued enlargement of the cardiac silhouette without appreciable vascular congestion.


SubjectID: 14871428, StudyID: 52498204, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with likely aspiration PNA now extubated // interval change interval change

IMPRESSION: In comparison with the study of ___, there are lower lung volumes. Bibasilar opacifications, most likely consistent with aspiration, are again seen   Keywords: again. Endotracheal tube has been removed. Other monitoring and support devices remain in place.


SubjectID: 14875942, StudyID: 59396136, Comparison: None

FINAL REPORT

INDICATION: ___-year-old with fever and cough, assess for pneumonia joint.

COMPARISONS: ___.

FINDINGS: Lungs are low lung volumes with vascular engorgement and thickened septal lines compatible with acute congestive failure. In this context, assessment for focal consolidation is limited. Bibasilar atelectasis is likely present. No definite pleural effusion or pneumothorax is seen. The heart is stably enlarged with a single-lead pacer unchanged in appearance.

IMPRESSION: Mild-to-moderate congestive failure. If concern for infectious process, consider diuresis and repeat imaging to assess for subtle pneumonia.


SubjectID: 14875942, StudyID: 56673529, Comparison: better

FINAL REPORT

INDICATION: ___-year-old female with dyspnea, cough, and fever concerning for pneumonia. Admission radiograph demonstrated pulmonary edema, and patient was diuresed overnight.

COMPARISON: ___. CHEST, PA AND LATERAL: Right ventricular pacemaker again courses in expected position, with discarded leads in the left chest wall. Following diuresis, there has been interval decrease in mild interstitial edema. Continued moderate cardiomegaly and central venous congestion. No pleural effusions. Persistent right lower lobe streaky opacities with adjacent pleural thickening, suggesting prior pneumonia.

IMPRESSION: 1. Decreased pulmonary edema   Keywords: decrease. 2. Sequelae of prior right lower lobe pneumonia.


SubjectID: 14875942, StudyID: 58014112, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___F with dyspnea // eval CHF

COMPARISON: ___ and ___.

FINDINGS: PA and lateral views of the chest provided. Left chest wall pacer is seen with lead extending to the region of the right ventricle. Cardiomegaly is noted with mild central hilar congestion. No frank edema. No large effusion or pneumothorax. No focal opacity concerning for pneumonia. Bony structures are intact. No free air below the right hemidiaphragm.

IMPRESSION: Cardiomegaly, mild central congestion.


SubjectID: 14875942, StudyID: 50222128, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with pulmonary edema // Interval change?

COMPARISON: Chest x-ray from ___ at 13:26

FINDINGS: Compared with 1 day earlier, the overall appearance is similar. Again seen is a left chest wall pacer, with lead tips over the right ventricle. Also again seen is cardiomegaly and hyperinflation. There is upper zone redistribution and mild vascular plethora. There is bibasilar atelectasis, similar to the prior film, without frank consolidation. No gross effusion.

IMPRESSION: Mild CHF and bibasilar atelectasis. Doubt significant interval change compared with 1 day earlier.


SubjectID: 14877188, StudyID: 56458673, Comparison: worse

FINAL REPORT

PORTABLE AP CHEST FILM, ___ at 921. CLINICAL

INDICATION: Status post orogastric tube placement, check position. Comparison is made to the patient's prior study dated ___ at 5 a.m. A single portable semi-erect chest film ___ at 921 is submitted.

IMPRESSION: Endotracheal tube and right internal jugular central line are unchanged in position. Interval placement of a nasogastric tube with its tip at the gastroesophageal junction. Advancement would be recommended at this time. The recommendation for advancement of the nasogastric tube was conveyed by phone to the patient's house staff, ___, in the intensive care unit on ___ at 1:12 p.m.. There is worsening interstitial and pulmonary edema   Keywords: worse. Persistent opacity at left base may represent a combination of atelectasis and pleural effusion, although pneumonia cannot be entirely excluded. No pneumothorax is seen.


SubjectID: 14877188, StudyID: 52031851, Comparison: worse

FINAL REPORT

PORTABLE AP CHEST FILM ___ AT ___ CLINICAL

INDICATION: ___-year-old requiring intubation, check tube placement. Comparison is made to the patient's prior study ___ at ___. Portable supine chest film ___ at ___ is submitted.

IMPRESSION: 1. Interval placement of an endotracheal tube with its tip 4.8 cm above the carina. Right internal jugular central line continues to have its tip in the proximal right atrium. There is increasing opacity at the left base which may represent a combination of atelectasis and pleural effusion. There is likely worsening pulmonary edema   Keywords: worse. Overall cardiac and mediastinal contours are difficult to assess given marked patient rotation on the current examination.


SubjectID: 14877188, StudyID: 50273085, Comparison: better

FINAL REPORT

PORTABLE AP CHEST FILM, ___ AT 4:26 AM CLINICAL

INDICATION: ___-year-old intubated. Check line placement. Comparison is made to the patient's previous study dated ___ at 22:12. Portable supine chest film ___ at 5 a.m. is submitted.

IMPRESSION: 1. Endotracheal tube unchanged in position. Right internal jugular central line has its tip in the proximal right atrium, unchanged. There is a worsening airspace process at the left base, which may reflect atelectasis in the setting of a pleural effusion. However, pneumonia and/or aspiration should also be considered. Improvement in mild pulmonary edema with residual mild interstitial edema   Keywords: improve. Persistent low lung volumes. Overall, cardiac and mediastinal contours are difficult to assess given the patient rotation on the current examination.


SubjectID: 14877188, StudyID: 55866631, Comparison: None

FINAL REPORT

HISTORY: New onset atrial fibrillation with desaturations.

TECHNIQUE: PA and lateral views of the chest.

COMPARISON: Chest radiograph ___. Chest CT ___.

FINDINGS: The heart size remains mildly enlarged. The aorta is tortuous and calcified but unchanged. The hilar contours are stable. There is prominence of the right paratracheal stripe which on the prior chest CT from ___ demonstrated this to be secondary to tortuous vessels and mediastinal lipomatosis. New patchy bibasilar airspace opacities are concerning for aspiration or infection. Lateral pleural thickening near the lung bases is stable. No pneumothorax or large pleural effusion is present. Pulmonary vascularity is not engorged. There are mild degenerative changes in the thoracic spine.

IMPRESSION: Patchy opacities at lung bases concerning for aspiration or infection.


SubjectID: 14877188, StudyID: 53674880, Comparison: same

FINAL REPORT

HISTORY: Subjective fevers, shortness of breath, crackles at the bases.

TECHNIQUE: PA and lateral views of the chest.

COMPARISON: Chest radiograph ___. Chest CT ___.

FINDINGS: There has been no significant interval change from the prior study   Keywords: no significant interval change. There is mild enlargement of cardiac silhouette which is stable. The mediastinal and hilar contours are unchanged, with tortuosity and calcifications of the thoracic aorta again noted. Fullness of the right paratracheal stripe is also unchanged, and compatible with tortuous vessels and mediastinal lipomatosis as demonstrated on prior chest CT from ___. There are persistent bibasilar airspace opacities   Keywords: persistent. Lateral pleural thickening at the lung bases is unchanged. There is no pulmonary edema, pleural effusion or pneumothorax. Degenerative changes in the thoracic spine are again noted.

IMPRESSION: No significant interval change from the prior study   Keywords: no significant interval change. Continued bibasilar airspace opacities which could reflect atelectasis, infection or aspiration.


SubjectID: 14927306, StudyID: 54677415, Comparison: 0.0

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___F with cough, fever // Eval for infiltrate

COMPARISON: ___.

FINDINGS: PA and lateral views of the chest provided. Midline sternotomy wires again noted. Lung volumes are low. Interstitial opacities are increased from prior which could represent an atypical pneumonia versus interstitial pulmonary edema   Keywords: increase. Elevated right hemidiaphragm is unchanged. No large effusion or pneumothorax. The heart and mediastinal contours are similar. Mild hilar congestion likely present. Bony structures are intact. Degenerative changes at the AC joints noted.

IMPRESSION: Stable cardiomegaly, likely mild interstitial edema   Keywords: stable. Difficult to exclude an atypical infection


SubjectID: 14927306, StudyID: 51427166, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with diastolic HF and suspected pneumonia // Interval change; evidence of infection or fluid overload?

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The alignment of the sternal wires and fixations is constant. Elevation of the right hemidiaphragm. Borderline size of the cardiac silhouette with elongation of the descending aorta. No pleural effusions. No pulmonary edema. No pneumonia.


SubjectID: 14929191, StudyID: 55959069, Comparison: better

FINAL REPORT

INDICATION: ___ year old woman with history of congestive heart failure now with increasing opacity in the right lung ?rotation vs. new lesion. // for reevaluation of right sided opacity.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiographs from ___, ___, ___. CT of the chest from ___.

IMPRESSION: Previously described nodular opacity in the right paratracheal region corresponds to a prominent pulmonary artery. Mild pulmonary edema is improved from ___   Keywords: improve. Linear opacity in the right lung has resolved. Small bilateral pleural effusions and severe cardiomegaly are stable from ___. Extensive kyphotic/scoliotic deformities and heavily calcified tortuous aorta are unchanged.


SubjectID: 14929191, StudyID: 55759109, Comparison: same

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___-year-old woman presenting with hypoxia. Evaluate for pneumonia.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph dated ___. CT chest dated ___.

FINDINGS: Bilateral parenchymal opacities, most pronounced in the right perihilar region is concerning for infection given the provided history. Increased opacities in the bilateral infrahilar regions could be infection or aspiration. Horizontal linear opacity projecting over the right mid lung may be focal scarring. The heart remains enlarged. Pulmonary vascular congestion persists   Keywords: persists. 9-mm opacity just to the right of the trachea is probably a vessel on-end, although could also be a nodule. There may be a trace right pleural effusion on the lateral view. No large pleural effusion or pneumothorax. Severe levoconvex scoliosis of the upper thoracic spine, mild dextroconvex scoliosis of the lower thoracic spine, and mild levoconvex scoliosis of the upper lumbar spine is overall unchanged with associated severe distortion of the thoracic cage and appearance of the mediastinum. The bones are diffusely demineralized, making it difficult to assess for fractures; however, significant loss of vertebral body height at multiple levels in the thoracic spine is noted and appears to have been present on the CT from ___. The stomach is distended with fluid and gas.

IMPRESSION: 1. Findings concerning for multifocal infection and aspiration. 2. Multiple thoracic vertebral body compression deformities. 3. Severe cardiomegaly, unchanged. 4. Markedly distended stomach.


SubjectID: 14941305, StudyID: 54853277, Comparison: worse

FINAL REPORT

TYPE OF

EXAMINATION: Chest AP portable single view.

INDICATION: ___-year-old female patient with chronic osteomyelitis and epidural abscess with atrial fibrillation, status post IV fluids and crackles in left base, evaluate for pulmonary edema versus infiltrate.

FINDINGS: AP single view of the chest has been obtained with patient in upright position. Analysis is performed in direct comparison with the next preceding PA and lateral chest examination of ___. Previously present mild enlargement of the heart appears stable. Configuration suggests mild enlargement of left atrial contour resulting in a double contour within the right-sided heart shadow. The pulmonary vasculature shows an upper zone redistribution pattern with mild perivascular haze. There is no evidence of advanced interstitial or alveolar edema. Similar as shown on the previous examination, there is mild blunting of the left lateral pleural sinus, probably indicative of scar formation as the posterior pleural sinus was free on the preceding examination. When comparison is made of the frontal views, there is a suggestion of some increased plethora of the pulmonary vasculature and slightly increased perivascular haze, but again acute pulmonary edema is not present   Keywords: increase. The present portable examination excludes the development of a new discrete pneumonic infiltrate.


SubjectID: 14941305, StudyID: 50456523, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Respiratory distress, evaluation for intrapulmonary process.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the signs indicative of moderate pulmonary edema have increased in extent and severity   Keywords: increase. Cardiomegaly has also increased. Pre-existing blunting of the costophrenic sinuses is more obvious than on the previous image and suggests the presence of small pleural effusions. No pneumothorax. No pneumonia.


SubjectID: 14941305, StudyID: 50423855, Comparison: None

WET READ: ___ ___ 11:26 PM New bibasilar opacities concerning for pneumonia in the appropriate clinical setting. No other change from recent prior. ___ p___

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Oxygen requirement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is unchanged evidence of basoapical blood flow re-distribution and increase in diameter of the pulmonary vessels. Overall, the findings are suggestive of mild pulmonary edema. Minimal blunting of the costophrenic sinuses could suggest the presence of minimal pleural effusion. Unchanged borderline size of the cardiac silhouette. No pneumothorax.


SubjectID: 14941305, StudyID: 53758146, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, bacteremia, questionable of right lower lobe pneumonia on previous chest x-ray.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no clear visual evidence of a parenchymal opacity in the right lower lobe. The opacity is seen on both the frontal and the lateral radiograph. The opacity is peribronchial in distribution and displays mild air bronchograms. Pneumonia is the most likely differential diagnosis. This observation was made at 10:08 a.m., on ___, and the referring physician, ___. ___ was paged for notification at 10:09 a.m. The findings were subsequently discussed over the telephone. Unchanged appearance of the cardiac silhouette. Unchanged course of the left PICC line. Minimal pleural effusions but no evidence of pulmonary edema.


SubjectID: 14941305, StudyID: 51277250, Comparison: None

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with CHF, COPD, acute shortness of breath, wheezing, pulmonary edema.

COMPARISON: ___.

FINDINGS: Small pleural effusions are slightly increased with bibasilar atelectasis. There is no new lung consolidation. Cardiac contour is top normal and stable. Left-sided PICC line ends in lower SVC. There is no pneumothorax.

CONCLUSION: Except for slight increase of bilateral small pleural effusions, the rest of the exam is stable.


SubjectID: 14941305, StudyID: 51863179, Comparison: better

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with shortness of breath and pulmonary edema, rule out pneumonia.

COMPARISON: ___.

FINDINGS: The patient has upper lobes oligemia, mostly compatible with emphysema. Mild pulmonary vessel cephalization is improved since ___ and stable since ___   Keywords: improve. Bibasilar atelectasis with small pleural effusion is unchanged. Mild cardiac enlargement is also stable. Left-sided PICC line ends in cavoatrial junction. There is no pneumothorax.

CONCLUSION: There is no change since prior exam and no new lung consolidation. Small bilateral pleural effusions with atelectasis is unchanged.


SubjectID: 14945369, StudyID: 56726325, Comparison: better

FINAL REPORT

PA AND LATERAL CHEST, ___.

COMPARISON: ___ radiograph.

FINDINGS: Interval removal of temporary transvenous pacing lead and placement of a dual-chamber permanent pacemaker. The right atrial lead has an expected course. The right ventricular lead terminates more superiorly than typical. There is no visible pneumothorax. The cardiac silhouette remains enlarged, and note is made of previous CoreValve procedure. No focal areas of consolidation are present within the lungs. Minimal interstitial edema has improved from the prior study   Keywords: improve. Small left pleural effusion is present, best visualized on the lateral radiograph.

IMPRESSION: Status post dual-chamber pacemaker placement as described. Findings discussed by telephone with Dr. ___ by telephone on ___ at 10:00 a.m. at the time of discovery.


SubjectID: 14945369, StudyID: 53489589, Comparison: None

WET READ: ___ ___ ___ 8:06 PM No change compared to ___ at 7:58am.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

HISTORY: Cardiac surgery, to assess for lead migration.

FINDINGS: In comparison with the study of ___, there is little overall change in the position of the pacer lead. However, it does appear to be slightly kinked in its transverse course, of uncertain significance.


SubjectID: 14945369, StudyID: 51067692, Comparison: same

FINAL REPORT

HISTORY: CoreValve placement with right IJ pacing wire.

FINDINGS: In comparison with the study of ___, there is little overall change   Keywords: little overall change. CoreValve and external pacemaker again seen with the tip extending to the region of the apex of the right ventricle. There is again mild elevation of pulmonary venous pressure with slight enlargement of the cardiac silhouette.


SubjectID: 14950396, StudyID: 59917654, Comparison: None

FINAL REPORT

INDICATION: Pulmonary hypertension and pulmonary edema. Status post dialysis, and removal of 10 liters of fluid. No improvement in hypoxia.

COMPARISONS: Chest radiograph ___ and multiple chest radiographs dating to ___.

FINDINGS: ___moderate-to-large left pleural effusion is unchanged since prior exam. ___small right pleural effusion is stable. The lung volumes are slightly lower in comparison to the prior exam. There is no consolidation or pneumothorax. Cardiomediastinal contours are unchanged, and poorly evaluated due to the adjacent effusion. ___left PICC terminates in the mid SVC.

IMPRESSION: No significant change in the moderate-to-large left and small right pleural effusions.


SubjectID: 14950396, StudyID: 58273530, Comparison: same

FINAL REPORT

INDICATION: Status post thoracentesis on the left. Evaluate for pneumothorax.

COMPARISONS: Chest radiograph ___ ___ 4:53.

FINDINGS: The left pleural effusion has significantly decreased in size since the prior exam. There is no evidence of pneumothorax. ___small right pleural effusion persists. Mild pulmonary edema is unchanged   Keywords: unchanged. There is no consolidation. The aorta is tortuous, and stable from the prior exam. The cardiac size is unremarkable.

IMPRESSION: 1. Significant decrease in size of left pleural effusion. 2. No pneumothorax. 3. Stable small right pleural effusion and mild pulmonary edema   Keywords: stable.


SubjectID: 14950396, StudyID: 57254825, Comparison: 1.0

FINAL REPORT

INDICATION: Recent respiratory distress. Evaluate for interval change.

COMPARISONS: Chest radiograph ___. Multiple chest radiographs dating to ___.

FINDINGS: Since the prior exam performed approximately 24 hours earlier, there has been ___decrease in the pulmonary edema   Keywords: decrease. Mild pulmonary edema persists   Keywords: persists. ___small left pleural effusion has slightly decreased in size. Bilateral basilar atelectasis is stable. The thoracic aorta is and tortuous and heavily calcified, unchanged from the prior exam. The cardiac silhouette is normal. The left PICC terminates in the right atirum, which appears slightly lower in positioning than in the prior exam. ___right internal jugular hemodialysis catheter also terminates in the right atrium.

IMPRESSION: 1. Slight decreased in mild pulmonary edema and small left pleural effusion   Keywords: decrease. 2. Stable bibasilar atelectasis. 3. Left PICC terminates in the right atrium. To ensure placement in the low SVC, could be removed 3 to 3.5 cm.


SubjectID: 14950396, StudyID: 51143423, Comparison: worse

FINAL REPORT

INDICATION: History of pulmonary hypertension. Evaluate for volume overload.

COMPARISONS: Chest radiograph ___ and multiple chest radiographs dating to ___.

FINDINGS: Since the prior radiograph one day prior, there has been re-accumulation of ___moderate-sized left pleural effusion. There is increasing interstitial prominence consistent with worsening of moderate pulmonary edema   Keywords: worse. ___small right pleural effusion persists. The aortic arch is enlarged and tortuous, unchanged from the prior exam. The cardiac silhouette is normal. ___left PICC is in unchanged position, terminating in the low SVC near the atriocaval junction. ___new right internal jugular hemodialysis catheter is present terminating just beyond the atriocaval junction in the right atrium. There is no pneumothorax.

IMPRESSION: Re-accumulation of left pleural effusion and worsening moderate pulmonary edema   Keywords: worse. Stable small right pleural effusion.


SubjectID: 14950396, StudyID: 50701136, Comparison: better

FINAL REPORT

INDICATION: ___-year-old female with hypoxia, effusions, and fluid overload status post dialysis. Evaluation for interval change.

COMPARISON: Comparison is made to the same day radiograph of the chest from 9 hours prior.

FINDINGS: Portable frontal radiograph of the chest demonstrates interval improvement in pulmonary edema, right greater than left   Keywords: improve. There is persistence of bilateral pleural effusions and bibasilar atelectasis. There is no pneumothorax. Cardiac size is unchanged.

CONCLUSION: Interval improvement of right pulmonary edema and stable bilateral pleural effusions and bibasilar atelectasis status post hemodialysis   Keywords: improve.


SubjectID: 14950396, StudyID: 58893397, Comparison: None

FINAL REPORT

___ CHEST, 5:15 ___M. ON ___

HISTORY: ___-year-old woman with shortness of breath and pleural effusion after intravenous fluids.

IMPRESSION: ___ chest compared to ___: Moderate-to-severe cardiomegaly is chronic. Moderate right and smaller left pleural effusion have both increased resulting in worsening basal atelectasis. Pulmonary vasculature is engorged to the point of edema. No pneumothorax.


SubjectID: 14950396, StudyID: 58054363, Comparison: None

FINAL REPORT

EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of shortness of breath, history of CHF.

COMPARISON: ___.

FINDINGS: Frontal and lateral views of the chest were obtained. There are moderate bilateral pleural effusions with overlying atelectasis. On the right, fluid is seen tracking along the minor fissure. Underlying basilar consolidation is not excluded. The aorta is unfolded and calcified. The cardiac silhouette is enlarged, appears larger than on the prior study, which may in part be due to ___ technique and shallower inspiration.

IMPRESSION: Moderate bilateral pleural effusions with overlying atelectasis, underlying consolidation cannot be excluded. Cardiomegaly; cardiac silhouette appears larger than on the prior study.


SubjectID: 14950396, StudyID: 56426177, Comparison: worse

FINAL REPORT

PA AND LATERAL CHEST, ___.

HISTORY: ___-year-old woman with sinus tachycardia. Possible PE.

IMPRESSION: ___ chest compared to ___: Mild pulmonary edema which developed between ___ and ___ has subsequently improved   Keywords: develop. Moderate right pleural effusion developed and has remained, and cardiac silhouette is severely enlarged. Left basal atelectasis has improved, severe right basal atelectasis has not.


SubjectID: 14950396, StudyID: 58243535, Comparison: None

WET READ: ___ ___ 7:19 PM ETT tip terminates 1.3 cm above carina. Dialysis catheter unchanged. Moderate right and small left pleural effusions stable with unchanged right perihilar and basilar opacification. Left basilar/retrocardiac opacification also unchanged. W/r in CCC -___ ______________________________________________________________________________

FINAL REPORT

___ CHEST 5:11 P.M. ON ___

HISTORY: ___ ___-year-old woman with end-stage renal disease and sepsis. Now intubated for hypoxia.

IMPRESSION: ___ chest compared to ___: Tip of the new endotracheal tube is no more than ___centimeter from the carina and should be withdrawn between 2 and 3 cm to avoid unilateral intubation. Moderate to large right pleural effusion unchanged. Right lung is generally edematous or consolidated raising concern for pneumonia and ipsilateral empyema. The moderately enlarged cardiac silhouette is larger today than it was in ___. ___dual-channel dialysis ends in the right atrium.


SubjectID: 14950396, StudyID: 56587905, Comparison: None

FINAL REPORT

PORTABLE CHEST 2:58 P.M., ___

HISTORY: ___ ___-year-old woman with end-stage renal disease, on hemodialysis, presenting with respiratory distress after dialysis.

IMPRESSION: ___ chest compared to ___: Moderate right pleural effusion was new on ___, subsequently unchanged. There is extensive consolidation in the perihilar right lung, both upper and lower lobes. This could be unilateral edema but needs to be evaluated for possible pneumonia and even empyema. ___dual-channel hemodialysis that ends in the right atrium. Small left pleural effusion has increased. Moderate enlargement of the cardiac silhouette is difficult to assess because of adjacent pleural effusion.


SubjectID: 14950396, StudyID: 55947652, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Questionable pneumonia.

COMPARISON: ___.

FINDINGS: ___ compared to the previous radiograph, the monitoring and support devices are unchanged. Unchanged appearance of the cardiac silhouette and of the left hemithorax. On the right, the effusion has slightly decreased and makes ___right basal parenchymal opacity better visible than on the previous image. Slight decrease of the signs indicative of pulmonary edema   Keywords: decrease. No pneumothorax.


SubjectID: 14950396, StudyID: 52287300, Comparison: None

FINAL REPORT

INDICATION: Cough and brown sputum.

COMPARISONS: Chest radiograph, ___. Multiple chest radiographs dating to ___.

FINDINGS: Since prior exam, there is ___new large consolidation involving the right mid and lower lung zones, which is concerning for pneumonia. The right heart border and right diaphragm are obscured. ___small-to-moderate left pleural effusion is present. The left lung is clear. There is mild stable blunting of the left costo-phrenic angle which may be ___trace left effusion or pleural thickening. There is no pneumothorax. The mediastinal contour is enlarged, although stable from multiple prior exams. The heart size is normal. ___right internal jugular dialysis catheter is in unchanged position terminating in the right atrium.

IMPRESSION: 1. New right mid and lower lung consolidation, most consistent with pneumonia. 2. Small-to-moderate right pleural effusion. 3. Stable small left pleural effusion or pleural thickening.


SubjectID: 14950396, StudyID: 50485864, Comparison: None

FINAL REPORT

___ CHEST, 12:52 P.M., ___

HISTORY: ___ ___-year-old woman with sepsis. Check ET tube placement.

IMPRESSION: ___ chest compared to ___: Moderate right pleural effusion pools dependently and could be smaller than it was on ___. Heterogeneous opacification in the right lung has improved, but is still sufficient to raise concern for pneumonia. Left lung is clear. Moderate cardiomegaly stable. Thoracic aorta heavily calcified and tortuous but not focally aneurysmal. ET tube in standard placement, nasogastric tube passes into the mid stomach. Dual-channel dialysis ends in the right atrium. No pneumothorax.


SubjectID: 14950396, StudyID: 50456547, Comparison: None

FINAL REPORT

HISTORY: Pneumonia.

FINDINGS: In comparison with study of ___, the monitoring and support devices remain in place. Unchanged appearance of the cardiac silhouette with right basilar opacification consistent with pleural effusion and volume loss in the right lower lung. In the appropriate clinical setting, supervening pneumonia would have to be considered. Less prominent opacification in the retrocardiac region is consistent with volume loss in the left lower lobe and small pleural effusion.


SubjectID: 14950396, StudyID: 55136142, Comparison: None

FINAL REPORT

INDICATION: Tachycardia, evaluate for infiltrate.

COMPARISON: Chest radiograph on ___.

FINDINGS: One ___ semi-erect portable view of the chest. Moderate cardiomegaly is again seen. There is fluid seen tracking along the right lung and along the minor fissure, decreased in amount when compared to prior study. There is ___moderate right pleural effusion. Aortic calcifications are again seen. There is right lower lobe atelectasis.

IMPRESSION: Moderate right pleural effusion. Right lower lobe atelectasis. Moderate cardiomegaly and interstitial edema.


SubjectID: 14950396, StudyID: 51300643, Comparison: better

FINAL REPORT

HISTORY: Sickle cell with acute chest symptoms.

FINDINGS: In comparison with the study of ___, there is continued enlargement of the cardiac silhouette, however, the bilateral pulmonary opacifications have decreased, consistent with resolving pulmonary edema   Keywords: decrease, resolving. Probable small bilateral pleural effusions persist. Tip of the right IJ catheter is in the mid-to-lower portion of the SVC.

IMPRESSION: Decreasing pulmonary opacifications   Keywords: decreasing.


SubjectID: 14950396, StudyID: 51105467, Comparison: None

FINAL REPORT

PORTABLE CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: ___. CLINICAL

HISTORY: Tachycardia, question pneumonia.

FINDINGS: ___ semi-upright portable chest radiograph is obtained. There has been interval placement of ___right IJ dialysis catheter, tip of which is seen extending into the right atrium. Bilateral pleural effusions are again noted with associated lower lung atelectasis. Mild edema would be difficult to exclude. Cardiomegaly is again seen. Patient is rotated to the right, limiting assessment. No large pneumothorax.


SubjectID: 14951133, StudyID: 59195601, Comparison: None

FINAL REPORT

INDICATION: Shortness of breath.

COMPARISON: ___ chest radiograph. UPRIGHT AP AND LATERAL VIEWS OF THE CHEST: The cardiac silhouette size remains mildly enlarged with a left ventricular predominance. The mediastinal and hilar contours are stable. No overt pulmonary edema is present. There are continued interstitial opacities which are most pronounced at the lung bases, which appear to be longstanding findings. No new areas of focal consolidation are demonstrated, and there is no pleural effusion or pneumothorax. No acute osseous abnormality is seen.

IMPRESSION: Findings compatible with chronic interstitial lung disease. No definite new areas of opacification to suggest a superimposed pneumonia. No pulmonary edema is seen.


SubjectID: 14951133, StudyID: 52067578, Comparison: same

FINAL REPORT

INDICATION: ___-year-old woman with interstitial lung disease, heart failure and increased shortness of breath.

COMPARISON: ___ to ___.

FINDINGS: A single portable frontal chest radiograph was obtained. Lung volumes remain low. Bilateral peripheral interstitial opacities in an apical to basal gradient are similar to prior exams dating back to ___   Keywords: similar. Mild cardiomegaly is unchanged. No effusion or pneumothorax is present.

IMPRESSION: Stable appearance of bilateral interstitial opacities   Keywords: stable.


SubjectID: 14961558, StudyID: 57743328, Comparison: None

FINAL REPORT

HISTORY: Bone marrow transplant with new pleural effusion, scheduled for methotrexate therapy.

FINDINGS: In comparison with the study of ___, there is again enlargement of the cardiac silhouette with evidence of mild-to-moderate pulmonary vascular congestion and bilateral pleural effusions with compressive atelectasis at the bases.


SubjectID: 14961558, StudyID: 50049434, Comparison: None

FINAL REPORT

CLINICAL

HISTORY: AML, status post allograft, previous history of fungal infections, now has hypoxia. CHEST AP The tip of the right subclavian line lies in the right atrium. The heart is enlarged. Some pulmonary plethora is present, and a left effusion may be present which was not seen on the prior chest x-ray of ___. No areas suggesting lung infection are seen. Atelectasis within the lingular segment is present.

IMPRESSION: Mild failure, evidence of active infection not seen.


SubjectID: 14961558, StudyID: 56931305, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Bone marrow transplant, evaluation for pneumonia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the previously not visible opacities in the upper lobes, documented on the previous CT examination, are now clearly visible on the chest radiograph. This suggests substantial progression of disease. At the level of the left hilus and the left lung bases, the disease is also clearly progressive. Moderate cardiomegaly persists. No pleural effusions. At the time of dictation and observation, 9:26 a.m., on the ___, the referring physician ___. ___ was paged for notification.


SubjectID: 14961558, StudyID: 56759282, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Hypoxia, crackles, evaluation.

COMPARISON: CT chest from ___.

FINDINGS: Moderate cardiomegaly and bilateral parenchymal opacities at the lung bases, likely atelectatic in origin. Moderate bilateral pleural effusions, better seen on the lateral than on the frontal radiograph. In addition, in both upper lobes, and predominantly located in perihilar lung areas, are subtle parenchymal opacities with air bronchograms, likely reflecting pneumonia. No change in appearance of the hilar structures   Keywords: no change. No pneumothorax. All of the described changes are better visualized on a CT examination performed on ___, 7:53 a.m.


SubjectID: 14963499, StudyID: 55734365, Comparison: 1.0

FINAL REPORT

STUDY: PA and lateral chest x-ray.

COMPARISON EXAM: PA and lateral chest x-ray ___, PA and lateral chest x-ray ___.

INDICATION: ___-year-old with hypoxemia and cough.

FINDINGS: There is continued improvement of diffuse interstitial opacities consistent with the diagnosis of pulmonary edema   Keywords: improve. The cardiomediastinal and hilar contours are stable. There is no pleural effusion or pneumothorax. Hiatal hernia is again seen.

IMPRESSION: 1. Continued improvement of diffuse interstitial opacification is consistent with pulmonary edema   Keywords: improve. 2. No new lung opacifications   Keywords: new.


SubjectID: 14963499, StudyID: 51865455, Comparison: worse

FINAL REPORT

CHEST, TWO VIEWS: ___.

HISTORY: ___-year-old female with shortness of breath. Question pneumonia.

FINDINGS: Frontal and lateral views of the chest are compared to previous exam from ___. Since prior, there has been interval development of bilateral alveolar opacities with central distribution, somewhat sparing the periphery   Keywords: development. There is no effusion. Cardiac silhouette is enlarged but stable in configuration. Atherosclerotic calcification is noted in the aorta. Osseous and soft tissue structures are unremarkable.

IMPRESSION: New bilateral parenchymal opacities which may represent pulmonary edema   Keywords: new. The possibility of infection should be correlated clinically. Followup to resolution is suggested after treatment.


SubjectID: 14982705, StudyID: 51492756, Comparison: None

WET READ: ___ ___ ___ 7:04 PM no pneumothorax. ______________________________________________________________________________

FINAL REPORT

HISTORY: Cardiomyopathy with placement of ICD, to assess for pneumothorax.

FINDINGS: In comparison with the study of ___, the degree of vascular congestion is less prominent than on the previous study. Triple-lead pacemaker device is in place with extension to the right atrium, apex of the right ventricle, and branches of the coronary sinus. No evidence of acute pneumonia or pneumothorax.


SubjectID: 14984395, StudyID: 59623273, Comparison: None

FINAL REPORT

INDICATION: Status post mediastinoscopy with possible pneumomediastinum on prior chest radiograph. The patient is clinically well, but repeating chest radiograph to assess for interval change.

COMPARISON: Chest radiograph from ___ at 9:31 a.m.

FINDINGS: As before, a right Port-A-Cath ends in the low SVC. Linear lucency along the left heart border seen on the prior radiograph from earlier today is less conspicuous on the present study. There is minimal bibasilar atelectasis, not significantly changed. A small left pleural effusion is not excluded. There is no right pleural effusion. No pneumothorax is seen. Mild cardiomegaly is unchanged. The mediastinal contours are normal.

IMPRESSION: 1. No definite pneumomediastinum or pneumothorax. Previously seen lucency along the left heart border is less conspicuous on the present study. 2. Unchanged minimal bibasilar atelectasis. 3. Unchanged mild cardiomegaly.


SubjectID: 14984395, StudyID: 51873099, Comparison: None

FINAL REPORT

INDICATION: Status post mediastinoscopy, evaluate for interval change.

COMPARISON: Chest radiograph from ___.

FINDINGS: A right Port-A-Cath ends in the low SVC. Lung volumes are slightly low. There is minimal bibasilar atelectasis. Mild cardiomegaly is not significantly changed. The descending thoracic aorta is slightly tortuous, as before. A small left pleural effusion is not excluded. There is no right pleural effusion. No pneumothorax is seen. A linear lucency along the left heart border could be due to minimal pneumomediastinum or a medial left pneumothorax, not unexpected status post mediastinoscopy. S-shaped scoliosis of the thoracolumbar spine is re-demonstrated.

IMPRESSION: 1. Possible minimal pneumomediastinum versus medial left pneumothorax. Follow-up to resolution is recommended. 2. Unchanged mild cardiomegaly. 3. Possible tiny small left pleural effusion. Impression point #1 was discussed with Dr. ___ by Dr. ___ at 11:56 p.m. via telephone on the day of the study.


SubjectID: 14984395, StudyID: 57087591, Comparison: None

FINAL REPORT

INDICATION: Diffuse T-cell lymphoma with shortness of breath status post left-sided thoracentesis, now with increasing shortness of breath.

TECHNIQUE: PA and lateral chest radiographs.

COMPARISON: ___.

FINDINGS: A right-sided PICC terminates in the right atrium. There is a moderate left pleural effusion, unchanged from ___. There may be a tiny right pleural effusion. There is mild pulmonary vascular congestion along with distention of the azygos vein. The heart size is within normal limits.

IMPRESSION: 1. Mild pulmonary edema. 2. Right PICC terminates in the low SVC. 3. Stable moderate left pleural effusion.


SubjectID: 14984395, StudyID: 57011717, Comparison: None

WET READ: ___ ___ ___ 12:37 AM Left pleural cath in the left basal pleural space. Decreased left effusion with improved left lung aeration. Moderate R effusion, larger since the prior study. RUE PICC in the lower SVC. No pneumothorax. ______________________________________________________________________________

FINAL REPORT

HISTORY: Left effusion after Pleurx catheter, to assess for pneumothorax.

FINDINGS: In comparison with the study of ___, there is a left Pleurx catheter at the base with decreased left effusion and improved lung aeration. The hemidiaphragmatic contour is now relatively sharply seen. There has been an increase in the amount of right effusion since the previous study. The PICC line tip remains either at the cavoatrial junction or possibly in the upper portion of the right atrium.


SubjectID: 14988347, StudyID: 58601696, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF. Assess for pulmonary edema. // r/o pulmonary edema r/o pulmonary edema

IMPRESSION: In comparison with the earlier study of this date, there is continued enlargement of the cardiac silhouette with mild effusions and volume loss predominantly involving the left lower lung. Mild elevation of pulmonary venous pressure persists.


SubjectID: 14988347, StudyID: 50702909, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with shortness of breath // r/o interval increase in pleural edema

TECHNIQUE: Single portable AP view radiograph of the chest.

COMPARISON: Prior chest radiographs dating back to___ and chest CT dated ___..

FINDINGS: Since ___, small bilateral pleural effusions have increased mildly. The pulmonary vasculature is mildly more congested. The heart is stably enlarged. There is no focal consolidation or pneumothorax.

IMPRESSION: Mild interval increase in small bilateral pleural effusions and mild pulmonary vascular congestion.


SubjectID: 14988347, StudyID: 50088914, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF. // Assess for pulmonary edema Assess for pulmonary edema

IMPRESSION: In comparison with the study of ___, there is continued enlargement of the cardiac silhouette with probable small effusions and volume loss most prominently in the left lower lung. Mild elevation of pulmonary venous pressure persists.


SubjectID: 14991576, StudyID: 59125218, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___-year-old female with a history of diabetes, hypertension and hypercholesterolemia, presenting for evaluation of chest pain and shortness of breath x2 days. WBC ___.

TECHNIQUE: Portable chest radiograph

COMPARISON: Chest radiograph ___

FINDINGS: There are diffuse interstitial opacities, compatible with interstitial pulmonary edema. Additionally, there is a more focal opacity at the right lung base, which is most likely also due to underlying pulmonary edema, although superimposed pneumonia could be considered in the appropriate clinical setting. There is no large pleural effusion or pneumothorax. Heart size is moderately enlarged, which appears new from the prior radiograph in ___, although it may partially be due to portable technique. Aortic arch calcifications are noted. No acute osseous abnormalities identified.

IMPRESSION: 1. Moderate cardiomegaly with diffuse interstitial opacities and redistribution, compatible with interstitial pulmonary edema. 2. More focal opacity at the right lung base is most likely due to underlying pulmonary edema, although superimposed pneumonia could be considered in the appropriate clinical setting.


SubjectID: 14991576, StudyID: 54295352, Comparison: worse

WET READ: ___ ___ ___ 9:40 AM Worsening interstitial pulmonary edema and redistribution compared to the prior radiograph performed 3 hours earlier   Keywords: worse. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___-year-old female with a history of diabetes, hypertension and hypercholesterolemia, now with worsening shortness of breath since the prior study performed several hr earlier. WBC ___.

TECHNIQUE: Portable chest radiograph

COMPARISON: Portable chest radiograph ___ at 23:17

FINDINGS: In comparison to the prior radiograph performed 3 hours earlier, there has been an interval increase in the diffuse interstitial opacities and redistribution, perhaps slightly worse at the right lung base. Along with underlying moderate cardiomegaly, these findings together suggest pulmonary edema. There is no substantial pleural effusion or pneumothorax. A linear radiopaque line along the periphery of the right hemithorax represents a fold from the patient's gown, as lung markings are seen lateral to this line. No acute osseous abnormalities identified.

IMPRESSION: Worsening interstitial pulmonary edema and redistribution compared to the prior radiograph performed 3 hours earlier.


SubjectID: 14992360, StudyID: 58503033, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST FILM CLINICAL

INDICATION: ___-year-old with pneumonia, new aspiration event, possible apical pneumothorax on prior chest film. Assess for interval change. Comparison is made to the patient's prior study of ___ at ___. PA and lateral views of the chest ___, at ___ are submitted.

IMPRESSION: Left-sided pacer is again seen with three leads terminating over the expected location of the right atrium and right ventricle, respectively. Overall, cardiac and mediastinal contours are stable. There is diffuse air space process with more focal consolidation again seen in the left mid lung and at the lung bases. This is concerning for bilateral pneumonia/aspiration. In addition, the lungs remain hyperinflated and there is parenchymal distortion and apical bullous changes consistent with underlying emphysema. No pneumothorax is seen. There is blunting of the costophrenic angles which may represent chronic pleural thickening or small effusions. Heart remains enlarged most likely representing cardiomegaly. In addition, the perihilar vasculature is somewhat more prominent and indistinct which suggests a component of superimposed perihilar edema.


SubjectID: 14992360, StudyID: 50857625, Comparison: None

WET READ: ___ ___ ___ 8:05 PM Interval increase in left upper lobe opacity, consistent with worsening pneumonia. New subtle, ill-defined bilateral lower lung opacities could be atelectasis, aspiration pneumonitis, or pneumonia. ______________________________________________________________________________

FINAL REPORT

HISTORY: Left upper lobe pneumonia.

FINDINGS: In comparison with the study of ___, there is increase in the left upper lobe consolidation accompanied by increased prominence of pulmonary vessels consistent with elevated pulmonary venous pressure. There is a possible small pleural line that could be reflection of a small apical pneumothorax on the right, there is suggestion of a vessel running beyond this line in the far apical region, raising the possibility that this could represent merely a skinfold.


SubjectID: 14993603, StudyID: 59704652, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p CABG,AVR // follow up edema/deep sulcus on L

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the lung volumes have decreased. As a consequence, there is an increase in density at both lung bases, caused by vascular and bronchial crowding. The appearance of the cardiac silhouette is unchanged. Minimal fluid overload but no overt pulmonary edema. The monitoring and support devices are constant. No pneumothorax. No larger pleural effusions.


SubjectID: 14993603, StudyID: 53441697, Comparison: same

WET READ: ___ ___ ___ 7:59 AM 1. Stable low lung volumes, bibasilar atelectasis, mild cardiomegaly, and mild central vascular congestion. 2. Left chest tube in unchanged location with no discrete residual left-sided pneumothorax. 3. Additional support lines and tubes are unchanged in position.

WET READ VERSION #1 ___ ___ ___ 7:06 PM 1. Stable low lung volumes, bibasilar atelectasis, mild cardiomegaly, and mild central vascular congestion. 2. Left chest tube in unchanged location with no discrete residual left-sided pneumothorax. 3. Additional support lines and tubes are unchanged in position. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p AVR,CABG // eval for worsening pneumothorax on Left

COMPARISON: ___.

IMPRESSION: No relevant change as compared to the previous image   Keywords: no relevant change. The monitoring and support devices are all in constant position. No pneumothorax. No larger pleural effusions. Unchanged postoperative appearance of the cardiac silhouette. Mild fluid overload but no overt pulmonary edema.


SubjectID: 14995538, StudyID: 59921986, Comparison: worse

WET READ: ___ ___ ___ 8:18 AM Endotracheal tube terminates 5.1 cm above the carina. There are worsening bilateral parenchymal opacities, compatible with severe pulmonary edema. A small to moderate pleural effusion is likely unchanged accounting for differences in positioning. There has been some re-expansion of the middle lobe.

WET READ VERSION #___ ___ ___ ___ 7:54 PM Endotracheal tube terminates 5.1 cm above the carina. There are worsening bilateral parenchymal opacities, compatible with severe pulmonary edema. A small to moderate pleural effusion is likely unchanged accounting for differences in positioning. There has been some re-expansion of the middle lobe. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with intubation // ET tube placement. RLL collapse?

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the patient was intubated. The tip of the endotracheal tube is projecting 5 cm above the carinal. The course of the previous left PICC line is unchanged. Moderate cardiomegaly persists. There is evidence of increasing pulmonary edema that is now severe   Keywords: increasing. Unchanged evidence of a retrocardiac atelectasis as well as of a right pleural effusion with subsequent basal atelectasis. No pneumothorax.


SubjectID: 14995538, StudyID: 59193309, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with respiratory distress, CHF, COPD, with mucous plug and right lung collapse on CXR, now on BIPAP // Eval for interval change

IMPRESSION: Persisting complete collapse of right middle and right lower lobe with adjacent small right pleural effusion. Worsening left lower lobe consolidation. Unchanged cardiomegaly and interstitial edema   Keywords: unchanged.


SubjectID: 14995538, StudyID: 56100996, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p OGT placement // eval OG tube placement

COMPARISON: ___, 19:01

IMPRESSION: As compared to the previous radiograph, the patient has received a nasogastric tube. The course of the tube is unremarkable, the tip of the tube projects over the middle parts of the stomach. No evidence of complications, notably no pneumothorax. Unchanged appearance of the lungs, the moderate cardiomegaly and the bilateral pleural effusions.


SubjectID: 14995538, StudyID: 56042298, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with fluid overload intubated // interval change

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the right pleural effusion has substantially decreased in extent. The signs indicative of pulmonary edema have decreased in severity   Keywords: decrease. Moderate cardiomegaly persists. Small right pleural effusion and retrocardiac atelectasis is present. The monitoring and support devices are in unchanged position.


SubjectID: 14995538, StudyID: 52537459, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with COPD, dCHF, PVD here for RLE infection with worsening respiratory distress and tacypnea // evaluate for volume overload/PNA

IMPRESSION: AS COMPARED TO ___ RADIOGRAPH, COMBINED RIGHT MIDDLE AND RIGHT LOWER LOBE COLLAPSE ARE NEW, SUGGESTING ACUTE MUCOUS PLUGGING IN THE BRONCHUS INTERMEDIUS. HEART REMAINS ENLARGED AND IS ACCOMPANIED BY PULMONARY VASCULAR CONGESTION AND INTERSTITIAL EDEMA   Keywords: remains. ADDITIONALLY, A WORSENING AIRSPACE OPACITY LEFT LOWER LOBE COULD POTENTIALLY BE DUE TO EVOLVING PNEUMONIA AND NOTE IS MADE OF BILATERAL PLEURAL EFFUSIONS.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 9:02 AM, 5 minutes after discovery of the findings.


SubjectID: 14995538, StudyID: 59642156, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with osteomyelitis and severe hypertension causing flash pulmonary edema // interval change

TECHNIQUE: Portable AP upright radiograph of the chest was obtained.

COMPARISON: Upright portable chest radiograph ___

FINDINGS: Endotracheal tube and nasogastric tubes are no longer visualized. Left central line is unchanged with tip terminating at the cavoatrial junction. There is blunting of the left costophrenic angle. There is improved aeration of the right lower lobe with decreased fluid within the right minor fissure and sharp right costophrenic angle. There is mildly improved left lower lung aeration. There is no pneumothorax. There is no new area of consolidation.

IMPRESSION: 1. Improved bibasilar aeration, right greater than left, and decrease in size of right pleural effusion. 2. Removal of nasogastric and endotracheal tubes.


SubjectID: 14995538, StudyID: 52630069, Comparison: None

FINAL REPORT

HISTORY: Hypoxemia, to assess for pulmonary edema or pneumonia.

FINDINGS: In comparison with the study of ___, the patient has taken a somewhat better inspiration. There is continued enlargement of the cardiac silhouette. No definite evidence of pulmonary vascular congestion. The left base is slightly more opaque than the right. This could reflect small amount of pleural fluid with atelectatic changes or even possible consolidation, though it also may be a manifestation of overlying soft tissues. If the condition of the patient would permit, a lateral view would be most helpful.


SubjectID: 14995538, StudyID: 51755970, Comparison: None

FINAL REPORT

HISTORY: Fever and new oxygen requirement.

COMPARISON: Comparison is made to radiographs of the chest from ___.

FINDINGS: PA and lateral views of the chest demonstrates persistent mildly enlarged heart size, unchanged since the prior. The lungs are well expanded with no evidence of pneumothorax, pleural effusion or overt pulmonary edema. Minimal streaky opacity in the right lung base is likely representative of a summation of vessels or minor atelectasis. No focal pneumonia is identified. Clips are again seen within the neck.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 15035666, StudyID: 57044147, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with heart failure, respiratory distress // Please eval for edema, interval change

TECHNIQUE: Portable AP radiograph of the chest.

COMPARISON: ___.

FINDINGS: The lungs are clear. There is no pneumothorax. Mild cardiomegaly despite the projection is unchanged. Regional bones and soft tissues are unremarkable. Metallic anchors at the left humeral head suggest prior rotator cuff repair.

IMPRESSION: No significant interval change   Keywords: no significant interval change.


SubjectID: 15035666, StudyID: 54461338, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with SOB // presence of pleural effusion, pulmonary edema

TECHNIQUE: Single frontal view of the chest

COMPARISON: None

FINDINGS: The cardiac silhouette is top-normal to mildly enlarged. No large pleural effusion is seen. . Patchy right basilar opacity may relate to prominent vascular structures, but underlying infection or aspiration is not excluded. Anchor screws overlie the left humeral head which could. Inferiorly simple in relation area

IMPRESSION: No pleural effusion or definite pulmonary edema. Patchy right basilar opacity may be due to prominent vascular structures but infection or aspiration not excluded.


SubjectID: 15035666, StudyID: 55734737, Comparison: None

FINAL REPORT

INDICATION: R PICC out of vein 3cm unable to see tip please do OBLIQUE ___ year old woman withR PICC - unable to see tip // R PICC out of vein 3cm unable to see tip please do OBLIQUE view ___ ___

EXAMINATION: CHEST (PORTABLE AP)

TECHNIQUE: Portable Chest radiograph, frontal view

COMPARISON: This radiograph ___ 11:57

FINDINGS: Right PICC line likely terminates in the right atrium. It can be pulled by 2.5 cm to reposition in the low SVC. There is no pneumothorax. Mild atelectasis at left lung base is unchanged from prior. Cardiomediastinal silhouette is within normal size and unchanged.

IMPRESSION: Right PICC line likely terminates in the right atrium. It can be pulled by 2.5 cm to reposition in the low SVC. Repeat RPO oblique view chest radiograph is recommended for better evaluation of PICC position.


SubjectID: 15035666, StudyID: 54994505, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with dyspnea, hypoxia // presence of pulmonary edema, infiltrate, effusion

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: Bilateral perihilar and bibasilar opacities are noted concerning for pulmonary edema, underlying infection not excluded. No large pleural effusion is seen. There is no evidence of pneumothorax. The cardiac silhouette is mildly enlarged.

IMPRESSION: Findings worrisome for pulmonary edema, underlying infection not excluded. Enlarged cardiac silhouette.


SubjectID: 15035666, StudyID: 50172256, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with sCHF presenting with worsening SOB and hypoxia with acute decompensation on the floor requiring Bipap // Please evaluate any evidence of worsening pulmonary edema or new consolidations to explain hypoxia Please evaluate any evidence of worsening pulmonary edema or

IMPRESSION: In comparison with the study of ___, there is little overall change in the degree of enlargement of the cardiac silhouette and pulmonary edema   Keywords: little overall change. No large effusion is seen or evidence of acute focal pneumonia. Retrocardiac opacification suggests some volume loss in the left lower lobe.


SubjectID: 15038651, StudyID: 55622460, Comparison: None

FINAL REPORT

INDICATION: Hypoxia.

COMPARISON: ___.

FINDINGS: Portable AP chest radiograph demonstrates persistent elevation of the left hemidiaphragm and bibasilar atelectasis. There is mild cardiomegaly but no evidence of pulmonary edema. There is no pleural effusion or pneumothorax.


SubjectID: 15038651, StudyID: 52813866, Comparison: None

FINAL REPORT

INDICATION: Worse peripheral edema. Concern for CHF.

COMPARISONS: ___ at 12:46 a.m.

FINDINGS: Portable AP chest radiograph demonstrates mildly improved inspiration compared to ___:46 a.m. There is persistent elevation of the left hemidiaphragm with associated atelectasis. The cardiomediastinal silhouette is stable. There is no pulmonary vascular congestion. There is no pleural effusion or pneumothorax.

IMPRESSION: No evidence of pulmonary edema.


SubjectID: 15084163, StudyID: 58318495, Comparison: better

FINAL REPORT

INDICATION: ___-year-old woman with back pain and fever.

COMPARISONS: ___. Semi-upright portable chest radiographs were obtained. The examination is limited due to poor penetration likely secondary to body habitus and portable technique without evidence of focal consolidation. Retrocardiac opacities are not well assessed on this single radiograph but appear improved compared to the radiograph from ___. For better evaluation, consider PA and lateral views. Heart is moderately enlarged. Mild pulmonary vascular engorgement appears slightly improved. Right humeral fixation hardware is incompletely assessed.

IMPRESSION: Improved retrocardiac opacities and pulmonary vascular congestion on this limited study   Keywords: improve. For better evaluation, two-view chest radiograph could be obtained.


SubjectID: 15084163, StudyID: 53172937, Comparison: same

FINAL REPORT

HISTORY: Fever.

TECHNIQUE: Upright AP and lateral views of the chest.

COMPARISON: ___ at 13: ___.

FINDINGS: Low lung volumes are present. Moderate cardiomegaly is unchanged. The mediastinal contours are stable with calcification of the thoracic aorta which is mildly tortuous. There is mild pulmonary vascular congestion unchanged from the radiograph performed earlier in the day   Keywords: unchanged. Streaky opacities in lung bases are re- demonstrated. No pleural effusion or pneumothorax is identified. Evaluation the osseous structures is limited due to the patient's large body habitus. Partially imaged is orthopedic hardware within the right humeral head.

IMPRESSION: Mild pulmonary vascular congestion unchanged compared to the radiograph from earlier in the day   Keywords: unchanged. Bibasilar airspace opacities could reflect areas of infection but are improved from ___.


SubjectID: 15084163, StudyID: 58060724, Comparison: worse

FINAL REPORT

AP CHEST, 8:29 AM, ___

HISTORY: Fracture and shortness of breath. Assess for possible pneumonia.

IMPRESSION: AP chest compared to ___ and ___.

FINDINGS: Mediastinal widening is new, and could be due to venous engorgement, which along with pulmonary vascular congestion and possible increase in heart size, all attest to heart failure   Keywords: increase. However, there is particular widening of the mediastinum in the region of the aortopulmonic window, which should be monitored to exclude either adenopathy or even aortic dissection, and there is a focal area of consolidation at the right lung base, which could be concurrent pneumonia. Careful radiographic followup is warranted. Dr. ___ was paged to report these findings, at the time of dictation.


SubjectID: 15084163, StudyID: 57999145, Comparison: worse

FINAL REPORT

INDICATION: Cough and fever.

COMPARISON: Chest radiograph from the same day at 21:50.

FINDINGS: Evaluation is again limited due to patient body habitus. There has been progression of bilateral diffuse interstitial opacities, which are most likely representative of mild pulmonary edema   Keywords: progression. Additionally, there is an opacity in the right upper lobe (between the first and second ribs) with a more confluent opacity in the left lower lobe. Mild cardiomegaly is again noted. Post-surgical changes in the right proximal humerus are partially visualized.

IMPRESSION: 1. Limited study due to patient body habitus demonstrates evidence of multifocal pneumonia with an opacity in the right upper lobe and a large confluent opacity at the left lower lobe. 2. Bilateral increased interstitial opacities concerning for worsening mild pulmonary edema   Keywords: worse, increase. 3. Mild cardiomegaly again noted. ___


SubjectID: 15084163, StudyID: 54636446, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior study from ___. CLINICAL

HISTORY: Cough and fever, assess for pneumonia.

FINDINGS: Semi-upright portable AP view of the chest was provided. The heart is top normal in size. There is mild diffuse ground-glass pulmonary opacity, which could represent pulmonary edema, less likely a typical infection. No large effusion or pneumothorax is seen. Bony structures are intact. Hardware partially visualized in the right proximal humerus.

IMPRESSION: Mild ground-glass diffuse pulmonary opacity is concerning for pulmonary edema. Mild cardiomegaly also again noted.


SubjectID: 15087570, StudyID: 57569009, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with heart failure // pulm edema, effusion, PNA pulm edema, effusion, PNA

IMPRESSION: In comparison with the earlier study from an outside facility, there is again substantial enlargement of the cardiac silhouette with engorged item and indistinct pulmonary vessels this is similar elevated pulmonary venous pressure. Poor definition of left hemidiaphragm is consistent with substantial loss of volume in the left lower lobe. Small pleural effusion is seen on this side as well.


SubjectID: 15087570, StudyID: 53591034, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF. // assess for interval change in pulmonary edema - for between ___AM on ___

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Since the prior study there has been interval improvement in pulmonary edema currently minimal with no change in bilateral at least moderate pleural effusions   Keywords: improve. Cardiomediastinal silhouette is stable.


SubjectID: 15087570, StudyID: 52343262, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with shortness of breath. // r/o pulmonary congestion

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Interval development of moderate to severe pulmonary edema associated with bilateral pleural effusions demonstrated   Keywords: development. Reassessment after diuresis is required.


SubjectID: 15087570, StudyID: 52842303, Comparison: None

WET READ: ___ ___ 9:13 PM New interstitial abnormality, which most likely represents mild pulmonary edema, but differential diagnosis includes atypical infection. New small bilateral pleural effusions. Follow up chest radiograph after diuresis, if performed, may be helpful. Discussed with Dr. ___ by phone at 21:09 on ___ at time of discovery. Retrocardiac density most likely represents atelectasis, but infection or aspiration cannot be excluded. Discussed with Dr. ___ by phone at 21:12 on ___ at time of discovery.

WET READ VERSION #1

WET READ VERSION #2 ___ ___ 9:09 PM New interstitial abnormality, which most likely represents mild pulmonary edema, but differential diagnosis includes atypical infection. New small bilateral pleural effusions. Follow up chest radiograph after diuresis, if performed, may be helpful. Discussed with Dr. ___ by phone at 21:09 on ___ at time of discovery. ______________________________________________________________________________

FINAL REPORT

HISTORY: Cholangitis, persistent dyspnea and hypoxia. Question pulmonary edema. CHEST, TWO VIEWS.

COMPARISON: Chest x-ray from ___. There are low inspiratory volumes. The cardiomediastinal silhouette is enlarged, slightly more than on the prior film. There is upper zone redistribution and mild diffuse vascular blurring, consistent with CHF. Probable atelectasis at both bases, though the possibility of an underlying pneumonic infiltrate would be difficult to exclude. Small bilateral effusions are noted.

IMPRESSION: 1. Findings consistent with CHF, with bibasilar atelectasis. A superimposed pneumonic infiltrate would be difficult to exclude. Small bilateral effusions. These findings are new compared with ___. 2. Cardiomediastinal enlargement, slightly more pronounced than on ___.


SubjectID: 15087570, StudyID: 51467863, Comparison: better

FINAL REPORT

HISTORY: CKD cholangitis, volume overload from resuscitation. Question interval change after diuresis. CHEST, TWO VIEWS.

COMPARISON: ___ at 18:21 p.m. Compared with the prior film, there has been considerable improvement in the CHF findings. There is residual upper zone redistribution, but generalized pulmonary vascular plethora and the interstitial edema has resolved. There are small bilateral effusions seen posteriorly. There is bibasilar atelectasis. The cardiomediastinal silhouette remains slightly enlarged, but appears slightly less prominent than on the prior exam. Otherwise, I doubt significant interval change. Suspect background COPD.

IMPRESSION: 1. Interval improvement in CHF findings   Keywords: improve. 2. Upper zone redistribution, bibasilar atelectasis, and small posterior effusions.


SubjectID: 15107848, StudyID: 59781202, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with resp failure, vol overload. // interval change, pleural effusions interval change, pleural effusions

IMPRESSION: In comparison with the study of ___, there is again substantial enlargement of the cardiac silhouette with severe pulmonary edema in a patient with low lung volumes. Bilateral pleural effusions and basilar atelectasis are seen. In the appropriate clinical setting, superimposed pneumonia would have to be considered.


SubjectID: 15107848, StudyID: 53200593, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with history of possible IPF, respiratory failure, and recurrent flash pulmonary edema s/p diuresis and high dose methylpred. // compare to prior compare to prior

IMPRESSION: In comparison with the study of ___, the Dobbhoff tube extends at least to the mid body of the stomach where it crosses the lower margin of the image. Other monitoring and support devices are unchanged. The patient has taken a slightly better inspiration. Continued enlargement of the cardiac silhouette with pulmonary vascular congestion that appears to be decreasing   Keywords: decreasing. .


SubjectID: 15107848, StudyID: 51822921, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with respiratory failure // Placement, evolution of edema/effusions Placement, evolution of edema/effusions

IMPRESSION: In comparison with the study of ___ there is little overall change in the appearance of the monitoring and support devices. Continue substantial enlargement of the cardiac silhouette with pulmonary vascular congestion in a patient with low lung volumes.


SubjectID: 15107848, StudyID: 59017457, Comparison: same

FINAL REPORT

INDICATION: History: ___M with ETT // eval ETT, OGT

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph from ___ and CT chest without contrast from ___.

FINDINGS: The endotracheal tube is appropriately positioned 2.7 cm above the carina. Nasogastric tube courses below the diaphragm into the stomach. There is no significant change in the appearance of the lungs since the recent prior radiograph, however there is significant worsening since ___   Keywords: no significant change. Patient has chronic interstitial lung disease. Severe bilateral pulmonary opacities and obscuration of the hemidiaphragms are unchanged concerning for bilateral consolidations with pulmonary edema   Keywords: unchanged. There is no pneumothorax.

IMPRESSION: 1. Endotracheal tube and nasogastric tube appropriately positioned. 2. Severe bilateral pulmonary opacities concerning may be due to pulmonary edema, however acute exacerbation of interstitial lung disease should also be considered.


SubjectID: 15107848, StudyID: 58965391, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with ETT recently moved across campus // ETT position, interval changes in consolidations

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: ET tube tip is 2.7 cm above the carinal. Right internal jugular line tip is at the level of cavoatrial junction. There is substantial interval progression of widespread consolidations concerning for progression of pulmonary edema in a patient with severe cardiomegaly


SubjectID: 15107848, StudyID: 55224103, Comparison: better

FINAL REPORT

INDICATION: Confirm line placement.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph from ___.

FINDINGS: There is been placement of a right internal jugular central line that terminates in the right atrium. Endotracheal tube, a nasogastric tube are unchanged and appropriately positioned. Compared to the prior study there is improved aeration and improvement in bilateral pulmonary opacities   Keywords: improve.

IMPRESSION: 1. Right internal jugular central line in the right atrium which should be retracted for more optimal positioning in the SVC. 2. Improved bilateral pulmonary opacities favoring pulmonary edema as the etiology   Keywords: improve.


SubjectID: 15107848, StudyID: 52301758, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with pulmonary fibrosis, CHF, on bipap, prior film from OSH // evaluate for pulmonary edema, pneumonia, acute change

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___ at 16:30, outside institution as well as ___

FINDINGS: Patient has underlying chronic interstitial lung disease. However, compared to chest radiograph from ___, there has been significant interval increase in bilateral pulmonary opacities as well as obscuration of the bilateral hemidiaphragms   Keywords: increase. Findings raise concern for bilateral pleural effusions with overlying atelectasis, subtle suggestion of bibasilar air bronchograms raises concern for bilateral consolidations which may be due to infection and/ or aspiration. Underlying pulmonary edema may also be present.


SubjectID: 15107848, StudyID: 58696024, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with idiopathic pulmonary fibrosis, acute on chronic resp distress // ? edema, interval change ? edema, interval change

IMPRESSION: In comparison with the study of ___, there is little change in the severe and extensive bilateral airspace opacities consistent with idiopathic pulmonary fibrosis. Given this extensive disease, it is very difficult to assess for of the amount of pulmonary vascular congestion. In the appropriate clinical setting, it would be extremely difficult to exclude superimposed pneumonia.


SubjectID: 15107848, StudyID: 57081157, Comparison: None

WET READ: ___ ___ ___ 9:17 AM Series demonstrating placement of a Dobbhoff tube with final positioning of the tip just below the diaphragm, likely in the proximal stomach.

WET READ VERSION #1 ___ ___ 8:49 PM Series demonstrating placement of a Dobbhoff tube with final positioning of the tip just below the diaphragm, likely in the proximal stomach. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with IPF s/p intubation // confirm ETT placement, staged dophoff placement

TECHNIQUE: 8 films during Dobbhoff placement

COMPARISON: ___

IMPRESSION: Series demonstrating placement of a Dobbhoff tube with final positioning of the tip just below the diaphragm, in the proximal stomach the appearance of the lungs in this patient with known IPF is not substantially changed. ET tube is 3 cm above the carina. Right PICC line tip is in the right atrium


SubjectID: 15107848, StudyID: 53938623, Comparison: 1.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with IPF, distolic dysfunction, now with worsening SOB, // ? worsening infiltrate, fluid

TECHNIQUE: Portable AP radiograph of the chest.

COMPARISON: ___, ___.

FINDINGS: All support devices have been removed. Extensive bilateral airspace opacities have minimally improved since the study of 3 days prior, particularly in the left upper lobe   Keywords: improve. However, the background of fine reticular interstitial opacities is unchanged   Keywords: unchanged. Lung volumes remain low. There is no pneumothorax. Moderate cardiomegaly despite the projection is unchanged. Small pleural effusions are unchanged.

IMPRESSION: Slightly improved aeration of the left upper lobe, which may be due to resolving pulmonary edema or IPF exacerbation   Keywords: resolving. Otherwise no significant interval change in severe pulmonary fibrosis, which has progressed since ___.


SubjectID: 15129946, StudyID: 52339954, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Increasing oxygen requirements, evaluation for pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Borderline size of the cardiac silhouette with mild enlargement of the left ventricle. No acute pulmonary edema. No pleural effusions. No pneumothorax. Moderate tortuosity of the thoracic aorta.


SubjectID: 15129946, StudyID: 50843361, Comparison: None

FINAL REPORT

CHEST, TWO VIEWS: ___

HISTORY: ___-year-old male with cough and decreased oxygen saturation, question pneumonia.

FINDINGS: AP and lateral views of the chest are compared to previous exam from ___. There is opacity at the left lung base laterally, also seen on the lateral view compatible with atelectasis versus infiltrate. Elsewhere, the lungs are clear of confluent consolidation but notable for prominent central indistinct vascular markings. Small effusion is noted on the left. Cardiac silhouette is enlarged but stable. Osseous structures again notable for posterior right rib fractures.

IMPRESSION: Left basilar opacity, potentially due to atelectasis versus consolidation and probable trace effusion. Findings suggestive of pulmonary vascular congestion.


SubjectID: 15131736, StudyID: 59799399, Comparison: better

FINAL REPORT

PORTABLE CHEST ___

COMPARISON: ___.

FINDINGS: Indwelling support and monitoring devices are unchanged in position. Stable cardiomegaly. Slight improvement in pulmonary vascular congestion   Keywords: improve. Improving aeration in left retrocardiac region with residual patchy atelectasis remaining. Likely small pleural effusions with some extension into the right minor fissure.


SubjectID: 15131736, StudyID: 56605562, Comparison: same

WET READ: ___ ___ ___ 9:13 PM ET tube 4.6 cm from carina - tube position D/w ___ (ICU resident) at 8:08 pm on ___ by telephone. Bibasilar opacities are unchanged - likely atelectasis. Small probable pleural effusions are stable. Right IJ in unchanged position. NG in the distal stomach. Lung apices not included in the image. Overall aeration of the lungs similar compared to recent prior. Stable cardiomegaly. ___ p_________________________________________________________________________________

FINAL REPORT

HISTORY: Dyspnea, for tube placement.

FINDINGS: In comparison with the earlier study of this date, the endotracheal tube lies approximately 5 cm above the carina. Bibasilar opacities persist, more prominent on the left, and most likely representing atelectasis and small effusion. In the appropriate clinical setting, superimposed pneumonia would have to be considered. Nasogastric tube extends to the distal stomach and central catheter tip is in the lower portion of the SVC. Stable cardiomegaly.

IMPRESSION: Little overall change   Keywords: little overall change.


SubjectID: 15131736, StudyID: 52404879, Comparison: same

FINAL REPORT

INDICATION: New endotracheal tube placement.

TECHNIQUE: Single frontal radiograph of the chest.

COMPARISON: Multiple prior examinations, most recent radiograph of the same date obtained approximately three hours prior.

FINDINGS: There has been interval placement of an endotracheal tube, which is low lying with tip approximately 1.6 cm above the carina. An esophageal tube is in place coursing inferior to the diaphragm; however, tip out of view of the radiograph. Lung volumes remain low with mild pulmonary edema   Keywords: remain. No significant pleural effusion or pneumothorax is identified. The cardiomediastinal silhouette is enlarged, however, unchanged.

IMPRESSION: Interval placement of endotracheal tube with tip low lying, approximately 1.6 cm above the carina. Mild pulmonary edema. Distal tip of esophageal tube not within the field of view of radiograph. Findings discussed with Dr. ___ at 5:10 p.m., ___.


SubjectID: 15131736, StudyID: 51229977, Comparison: same

FINAL REPORT

EXAM: Chest, single AP upright portable view. CLINICAL INFORMATION: ___-year-old female with history of CHF and lower extremity edema with shortness of breath.

COMPARISON: ___.

FINDINGS: Single AP upright portable view of the chest was obtained. There are relatively low lung volumes. Mild elevation of the right hemidiaphragm is unchanged. There has been interval removal of endotracheal and nasogastric tubes. There is pulmonary vascular congestion. No large pleural effusions are seen, although a trace effusion on the left would be difficult to exclude. No pneumothorax is seen. The cardiac silhouette remains enlarged.

IMPRESSION: Pulmonary vascular congestion with persistent enlargement of the cardiac silhouette   Keywords: persistent. No large pleural effusion is seen, although a small left pleural effusion would be difficult to exclude.


SubjectID: 15131736, StudyID: 50908995, Comparison: better

FINAL REPORT

AP CHEST, 5:06 A.M., ON ___

HISTORY: ___-year-old woman with CHF, diabetes, coronary artery disease, morbid obesity, obstructive sleep apnea on CPAP. Diastolic heart failure, COPD, and smoking. Respiratory distress.

IMPRESSION: AP chest compared to ___: Pulmonary edema that was present on ___ has nearly resolved   Keywords: resolve. Severe cardiomegaly, mediastinal vascular engorgement and a very large pulmonary arteries indicating pulmonary arterial hypertension is all stable. Consolidation persists in the left lower lung, and may well be pneumonia. Small bilateral pleural effusions are presumed. No pneumothorax. Tip of the ET tube is at the upper margin of the clavicles, no less than 55mm from the carina and could be advanced 2 cm for more secured seating. Right jugular line ends in the mid to low SVC and a nasogastric tube passes into the stomach and out of view. No pneumothorax.


SubjectID: 15131736, StudyID: 59523783, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF exacerbation, pulmonary edema // interval change

IMPRESSION: In comparison to previous radiograph of 1 day earlier, marked cardiomegaly persists, accompanied by pulmonary vascular congestion and slight improvement in pulmonary edema   Keywords: improve. Interval worsening of right retrocardiac opacity, likely due to atelectasis. Persistent small pleural effusions.


SubjectID: 15131736, StudyID: 58698919, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with CHF exacerbation // Eval for interval change

COMPARISON: The comparison is made with prior studies including ___.

IMPRESSION: The endotracheal tube and nasogastric tubes have been removed. There is no significant change in the pulmonary edema   Keywords: no significant change. There are no new areas of consolidation with some persistent density in the right lung base. There is no pneumothorax.


SubjectID: 15131736, StudyID: 58145542, Comparison: same

WET READ: ___ ___ ___ 4:17 PM 1. The new endotracheal tube tip projects 4.0 cm above the carina. 2. Persistent pulmonary edema   Keywords: persistent and low lung volumes. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with new endotracheal tube placement. Evaluate tube position.

TECHNIQUE: Single portable AP view of the chest.

COMPARISON: Chest radiographs of ___.

FINDINGS: Compared with the earlier study, a new endotracheal tube terminates 4.0 cm above the carina. Lobe lung volumes are re- demonstrated, with cardiomegaly, mild to moderate pulmonary edema, and persistent hilar congestion   Keywords: persistent. No large pleural effusions or pneumothorax on this limited scan. A presumed enteric tube courses be low the left hemidiaphragm another view.

IMPRESSION: ET tube tip positioned 4 cm above the carina. NG tube extends inferiorly, tip not seen. Persistent pulmonary edema.


SubjectID: 15131736, StudyID: 50016102, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with history of CHF, COPD worsening dyspnea. No wheezing heard // eval for pulm edema

COMPARISON: ___

FINDINGS: AP portable upright view of the chest. Evaluation limited due to underpenetration and low lung volumes. There is cardiomegaly with hilar congestion and mild pulmonary edema. No large effusion is seen the small effusions difficult to exclude. No overt signs of pneumonia though Lung bases are suboptimally assessed. No large pneumothorax.

IMPRESSION: Cardiomegaly with hilar congestion and mild pulmonary edema. Somewhat limited exam.


SubjectID: 15131736, StudyID: 59361128, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___.

COMPARISON: ___. CLINICAL

HISTORY: Worsening shortness of breath.

FINDINGS: AP, upright and lateral views of the chest were provided. Lung volumes are low, though there is evidence of pulmonary edema. Small effusions are difficult to exclude. The heart is impossible to assess. Previously noted endotracheal tube and NG tubes have been removed. The imaged osseous structures are intact.

IMPRESSION: Pulmonary edema with probable small bilateral effusions. Limited exam.


SubjectID: 15131736, StudyID: 59112340, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: COPD and CHF exacerbation, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Moderate pulmonary edema with small bilateral pleural effusions and areas of atelectasis at the lung bases. Moderate-to-severe cardiomegaly. Overall, low lung volumes. No newly appeared parenchymal opacities   Keywords: new. No pneumothorax.


SubjectID: 15131736, StudyID: 59242045, Comparison: None

FINAL REPORT

INDICATION: ___F with hypoxia,dyspnea and cough // r/o PNA

TECHNIQUE: Single portable view of the chest.

COMPARISON: ___.

FINDINGS: Enteric and ET tubes are no longer visualized. Degree of pulmonary edema perhaps minimally less extensive when compared to prior. Cardiomegaly is again seen. Retrocardiac region is not well-visualized potentially in part due to overlying soft tissues and atelectasis although underlying infection cannot be excluded.

IMPRESSION: Moderate pulmonary edema. Retrocardiac opacity potentially in part technical although underlying infection can not be excluded. Appearance is similar compared to prior. Consider PA and lateral if patient is amenable.


SubjectID: 15131736, StudyID: 56644987, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with hypoxia // r/o acute process

COMPARISON: Radiographs from ___.

IMPRESSION: Heart size is enlarged but stable. There remains moderate pulmonary edema which is unchanged   Keywords: unchanged, remains. There is an unchanged left retrocardiac opacity. There are likely small bilateral effusions. There are no pneumothoraces.


SubjectID: 15131736, StudyID: 54867671, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with influenza, pulmonary edema. Improvement in edema?

TECHNIQUE: Single portable AP view of the chest.

COMPARISON: Chest radiographs from ___, ___, and ___.

FINDINGS: Mild to moderate cardiomegaly is stable. Compared to the prior radiograph, the degree of pulmonary edema is unchanged   Keywords: unchanged. No new focal consolidation or pneumothorax. Persistent bilateral pleural effusions and bibasilar atelectasis.

IMPRESSION: No change in the degree of pulmonary edema, with persistent bilateral pleural effusions and bibasilar atelectasis   Keywords: persistent, no change.


SubjectID: 15131736, StudyID: 58833368, Comparison: worse

FINAL REPORT

HISTORY: Respiratory failure status post intubation.

COMPARISON: ___

FINDINGS: There is a new ET tube 5.4 cm above the carina. There is pulmonary vascular redistribution that is worsened in the interval with alveolar infiltrates bilaterally and dense retrocardiac opacity that could be due to volume loss/infiltrate/effusion. The heart size is moderately enlarged. NG tube tip is in the stomach. There is a small right effusion.

IMPRESSION: 1. ET tube in good location. 2. Increased CHF   Keywords: increase. An underlying infectious infiltrate cannot be excluded


SubjectID: 15131736, StudyID: 57823021, Comparison: same

FINAL REPORT

HISTORY: Hypoxemic respiratory failure.

COMPARISON: ___.

FINDINGS: Compared to the prior exam there is no significant interval change   Keywords: no significant interval change.


SubjectID: 15131736, StudyID: 53690114, Comparison: same

FINAL REPORT

HISTORY: Hypoxemia hypercarbic respiratory failure.

COMPARISON: ___.

FINDINGS: Compared to prior study there is no significant interval change   Keywords: no significant interval change.


SubjectID: 15131736, StudyID: 54622603, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with CHF exacerbation, now extubated, concern for aspiration // eval interval change, concern for aspiration PNA vs pneumonitis

COMPARISON: Comparison is made with prior studies including ___.

IMPRESSION: There is persistent pulmonary edema present and this is unchanged on the left side and slightly more pronounced on the right as compared to the earlier exam   Keywords: persistent, unchanged. There is stable cardiomegaly. There is no pneumothorax.


SubjectID: 15131736, StudyID: 50927676, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with COPD, suspected aspiration // interval changes interval changes

IMPRESSION: Cardiomegaly is severe and unchanged. Mediastinal silhouette is enlarged, unchanged as well. Vascular congestion is severe. There is potentially mild interstitial edema overall similar to previous examination   Keywords: similar. No appreciable pleural effusion demonstrated. No focal consolidations that would explain suspected aspiration demonstrated.


SubjectID: 15131736, StudyID: 57913253, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF exacerbation, intubated/sedated. // assess interval change

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the pre-existing pulmonary edema has minimally decreased in severity and extent   Keywords: decrease. Low lung volumes and moderate to massive cardiomegaly persists. No pleural effusions. No pneumonia. No pneumothorax.


SubjectID: 15131736, StudyID: 57865645, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with shortness of breath and low oxygen saturation

TECHNIQUE: Upright AP view of the chest

COMPARISON: ___

FINDINGS: Lung volumes are low. Moderate cardiomegaly is re- demonstrated. There is mild pulmonary edema, perhaps minimally worse compared to the previous exam   Keywords: worse. Small bilateral pleural effusions may be present, and bibasilar opacities likely reflect areas of atelectasis. No large pneumothorax is present though assessment of the left apex is slightly obscured due to the patient's neck and soft tissues projecting over this region. Degenerative changes of the left glenohumeral joint are noted.

IMPRESSION: Low lung volumes. Mild pulmonary edema and probable small bilateral pleural effusions with bibasilar atelectasis.


SubjectID: 15131736, StudyID: 52062934, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p intubation. Assess ett placement. // assess ETT placement

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: ET tube tip is 5.5 cm above the carinal. NG tube tip is in the stomach. Cardiomegaly is substantial. Vascular enlargement is severe with border lining interstitial pulmonary edema, unchanged   Keywords: unchanged. Bilateral pleural effusions are most likely present.


SubjectID: 15131736, StudyID: 54626336, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Intubation and pneumonia, ETT placement, questionable progression.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Moderate atelectasis in the retrocardiac lung regions. No new parenchymal opacities   Keywords: new. Unchanged position of the endotracheal tube and nasogastric tube.


SubjectID: 15131736, StudyID: 57642788, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with altered mental status. Evaluate for pneumonia.

TECHNIQUE: Portable frontal chest radiograph was taken.

COMPARISON: Chest radiograph from ___, ___ and ___. .

FINDINGS: The lungs are hypoinflated. The cardiac silhouette is enlarged. There is pulmonary vascular congestion and mild pulmonary edema. A left retrocardiac opacity likely reflects pleural effusion with adjacent atelectasis. An underlying left basilar consolidation cannot be excluded. Calcifications are noted along the aortic arch.

IMPRESSION: 1. Congestive heart failure with cardiomegaly and mild pulmonary edema. 2. Probable left pleural effusion with adjacent atelectasis, though an underlying consolidation cannot be excluded.


SubjectID: 15131736, StudyID: 53904896, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman admitted with resp distress, chronic COPD, OSA // eval for evolution of pulmonary edema

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Moderate pulmonary edema with moderate cardiomegaly but without pleural effusions. Overall low lung volumes. Retrocardiac atelectasis.


SubjectID: 15131736, StudyID: 57531802, Comparison: None

FINAL REPORT

INDICATION: History of CHF and decreased O2 sats now with altered mental status, evaluate for pneumonia or CHF.

COMPARISON: ___ and ___ chest radiograph. SINGLE PORTABLE FRONTAL VIEW OF THE CHEST: Lung volumes are low resulting in vascular crowding. However, despite this, there is evidence of mild to moderate pulmonary vascular congestion. Cardiac silhouette is enlarged despite the portable technique. Probable small bilateral pleural effusions. No focal consolidation is seen to suggest pneumonia. No pneumothorax is evident although the lung apices are obscured by overlying soft tissue.

IMPRESSION: Mild-to-moderate pulmonary edema.


SubjectID: 15131736, StudyID: 50142753, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: COPD, ETT placement.

COMPARISON: ___.

FINDINGS: Compared to the previous radiograph, the patient has been intubated. The tip of the endotracheal tube projects 3.5 cm above the carina. The pre-existing cardiomegaly with signs of moderate fluid overload is unchanged   Keywords: unchanged. The patient has also received a nasogastric tube. The tube shows a normal course. The tip is not included in the image, but likely positioned in the stomach.


SubjectID: 15131736, StudyID: 57495351, Comparison: -1.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F POD ___ s/p exlap loa and ventral hernia repair // interval change; continued diuresis

IMPRESSION: In comparison to ___ chest radiograph, pulmonary edema and bibasilar atelectasis have decreased in extent   Keywords: decrease. No other relevant change   Keywords: no other relevant change.


SubjectID: 15131736, StudyID: 57458228, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with intubated,sepsis // acute process

IMPRESSION: In comparison to ___ chest radiograph, cardiomegaly is accompanied by pulmonary vascular congestion and mild edema, with increasing small right and new small left pleural effusions   Keywords: new, increasing. Worsening left retrocardiac opacification could reflect atelectasis or infectious consolidation.


SubjectID: 15131736, StudyID: 52920123, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF, COPD, remains intubated // assess pulmonary edema assess pulmonary edema

IMPRESSION: ET tube tip is 4.5 cm above the carinal. Right internal jugular line tip is at the level of cavoatrial junction. NG tube tip is in the stomach. Cardiomegaly is substantial. There is vascular congestion. There are bibasal opacities concerning for infectious process.


SubjectID: 15131736, StudyID: 56536391, Comparison: worse

FINAL REPORT

INDICATION: ___ year old woman with COPD/dCHF, failure to wean from vent // assess for pulmonary edema

TECHNIQUE: Portable AP chest radiograph.

COMPARISON: Chest radiographs from ___, most recently ___.

FINDINGS: Lung volumes low with bibasilar atelectasis and increased bilateral alveolar opacities and bilateral pleural effusions. NG tube has been advanced now terminating in the stomach although the side port is difficult to visualize. Other indwelling monitoring and support devices are stable and appropriate position.

IMPRESSION: Moderate pulmonary edema and small bilateral pleural effusions worse from ___   Keywords: worse.


SubjectID: 15131736, StudyID: 52604478, Comparison: better

FINAL REPORT

INDICATION: ___ year old woman with COPD, dCHF, influenza with hypoxia requiring NRB // eval for effusion or pulm edema

COMPARISON: Radiographs from ___.

IMPRESSION: There is unchanged cardiomegaly. There is improvement of the pulmonary interstitial edema   Keywords: improve. There remains a left retrocardiac opacity. No pneumothoraces are seen.


SubjectID: 15131736, StudyID: 56589755, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hypoxia // acute process

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change.


SubjectID: 15131736, StudyID: 52259319, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF, failure to wean from vent // pulmonary edema pulmonary edema

IMPRESSION: ET tube tip is 5 cm above the carinal. NG tube tip is in the stomach. Vascular congestion is mild to moderate. There is no appreciable pleural effusion. There is no pneumothorax.


SubjectID: 15131736, StudyID: 51140617, Comparison: better

FINAL REPORT

INDICATION: ___-year-old woman with a history of chronic obstructive pulmonary disease and congestive heart failure presents from a nursing home. Bibasilar crackles on exam.

TECHNIQUE: Frontal lateral views of the chest.

COMPARISON: Chest radiograph ___.

FINDINGS: Mild pulmonary vascular congestion is present, and previously present mild pulmonary edema has resolved   Keywords: resolve. There is no new focal opacity, pleural effusion or pneumothorax. The cardiac and mediastinal contours are stable.

IMPRESSION: Mild pulmonary edema is improved from ___   Keywords: improve.


SubjectID: 15131736, StudyID: 55827546, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with resp distress // ? pna

COMPARISON: ___.

FINDINGS: AP portable semi upright view of the chest. Lung volumes are low limiting assessment. The patient's chin obscures the lung apices. Allowing for limitations, the heart is enlarged with mild to moderate pulmonary edema noted. No large effusion. No gross bony abnormalities.

IMPRESSION: Mild to moderate pulmonary edema, mild cardiomegaly. Limited exam.


SubjectID: 15131736, StudyID: 53318102, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with COPD, CHF // Interval change

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Moderate to severe cardiomegaly is stable. Mild pulmonary edema has improved   Keywords: improve. Retrocardiac opacities have improved consistent with improving atelectasis. There is no evident pneumothorax or increasing effusions.


SubjectID: 15131736, StudyID: 54906849, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with volume overload and hypoxia // Pulmonary edema

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Severe cardiomegaly is a stable. Mild vascular congestion is unchanged   Keywords: unchanged. Retrocardiac opacities have improved consistent with improving atelectasis. If any there is a small left effusion. There is no pneumothorax


SubjectID: 15131736, StudyID: 52937624, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with COPD, CHF recent pneumonia

TECHNIQUE: Portable upright AP view of the chest

COMPARISON: ___ chest radiograph

FINDINGS: Exam is limited by patient positioning as well as the patient's chin and neck obscuring the lung apices. Low lung volumes are present. Heart size is moderately enlarged. Atherosclerotic calcifications are noted at the aortic knob. Mediastinal contours are unremarkable. Crowding of bronchovascular structures is present with possible mild pulmonary vascular congestion. Small left pleural effusion is likely present. Patchy bibasilar opacities may reflect atelectasis. No large pneumothorax is present. There are hypertrophic changes noted in the thoracic spine.

IMPRESSION: Low lung volumes with probable bibasilar atelectasis. Infection at the lung bases cannot be excluded in the correct clinical setting. Mild pulmonary vascular congestion and trace left pleural effusion.


SubjectID: 15131736, StudyID: 53481305, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with COPD, dCHF here with hypoxic respiratory failure s/p intubation. // ? interval change in pulmonary edema, confirm tube placement and PICC placement

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The monitoring and support devices are constant. Low lung volumes. Moderate cardiomegaly. Mild to moderate pulmonary edema. No larger pleural effusions. Retrocardiac atelectasis. No new focal parenchymal opacities   Keywords: new.


SubjectID: 15131736, StudyID: 50677639, Comparison: same

FINAL REPORT

INDICATION: ___F now intubated // ETT placement?

TECHNIQUE: Portable chest, single view.

COMPARISON: Film from earlier the same day at 13:45.

FINDINGS: Endotracheal tube is seen with tip approximately 4 cm from the carina. Otherwise, there has been no significant interval change   Keywords: no significant interval change. Bilateral parenchymal opacities suggestive of edema are seen noting that infection cannot be excluded.


SubjectID: 15141762, StudyID: 57445167, Comparison: -1.0

FINAL REPORT

INDICATION: NSTEMI, evaluate line placement.

COMPARISON: ___.

TECHNIQUE: Portable frontal chest radiograph.

FINDINGS: Cardiac silhouette remains moderately enlarged with stable mediastinal silhouette and hilar contours. There has been interval placement of a femoral approach Swan-___ catheter which is located in a lower right segmental pulmonary artery 3.5 cm beyond the border of the mediastinum. A femoral-approach intraaortic balloon pump is in place projecting at the superior contour of the aortic arch. Pulmonary edema is unchanged with slight increase in the bilateral pleural effusions   Keywords: increase. Atelectasis is unchanged.

IMPRESSION: Femoral approach Swan-Ganz positioned 3.5cm past the border of the mediastinum in a lower segmental pulmonary artery. Recommend withdrawal of Swan-Ganz by 3.5 cm. Intraaortic balloon pump at the level of the superior border of the aortic arch. Recommend withdrawal by 1 cm. Otherwise, little change compared to ___   Keywords: little change. Results discussed over the telephone with ___ ___ by ___ at 4:20 p.m. on ___ at the time of initial review.


SubjectID: 15141762, StudyID: 51890834, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Intra-aortic balloon pump, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the position of the intra-aortic balloon pump is unchanged, with the tip being located just several millimeters below the superior aspects of the aortic arch. The device could be pulled back by approximately 1 to 2 cm. The Swan-Ganz catheter is in unchanged position. Unchanged appearance of the cardiac silhouette. Unchanged mild bilateral pleural effusions.


SubjectID: 15141762, StudyID: 50662894, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Intra-aortic balloon pump.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The Swan-Ganz catheter has been pulled back and is now in correct position. The tip projects over the central aspect of the right pulmonary artery. The intra-aortic balloon pump is also unchanged, the device could be pulled back by approximately 1 cm, as it is only 4-5 mm below the superior aspect of the aortic arch. No pneumothorax. Unchanged mild pleural effusions. Borderline size of the cardiac silhouette.


SubjectID: 15144601, StudyID: 55341919, Comparison: None

FINAL REPORT

AP CHEST, 10:41 A.M., ___

HISTORY: Redo CABG.

IMPRESSION: AP chest compared to ___: Postoperative widening of the cardiomediastinal silhouette continues to improve. Lungs low in volume but clear. Pleural effusion is small if any on the left. No pneumothorax. Transvenous right atrial and right ventricular pacer leads in standard placements. A right subclavian line passes into the right atrium, but the tip is indistinct. No pneumothorax.


SubjectID: 15144601, StudyID: 55001785, Comparison: None

FINAL REPORT

HISTORY: Central line insertion.

FINDINGS: In comparison with the study of ___, the IJ catheter has been removed and replaced with a right subclavian catheter that extends to the lower portion of the SVC. Continued enlargement of the cardiac silhouette with pacer-defibrillator in place. Mild indistinctness of pulmonary vessels could reflect some elevated pulmonary venous pressure. The retrocardiac area is not optimally seen, though there is only mild atelectasis. Bilateral chest tubes are in place and there is no evidence of pneumothorax.


SubjectID: 15144601, StudyID: 54398860, Comparison: None

FINAL REPORT

AP CHEST 10:06 A.M. ___

HISTORY: CABG. Left chest tube removed.

IMPRESSION: AP chest compared to ___: There is no appreciable pneumothorax or pleural collection in the left chest following removal of the left pleural tube. Right pleural tube still in place. Left basal atelectasis is mild to moderate but unchanged. Post-operative enlargement of the cardiomediastinal silhouette which improved between ___ and ___ is stable. No appreciable right pleural effusion. Right subclavian line ends in the upper SVC. Transvenous right atrial and right ventricular pacer leads unchanged in their respective positions. No pulmonary edema.


SubjectID: 15145407, StudyID: 52080111, Comparison: None

FINAL REPORT

CHEST, TWO VIEWS: ___

HISTORY: ___-year-old female with CHF and rales in bilateral lung bases. Question pulmonary edema and vascular congestion.

FINDINGS: AP and lateral views of the chest are compared to previous exam from ___. Again seen is massive cardiomegaly which is stable in configuration compared to prior. There is no evidence of pulmonary vascular congestion on the current exam nor pleural effusion. Osseous and soft tissue structures are unremarkable.

IMPRESSION: Persistent massive cardiomegaly without evidence of congestive failure.


SubjectID: 15145407, StudyID: 55705835, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Hypercarbic and desaturation, evaluation for pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is a slight increase in diameter of the pulmonary vasculature as well as some perihilar haze. In combination with increased cardiac silhouette this could be indicative of mild pulmonary edema. In unchanged manner, there is a moderate retrocardiac atelectasis and a small left pleural effusion. The observation was made at 11:20 a.m., ___, at the same time point the referring physician, ___. ___, was paged for notification.


SubjectID: 15145407, StudyID: 55474188, Comparison: same

WET READ: ___ ___ ___ 7:55 PM severe cardiomegaly. no definite consolidation though a developing retrocardiac process would be difficult to exclude. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Hypoxia, evaluation for pneumonia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is unchanged severe cardiomegaly, with a small left pleural effusion and a retrocardiac atelectasis. On the right, there is no evidence of parenchymal pathologies, notably no evidence of pneumonia or pulmonary edema, a minimal decrease in translucency of the right lung base as compared to the previous image is likely caused by patient rotation and overlying soft tissues   Keywords: decrease.


SubjectID: 15145407, StudyID: 52978613, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Moderate cardiomegaly with signs of mild overhydration. No overt pulmonary edema. Left retrocardiac atelectasis. The presence of a minimal left pleural effusion cannot be excluded. No interval appearance of pneumonia.


SubjectID: 15165563, StudyID: 59056083, Comparison: worse

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: History: ___M with neutropenic fever? // acute process?

TECHNIQUE: Chest Frontal and Lateral

COMPARISON: ___

FINDINGS: As compared to the prior study, there has been interval increase in interstitial markings, somewhat similar to that seen on ___, which could represent mild interstitial edema versus atypical infection   Keywords: increase   Keywords: increase. No lobar consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable.

IMPRESSION: As compared to the prior study, there has been interval increase in interstitial markings, somewhat similar to that seen on ___, which could represent mild interstitial edema versus atypical infection.


SubjectID: 15165563, StudyID: 51659523, Comparison: better

FINAL REPORT

EXAMINATION: Chest radiograph PA and lateral

INDICATION: ___ year old man with transfusion dependent anemia, MDS with chronic neutropenia, pulmonary hypertention, s/p recent hospitalization with fever. Reporting increasing fatigue, weakness, DOE. // Assess for abnormalities. ? infiltrate, effusion

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest x-ray ___

FINDINGS: The lungs are hyperinflated with flattening of bilateral hemidiaphragms, suggesting chronic pulmonary disease. The diffuse prominent interstitial markings which that were noted on the prior chest x-ray have improved, which likely suggests resolving interstitial edema   Keywords: resolving, improve. Lungs are otherwise free of consolidations, pleural effusions or pneumothorax. Mediastinum and hila are normal. Mild cardiomegaly, stable since ___. No acute osseous abnormalities.

IMPRESSION: Improving diffuse interstitial markings likely suggests resolving interstitial edema   Keywords: improving, resolving. Diffuse infectious process is unlikely.


SubjectID: 15165563, StudyID: 54307084, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with MDS, on thalidomide/prednisone, reporting 2 days of cough, wheezing, DOE, increasing fatigue // Pneumonia? Acute changes?

COMPARISON: ___

IMPRESSION: The pre-existing right upper lobe pneumonia has almost completely cleared. No new parenchymal opacities   Keywords: new. Minimal pleural thickening at the left lateral aspect of the chest wall. Moderate cardiomegaly without pulmonary edema. Mild elongation of the descending aorta. No pleural effusions.


SubjectID: 15165563, StudyID: 53383993, Comparison: same

FINAL REPORT

INDICATION: ___M with wheezing and SOB after blood transfusion // Eval for pneumonia or pulmonary edema

TECHNIQUE: Single portable view of the chest.

COMPARISON: ___.

FINDINGS: Given differences in technique from exam from earlier the same day, there has been no significant interval change   Keywords: no significant interval change. Lower lung volumes are seen with secondary crowding of the bronchovascular markings and accentuation of the cardiomediastinal silhouette. Right mid lung opacity is likely atelectasis. Tortuosity of descending thoracic aorta is unchanged.

IMPRESSION: Cardiomegaly without definite acute cardiopulmonary process.


SubjectID: 15176968, StudyID: 59642952, Comparison: same

FINAL REPORT

HISTORY: Acute CHF.

COMPARISON: ___.

FINDINGS: Right and moderate bilateral pleural effusions, mild cardiomegaly, pulmonary vascular redistribution consistent with CHF. Compared to prior exam there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: CHF


SubjectID: 15176968, StudyID: 59475713, Comparison: better

FINAL REPORT

HISTORY: Acute CHF.

COMPARISON: ___.

FINDINGS: There has been interval decrease in the bilateral pleural effusions with small residual pleural effusions left greater than right there is some volume loss at the left base heart is mildly increased in size.

IMPRESSION: Improvement in CHF   Keywords: improve.


SubjectID: 15192733, StudyID: 59277800, Comparison: better

FINAL REPORT

PORTABLE CHEST X-RAY, ___

COMPARISON: ___ radiograph.

FINDINGS: Persistent cardiomegaly accompanied by mild pulmonary vascular congestion, improving pulmonary edema, and persistent opacities in the lower lungs, likely a combination of basilar atelectasis and adjacent moderate bilateral pleural effusions   Keywords: improving. Diffuse haziness in the imaged portion of the upper abdomen suggests ascites.


SubjectID: 15192733, StudyID: 54119230, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, evaluation for interval change.

COMPARISON: ___.

FINDINGS: Massive cardiomegaly with mild fluid overload persists   Keywords: persists. Also unchanged are bilateral areas of relatively extensive atelectasis, caused by bilateral pleural effusions. No new parenchymal opacities   Keywords: new. Unchanged right venous introduction sheath.


SubjectID: 15192733, StudyID: 52559086, Comparison: same

FINAL REPORT

HISTORY: CHF, to assess for change.

FINDINGS: In comparison with the study of ___, there is little interval change   Keywords: little interval change. Again there is massive cardiomegaly with a mild-to-moderate fluid overload and bilateral pleural effusions with extensive basilar atelectasis.


SubjectID: 15192733, StudyID: 53208389, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: COPD, chronic heart failure, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the malpositioned PICC line on the right has been removed. The venous introduction sheath positioned in the right internal jugular vein remains in unchanged position. There is unchanged evidence of moderate-to-severe cardiomegaly, the shape of the cardiac silhouette could suggest the presence of pericardial effusion. This could be confirmed or rule out with echocardiography. The extent of the pre-existing bilateral pleural effusions remains constant. Also constant is the appearance of the lung parenchyma, with atelectatic changes at the lung bases but without evidence of pneumonia in the well-ventilated lung portions.


SubjectID: 15198897, StudyID: 52716806, Comparison: same

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old woman with CHF, SOB with new more severe cough and subjective fevers/chills. // r/o PNA

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph from ___

FINDINGS: There are low lung volumes. Mild patchy bibasilar opacities, not significantly changed since ___   Keywords: not significantly changed. Mild pulmonary vascular congestion. There are no large pleural effusions or pneumothorax. The hila and mediastinum are within normal limits. Heart is mildly enlarged. No acute osseous abnormalities.

IMPRESSION: Unchanged bibasilar opacities, most likely representing atelectasis, but pneumonia cannot be excluded in the appropriate clinical setting.


SubjectID: 15198897, StudyID: 50660374, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___F with dyspnea // eval for pulmonary edema

TECHNIQUE: Upright AP view of the chest

COMPARISON: ___

FINDINGS: Cardiac silhouette size remains moderately to severely enlarged. Mediastinal and hilar contours are unchanged. There is mild pulmonary vascular engorgement. Patchy opacities within the lower lobes bilaterally may reflect areas of atelectasis but aspiration or infection cannot be excluded. No pleural effusion or pneumothorax is identified. Multilevel degenerative changes are noted in the thoracic spine.

IMPRESSION: Mild pulmonary vascular congestion. Bibasilar patchy opacities may reflect atelectasis but infection or aspiration cannot be excluded.


SubjectID: 15231087, StudyID: 58752822, Comparison: 0.0

WET READ: ___ ___ ___ 8:12 PM No focal consolidation to suggest pneumonia. Unchanged severe cardiomegaly with mild pulmonary edema.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Infection.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the signs indicative of pulmonary edema have decreased in severity   Keywords: decrease. However, moderate cardiomegaly is still present and signs of mild pulmonary edema persist   Keywords: still. No pleural effusions. The pacemaker and the sternal wires are in constant position. No evidence of pneumonia.


SubjectID: 15231087, StudyID: 56660213, Comparison: 1.0

FINAL REPORT

EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Weight gain, dyspnea, rule out CHF.

COMPARISON: ___.

FINDINGS: Frontal and lateral views of the chest were obtained. Dual-lead left-sided pacemaker is seen with leads extending to the expected locations of the right atrium and right ventricle. Patient is status post median sternotomy. The cardiac and mediastinal silhouettes are stable. Mild-to-moderate pulmonary edema is again seen   Keywords: again. Relative slightly more confluent opacity projecting over the right lower lung most likely relates to prominent vascular structures rather than infection. A trace left pleural effusion is difficult to exclude, however, there is no large pleural effusion. No evidence of pneumothorax is seen. Old right-sided rib fractures with pleural thickening are again seen.

IMPRESSION: Persistent cardiomegaly and mild-to-moderate pulmonary edema which appears increased as compared to the prior study   Keywords: increase. Relative more confluent opacity at the right lung base most likely relates to confluence of vascular structures; however, an underlying infectious process is not excluded in the appropriate clinical setting.


SubjectID: 15233042, StudyID: 57352188, Comparison: 0.0

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, liver dysfunction, assessment for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is a minimal decrease in severity of the pre-existing pulmonary edema   Keywords: decrease. The overall severity of the edema, however, is still moderate to severe   Keywords: still. Unchanged moderate cardiomegaly. No pleural effusions. Unchanged appearance of the right internal jugular vein catheter and the ruptured sternal wires.


SubjectID: 15233042, StudyID: 51401129, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: ___. CLINICAL

HISTORY: Altered mental status, assess pneumonia.

FINDINGS: AP and lateral views of the chest were provided. Midline sternotomy wires are unchanged, several appearing fragmented. The heart remains mildly enlarged and there is mild pulmonary edema which is not significantly changed from prior   Keywords: not significantly changed, remains. No large effusion or pneumothorax is seen.

IMPRESSION: Pulmonary edema, no significant interval change   Keywords: no significant interval change.


SubjectID: 15233042, StudyID: 51256802, Comparison: better

FINAL REPORT

PA AND LATERAL CHEST X-RAY

INDICATION: Altered mental status, elevated liver function tests, edema.

COMPARISON: ___.

FINDINGS: Mild-to-moderate pulmonary edema has completely resolved   Keywords: resolve   Keywords: resolve. Severe cardiomegaly is stable. Right jugular line is in adequate position in mid SVC. The patient had prior sternotomy and broken first sternal wires are unchanged. There is no pleural effusion or pneumothorax.

CONCLUSION: Mild-to-moderate pulmonary edema has completely resolved.


SubjectID: 15233042, StudyID: 50053299, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Line placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the right internal jugular vein catheter has been pulled back. The tip now projects over the lower SVC. No evidence of complications, notably no pneumothorax. Otherwise, unchanged chest radiograph.


SubjectID: 15233042, StudyID: 50050714, Comparison: 0.0

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Shortness of breath, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is minimal improvement of the pre-existing moderate pulmonary edema   Keywords: improve. No new parenchymal opacities   Keywords: new. Signs of edema, however, still persists   Keywords: persists, still. Unchanged moderate cardiomegaly, no larger pleural effusions. No pneumothorax. Unchanged position of the right internal jugular vein catheter.


SubjectID: 15233042, StudyID: 56052295, Comparison: None

FINAL REPORT

HISTORY: Common duct stones with CHF exacerbation.

FINDINGS: In comparison with the study of ___, there is continued substantial enlargement of the cardiac silhouette with pulmonary edema. Hardware is again seen in the right proximal humerus and there again are multiple breaks in one of the sternal sutures.


SubjectID: 15233042, StudyID: 52341851, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___.

COMPARISON: ___. CLINICAL

HISTORY: Respiratory distress, assess for CHF.

FINDINGS: Portable AP upright chest radiograph obtained. Patient rotated to the right. There are unchanged midline sternotomy wires, fragmented in part. There is pulmonary edema, which appears slightly worsened from prior exam   Keywords: worse. The overall cardiomediastinal silhouette is unchanged. No large effusion or pneumothorax seen. Hardware is noted in the right proximal humerus.

IMPRESSION: Mild worsening of pulmonary edema   Keywords: worse.


SubjectID: 15233042, StudyID: 55499835, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with COPD, reports worse cough // evaluate for acute process, pneumonia

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: The patient is status post median sternotomy and CABG. The cardiac silhouette is top-normal to mildly enlarged. Mediastinal contours are similar compared to ___ which was also an AP portable view. Broken sternotomy wires are again seen. There is mild pulmonary edema. No large pleural effusion or pneumothorax is seen. No definite focal consolidation is seen.

IMPRESSION: Mild pulmonary edema.


SubjectID: 15233042, StudyID: 54232257, Comparison: same

FINAL REPORT

INDICATION: ___-year-old female with sepsis and right internal jugular vein line placement.

COMPARISON: Radiograph performed ___ approximately and hr prior.

FINDINGS: New right internal jugular line ends in the mid SVC. There is no pneumothorax. Patient is status post median sternotomy and CABG. Relative to prior study, there is been little interval change in the overall appearance of the thorax   Keywords: little interval change. Main pulmonary artery is chronically enlarged, and mediastinal veins are more engorged relative to ___, but there is no evidence of mediastinal bleeding. Pulmonary vascular engorgement is chronic, and there is no pulmonary edema. There is no pneumothorax or appreciable pleural effusion. Pregnant upper sternal wires have probably not changed since at least ___. .

IMPRESSION: Interval placement of right internal jugular vein line, its tip terminating within the mid superior vena cava. No pneumothorax.


SubjectID: 15233042, StudyID: 55201313, Comparison: worse

FINAL REPORT

HISTORY: Postop renal failure and COPD.

FINDINGS: In comparison with study of ___, there are lower lung volumes with worsening pulmonary edema   Keywords: worse. Severe enlargement of the cardiac silhouette persists. Costophrenic angles are sharply seen. Fracture of sternotomy wires again seen.


SubjectID: 15233042, StudyID: 54464701, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluation for fluid overload, chronic heart failure.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is unchanged evidence of sternal wires and partially ruptured and displaced wires. Status post right shoulder surgery. The current radiograph shows moderate-to-severe cardiomegaly with mild-to-moderate pulmonary edema. No pleural effusions. No evidence of pneumonia. At the time of dictation and observation, ___, 8:46 a.m., the referring physician, ___. ___ was paged for notification.


SubjectID: 15233944, StudyID: 55017952, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with hx of CHF, severe SOB // eval for pulm edema

TECHNIQUE: Single frontal view of the chest

COMPARISON: None

FINDINGS: Extensive bilateral perihilar MVA basilar opacities are worrisome for pulmonary edema with possible superimposed infection. Obscuration of the left hemidiaphragm is concerning for atelectasis and pleural effusion. There is also likely a small right pleural effusion. The cardiac silhouette is top-normal. Mediastinal contours are unremarkable.

IMPRESSION: Extensive perihilar and bibasilar opacities concerning for significant pulmonary edema, superimposed infection not excluded. Small bilateral pleural effusions.


SubjectID: 15233944, StudyID: 53990326, Comparison: nan

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with decompensated HF with pulm edema and small bilateral effusions requiring BiPAP. // Comparison to previous

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the bilateral parenchymal opacities at the lung bases have improved   Keywords: improve. Also improved is the pre-existing left pleural effusion. Retrocardiac atelectasis and remnant opacities, however, persist. No new opacities   Keywords: new. The lung volumes remain low. Moderate cardiomegaly without pulmonary edema.


SubjectID: 15237286, StudyID: 57638910, Comparison: worse

FINAL REPORT

EXAMINATION: PA AND LATERAL CHEST RADIOGRAPHS

INDICATION: ___-year-old male with shortness of breath, lower extremity edema, cough.

TECHNIQUE: PA and lateral chest radiographs

COMPARISON: ___.

FINDINGS: The lungs are well-expanded. Compared with prior radiograph there is increased vascular congestion   Keywords: increase. There are also patchy nodular opacities, more prominent in the right lower lung and streaky opacities in the left lower lung which appear new compared with the previous exam. Cardiomediastinal and hilar contours unremarkable. There is no pleural effusion or pneumothorax.

IMPRESSION: Findings may represent pneumonia in the appropriate clinical setting. Pulmonary vascular congestion.


SubjectID: 15237286, StudyID: 57605865, Comparison: None

FINAL REPORT

INDICATION: Question CHF versus pneumonia.

TECHNIQUE: Frontal and lateral chest radiographs

COMPARISON: ___

FINDINGS: There is mild perihilar haziness suggesting volume overload. The heart is mildly enlarged. There is no pleural effusion. No pneumothorax or definite focal consolidation.

IMPRESSION: Mild vascular congestion.


SubjectID: 15237286, StudyID: 50735465, Comparison: None

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPH

INDICATION: Increase leukocytosis.

TECHNIQUE: Chest, portable AP upright.

COMPARISON: ___, earlier on the same day.

FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged allowing for differences in technique. Asymmetric opacities are greater on the left than right and probably increased somewhat concerning for pneumonia. Accompanying venous pulmonary venous hypertension or very mild congestion is also suspected but less striking.

IMPRESSION: Vague opacities, most confluent in the left lower lung, suggestive of pneumonia. Short-term follow-up with standard PA and lateral radiographs may be helpful to reassess if feasible.


SubjectID: 15245121, StudyID: 59712352, Comparison: same

FINAL REPORT

PORTABLE CHEST X-RAY, ___

COMPARISON: Radiograph of earlier the same date.

FINDINGS: Interval placement of endotracheal tube, terminating 3 cm above the carina, and placement of nasogastric tube, terminating within the stomach. New patchy bibasilar opacities may reflect atelectasis or aspiration. Otherwise, no relevant changes since previous study of earlier the same date   Keywords: no relevant change.


SubjectID: 15245121, StudyID: 58498816, Comparison: None

FINAL REPORT

PORTABLE CHEST ___

COMPARISON: ___ radiograph.

FINDINGS: Indwelling support and monitoring devices remain in standard position, and cardiomediastinal contours are stable in appearance allowing for leftward patient's rotation. Patchy bibasilar opacities probably represent atelectasis. Apparent small left pleural effusion appears unchanged.


SubjectID: 15245121, StudyID: 57892263, Comparison: worse

FINAL REPORT

PORTABLE CHEST X-RAY OF ___

COMPARISON: ___ radiograph.

FINDINGS: Indwelling support and monitoring devices remain in standard position. Widening of cardiomediastinal contours are stable allowing for positional differences between the exams. Pulmonary vascular congestion is present as well as worsening patchy bibasilar opacities which may reflect patchy atelectasis or aspiration   Keywords: worse. Apparent small left pleural effusion has increased in size.


SubjectID: 15245121, StudyID: 56312848, Comparison: None

FINAL REPORT

PORTABLE CHEST X-RAY, ___

COMPARISON: Radiograph of earlier the same date.

FINDINGS: New right internal jugular central venous catheter terminates in a region of the cavoatrial junction, with no visible pneumothorax. Improved lung volumes compared to prior radiograph, with associated improved aeration at the lung bases, with residual patchy and linear atelectasis remaining in the left lower lobe as well as an apparent small left pleural effusion.


SubjectID: 15245121, StudyID: 56960648, Comparison: None

FINAL REPORT

HISTORY: Cholangitis.

FINDINGS: In comparison with the study of ___, the endotracheal tube has been removed. Widening of the cardiomediastinal contour is less evident on the current study. There are lower lung volumes and the degree of elevated pulmonary venous pressure appears to be decreasing. Left hemidiaphragm is not sharply seen, indicating some improvement in the volume loss in the left lower lobe.


SubjectID: 15245319, StudyID: 57190825, Comparison: better

FINAL REPORT

INDICATION: The hemoptysis.

COMPARISON: Chest radiograph from ___ ___. Chest CT from ___.

TECHNIQUE: Frontal chest radiograph.

FINDINGS: Widespread reticular opacities reflect chronic interstitial disease, better appreciated on the CT examination from ___   Keywords: better. There are also superimposed widespread opacities, suspicious for edema, blood, or atypical infection. There is focally increased opacity against the right upper mediastinum, which could represent more focal consolidation or new lymphadenopathy. No pneumothorax or pleural effusion is detected.

IMPRESSION: Widespread pulmonary opacities superimposed on the background of known pulmonary interstitial fibrosis, concerning for atypical infection, edema, or hemorrhage. Increased right paramediastinal opacity, representing more focal consolidation or lymphadenopathy.


SubjectID: 15245319, StudyID: 56445866, Comparison: same

FINAL REPORT

INDICATION: Concern for cardiogenic pulmonary edema.

COMPARISON: Chest radiographs from ___. CT examination from ___.

TECHNIQUE: Frontal chest radiograph.

FINDINGS: Widespread pulmonary opacities are minimally changed since the ___ examination, likely reflecting known severe parenchymal fibrosis demonstrated on the ___ CT. No superimposed consolidation, pneumothorax, effusion, or edema is seen in comparison to the prior two radiographs. The cardiac and mediastinal contours are unchanged.

IMPRESSION: Unchanged appearance of widespread parenchymal fibrosis, better seen on recent CT examination. No superimposed new consolidation, effusion, or edema since the ___ radiographs   Keywords: new.


SubjectID: 15245319, StudyID: 50485267, Comparison: worse

FINAL REPORT

INDICATION: Acute on chronic hypoxia.

COMPARISON: Chest radiograph from ___.

TECHNIQUE: Frontal chest radiograph.

FINDINGS: Again seen are widespread reticular pulmonary opacities, reflecting underlying parenchymal fibrosis. However, there are superimposed widespread opacities, likely reflecting pulmonary edema or new consolidations, worse on the right   Keywords: new, worse. There is no pleural effusion or pneumothorax. The cardiac and mediastinal contours are unchanged.

IMPRESSION: New pulmonary edema or consolidations superimposed on a background of parenchymal fibrosis, slightly worse on the right   Keywords: new.


SubjectID: 15245319, StudyID: 50198647, Comparison: better

FINAL REPORT

INDICATION: CHF.

COMPARISON: Chest radiograph from ___.

TECHNIQUE: Frontal chest radiograph.

IMPRESSION: Widespread pulmonary opacities are slightly improved since the ___ radiograph   Keywords: improve. There is no new effusion or pneumothorax. The cardiac and mediastinal contours remain within normal limits.


SubjectID: 15245319, StudyID: 54059159, Comparison: 0.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M w/ ILD, CKD and NSTEMI // Evaluate for interval change in bilateral infiltrates

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the bilateral parenchymal opacities have moderately decreased in extent and severity   Keywords: decrease. The cardiac silhouette remains enlarged. No new opacities are seen   Keywords: new. Elongation of the descending aorta. No pleural effusions.


SubjectID: 15251751, StudyID: 55224409, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Outside hospital, chronic heart failure, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient now has a correctly positioned right-sided PICC line in addition to the left pectoral Port-A-Cath. The technical quality of the examination is limited, given the body habitus of the patient. There is moderate cardiomegaly and likely presence of mild pulmonary edema. Larger parenchymal consolidations and pleural effusions are not seen on the image.


SubjectID: 15251751, StudyID: 52225153, Comparison: same

FINAL REPORT

INDICATION: ___-year-old woman with cough, leukocytosis, question pneumonia.

COMPARISON: ___ to ___.

FINDINGS: The appearance of the chest is unchanged since ___. Mild cardiomegaly without evidence of pulmonary edema is unchanged   Keywords: unchanged. Retrocardiac atelectasis is similar. Dual-chamber pacing leads project over the expected position of the right atrium and right ventricle. No effusion or pneumothorax is present.

IMPRESSION: No change since ___   Keywords: no change.


SubjectID: 15251751, StudyID: 50964286, Comparison: same

FINAL REPORT

INDICATION: ___-year-old with upper abdominal pain, please assess for pneumonia.

TECHNIQUE: Frontal and lateral radiographs of the chest were obtained.

COMPARISON: Chest radiograph from ___.

FINDINGS: There is no evidence of pneumonia. There is mild cardiomegaly but no pulmonary edema. There are no large pleural effusions and there is no pneumothorax. Pacemaker leads end in the right atrium and right ventricle. No change from the prior study in ___   Keywords: no change.

IMPRESSION: 1. No evidence of pneumonia. 2. No change from ___   Keywords: no change.


SubjectID: 15259244, StudyID: 51427308, Comparison: None

WET READ: ___ ___ ___ 9:53 PM New feeding tube in stomach. Right IJ in upper SVC. Large bore right catheter terminating in right atrium - unchanged. Moderate left pleural effusion and consolidation appear stable compared to CXR from earlier on the same day. Atelectasis and small right effusion are unchanged. ___ ___ ______________________________________________________________________________

FINAL REPORT

AP CHEST, 6:24 P.M. ON ___

HISTORY: New Dobbhoff tube.

IMPRESSION: AP chest compared to ___ and ___, 2:57 p.m.: Tip of the new Dobbhoff feeding tube, with a wire stylet in place, ends in the mid-to-low stomach. Right internal jugular sheath ends at the junction of the brachiocephalic veins and the right supraclavicular dialysis catheter orifices are in the right atrium. A small-to-moderate right and moderate left pleural effusion are slightly larger than earlier in the day. Left perihilar consolidation, probably atelectasis, is unchanged. There is probably no pulmonary edema. No pneumothorax. Moderate postoperative widening of the cardiomediastinal silhouette, which progressed after tracheal extubation is stable since earlier in the day, but should be followed to exclude mediastinal bleeding.


SubjectID: 15259244, StudyID: 59671026, Comparison: worse

FINAL REPORT

PORTABLE AP CHEST FILM, ___ AT 13:17 CLINICAL

INDICATION: ___-year-old immunosuppressed patient with increasing productive cough with associated hemoptysis, evaluate for interval change. Comparison is made to the patient's previous study dated ___ at 5:11. Portable AP upright chest film, ___ at 13:17 is submitted.

IMPRESSION: 1. Right internal jugular dialysis catheter again having its tip within the right atrium in similar position as compared to multiple prior studies. There is increasing bibasilar and perihilar airspace opacities, which likely reflect worsening moderate pulmonary edema   Keywords: worse, increasing. There are likely layering effusions, left greater than right. Diffuse pneumonia would be less likely given the rapidity of interval change. No pneumothorax is seen. Overall, cardiac and mediastinal contours are unchanged, with the heart being stably enlarged.


SubjectID: 15259244, StudyID: 54912258, Comparison: worse

FINAL REPORT

HISTORY: Kidney transplant with CHF and respiratory distress.

FINDINGS: In comparison with study of ___, there is increasing bilateral pulmonary opacifications consistent with worsening effusions, consistent with volume loss, and worsening pulmonary vascular congestion   Keywords: worse, increasing. The possibility of supervening pneumonia must be seriously considered in the appropriate clinical setting, and is difficult to evaluate due to the substrate of extensive pulmonary changes. Dual-channel catheter, presumably due for hemodialysis ends in the right atrium.


SubjectID: 15259244, StudyID: 54251102, Comparison: None

FINAL REPORT

PORTABLE AP UPRIGHT CHEST FILM, ___ AT 5:11 CLINICAL

INDICATION: Postmenopausal woman with DVT and hemoptysis, assess for interval change. Comparison is made to the prior study of ___. Portable AP upright chest film, ___ at 5:11 is submitted.

IMPRESSION: 1. Interval placement of a right internal jugular dialysis catheter, which has its tip in the right atrium and is in similar position to that on prior study dated ___. 2. The previously seen left effusion has decreased in size. There is a diffuse bilateral interstitial process, which likely reflects a component of mild pulmonary edema. The heart remains borderline enlarged. Mediastinal contours are unchanged. No pneumothorax. No focal airspace consolidation to suggest pneumonia.


SubjectID: 15259244, StudyID: 52824127, Comparison: worse

WET READ: ___ ___ ___ 9:13 PM Right-sided large bore central line in unchanged position - RA/RV. Mild to moderate interstitial pulmonary edema - slightly increased since prior. Stable bibasilar consolidations - likely atelectasis. Increasing bilateral pleural effusions - though both small. No pneumothorax. ___ p_________________________________________________________________________________

FINAL REPORT

AP CHEST, 7:13 P.M., ON ___

HISTORY: CHF. Urgent respiratory distress.

IMPRESSION: AP chest compared to ___ through ___, 1:17 p.m.: Moderately severe pulmonary edema has not worsened since earlier in the day, though moderate right and small left pleural effusions have increased   Keywords: worse. Moderate cardiomegaly has remained stable over the past several days, but has progressed substantially since ___ and could be due to cardiomegaly and/or pericardial effusion. Dual-channel catheter, presumably for hemodialysis ends in the right atrium. No pneumothorax.


SubjectID: 15259244, StudyID: 59654440, Comparison: same

FINAL REPORT

AP CHEST, 3:35 P.M. ON ___

HISTORY: ___-year-old woman with hemoptysis, question interval change.

IMPRESSION: AP chest compared to ___ through ___.

FINDINGS: Since consolidation has largely cleared from the right lung base since ___, this was presumably either dependent edema alone or dependent edema and atelectasis. Minimal interstitial edema remains, but the left lower lobe is much better aerated today   Keywords: remains. The heart is mildly to moderately enlarged. No pneumothorax. Dual-channel dialysis line ends in the right atrium.


SubjectID: 15259244, StudyID: 58869711, Comparison: worse

FINAL REPORT

HISTORY: Cellulitic left lower lobe infiltrate. CHEST, SINGLE AP PORTABLE VIEW. Lungs are hyperinflated, consistent with COPD. There is cardiomegaly. The patient is status post sternotomy, with prosthetic valve. There is upper zone redistribution and diffuse vascular blurring, consistent with CHF. There is a moderate to moderately large left effusion layering along the left chest wall and left apex, with underlying collapse and/or consolidation. Minimal blunting of the right costophrenic angle is present. There is atelectasis at the right base. There is straightening of the AP window on the left and prominence of the right hilum. This could reflect pulmonary hypertension. A dual lumen right-sided catheter is present, distal tip overlying the right atrium. A slightly displaced left posterolateral third rib fracture again noted, unchanged. This was present on a chest x-ray dated ___.

IMPRESSION: 1. Continued CHF, probably slightly worse compared with ___   Keywords: worse. 2. Left pleural fluid/thickening, left lower lobe collapse and/or consolidation, overall similar.


SubjectID: 15259244, StudyID: 54517823, Comparison: worse

FINAL REPORT

INDICATION: A ___-year-old female with fever and immunosuppressive for pancreas and kidney transplant.

COMPARISON: PA and lateral chest radiograph ___. PORTABLE AP CHEST RADIOGRAPH: Small bilateral pleural effusions improved on the right and increased on the left since the most recent prior examination of ___. Increased opacification at the left lung base may represent underlying infection. Moderate-to-severe enlargement of the cardiac silhouette is chronic and unchanged. Bilateral low lung volumes are noted with crowding of bronchovascular markings. A supraclavicular dialysis catheter ends in the right atrium. In the interim since the most recent prior examination, there has been removal of the left-sided PICC tip. Sternotomy wires are midline and intact. Patient is status post left mitral valve repair.

IMPRESSION: 1. Bilateral pleural effusions, improved on the right compared to the prior examination, but worsened on the left. Increased opacification at the left lung base may represent underlying infection. 2. Low lung volumes with crowding of bronchovascular markings and minimal increased pulmonary vascular engorgement   Keywords: increase.


SubjectID: 15259244, StudyID: 58685714, Comparison: same

FINAL REPORT

HISTORY: Effusions with pigtail catheters.

FINDINGS: In comparison with the study of ___, there are bilateral pigtail catheters at the bases. There has been a substantial decrease in effusion on the right with reexpansion of the lung. On the left, there has been no decrease in effusion with increased amount of opacification along the left lateral chest wall. Some of this may represent loculated rather than free effusions. Monitoring and support devices remain in place, and there is again evidence of vascular congestion and cardiomegaly   Keywords: again.


SubjectID: 15259244, StudyID: 56972683, Comparison: None

WET READ: ___ ___ 9:18 PM ET tube sits 4-4.5 cm above carina. ______________________________________________________________________________

FINAL REPORT

PORTABLE AP CHEST FILM ___ AT 20:04 CLINICAL

INDICATION: ___-year-old status post mitral valve annuloplasty, CABG. Evaluate for position of endotracheal tube. PRIOR STUDY: ___ at 13:29. Portable supine chest film ___ at 20:04 is submitted.

IMPRESSION: 1. Left subclavian PICC line with its tip in the mid-to-distal SVC. Endotracheal tube has its tip 4.5 cm above the carina. A right internal jugular large-bore catheter has its tip in the right atrium, unchanged. Gastric tube is seen coursing below the diaphragm with the tip not identified. 2. Bilateral pleural pigtail catheters are again seen and are unchanged in position. Overall, cardiac and mediastinal contours are stable in this postoperative patient status post median sternotomy with mitral valve annuloplasty. Increasing opacity at right lung base and the costophrenic angle which could represent accumulating fluid or an area of evolving pneumonia. Clinical correlation is advised. No evidence of pulmonary edema. Patchy opacities at left base likely reflects atelectasis. No pneumothorax.


SubjectID: 15259244, StudyID: 54865295, Comparison: same

FINAL REPORT

HISTORY: Dyspnea, to evaluate for pleural effusion.

FINDINGS: In comparison with the study of ___, there is continued enlargement of the cardiac silhouette with vascular congestion and large pleural effusions, more prominent on the left with underlying substantial compressive atelectasis   Keywords: continue. Dual-channel dialysis catheter remains in place. There has been insertion of a left subclavian catheter. The tip of this is difficult to evaluate because it is superimposed on the dialysis catheter. It definitely extends at least to the lower portion of the SVC. To more precisely demonstrate the tip of this catheter, oblique views would be necessary.


SubjectID: 15259244, StudyID: 58008930, Comparison: None

FINAL REPORT

SUPINE PORTABLE CHEST, ___ AT 21:05 HOURS.

HISTORY: Fever and altered mental status. The patient is on dialysis.

COMPARISON: Multiple priors, the most recent dated ___.

FINDINGS: Consistent with the given history, large-bore dual-lumen dialysis catheter from a right internal jugular approach is in stable and standard course and position from a right internal jugular approach. A left internal jugular central venous catheter device has been removed in the interval. No consolidation or edema is evident. The mediastinum is unremarkable. The cardiac silhouette is enlarged. This is an interval change compared to the most recent prior study but has been noted on other prior studies. Subtle blunting of the right costophrenic angle suggests a tiny effusion. No pneumothorax is evident. There are no displaced fractures.

IMPRESSION: Small bilateral pleural effusions. Interval marked enlargement of the cardiac silhouette relative to the most recent prior exam. However, other more remote exams have demonstrated enlargement of the silhouette, thereby suggesting the possibility of waxing and waning pericardial effusion. Correlate clinically.


SubjectID: 15259244, StudyID: 57867628, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female status post CABG.

COMPARISON: Multiple chest radiographs dating back to ___, most recent ___.

TECHNIQUE: Portable upright AP chest radiograph.

FINDINGS: There are moderately low lung volumes bilaterally with an increase in left lower lobe atelectasis. Bilateral pleural effusions are seen. There is a stable enlarged cardiomediastinal silhouette. A right IJ catheter sheath is seen terminating in the mid SVC. A right subclavian double-lumen catheter is seen to terminate within the right atrium. An NG tube is again seen entering the stomach and then out of the field of view. There is no pneumothorax.

IMPRESSION: 1) Bilateral pleural effusion with stable cardiomediastinal silhouette. 2) Low lung volumes bilaterally with increased left mid and lower lung atelectasis.


SubjectID: 15259244, StudyID: 54007778, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female status post mitral valve repair.

COMPARISON: Multiple chest radiographs dating back to ___ and most recently ___.

TECHNIQUE: Portable AP upright chest radiograph.

FINDINGS: There is stable massive cardiomegaly which does not show any improvement in past 48 hours. There is significant dilatation of the main pulmonary artery which also has not abated. Lung volumes are low and unchanged with left-sided atelectasis essentially the same. There is no pneumothorax. IJ catheter sheath is seen in position terminating within the mid SVC. A supraclavicular triple-lumen catheter is seen terminating within the right atrium. Moderate bilateral pleural effusions are unchanged.

IMPRESSION: No decrease in massive cardiomegaly or pulmonary artery dilatation . Echocardiography is recommended to further evaluate this finding. These findings were reported to physician assistant, Ms. ___, at 12:10 p.m. via phone by ___.


SubjectID: 15259244, StudyID: 56723838, Comparison: worse

FINAL REPORT

HISTORY: Transplant with respiratory distress.

FINDINGS: In comparison with the study of ___, there is continued diffuse bilateral pulmonary opacifications consistent with worsening effusions, volume loss, and increased pulmonary vascular congestion   Keywords: worse, increase. Possibility of supervening pneumonia must be seriously considered in the appropriate clinical setting, though this is difficult to evaluate in view of the substrate of extensive pulmonary changes.


SubjectID: 15259244, StudyID: 56680584, Comparison: None

FINAL REPORT

INDICATION: Right IJ central venous line attempt. Please evaluate for pneumothorax.

COMPARISON: Comparison is made to chest radiograph performed the same day.

FINDINGS: No central venous line visualized. No pneumothorax identified. Otherwise, stable examination with unchanged left base retrocardiac opacification likely representing a combination of atelectasis and effusion. Cardiomediastinal and hilar contours are unchanged.

IMPRESSION: Unchanged exam. No pneumothorax.


SubjectID: 15259244, StudyID: 54434271, Comparison: None

FINAL REPORT

EXAM: Chest, supine AP portable view. CLINICAL INFORMATION: Hypoxia.

COMPARISON: ___.

FINDINGS: Single frontal view of the chest was obtained. A left pleural effusion with overlying atelectasis remains present. Left base retrocardiac opacity likely represents combination of atelectasis and effusion, although underlying consolidation is difficult to exclude. Patient is status post median sternotomy and CABG. No definite focal consolidation is seen in the right lung. The patient is status post median sternotomy and cardiac valve replacement. Cardiac and mediastinal silhouettes are stable.

IMPRESSION: Left pleural effusion with overlying atelectasis, underlying consolidation is difficult to exclude.


SubjectID: 15259244, StudyID: 52488909, Comparison: same

FINAL REPORT

HISTORY: ESRD and hypotension.

FINDINGS: There is little overall change   Keywords: little overall change. Again there is moderate pulmonary edema with probable bilateral effusions and substantial volume loss in the left lower lobe   Keywords: again. In the appropriate clinical setting, superimposed pneumonia would have to be considered.


SubjectID: 15259244, StudyID: 54770541, Comparison: same

FINAL REPORT

INDICATION: Hypotension with central line placement.

COMPARISON: ___ at 13:56. SUPINE AP VIEW OF THE CHEST: Right internal jugular central venous catheter tip terminates in the SVC. No pneumothorax is present. Patient is status post median sternotomy, CABG, and mitral valve repair. There is continued opacification of the left lung base. Small bilateral pleural effusions, left greater than right are again noted. There is mild pulmonary edema. Subacute left posterior third rib fracture is present. Streaky opacity in the right lung base may reflect atelectasis.

IMPRESSION: Right internal jugular central venous catheter tip in the SVC. No interval change in mild pulmonary edema with continued left basilar consolidation possibly reflecting atelectasis or infection, with small bilateral pleural effusions   Keywords: continue, no interval change.


SubjectID: 15259244, StudyID: 52697942, Comparison: same

FINAL REPORT

PORTABLE CHEST: ___.

HISTORY: ___-year-old female with malaise and generalized weakness. Low hematocrit and low blood pressure at rehab. Question acute chest process.

FINDINGS: Single portable view of the chest is compared to previous exam from ___. Compared to prior, there has been no significant interval change   Keywords: no significant interval change. Dense retrocardiac opacity is again seen silhouetting of the hemidiaphragm. The right lung remains grossly clear. Mild pulmonary vascular congestion is unchanged   Keywords: unchanged. Cardiac silhouette is enlarged, but stable and notable for a prosthetic device.

IMPRESSION: No significant interval change since ___ noting left basilar opacity due to combination of pleural effusion with underlying atelectasis and possible consolidation.


SubjectID: 15259244, StudyID: 50903359, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST, ___

HISTORY: Mitral valve ring. Evaluate effusions.

IMPRESSION: PA and lateral chest compared to ___: Bilateral pleural effusion, moderate on the right and moderate-to-large on the left and severe bibasilar atelectasis have not improved since ___. Pulmonary vasculature is engorged, but edema is minimal if any. Severe cardiac enlargement is stable. Dual-channel dialysis catheters ends in the right atrium. No pneumothorax.


SubjectID: 15259244, StudyID: 50243155, Comparison: worse

FINAL REPORT

PORTABLE CHEST X-RAY ___

COMPARISON: ___ chest x-ray.

FINDINGS: Removal of dialysis catheter with no evidence of pneumothorax. Heart is mildly enlarged and is accompanied by vascular engorgement and new septal lines consistent with interstitial edema   Keywords: new. Small pleural effusions have increased in size in the interval.


SubjectID: 15268535, StudyID: 54768934, Comparison: worse

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph of one day earlier.

FINDINGS: Stable marked enlargement of cardiac silhouette accompanied by pulmonary vascular congestion, mild pulmonary edema. A more confluent opacity in the right lower lobe has worsened and could reflect asymmetrical edema or secondary process such as infection   Keywords: worse. Small right pleural effusion has increased in size, but small left pleural effusion and adjacent left retrocardiac opacity are unchanged.


SubjectID: 15268535, StudyID: 56852144, Comparison: worse

FINAL REPORT

INDICATION: CHF, tachypnea and aspiration question aspiration versus worsening CHF.

COMPARISON: ___.

FINDINGS: Portable radiograph of the chest demonstrates stable severe cardiomegaly with post CABG changes. Mild pulmonary edema is slightly worse with increase in size of bilateral pleural effusions   Keywords: worse, increase. Bibasilar opacities likely reflect a combination of effusion and atelectasis; although, aspiration or infection is also possible.


SubjectID: 15273286, StudyID: 56363267, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: None. CLINICAL

HISTORY: Cough, question pneumonia.

FINDINGS: AP upright and lateral views of the chest were provided. The heart is moderately enlarged. There are small bilateral pleural effusions. There is mild pulmonary edema with hilar engorgement noted. Atherosclerotic calcifications along the thoracic aorta noted. No convincing signs of pneumonia, though the presence of underlying edema does limit the evaluation. Bony structures are intact.

IMPRESSION: Mild pulmonary edema, small bilateral pleural effusions, moderate cardiomegaly.


SubjectID: 15273286, StudyID: 51311104, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Advanced dementia, hypoxia, pulmonary edema.

COMPARISON: Chest radiograph from ___.

FINDINGS: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Moderate cardiomegaly with mild fluid overload but no overt pulmonary edema. Mild areas of atelectasis at the left lung bases. No larger pleural effusions. No pneumothorax.


SubjectID: 15284020, StudyID: 53970670, Comparison: None

FINAL REPORT

HISTORY: Patient is status post AVR and CABG, with ongoing effusions, eval for interval change.

COMPARISON: ___.

FINDINGS: Frontal and lateral chest radiographs were obtained. The right hemidiaphgragm is chronically elevated. Bilateral pleural effusions have improved with only small effusions remaining. The cardiomediastinal silhouette and hilar contours are stable. There is no pneumothorax. The right chest pacer leads are unchanged in position. Median sternotomy wires are intact. The mitral annulus is heavily calcified.

IMPRESSION: Interval improvement in bilateral pleural effusions with only small effusions remaining.


SubjectID: 15284020, StudyID: 50880424, Comparison: better

FINAL REPORT

HISTORY: Patient with dyspnea, eval interval change in effusions.

COMPARISON: ___.

FINDINGS: Frontal and lateral chest radiographs were obtained. There is a large right pleural effusion and a moderate left pleural effusion, resulting in bibasilar compressive atelectasis. The pulmonary vascular congestion appears to have improved, though this could be secondary to patient in upright position   Keywords: improve. No pneumothorax is seen. The cardiomediastinal silhouette is stable.

IMPRESSION: Bilateral pleural effusions, right greater than left with associated babasilar atelectasis.


SubjectID: 15285738, StudyID: 57785280, Comparison: None

FINAL REPORT

INDICATION: Productive cough, dyspnea and fever, here to evaluate for pneumonia.

COMPARISON: Chest radiograph, last performed on ___.

TECHNIQUE: Upright AP and lateral radiographs of the chest.

FINDINGS: Two vascular stents are again noted, the first in the superior vena cava and the second in the left brachiocephalic vein, unchanged. The cardiac silhouette is clearly enlarged, but stable compared to the prior study. The mediastinal and hilar contours are within normal limits. Mild calcification of the aortic knob is noted. There is pulmonary vascular congestion with mild pulmonary interstitial edema. No significant pleural effusion or pneumothorax is detected. Evaluation is limited due to difficult patient positioning secondary to pain with the patient's arm obscuring the lateral radiograph.

IMPRESSION: 1. Limited evaluation due to patient discomfort and limited positioning. Overall, stable appearance of the chest from ___. 2. Mild pulmonary vascular congestion and interstitial edema. 3. Stable severe cardiomegaly.


SubjectID: 15285738, StudyID: 54167356, Comparison: same

FINAL REPORT

INDICATION: ___-year-old female with fever.

COMPARISON: ___.

TECHNIQUE: Frontal and lateral chest radiographs were obtained.

FINDINGS: There may be increased opacification at the right lung base. A tiny pleural effusion is seen on lateral view. No pneumothorax is seen. Stents in the expected locations of the left brachiocephalic vein and superior vena cava are again noted. The aorta is calcified and tortuous. Heart size is stably enlarged. Pulmonary vascular redistribution is stable   Keywords: stable.

IMPRESSION: Equivocal right lower lung opacity, which could represent mild asymmetric lower lung predominant edema or less likely early pneumonia. Preliminary findings were discussed with Dr. ___ by Dr. ___ by telephone at 11:40 p.m. on ___ at the time of discovery of these findings. Updated interpretation was discussed with Dr. ___ by Dr. ___ by telephone at 9:16 a.m. on ___ after attending radiologist review.


SubjectID: 15285738, StudyID: 50971124, Comparison: None

FINAL REPORT

INDICATION: ___-year-old woman with dialysis and desaturation while ambulating and flat. Improves with rising up the bed, evaluate for volume overload, change from prior new infiltrates.

COMPARISONS: Multiple prior radiographs, most recently PA and lateral from ___.

FINDINGS: There is no focal consolidation or vascular congestion. There are small bilateral pleural effusions. Moderate cardiomegaly is stable. Again seen are stents in the left brachiocephalic and SVC. There is no pneumothorax.

IMPRESSION: Small bilateral pleural effusions. Moderate cardiomegaly is unchanged.


SubjectID: 15290047, StudyID: 59998788, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman w/ multiple rib fractures s/p cpr for multiple PEA arrests now w/ nerve blocks // ? ptx, effusion ? ptx, effusion

IMPRESSION: In comparison with the earlier study of this date, the monitoring and support devices are unchanged. Multiple rib fractures are stable. No evidence of pneumothorax. Little change in the bilateral layering pleural effusions with compressive basilar atelectasis and substantial enlargement of the cardiac silhouette.


SubjectID: 15290047, StudyID: 59108519, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with rib fractures s/p multiple pea arrests // Effusions, ptx, consolidation Effusions, ptx, consolidation

COMPARISON: Comparison to ___ at 07:40

FINDINGS: Portable semi supine chest radiograph ___ at 08:20 is submitted.

IMPRESSION: The patient is markedly rotated limiting evaluation of the cardiac and mediastinal contours. However, the heart does remain enlarged which may reflect cardiomegaly, although pericardial effusion should also be considered. There is worsening pulmonary edema   Keywords: worse. Bilateral layering effusions. Bilateral rib fractures as previously seen.


SubjectID: 15290047, StudyID: 55387796, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___ year old woman w/ anemia s/p PEA arrest. // interval change

TECHNIQUE: Portable AP chest radiograph

COMPARISON: Prior chest radiographs from ___, ___ CTA chest/abdomen/ pelvis from ___

FINDINGS: Since ___, the right lung has new opacifications in the mid to lower lung field with increased basilar atelectasis, concerning for pleural effusion. Left retrocardiac and basilar atelectasis is increased. Bilateral atelectasis. Unchanged moderate to severe cardiomegaly. Positioning of temporary pacemaker wire is seen in the RV. The tip of an endotracheal tube is seen 4.0 cm above the carina. No pneumothorax.

IMPRESSION: 1. New opacifications in the mid to lower right lung field, representing moderate right pleural effusion, with increased basilar atelectasis since ___.


SubjectID: 15290047, StudyID: 53159780, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p cardiac arrest, multiple rib fractures, now s/p nerve blocks for rib fxs // ? effusion, consolidation, ptx ? effusion, consolidation, ptx

IMPRESSION: Compared to chest radiographs ___ through ___ at 22:35. Large right and moderate left pleural effusion and severe cardiomegaly are unchanged. No pneumothorax. Previous pulmonary edema has resolved   Keywords: resolve. Multiple left rib fractures have been previously noted. Today's study shows fracture and lateral aspect of at least one right middle rib. Cardiopulmonary support devices in standard placements unchanged.


SubjectID: 15290047, StudyID: 59930848, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with pna // pna and pulmonary edema pna and pulmonary edema

IMPRESSION: In comparison with the study of ___, there is less obliquity of the patient. The on this limited study, there again is substantial enlargement of the cardiac silhouette with pulmonary edema and bilateral pleural effusions with volume loss in the lower lungs, especially on the left. Given the extensive changes, in the appropriate clinical setting it would be impossible to exclude superimposed pneumonia, especially in the absence of a lateral view.


SubjectID: 15290047, StudyID: 58654739, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman now extubated but with ongoing O2 requirement. Assess interval change. // assess interval change assess interval change

IMPRESSION: In comparison with the study of ___, the endotracheal tube and nasogastric tube have been removed. Obliquity of the patient makes it difficult to properly evaluate the heart and lungs. However there is again substantial enlargement of the cardiac silhouette with pulmonary vascular congestion and bilateral pleural effusions with volume loss in the lower lungs, especially on the left. In view of the extensive changes and absence of a lateral view, it would be impossible to exclude superimposed pneumonia.


SubjectID: 15290047, StudyID: 56132642, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with pna, changing oxygen requirement // please eval for interval changes please eval for interval changes

IMPRESSION: In comparison with the earlier study of this date, the current examination is again somewhat limited. There is substantial large min of the cardiac silhouette with prominent pulmonary edema that appears to be increasing   Keywords: increasing. Bilateral pleural effusions and compressive basilar atelectasis are also seen. The possibility of superimposed pneumonia can certainly not be excluded in the appropriate clinical setting.


SubjectID: 15290047, StudyID: 55058727, Comparison: worse

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___F with CHF (___ EF ___%), Afib on eliquis, and dementia, now presenting with cardiac arrest and hypoxic respiratory failure // interval change

TECHNIQUE: Portable AP chest right

COMPARISON: Prior chest radiographs from ___, ___, ___, ___

FINDINGS: This exam is very limited by obliquity of patient positioning. Extensive pulmonary edema is increased since at least ___ with near complete opacification of both lungs   Keywords: increase. Lung volumes are extremely low. The heart size is impossible to assess. A left PICC line is presumably in unchanged position. Concurrent pneumonia obviously cannot be excluded.

IMPRESSION: 1. Extremely limited study. Probable increase in extensive pulmonary edema with near complete opacification of both lungs   Keywords: increase. Concurrent pneumonia cannot be excluded.

RECOMMENDATION(S): A CT exam could be obtained for further evaluation.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ ___ on the telephoneon ___ at 12:43 AM, 20 minutes after discovery of the findings.


SubjectID: 15290047, StudyID: 59789416, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with desaturation to ___%, unclear etiology. // assess for pneumothorax, PNA or malpositioned ETT assess for pneumothorax, PNA or malpositioned ETT

IMPRESSION: Compared to prior chest radiographs ___ through ___ at 12:12. Since ___:12, the left lung has collapsed, shifting the mediastinum to the left obscuring the size of the large cardiac silhouette. Severe pulmonary edema and large right pleural effusion have worsened   Keywords: worse. No pneumothorax. ET tube in standard placement. Nasogastric tube ends in the upper stomach but would need to be advanced several cm to move all the side ports below the diaphragm.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the ___ ___ at 6:12 PM, 2 minutes after discovery of the findings.


SubjectID: 15290047, StudyID: 58907628, Comparison: better

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___ year old woman with pulmonary edema // Pulmonary edema

TECHNIQUE: Portable AP chest radiograph

COMPARISON: Chest radiographs from ___, ___, ___, ___.

FINDINGS: Since ___, moderate asymmetric pulmonary edema appears unchanged with improved aeration of the right lung base, bilateral pleural effusions, right greater than left, are unchanged, and associated atelectasis is improved on the right and worse on the left   Keywords: improve. Lung volumes remain low. The tip of an endotracheal tube is seen 2.9 cm above the carina. Severe cardiomegaly persists.

IMPRESSION: 1. Mild improvement of moderate asymmetric pulmonary edema with improved aeration of the right lung base   Keywords: improve. 2. Persistence of right upper lobe opacity could represent asymmetric edema or pneumonia.


SubjectID: 15290047, StudyID: 52958260, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with ETT // ETT placement ETT placement

COMPARISON: Comparison to ___ at 03:58

FINDINGS: Portable semi-erect chest radiograph ___ at 07:29

IMPRESSION: Endotracheal tube has its tip by 5.5 cm above the carina. The nasogastric tube is unchanged in position with its tip projecting over the proximal stomach. The heart remains stably enlarged. There are improving but residual patchy airspace opacities consistent with resolving mild to moderate pulmonary edema   Keywords: improving, resolving. There are likely small layering effusions. No obvious pneumothorax. Multiple old left-sided posterolateral rib fractures.


SubjectID: 15290047, StudyID: 52665154, Comparison: worse

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___ year old woman with ETT // ETT

TECHNIQUE: Portable AP chest radiograph

COMPARISON: Chest radiographs from ___, ___, ___, ___

FINDINGS: Since ___, bilateral multifocal opacities appear worse and may represent increasing pulmonary edema   Keywords: worse, increasing. However, concurrent multifocal pneumonia is not excluded. Bilateral pleural effusions, moderate to large on the right and small on the left, and associated bibasilar atelectasis are increased. Lung volumes remain low. The tip of an endotracheal tube terminates 2.5 cm above the carina. An NG tube is seen in the stomach and continues out of view. No pneumothorax.

IMPRESSION: 1. Worsening bilateral multifocal opacities may represent increasing pulmonary edema   Keywords: increasing, worse. However concurrent pneumonia is not excluded. 2. Bilateral pleural effusions, moderate to large on the right and small on the left, and associated bibasilar atelectasis are increased. 3. The tip of the ETT seen 2.5 cm above the carina.


SubjectID: 15290047, StudyID: 51094749, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman intubated, s/p PEA arrest and w/known rib fractures. Please assess for evidence of volume overload / PNA. // assess volume overload/PNA

IMPRESSION: Compared to ___ chest radiograph, widespread pulmonary edema has worsened in severity   Keywords: worse. Moderate right pleural effusion appears slightly smaller, but positional differences limit comparison. Small left pleural effusion and adjacent left retrocardiac opacification are unchanged.


SubjectID: 15290047, StudyID: 50726250, Comparison: better

WET READ: ___ ___ ___ 8:10 AM Endotracheal tube terminates 4.5 cm above the carina. An enteric tube terminates in the region of the stomach. There is markedly improved ventilation of the left lower lobe. No pneumothorax. Small the moderate bilateral effusions persist. Mild to moderate pulmonary edema persists but is improved from the prior examination.

WET READ VERSION #___ ___ ___:17 PM Endotracheal tube terminates 4.5 cm above the carina. An enteric tube terminates in the region of the stomach. There is markedly improved ventilation of the left lower lobe. No pneumothorax. Small the moderate bilateral effusions persist. Mild to moderate pulmonary edema persists but is improved from the prior examination. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with ETT, likely LLL collapse suspect has resolved after suctioning // LLL collapse

IMPRESSION: As compared to the prior study from earlier the same date, previously present complete left lung collapse has substantially improved with residual partial atelectasis of the left lower lobe. Diffuse pulmonary edema has decreased in severity   Keywords: decrease. Moderate right and small to moderate left pleural effusions are noted. Endotracheal tube is in standard position, and nasogastric tube has apparently been withdrawn with side-port potentially proximal to GE junction level. This could be advanced a few cm for standard positioning.


SubjectID: 15290047, StudyID: 59257984, Comparison: better

WET READ: ___ ___ ___ 7:23 AM Bilateral multifocal consolidations are minimally improved from ___. Bilateral effusions may be minimally increased. Endotracheal tube is 4.5 cm above the carina. No pneumothorax.

WET READ VERSION #___ ___ ___ ___ 8:14 PM Bilateral multifocal consolidations are minimally improved from ___. Bilateral effusions may be minimally increased. Endotracheal tube is 4.5 cm above the carina. No pneumothorax. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman intubated, s/p PEA arrest, with VAP pneumonia. Please assess for pneumonia. // assess interval change assess interval change

IMPRESSION: In comparison with the study of ___, there again are substantial bilateral layering effusions with compressive atelectasis at the bases. What appeared to be central vascular congestion bilaterally has decreased   Keywords: decrease. Tip of the endotracheal tube is approximately 4.5 cm above the carina. Nasogastric tube extends to the stomach, though the side port is close to the esophagogastric junction. Right IJ pacer wire again extends to the apex of the right ventricle.


SubjectID: 15290047, StudyID: 57662558, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p ___ pea arrests, multiple rib fractures, now paced, epidural pain catheter, intubated and sedated // ? ptx, effusion, consolidation

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Moderate cardiomegaly is stable. Pacer lead tip is in standard position in the right ventricle. NG tube tip is out of view below the diaphragm. Right upper lobe, the left lower and left perihilar opacities have worsened worrisome for multifocal pneumonia. There is no evident pneumothorax. ET tube is in standard position preop bilateral effusions are unchanged


SubjectID: 15290047, StudyID: 59095276, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with GI bleed s/p cardiac arrest // confirm placement of the ___ catheter tip. confirm placement of the swan catheter tip.

IMPRESSION: In comparison with the study of earlier in this date, the tip of the Swan-Ganz catheter is in the pulmonary outflow tract or possibly the most proximal portion of the right pulmonary artery. The hazy opacification at the right base has decreased in the hemidiaphragm is well seen. This could represent improved pleural effusion, though it could merely be a manifestation of a more upright position of the patient.


SubjectID: 15290047, StudyID: 55752741, Comparison: worse

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___ year old woman s/p cardiac arrest with hypoxia // s/p cardiac arrest

TECHNIQUE: Portable AP chest radiograph

COMPARISON: Prior chest radiographs from ___, ___, ___, ___ CTA chest, abdomen, and pelvis from ___

FINDINGS: Since earlier same day chest radiograph, mild pulmonary edema is slightly worse, bilateral pleural effusions, moderate on the right and small on the left, are unchanged, and bibasilar atelectasis, right greater than left, are increased   Keywords: worse. Lucency in right upper quadrant of the abdomen is potentially projectional, although free air or basilar pneumothorax may produce a similar appearance. Severe cardiomegaly is unchanged. Known rib deformities are again noted. Tip of the endotracheal tube is seen 2.3 cm above the carina. A feeding tube is seen in the stomach and can be advanced further.

IMPRESSION: 1. Mild pulmonary edema, bilateral pleural effusions, accompanied by with worsening bibasilar atelectasis and small pleural effusions   Keywords: worse. 2. Right upper quadrant lucency may be projectional, but basilar pneumothorax or free intraperitoneal air could have a similar radiographic presentation. Left lateral decubitus radiograph may be helpful for further evaluation. .

RECOMMENDATION(S): If clinically indicated, further imaging could be obtained with a left lateral decubitus chest radiograph to better evaluate for pneumothorax.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ ___ on the telephoneon ___ at 11:18 AM, 5 minutes after discovery of the findings.


SubjectID: 15290047, StudyID: 54197950, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p cardiac arrest // ? ptx, effusion, consolidation ? ptx, effusion, consolidation

IMPRESSION: In comparison with the earlier study of this date, there is little change   Keywords: little change. The monitoring and support devices are stable, as is the appearance of the heart and lungs. An area of lucency in the left lung laterally most likely represents a skin fold rather than pneumothorax, since vessels are seen filling beyond it.


SubjectID: 15290047, StudyID: 52537712, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with intubation, multifactorial shock // Eval ETT placement

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: Patient is rotated considerably to the right. Given this, interval placement of endotracheal tube is seen, terminating approximately 4 cm above the level of the carina. Enteric tube courses below the level of the diaphragm into the left upper quadrant, presumed terminating in the stomach, with side port at the level of the GE junction. The cardiac and mediastinal silhouettes are grossly stable given differences in patient position, with the cardiac silhouette enlarged. There is persistent blunting of the right costophrenic angle. Vascular prominence appears stable to possibly minimally decreased   Keywords: decrease. Chronic appearing left rib deformities are noted.

IMPRESSION: Endotracheal tube terminates 4 cm above the level the carina. Enteric tube terminates in the left upper quadrant, presumed in the stomach; side port at the level the GE junction consider advancement so that it is well within the stomach.


SubjectID: 15290047, StudyID: 52159561, Comparison: None

FINAL REPORT

INDICATION: ___ -year-old female with shortness of breath.

TECHNIQUE: Portable AP

COMPARISON: Multiple prior chest radiographs dated most recently ___ as well as CTA chest dated ___

FINDINGS: Single portable chest radiograph demonstrates cardiomegaly, not significantly changed in size relative to CT chest dated ___. Obscuration of the bilateral costophrenic angles likely suggest small pleural effusions, right greater than left. Central vascular engorgement is present with probable mild to moderate pulmonary edema. There is no pneumothorax. Clips are noted superiorly in the expected location of the thyroid gland in this patient status post thyroidectomy.

IMPRESSION: Cardiomegaly with small pleural effusions and probable mild to moderate pulmonary edema.


SubjectID: 15290047, StudyID: 58995135, Comparison: worse

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___ year old woman with hypoxia // PNA?

TECHNIQUE: Chest PA and lateral

COMPARISON: Prior chest radiographs from ___

FINDINGS: Since ___, the left lower lobe has increased collapse and the bilateral perihilar opacities persist, compatible with pulmonary edema   Keywords: increase. The right perihilar and basilar opacities are concerning for concurrent pneumonia. Moderate bilateral pleural effusions are unchanged. Lung volumes are very low. The previously noted feeding tube has been removed. Severe cardiomegaly is unchanged. No pneumothorax. The left PICC line is in unchanged position.

IMPRESSION: 1. Left lower lobe collapse is increased and bilateral perihilar opacities since ___, compatible with increasing pulmonary edema   Keywords: increase. 2. The right perihilar basilar opacities are concerning for concurrent pneumonia.


SubjectID: 15290047, StudyID: 52946240, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with RESPIRATORY FAILURE // Worsening PNA?

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Left pigtail catheter at projects in the right atrium probably in the lower cavoatrial junction. Large left pleural effusion with adjacent left lower lobe collapse has increased. Opacities in the right base are grossly unchanged allowing the difference in positioning of the patient combination of effusion and adjacent atelectasis. Patient's chin obscures the apices of the lungs. Cardiomegaly cannot be assessed. Pulmonary edema has markedly improved   Keywords: improve. .


SubjectID: 15290047, StudyID: 56267282, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with intubation, pna // please eval for interval changes please eval for interval changes

IMPRESSION: Compare to prior chest radiographs ___ through ___. Substantial bilateral pulmonary consolidation accompanied by increasing moderate to severe cardiomegaly is probably largely pulmonary edema, particular in light of the persistent moderate bilateral pleural effusions, right stable, left increasing   Keywords: persistent. Since there is persistent severe lower lobe atelectasis, more pronounced on the left than the right, concurrent pneumonia may also be present. ET tube, esophageal drainage tube, and left central venous catheter are in standard placements. No pneumothorax.


SubjectID: 15292682, StudyID: 53570626, Comparison: None

FINAL REPORT

AP CHEST, 8:41 P.M. ON ___

HISTORY: New ICD. Rule out pneumothorax.

IMPRESSION: AP chest compared to ___. Transvenous right atrial pacer and right ventricular pacer defibrillator leads follow their expected courses. A third lead may cannulate the coronary sinus, ending in a proximal cardiac vein. Lateral view would be required for confirmation. There is no pneumothorax, pleural effusion or mediastinal widening to suggest any complications, heart size is normal and the lungs are clear.


SubjectID: 15303179, StudyID: 58127235, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M, intubated

TECHNIQUE: Semi upright AP view of the chest

COMPARISON: None. Patient is currently listed as EU critical.

FINDINGS: Endotracheal tube tip measures 3.5 cm from the carina. Heart size is mildly enlarged. Diffuse alveolar opacities are seen bilaterally. No large pleural effusion is noted, though there may be pleural thickening along the right apex. No pneumothorax is identified. Left-sided VP shunt catheter is noted. No acute osseous abnormality is present.

IMPRESSION: 1. Endotracheal tube in standard position. 2. Extensive diffuse alveolar opacities, findings which may reflect severe pulmonary edema/ARDS. Extensive pneumonia or diffuse alveolar hemorrhage is not excluded.


SubjectID: 15303179, StudyID: 50771711, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man intubated with pulmonary edema // Interval change?

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the diffuse bilateral severe parenchymal opacities are not substantially changed. Only on the right, the opacity might have minimally decreased in severity but is stable in extent. The size of the cardiac silhouette is unchanged. Unchanged position of the endotracheal tube and the nasogastric tube.


SubjectID: 15303179, StudyID: 57135838, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pulm edema // eval for interval change

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the extent and severity of the diffuse bilateral parenchymal opacities is not substantially changed. In the interval, the patient has been extubated and the nasogastric tube was removed. Mild cardiomegaly. No pleural effusions.


SubjectID: 15303179, StudyID: 53676721, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with HCAP, respiratory failure requiring intubation // eval for ETT placement, OG tube placement eval for ETT placement, OG tube placement

COMPARISON: Chest radiographs ___ through ___.

IMPRESSION: There has been enough improvement in the severe infiltrative pulmonary abnormality in the lungs to make it apparent that there are many lung nodules from 8-15 mm in diameter. some nodules may have been present since ___, obscured by the generalize process, but I suspect more nodules have formed. This points to disseminated infection. It would be very helpful to do a CT scan. The heart is normal size. Endotracheal tube ends in at the carina an should be withdrawn 3 cm. House staff notified. Nasogastric tube ends in the stomach. Pleural effusion is small on the right. No pneumothorax.

NOTIFICATION: Dr. ___ reported the findings to ___ by telephone on ___ at 3:44 PM, 1 minutes after discovery of the findings.


SubjectID: 15303179, StudyID: 52993222, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CA-P, intubated // eval for interval change, position of ETT

COMPARISON: Chest radiograph ___, CT chest ___

FINDINGS: Single AP view of the chest provided. ET tube ends 4.0 cm above the Carina. A transesophageal tube ends in the proximal stomach. Patchy diffuse, bilateral interstitial and alveolar opacities, some of which have a nodular appearance are improving from ___. No pleural effusion or pneumothorax. Hilar and cardiomediastinal contours are normal.

IMPRESSION: 1. ET tube is in standard position 4.0 cm above the Carina. 2. Diffuse nodular opacities are mildly improved from ___ and again suggest disseminated infection, possibly septic emboli. 3. A transesophageal tube ends in the proximal stomach. Advancement 2.0 cm is recommended to ensure proper placement.


SubjectID: 15310905, StudyID: 51710979, Comparison: same

FINAL REPORT

CHEST, TWO VIEWS: ___

HISTORY: ___-year-old female with dyspnea and history of CHF.

COMPARISON: ___.

FINDINGS: Frontal and lateral views of the chest. Compared to prior, there has been interval enlargement of the right-sided pleural effusion. There is a persistent left-sided effusion which is grossly unchanged. Superiorly, the lungs demonstrate mildly indistinct pulmonary vascular markings suggesting vascular congestion. Cardiomediastinal silhouette is unchanged, at least moderately enlarged. Chronic changes seen at the shoulders bilaterally. Mid thoracic vertebral body severe compression deformity is again noted.

IMPRESSION: Interval increase in size of right-sided pleural effusion with probable underlying atelectasis, noting that infection cannot be entirely excluded. Persistent left effusion and mild pulmonary vascular congestion   Keywords: persistent.


SubjectID: 15310905, StudyID: 59521399, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Acute hypoxemia, questionable pulmonary edema.

COMPARISON: ___.

FINDINGS: The lung volumes are relatively low. There are new bilateral moderate pleural effusions as well as increasing diameter of the pulmonary vasculature. Together with the also newly occurred retrocardiac atelectasis and the moderate cardiomegaly, overall moderate pulmonary edema is present. No evidence of pneumonia. The observation was made at the time of dictation, 11:25 a.m., and the referring physician, ___. ___ was paged for notification at 11:27 a.m., ___.


SubjectID: 15310905, StudyID: 58645025, Comparison: None

FINAL REPORT

HISTORY: Pleural effusion and lower lobe collapse.

FINDINGS: In comparison with the study of ___, there is substantial change, most likely related primarily to the upright technique. Substantial pleural effusions are seen bilaterally, more prominent on the left. There is increased opacification in the retrocardiac area, consistent with volume loss involving the left lower lobe. Some indistinctness of pulmonary vessels could reflect elevated pulmonary venous pressure in a patient with mild enlargement of the cardiac silhouette.


SubjectID: 15310905, StudyID: 55193975, Comparison: better

FINAL REPORT

AP CHEST, ___, 6:31 A.M.

HISTORY: CHF. Oxygen requirement.

IMPRESSION: AP chest compared to ___ and ___ at 10:48 a.m.: Since yesterday moderately severe pulmonary edema has improved, while moderate right pleural effusion has increased   Keywords: improve. Left lower lung remains largely airless and should be reevaluated after patient's cardiovascular situation has improved. Heart size is chronically and severely enlarged, with particularly large left atrium and dilated pulmonary arteries. No pneumothorax.


SubjectID: 15310905, StudyID: 59351082, Comparison: None

FINAL REPORT

HISTORY: CHF with reaccumulating right pleural effusion.

COMPARISON: Multiple prior chest radiographs, most recently ___.

FINDINGS: Single frontal view of the chest. Heart size and mediastinal contours are stable. Right pleural effusion has increased since the prior exam with increased right mid and right lower lobe atelectasis. Small left pleural effusion is unchanged with stable left lower lobe atelectasis. No pneumothorax.


SubjectID: 15310905, StudyID: 57491665, Comparison: same

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___ radiograph.

FINDINGS: Moderate right pleural effusion has slightly increased in size following removal of right pleural catheter. Slight worsening atelectasis in right mid and lower lung regions. Stable cardiomegaly and pulmonary vascular congestion   Keywords: stable. Worsening left lower lobe atelectasis and persistent adjacent small-to-moderate left pleural effusion.


SubjectID: 15310905, StudyID: 54903096, Comparison: None

FINAL REPORT

HISTORY: Effusion with pleur-x catheter.

COMPARISON: Multiple prior chest radiographs, most recently of ___ at 07:57.

FINDINGS: Single frontal view of the chest. There is a right pleural drain with interval decrease in size of a now small right pleural effusion. No pneumothorax. Moderate-sized left pleural effusion persists. Bibasilar consolidations are unchanged. Prominence of the main pulmonary artery is suggestive of pulmonary arterial hypertension. Heart size and cardiomediastinal contours are stable.

IMPRESSION: Status post right pleural drain placement with interval decrease in size of now small right pleural effusion. Moderate left pleural effusion and bibasilar consolidation persist.


SubjectID: 15310905, StudyID: 52958045, Comparison: same

FINAL REPORT

HISTORY: Follow up effusions.

COMPARISON: ___.

FINDINGS: Single frontal view of the chest. There has been no interval change since the prior radiograph   Keywords: no interval change. Bilateral moderate pleural effusions with bibasilar consolidations persist. No new consolidation or pneumothorax. Heart size and cardiomediastinal contours are stable.

IMPRESSION: Stable bilateral pleural effusions with adjacent bibasilar consolidations.


SubjectID: 15310905, StudyID: 59270299, Comparison: better

FINAL REPORT

INDICATION: CHF and recurrent right pleural effusion thorax in place. Drainage of 1 liter.

COMPARISON: ___.

FINDINGS: AP and lateral views of the chest. Right pleural effusion is significantly decreased, now with trace amount on the right. Small-to-moderate left pleural effusion is unchanged. Pulmonary edema has decreased some residual hazy opacities in the right lung   Keywords: decrease. Bibasilar atelectasis. No pneumothorax. Cardiomediastinal and hilar contours are stable.

IMPRESSION: Significant decrease in right pleural effusion, possibly some reexpansion edema in the right but significantly decreased edema bilaterally compared to prior study   Keywords: decrease. Small-to-moderate left pleural effusion is unchanged.


SubjectID: 15310905, StudyID: 57556581, Comparison: worse

FINAL REPORT

HISTORY: Shortness of breath.

TECHNIQUE: Upright AP and lateral views of the chest.

COMPARISON: Chest CT ___ and chest radiograph ___.

FINDINGS: The exam is limited due to patient rotation. Assessment of the cardiac silhouette is difficult to assess given the presence of moderate bilateral pleural effusions, right greater than left. Aortic knob calcifications are re- demonstrated. Hazy opacification in the lungs with indistinctness of the vasculature likely reflects mild pulmonary edema. Bibasilar airspace opacities may reflect atelectasis though infection or aspiration cannot be completely excluded. Previously seen tiny right apical pneumothorax is not clearly visualized on the current exam. Marked degenerative changes of both glenohumeral joints are noted. Right-sided chest tube terminates along the medial aspect of the mid right hemithorax.

IMPRESSION: Mild pulmonary edema, new compared to the prior exam   Keywords: new. Moderate size bilateral pleural effusions, right greater than left, relatively unchanged compared to the prior exam with PleurX catheter in unchanged position. Previously described tiny right apical pneumothorax is not clearly demonstrated on the current exam. Bibasilar opacities may reflect atelectasis, but infection or aspiration are not completely excluded.


SubjectID: 15310905, StudyID: 58635000, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Dyspnea.

COMPARISONS: ___; ___.

TECHNIQUE: Chest, PA and lateral.

FINDINGS: The cardiac, mediastinal and hilar contours appear stable including moderate cardiomegaly and enlargement of the main pulmonary artery contour. There is mild unfolding of the thoracic aorta, which is calcified in a patchy fashion. There are persistent pleural effusions, possibly decreased on the left, but similar-to-increased on the right and moderate in size. In addition, a lenticular opacity along the posterior right hemithorax suggests a loculated effusion, similar-to-increased but not easy to compare to the recent prior radiographs due to slight differences in orientation. Fissures are thickened. There is a moderate interstitial abnormality suggestive of pulmonary edema, increased since the prior examinations, but also a relatively confluent area of vague right lower lung opacification   Keywords: increase. The possibility of coinciding pneumonia could be considered. Short-term serial radiographic followup may be helpful to reevaluate. There is exaggerated kyphotic curvature and a similar severe lower thoracic compression deformity. The bones appear demineralized.

IMPRESSION: 1. Findings suggesting moderate interstitial pulmonary edema. 2. Relatively dense area of opacity increased at the right lung base. The possibly of coinciding pneumonia could be considered; it may be appropriate to consider short-term follow-up radiographs to reassess.


SubjectID: 15310905, StudyID: 54937123, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman with pneumonia and CHF exacerbation. Evaluate for pneumonia.

FINDINGS: Comparison is made to previous study from ___. There are again seen diffuse airspace opacities and consolidation, worse within the right lung. There are bilateral pleural effusions, right equal to left, also unchanged. No pneumothoraces are seen. There are calcifications in thoracic aorta. Severe degenerative changes of the glenohumeral joints bilaterally is partially included on the field of view.


SubjectID: 15310905, StudyID: 57200051, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Congestive heart failure, pigtail catheter placement, evaluation of pleural effusion.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the position of the right pigtail catheter in the pleural space is slightly changed. The effusion on the right appears to have minimally increased. On the left, the appearance of the pleural space, the lung parenchyma and the heart is constant. Overall, the lung volumes are low. No evidence of pneumonia or new parenchymal opacities.


SubjectID: 15310905, StudyID: 57017479, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post right pigtail placement. Check for pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has received a right pleural pigtail catheter. This catheter has almost completely drained the pre-existing right pleural effusion. There is no visible pneumothorax. The lung volumes remain low. Moderate cardiomegaly persists. Moderate left pleural effusion with subsequent atelectasis is unchanged as compared to the previous image.


SubjectID: 15310905, StudyID: 55487873, Comparison: same

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old woman with dysphagia and now status post intubation.

FINDINGS: A comparison is made to prior study from ___. The tip of the endotracheal tube is 3 cm above the carina. There is cardiomegaly with a left retrocardiac opacity. There is a left-sided pleural effusion. The right CP angle is not well visualized. There is a persistent pulmonary edema   Keywords: persistent.


SubjectID: 15310905, StudyID: 54057411, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: ___. CLINICAL

HISTORY: Dysphagia, question foreign body.

FINDINGS: PA and lateral views of the chest were obtained. Cardiomegaly is again noted with diffuse ground-glass opacity concerning for pulmonary edema. Bilateral pleural effusions are present, left greater than right with bibasilar consolidation, likely representing compressive atelectasis. No pneumothorax is seen. Aortic calcifications again noted. Bony structures are demineralized.

IMPRESSION: Pulmonary edema, bilateral effusions and bibasilar atelectasis, stable cardiomegaly   Keywords: stable.


SubjectID: 15310905, StudyID: 54219393, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph of one day earlier.

FINDINGS: Right Pleurx catheter remains in place. Interval increase in size of right pleural effusion, now moderate in size. Small right apical pneumothorax is also demonstrated. Stable cardiomegaly and persistent left lower lobe atelectasis and adjacent pleural effusion.


SubjectID: 15312163, StudyID: 55752073, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___.

COMPARISON: CT torso from ___ as well as a chest radiograph also from that day. CLINICAL

HISTORY: ___-year-old female with shortness of breath and lower extremity edema, assess for congestive heart failure.

FINDINGS: PA and lateral views of the chest are provided. Dual-lead pacer is unchanged in position. There is persistent elevation of the left hemidiaphragm which is stable. There is interval development ___ ___ B lines, indicative of mild pulmonary interstitial edema. There is no effusion or pneumothorax. Heart and mediastinal contour remain stable. Bony structures are intact.

IMPRESSION: Mild interstitial edema, new from prior   Keywords: new.


SubjectID: 15312163, StudyID: 51697140, Comparison: 1.0

FINAL REPORT

HISTORY: Mild interstitial edema seen on ___. Cough and concern for pneumonia.

COMPARISON: Multiple priors from ___ to ___.

FINDINGS: PA and lateral chest radiographs demonstrate resolution of mild interstitial edema with a small, persistent pleural effusion   Keywords: persistent. There is no focal consolidation or pneumothorax. The left hemidiaphragm is persistently elevated dating back to ___. The cardiomediastinal silhouette is stable.

IMPRESSION: Improvement of interstitial edema from ___   Keywords: improve. No evidence of pneumonia.


SubjectID: 15313897, StudyID: 56929974, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___.

COMPARISON: ___. CLINICAL

HISTORY: Failure to thrive, assess for pneumonia.

FINDINGS: AP and lateral views of the chest are provided. There is diffuse pulmonary edema with bilateral pleural effusions. Heart size is top normal. Aortic calcifications are noted. Hilar congestion noted. No pneumothorax. Bony structures are intact, though demineralized. There is dense mitral annular calcification noted.

IMPRESSION: Pulmonary edema, effusions, cardiomegaly.


SubjectID: 15313897, StudyID: 54937644, Comparison: None

FINAL REPORT

HISTORY: Constipation, for NG tube placement.

FINDINGS: In comparison with the study of ___, there has been placement of a nasogastric tube that extends to the mid-to-lower body of the stomach. There appears to be more asymmetry of the prominence of interstitial markings, raising the possibility of some degree of dependent gravitational edema. Bilateral effusions persist.


SubjectID: 15326209, StudyID: 56694882, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post CABG, evaluation for pleural effusions.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has been extubated and the nasogastric tube is removed. The Swan-Ganz catheter and the pleural and mediastinal drains are also removed. Only a right internal jugular introduction sheath and a left chest tube persist. There is a minimal right pleural effusion. Currently, there is no indication for existence of a pneumothorax. Post-operative appearance of the cardiac silhouette. Unchanged normal alignment of the sternal wires and fixations. No pulmonary edema.


SubjectID: 15326209, StudyID: 54993055, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: PICC line placement.

COMPARISON: ___, 1:38 a.m.

FINDINGS: As compared to the previous radiograph, the patient has received a left-sided PICC line. The course of the line is unremarkable, the tip of the line projects over the confluence of the superior vena cava and brachiocephalic vein. To ensure safe position in the mid SVC, the device should be advanced by approximately 2 cm. No evidence of complications, notably no pneumothorax. Otherwise, the radiograph is unchanged.


SubjectID: 15326209, StudyID: 50070616, Comparison: None

FINAL REPORT

AP CHEST, 7:30 A.M., ___

HISTORY: ___-year-old woman, evaluate effusion.

IMPRESSION: AP chest compared to ___: Pulmonary vascular engorgement is a little more pronounced and there is a small region of edema in the left mid lung, but pleural effusions are small, if any, and left lower lobe atelectasis has not worsened. Cardiomediastinal silhouette has a normal postoperative appearance. No pneumothorax.


SubjectID: 15341985, StudyID: 57718746, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with chf, new TAVR, tech is here in unit currently. // eval for right base abnormality

IMPRESSION: As compared to the prior radiograph of 1 day earlier, right basilar opacity with associated volume loss has slightly worsened, and favors atelectasis over infectious pneumonia. Remainder of the exam is unchanged.


SubjectID: 15341985, StudyID: 51382199, Comparison: same

FINAL REPORT

EXAMINATION: Without the:

INDICATION: ___ year old man with AS s/p tavr // s/p TAVR

IMPRESSION: As compared to ___ chest radiograph, a right internal jugular catheter is been placed, with tip terminating in the lower superior vena cava, with no visible pneumothorax. No other relevant changes since recent study   Keywords: no other relevant change.


SubjectID: 15356161, StudyID: 57273273, Comparison: None

FINAL REPORT

HISTORY: Fusion.

FINDINGS: In comparison with the study of ___, there is little overall change in the substantial left pleural effusion with underlying compressive atelectasis. No evidence of acute focal pneumonia or vascular congestion or change in the cardiomediastinal silhouette.


SubjectID: 15356161, StudyID: 51900456, Comparison: None

FINAL REPORT

INDICATION: Recurrent effusion. Status post thoracentesis, question pneumothorax.

COMPARISON: ___ at 13:05.

FINDINGS: AP view of the chest. Lower lung volumes. The left-sided pleural effusion persists, may be slightly smaller, however, persists. Tiny left apical pneumothorax. Left basilar consolidation cannot be entirely ruled out.

IMPRESSION: Slight decrease in density in the left pleural effusion on this AP view may indicate slight decrease in size. Tiny apical left pneumothorax.


SubjectID: 15357459, StudyID: 59044456, Comparison: None

FINAL REPORT

HISTORY: ___-year-old male status post thoracotomy and pacemaker insertion. Assess for pneumothorax.

COMPARISON: Chest radiograph from ___ PORTABLE FRONTAL CHEST RADIOGRAPH: A pacemaker generator overlies the left chest wall. Right atrial and biventricular leads appear in expected position. Temporary epicardial pacing leads project over the left ventricle. There has been interval placement of a right internal jugular central venous catheter, terminating in the upper SVC. Lung volumes are low, and there is increased opacification of the left lung base, suggesting worsening atelectasis and pleural effusion. Opacities in the right lung base appears stable and likely reflect atelectasis. There is no post-procedure pneumothorax.

IMPRESSION: 1. Increasing left basilar opacity, suggestive of worsening effusion and atelectasis. 2. No post-procedural pneumothorax.


SubjectID: 15357459, StudyID: 55491388, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Thoracotomy for pacemaker insertion, persistent pain, assessment for effusion, pneumothorax or other change.

COMPARISON: ___, 1:33 p.m.

FINDINGS: As compared to the previous radiograph, there are no relevant changes   Keywords: no relevant change. Chest tube in situ. There is a minimal left pleural effusion with left basal atelectasis, but no evidence of increase left pleural fluid in the interval. Unchanged epicardial leads and pacemaker leads. Changed right central venous access line. No pneumothorax, no other lung parenchymal changes have occurred in the interval.


SubjectID: 15357459, StudyID: 54969000, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post thoracocentesis, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the left chest tube has been removed. The right central venous line and the intravascular and epicardial pacemaker leads are unchanged. Unchanged minimal left pleural effusion. No left pneumothorax. Borderline size of the cardiac silhouette. Mild left basal atelectasis.


SubjectID: 15357459, StudyID: 54343248, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Pneumothorax, status post epicardial lead placement, chest tube on waterseal.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The chest tube is in unchanged position. There is no pneumothorax. The epicardial and intravascular leads are in constant position. Unchanged low lung volumes. Unchanged moderate cardiomegaly with atelectasis at the left lung bases. Potential small pleural effusion on the left, no right pleural effusion.


SubjectID: 15366038, StudyID: 57502404, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with recent TAVR, temp pacing wire in place // Interval change, position of pacing wires, s/p TAVR Interval change, position of pacing wires, s/p TAVR

IMPRESSION: Comparison to ___. Stable position of the external right ventricular pacemaker. Mild cardiomegaly. No pulmonary edema. No pneumonia, no pleural effusions.


SubjectID: 15366038, StudyID: 52918788, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman s/p TAVR. // assess lungs

TECHNIQUE: Chest PA and lateral

IMPRESSION: Comparison to ___. New right internal jugular pacer with the tip in the RV. Stable bilateral paramediastinal fibrosis and known calcified granuloma in the right upper lobe. No evidence of acute pulmonary or cardiac changes. No pneumothorax there


SubjectID: 15373413, StudyID: 51761543, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female with shortness of breath. STUDY: PA and lateral chest radiograph.

COMPARISON: ___.

FINDINGS: The heart size is at the upper limits of normal. The mediastinal and hilar contours are within normal limits. The lungs are clear of consolidation, although they exhibit low lung volumes which exaggerates the vascular and parenchymal markings. There is no pleural effusion or pneumothorax.

IMPRESSION: Low lung volumes but no evidence of pneumonia.


SubjectID: 15373413, StudyID: 50678123, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with shortness of breath. Evaluate for edema or CHF.

COMPARISONS: Chest CTA ___ ___. Chest radiograph ___ ___.

FINDINGS: Frontal and lateral views of the chest were obtained. Mild cardiomegaly is stable. The aorta is tortuous with focal dilatation of the descending thoracic aorta, similar to ___. Mild emphysema is present with hyperinflation of lungs and flattening of the diaphragms. No focal consolidation, pleural effusion, or pneumothorax. No radiopaque foreign body.

IMPRESSION: No evidence for acute cardiopulmonary process. Stable emphysema and mild cardiomegaly. Focal dilatation of the descending thoracic aorta is similar to ___.


SubjectID: 15375544, StudyID: 57401082, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF exacerbation // assess for edema

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the lung volumes have decreased. Borderline size of the cardiac silhouette and mild pulmonary edema is present. No pleural effusions. Minimal atelectasis at the left lung bases. No pneumonia.


SubjectID: 15375544, StudyID: 50754395, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with severe AS s/p TAVR in ___, systolic HFrEF (___%), CAD s/p BMS to LAD/Diag, transfer from ___ here he presented on ___ w/ shortness of breath and malaise. Echo (TTE) there revealed 2 vegetations on Mitral valve. // Evidence of edema/PNA?

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Mild pulmonary edema but no evidence of pneumonia. Mild cardiomegaly. No larger pleural effusions. Unchanged course of the pacemaker leads.


SubjectID: 15375544, StudyID: 56869497, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with AS s/p corevalve, AV block s/p dual chamber pacemaker via L subclavian. // Lead position, pneumothorax

TECHNIQUE: CHEST (PA AND LAT)

COMPARISON: ___

IMPRESSION: There has been interval improvement in interstitial pulmonary edema with only mild interstitial edema currently present   Keywords: improve. There is interval increase in bilateral pleural effusions most likely as part of the resolution of pulmonary edema. No pneumothorax. Supporting devices are in unchanged position.


SubjectID: 15375544, StudyID: 54253010, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with shortness of breath. // Please evaluation for pulmonary edema, pneumonia, acute process.

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Heart size is enlarged, overall unchanged since the prior study. The patient is after TAVR placement. There is upper zone re- distribution, more pronounced than on the prior study that might be consistent with vascular congestion but no overt pulmonary edema is currently seen. Small amount of pleural effusion cannot be excluded.


SubjectID: 15375544, StudyID: 53283797, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with AS s/p corevalve, AV block s/p dual chamber pacemaker via L subclavian. Please eval for pneumothorax // pneumothorax

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: Almost ___ ___

IMPRESSION: There has been interval development of moderate to severe interstitial pulmonary edema   Keywords: development. There has been interval placement of the dual lead pacemaker through the left subclavian access was no evidence of pneumothorax. No pleural effusion is seen. The a transcatheter aortic valve is appropriately positioned


SubjectID: 15377618, StudyID: 55085185, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with infection // location of left picc tip after 1 cm pull back and power flush location of left picc tip after 1 cm pull back and power flu

IMPRESSION: In comparison with the study of ___, the PICC line has been withdrawn slightly so that the tip appears to be in the SVC at about the orifice of the azygos vein. The patient has taken a better inspiration and the bases are somewhat clearer, though there still is evidence of pleural fluid and atelectatic changes, especially on the left.


SubjectID: 15377618, StudyID: 52257189, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with atrial fibrillation not on anticoagulation presents with rapid ventricular rate and CHF exacerbation.

TECHNIQUE: Upright AP view of the chest

COMPARISON: ___ chest radiograph, thoracic spine radiograph ___

FINDINGS: Lung volumes are low. Heart size is at least moderately enlarged. Mediastinal contours are unchanged. Mild pulmonary edema is noted, worse in the interval   Keywords: worse. Small bilateral pleural effusions are likely present with bibasilar airspace opacities, most likely reflective of atelectasis. No pneumothorax is identified. Percutaneous catheter is noted with pigtail in the right upper quadrant of the abdomen. Left PICC tip now appears to be flipped, likely within the azygos.

IMPRESSION: 1. Mild pulmonary edema and small bilateral pleural effusions. Bibasilar airspace opacities, likely compressive atelectasis. Infection is not excluded. 2. PICC tip appears to be flipped in the interval, potentially within the azygos. This can be confirmed with a lateral view.


SubjectID: 15380734, StudyID: 58155125, Comparison: better

FINAL REPORT

HISTORY: ___-year-old female with hypotension and hypoglycemia.

COMPARISON: Chest radiograph from ___. PORTABLE AP CHEST RADIOGRAPH: Moderate bibasilar opacities persist, likely reflecting a combination of atelectasis and pleural effusions. The left-sided effusion is moderate and the right effusion is small; both are unchanged compared to prior examination from ___. Mild pulmonary edema is improved in the interval. There is no pneumothorax. A coarse linear opacity in the right upper lung is unchanged dating back to ___, and likely reflects vascular calcifications.

IMPRESSION: Grossly stable bibasilar opacities, likely a combination of atelectasis and bilateral pleural effusions, left greater than right. Improving mild pulmonary edema   Keywords: improving.


SubjectID: 15380734, StudyID: 51191114, Comparison: None

FINAL REPORT

HISTORY: CHF.

FINDINGS: In comparison with the study of ___, there is again enlargement of the cardiac silhouette with extensive bilateral pleural effusions and compressive atelectasis combined with pulmonary vascular congestion.


SubjectID: 15382919, StudyID: 57492123, Comparison: same

FINAL REPORT

HISTORY: Dyspnea and fluid overload.

FINDINGS: In comparison with study of ___, there is little change in the enlargement of the cardiac silhouette with pulmonary vascular congestion and bilateral pleural effusions with dual-channel pacemaker in place   Keywords: little change.


SubjectID: 15382919, StudyID: 55539018, Comparison: worse

FINAL REPORT

HISTORY: CHF and COPD presenting with diarrhea and tachypnea.

TECHNIQUE: Portable frontal chest radiograph. 2 views.

COMPARISON: ___.

FINDINGS: Cardiac silhouette remains prominent may enlarged. Left implanted dual lead pacer is unchanged in position. Vascular congestion with mild interstitial pulmonary edema is slightly increased from prior study   Keywords: increase. There is no large pleural effusion or pneumothorax. No focal consolidation worrisome for pneumonia.

IMPRESSION: Vascular congestion and mild interstitial edema slightly worsened from prior study   Keywords: worse.


SubjectID: 15382919, StudyID: 56379384, Comparison: same

FINAL REPORT

HISTORY: Shortness of breath.

FINDINGS: In comparison with the study of ___, the patient has taken a better inspiration. Dual-channel pacer device remains in place in this patient with substantial enlargement of the cardiac silhouette. Some indistinctness of engorged pulmonary vessels is again consistent with mild elevation of pulmonary venous pressure   Keywords: again. Hazy opacification at the bases, especially on the right, is consistent with layering pleural effusions.

IMPRESSION: Better inspiration, but otherwise little change   Keywords: little change.


SubjectID: 15382919, StudyID: 53592071, Comparison: None

FINAL REPORT

HISTORY: ___-year-old man with tachypnea and tachycardia. Question infiltrate.

COMPARISON: ___.

TECHNIQUE: Single portable view of the chest.

FINDINGS: A left-sided pacemaker with leads terminating in right atrium and right ventricle is in unchanged position. Cardiomegaly is again present. A right lower lobe opacity is again present and certainly could represent pneumonia in the correct clinical setting. Other considerations to be atelectasis versus layering effusions.

IMPRESSION: Right lower lobe opacity, which in the correct clinical setting could certainly be pneumonia.


SubjectID: 15382919, StudyID: 54882727, Comparison: None

WET READ: ___ ___ ___ 6:07 PM Significantly decreased or resolved right pleural effusion status post right thoracentesis. No definitive evidence of pneumothorax although evaluation is limited due to superimposition of neck soft tissues over the right lung apex. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Right-sided pleural effusion, status post thoracocentesis, evaluation for pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there are improved lung volumes, reflecting increased inspiration. The lung bases are more transparent than on the previous examination. Left-sided pacemaker in situ. Unchanged moderate cardiomegaly without larger pleural effusions. No pulmonary edema, atelectasis in the retrocardiac lung areas and at the lung bases.


SubjectID: 15382919, StudyID: 53070107, Comparison: -1.0

FINAL REPORT

INDICATION: History of diastolic CHF with continued leukocytosis. Evaluate size of pleural effusion.

COMPARISONS: Chest radiograph from ___. Chest CT from ___.

TECHNIQUE: A single upright AP view of the chest was obtained.

FINDINGS: Since the prior exam, the mild pulmonary edema has improved   Keywords: improve. There is increased consolidation at the right base. There are probable stable small bilateral pleural effusions. There is no pneumothorax. The cardiomediastinal silhouette is unchanged, with stable severe cardiomegaly. A pacemaker is unchanged.

IMPRESSION: Increasing opacification at the right base, which is likely some residual edema and atelectasis associated with a small pleural effusion   Keywords: increasing. In the proper clinical setting, aspiration or pneumonia is a consideration.


SubjectID: 15385889, StudyID: 59752715, Comparison: None

FINAL REPORT

HISTORY: Line pulled back 1 cm.

FINDINGS: In comparison with the earlier study of this date, the right IJ catheter tip is in the region of the cavoatrial junction.


SubjectID: 15385889, StudyID: 53935960, Comparison: -1.0

FINAL REPORT

HISTORY: Septic shock and worsening pulmonary edema.

FINDINGS: In comparison with the study of ___, there is little overall change   Keywords: little overall change. Again there are areas of increased opacification bilaterally consistent with pulmonary vascular congestion and diffuse airspace opacities   Keywords: increase. In the appropriate clinical setting, supervening pneumonia would have to be seriously considered. There are bilateral pleural effusions with volume loss in the region of the left lower lobe.


SubjectID: 15385889, StudyID: 53830617, Comparison: -1.0

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___ radiograph.

FINDINGS: Cardiac silhouette remains enlarged, and is accompanied by pulmonary vascular congestion and worsening diffuse airspace opacities throughout the right lung   Keywords: worse. Although potentially due to asymmetrical pulmonary edema, considering history of interval thoracentesis, pneumonia should also be considered in the appropriate clinical setting. Within the left lung, left perihilar haziness has improved, and may have been due to pulmonary edema   Keywords: improve. Left retrocardiac opacity is minimally improved, and small-to-moderate bilateral pleural effusions are persistent.


SubjectID: 15385889, StudyID: 59694925, Comparison: nan

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with worsening crackles and continued oxygen requirement // Please evaluate for interval change of pulmonary edema; any evidence of consolidation Please evaluate for interval change of pulmonary edema; any

IMPRESSION: In comparison with the study of ___, there may be some increase in the pulmonary vascular congestion in a patient with substantial enlargement of the cardiac silhouette   Keywords: increase. An a more focal area of opacification at the right base would be worrisome for superimposed pneumonia or aspiration in the appropriate clinical setting. Otherwise little change   Keywords: little change.


SubjectID: 15385889, StudyID: 55749259, Comparison: same

FINAL REPORT

INDICATION: ___F with cough and malaise // R/O pneumonia

TECHNIQUE: AP and lateral views the chest.

COMPARISON: ___.

FINDINGS: There is moderate cardiomegaly. Median sternotomy wires are again noted as well as a prosthetic aortic valve. There is a small right pleural effusion. In addition, there is increased parenchymal opacity at the right lung base slightly progressed since prior. Mild pulmonary edema is also noted, unchanged   Keywords: unchanged. The left lung is grossly clear. Although left rib fractures are identified.

IMPRESSION: Cardiomegaly, small right pleural effusion and mild pulmonary edema. More confluent right basilar opacity suspicious for pneumonia in the proper clinical setting. Please note that a repeat will be necessary to document resolution given similar finding present in ___.


SubjectID: 15385889, StudyID: 59643310, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with sCHF, CAD, Aortic Stenosis s/p bovine AVR, and numerous aspiration pneumonias with shortness of breath. // Please evaluate for aspiration pneumonia/volume overload. Please evaluate for aspiration pneumonia/volume overload.

IMPRESSION: In comparison with the study of ___, there is again some enlargement of the cardiac silhouette with engorgement of pulmonary vessels consistent with elevated pulmonary venous pressure. The left hemidiaphragm is more sharply seen, consistent with improving atelectasis. There is asymmetry at the bases with increased opacification on the right. Although this could be a manifestation of asymmetric pulmonary edema, in the appropriate clinical setting superimposed pneumonia would have to the considered.


SubjectID: 15385889, StudyID: 57043422, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with cardiogenic shock who removed NG 10cm // ?NG tube placement ?NG tube placement

IMPRESSION: In comparison with the study of ___, the tip of the new nasogastric tube lies close to the esophagogastric junction. Otherwise, little change in the appearance of the heart and lungs.


SubjectID: 15385889, StudyID: 56169722, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: NGT // NGT

COMPARISON: Chest radiograph ___

FINDINGS: Single AP view of the chest provided. Patient is status post median sternotomy. Wires are intact and properly aligned. A nasogastric tube extends past the diaphragm and projects over the stomach. Mild cardiomegaly, engorgement of pulmonary vessels and basilar atelectasis are unchanged from the prior examination same date.

IMPRESSION: 1. Nasogastric tube extends past the diaphragm and projects over the stomach. Of note, the tube coils and the tip points upward towards the fundus. 2. Mild cardiomegaly, engorgement of the pulmonary vasculature, possible right lung base consolidation and basilar atelectasis are unchanged from prior examination on the same date.


SubjectID: 15385889, StudyID: 50127011, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: dobhoff placenemnt // dobhoff placenemnt

COMPARISON: Chest radiograph ___

FINDINGS: Multiple AP views of the chest provided showing first placement of abdominal off down the right mainstem bronchus in subsequently placement of a Dobbhoff down the left mainstem bronchus. Patient is status post median sternotomy with wires intact and proper alignment. Mild cardiomegaly and mild engorgement the pulmonary vessels are unchanged. Asymmetry of the lung bases with increased opacification on the right may represent pneumonia. No pleural effusion or pneumothorax. Hilar and cardiomediastinal contours are normal.

IMPRESSION: 1. Images show a Dobbhoff placed in the right mainstem bronchus and a second image in which it went down the left mainstem bronchus. Of note, subsequent images were obtained showing proper placement of a nasogastric tube and removal of the Dobbhoff. 2. Prominence the pulmonary vasculature, pulmonary edema are stable from the prior examination same date   Keywords: stable, same. 3. Possible right lung base opacity is unchanged from the prior examination on the same date.


SubjectID: 15385889, StudyID: 59640953, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with recent pneumonia and known CHF. Evaluate for pneumonia versus effusion. Comparison made to portable AP chest radiograph ___. PA AND LATERAL CHEST RADIOGRAPH: Sternotomy wires are midline and intact. Valvular prosthesis is again noted. Bibasilar opacifications, right greater than left, are worsened since ___ and may represent a combination of pleural effusion and compressive atelectasis; however, underlying infectious process cannot be completely excluded. Mild prominence of vasculature is concerning for mild pulmonary edema.

IMPRESSION: Bibasilar opacification may represent a combination of pleural effusion and compressive atelectasis; however, supervening pulmonary infection cannot be completely excluded and should be considered in the correct clinical setting.


SubjectID: 15385889, StudyID: 58912490, Comparison: worse

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with pneumonia, failure to improved on ceftriaxone and azithromycin, rule out progression.

COMPARISON: ___.

FINDINGS: Severe pulmonary edema has increased bilaterally   Keywords: increase. Right lower lung pneumonia is partially obscured by the pulmonary edema and has possibly increased   Keywords: increase. Bilateral pleural effusion is small with bibasilar atelectasis. The patient had prior sternotomy for CABG and mediastinal and cardiac contours are top normal. There is no pneumothorax.

CONCLUSION: 1. Severe pulmonary edema has worsened   Keywords: worse. 2. Right lower lung pneumonia is obscured by the pulmonary edema and has possibly increased   Keywords: increase. Dr.___ has been verbally contacted for the results.


SubjectID: 15385889, StudyID: 57966555, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___ Comparison with a prior study from ___. CLINICAL

HISTORY: Fever, cough, question pneumonia.

FINDINGS: PA and lateral views of the chest were provided. Midline sternotomy wires and prosthetic cardiac valve as well as mediastinal clips are noted. There is bilateral interstitial edema with a small right pleural effusion. There is poorly defined airspace opacity in the right lung base which could represent pneumonia. The heart is mildly enlarged. The hila is engorged. No pneumothorax is seen. Bony structures intact. No free air below the right hemidiaphragm.

IMPRESSION: Mild cardiomegaly, interstitial edema, small right pleural effusion. Ill-defined opacity in the right lung base is concerning for pneumonia. Followup to resolution is advised.


SubjectID: 15385889, StudyID: 54227826, Comparison: None

WET READ: ___ ___ 7:08 PM Interval decrease in size of right pleural effusion status post thoracentesis without evidence for pneumothorax. Bibasilar opacities and persistent small left pleural effusion. Cardiomegaly unchanged. Prominent pulmonary vasculature and mild interstitial edema similar to prior. ______________________________________________________________________________

FINAL REPORT

HISTORY: Thoracentesis.

FINDINGS: In comparison with the study of earlier in this date, there has been a thoracentesis with removal of pleural fluid, and no evidence of post-procedure pneumothorax. Continued enlargement of the cardiac silhouette with elevated pulmonary venous pressure. Retrocardiac opacification persists, consistent with atelectasis and effusion.


SubjectID: 15385889, StudyID: 50400408, Comparison: same

FINAL REPORT

HISTORY: Hypoxemia. Evaluate for change in pulmonary edema.

COMPARISON: ___, ___.

FINDINGS: Portable AP chest radiograph. Compared to most recent radiograph, there is no significant interval change   Keywords: no significant interval change. Again seen is mild cardiomegaly, bilateral pleural effusions, and pulmonary vascular engorgement. Healed posterior left rib fracture is noted. The previously noted left 7th rib fracture on is barely seen. There is no pneumothorax.

IMPRESSION: Mild pulmonary edema, unchanged from ___   Keywords: unchanged.


SubjectID: 15385889, StudyID: 56775796, Comparison: same

FINAL REPORT

HISTORY: Dobbhoff placement.

FINDINGS: In comparison with study of ___, there has been placement of a Dobbhoff tube that extends to the mid-to-distal portion of the stomach. Little overall change in the appearance of the heart and lungs with bilateral pulmonary opacifications consistent with some combination of residual pneumonia and pulmonary edema   Keywords: little overall change.


SubjectID: 15385889, StudyID: 55587987, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old ___ speaking female with h/o sCHF (EF ___% ___), CAD s/p CABG in ___, AS s/p bovine AVR, DM2 p/w 2d h of abdominal pain and diarrhea thought to be ___ viral gastroenteritis now with persistent respiratory symptoms and fatigue, found to be flu A positive now with rising WBC count and worsening mental status. // Assess for interval change, acute process

TECHNIQUE: PA and lateral radiographs of the chest.

COMPARISON: ___ and dating back to ___.

FINDINGS: The right lower lobe airspace opacity is not appreciably changed since ___. The patient has had prior median sternotomy with valve replacement. There is no pleural effusion. Moderate cardiomegaly is stable. There is no pneumothorax. Generalized osteopenia and multilevel spinal degenerative changes are also stable.

IMPRESSION: Stable right lower lobe pneumonia. Stable moderate cardiomegaly.


SubjectID: 15385889, StudyID: 52160977, Comparison: 1.0

FINAL REPORT

INDICATION: Edema.

COMPARISON: Chest radiograph ___.

TECHNIQUE: Frontal chest radiograph.

IMPRESSION: Moderate cardiomegaly is unchanged. There is slight improvement of a known right basilar opacity. Central pulmonary vascular congestion is again demonstrated   Keywords: again. Minimal interstitial edema has also improved   Keywords: improve. A small left pleural effusion is unchanged. There is no pneumothorax. The patient is post CABG.


SubjectID: 15385889, StudyID: 50992008, Comparison: None

FINAL REPORT

CLINICAL

HISTORY: Desating to ___. Evaluate for cause. CHEST, AP ERECT There has been no significant change since the prior chest x-ray of ___. The heart is enlarged with an aortic valve replacement. Some upper zone redistribution and bilateral effusions are still present indicating some failure. Probable volume loss in the left lower lobe is present.

IMPRESSION: Persistent failure.


SubjectID: 15394326, StudyID: 57654350, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with multilobar PNA // Interval change Interval change

IMPRESSION: Since ___ there is slight interval improvement in the lower lobe consolidations with substantial improvement in the mid lung consolidations, consistent with gradual resolution of infectious process. Bilateral pleural effusions are small to moderate. There is no pneumothorax. Cardiomediastinal silhouette is unchanged.


SubjectID: 15394326, StudyID: 52569713, Comparison: -1.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with multilobar PNA, pleural effusions // chest tube placement chest tube placement

IMPRESSION: Comparison ___. Improvement of the bilateral parenchymal opacities at the lung bases   Keywords: improve. The opacities, however, remain relatively extensive   Keywords: remain. New right chest tube, positioned at the basis of the right hemi thorax. No pneumothorax. Stable mild cardiomegaly with minimal pulmonary edema   Keywords: stable.


SubjectID: 15394326, StudyID: 56032512, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___M with dyspnea on exertion // eval for pneumonia

TECHNIQUE: Chest PA and Lateral

COMPARISON: ___

FINDINGS: Since the prior study, there has been a interval increase in bibasilar opacities as well as perihilar opacities and ___ B-lines compatible with heart failure   Keywords: increase. The cardiac silhouette, now moderate to severely enlarged, has increased since the prior study. Superimposed infection in the right lower lobe could be possible and followup radiograph after diuresis would help better evaluate this. Small bilateral pleural effusions are also present.

IMPRESSION: Cardiac failure and mild to moderate pulmonary edema.


SubjectID: 15394326, StudyID: 54349410, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CAD presenting with SOB // ?resolution of pulmonary edema s/p HD ?resolution of pulmonary edema s/p HD

IMPRESSION: In comparison with the study of ___, there is little overall change   Keywords: little overall change. Again there is enlargement of cardiac silhouette with pulmonary edema more prominent on the right and bibasilar opacifications consistent with pleural effusion and volume loss in the lower lobes, more prominent on the left. In the appropriate clinical setting, superimposed pneumonia would have to be considered.


SubjectID: 15394326, StudyID: 55877355, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with chest tube placement // pls eval for interval change pls eval for interval change

IMPRESSION: Comparison to ___, 05:18. The right chest tube is in unchanged position. The left parenchymal opacities are stable but on the right the opacities have slightly increased in extent and severity   Keywords: increase. Moderate cardiomegaly persists.


SubjectID: 15400654, StudyID: 57878893, Comparison: None

FINAL REPORT

INDICATION: ___F with dyspnea and lethargy // r/o acute process

TECHNIQUE: Single AP view of the chest.

COMPARISON: Prior films with most recent chest x-ray from ___, and dating back to ___.

FINDINGS: There is left apical pleural thickening and scarring with associated volume loss and superior retraction of the left hilum. Calcified left hilar nodes are again noted. New perihilar opacities are noted on the right greater than left as well as blunting of the right lateral costophrenic angle suggesting underlying effusion. Cardiomediastinal silhouette is grossly unchanged given differences in positioning and technique. Severe degenerative changes noted at the shoulders bilaterally. Median sternotomy wires are intact.

IMPRESSION: Perihilar opacities, right greater than the left with a right pleural effusion. Findings are suggestive of pulmonary edema noting that infection would also be possible. Chronic changes involving the left lung apex.


SubjectID: 15400654, StudyID: 50264297, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with acute decompensated CHF // e/o pulm edema e/o pulm edema

IMPRESSION: No relevant change as compared to ___   Keywords: no relevant change. Minimally increasing right pleural effusion. Otherwise unchanged moderate pulmonary edema   Keywords: unchanged. Moderate cardiomegaly. Scarring at the left lung apex. No pneumothorax. Unchanged alignment of the sternal wires.


SubjectID: 15400654, StudyID: 57658580, Comparison: None

FINAL REPORT

INDICATION: History: ___F with R sided wakeness and AMS. // ICH, PNA

TECHNIQUE: Single portable chest radiograph.

COMPARISON: Chest radiograph from ___

FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax. Right apical calcifications are unchanged. The cardiomediastinal silhouette is unchanged. Median sternotomy wires are intact. The aorta is tortuous. Imaged upper abdomen is unremarkable. There are severe degenerative changes at the glenohumeral joints bilaterally.

IMPRESSION: No acute cardiopulmonary process or significant change since ___.


SubjectID: 15400654, StudyID: 53836902, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with resp distress // eval for acute process

COMPARISON: ___

IMPRESSION: No relevant change as compared to the previous image   Keywords: no relevant change. Moderate cardiomegaly. Mild pulmonary edema. Small bilateral pleural effusions. No pneumonia. Constant alignment of the sternal wires.


SubjectID: 15400654, StudyID: 50158260, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with increasing oxygen requirement // eval for acute process/volume overload

IMPRESSION: As compared to ___ radiograph, pulmonary vascular congestion and mild edema are new   Keywords: new. Focal left lower lobe consolidation with adjacent small pleural effusion is also new and could reflect asymmetrical edema, aspiration, and less likely a developing infectious pneumonia   Keywords: developing, new. Architectural distortion and parenchymal scarring in the left juxta hilar region are unchanged.


SubjectID: 15400654, StudyID: 56755016, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with acute decomp CHF // e/o pulm edema e/o pulm edema

IMPRESSION: No relevant change as compared to ___   Keywords: no relevant change. Moderate bilateral pleural effusions. Known scarring at the left lung apex. Moderate pulmonary edema persists   Keywords: persists.


SubjectID: 15410407, StudyID: 53066792, Comparison: None

FINAL REPORT

EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history complains of low hemoglobin. Patient with end-stage renal disease, going on dialysis soon. Found to have a hemoglobin of 7.9 today. No history of GI bleed. Hemoptysis for two days.

COMPARISON: ___.

FINDINGS: Frontal and lateral views of the chest were obtained. The patient is status post median sternotomy and CABG. The cardiac silhouette remains top normal to mildly enlarged. The mediastinal contours are stable. There is blunting of bilateral posterior costophrenic angles suggesting small bilateral pleural effusions. No pneumothorax is seen. The aorta remains calcified and tortuous.

IMPRESSION: Small bilateral pleural effusions with overlying atelectasis. Mildly enlarged cardiac silhouette.


SubjectID: 15424569, StudyID: 59276449, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with acute decompensated HF, s/p RHC and swan // eval Swan placement, interval change

TECHNIQUE: APsingle view

COMPARISON: ___

FINDINGS: Lines and Tubes: Right PICC, left upper chest wall pacemaker are unchanged in position. There has been interval removal of a Swan-Ganz catheter. Lungs: Persistent low lung volumes with mild pulmonary edema and left basilar atelectasis, unchanged   Keywords: persistent, unchanged. Pleura: There is no pleural effusion or pneumothorax Mediastinum: Persistent cardiomegaly, unchanged. Bony thorax: No interval change   Keywords: no interval change.

IMPRESSION: Mild pulmonary edema, cardiomegaly and left basilar atelectasis remain unchanged   Keywords: remain, unchanged. Interval removal of Swan-Ganz catheter.


SubjectID: 15424569, StudyID: 51206856, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with acute decompensated HF, s/p RHC and swan // eval Swan placement, interval change

TECHNIQUE: Portable single AP radiograph of the chest

COMPARISON: ___

FINDINGS: Unchanged position of a Swan-Ganz catheter and left-sided pacemaker with a single intact pacer wire. Right PICC terminates at the cavoatrial junction. Low lung volumes with unchanged linear atelectasis in the left lower lobe. No pleural effusion or pneumothorax.

IMPRESSION: No significant interval change   Keywords: no significant interval change.


SubjectID: 15424569, StudyID: 59152564, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with RV failure w/ PA catheter // PA catheter placement

TECHNIQUE: Portable AP radiograph of the chest.

COMPARISON: ___ and dating back to ___.

FINDINGS: Sternotomy wires are intact and aligned. The patient has had previous CABG. The Swan-Ganz catheter and left pectoral pacemaker are unchanged in position. The distal aspect of the right PICC line likely projects well into the right atrium. Left basilar subsegmental atelectasis has slightly improved. Layering small left pleural effusion is unchanged.

IMPRESSION: Tip of right PICC line projects well into the right atrium. Retraction by 10 cm would position its tip in the low SVC. No significant interval change in mild pulmonary edema with a small left pleural effusion   Keywords: no significant interval change.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 3:31 PM, 120 minutes after discovery of the findings.


SubjectID: 15424569, StudyID: 58589504, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cardiogenic shock // PA catheter placement

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the patient has received a right Swan-Ganz catheter. The course of the catheter is unremarkable, the tip of the catheter projects over the proximal parts of the right pulmonary artery. No complications, notably no pneumothorax. Low lung volumes. Borderline size of the cardiac silhouette. Bilateral areas of atelectasis and mild pulmonary edema.


SubjectID: 15424569, StudyID: 54129303, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with RV failure and decompensated CHF on inotropes // PA catheter placement

COMPARISON: Radiographs from ___

IMPRESSION: The Swan-Ganz catheter has been pulled back slightly and the distal tip is at the confluence of the main and right pulmonary arteries. The tip of the right-sided PICC line is again seen in the right atrium and this could be pulled back several cm for more optimal placement. There is a left-sided pacemaker. Heart size is prominent. There is a left retrocardiac opacity and likely small left-sided pleural effusion. No pneumothoraces are seen.


SubjectID: 15424569, StudyID: 51404776, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF, swan ganz // interval change, line position

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the Swan-Ganz catheter has been advanced. The tip now projects over the right lower lobe pulmonary artery, the line should be pulled back by approximately 4 cm. No complications, notably no pneumothorax. No pleural effusions. No pneumonia.


SubjectID: 15424569, StudyID: 50793934, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with CHF, swan ganz // Innterval change, line position //

TECHNIQUE: Single AP portable view the chest

COMPARISON: ___ and ___

FINDINGS: A Swan-Ganz catheter and single lead pacemaker are in unchanged and appropriate positions. A right-sided PICC line terminates at least 2 cm in the cavoatrial junction, although the tip is obscured. A sternotomy wires are well aligned and intact. There is little change in the mild pulmonary edema along with a left-sided pleural effusion and atelectasis   Keywords: little change.

IMPRESSION: 1. Right-sided PICC terminating in the right ventricle at least 2 cm from the cavoatrial junction. A lateral or PA view of the film may help determine with the tip position to measure of the distance of retraction necessary for low SVC placement. 2. Unchanged mild pulmonary edema, left sided pleural effusion and atelectasis   Keywords: unchanged.


SubjectID: 15447063, StudyID: 58459206, Comparison: None

WET READ: ___ ___ ___ 5:12 PM No acute cardiothoracic process.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

INDICATION: ___-year-old man with left chest pain.

TECHNIQUE: Frontal and lateral radiographs of the chest were obtained.

COMPARISON: ___ chest radiograph.

FINDINGS: The lungs are clear, the cardiomediastinal silhouette and hila are normal. There is no pleural effusion, no pneumothorax.

IMPRESSION: No acute cardiothoracic process.


SubjectID: 15447063, StudyID: 57028431, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Postoperative fever, evaluation for pneumonia or other acute process.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, signs of interstitial fluid overload have completely cleared. Although mild cardiomegaly is still present, there is no evidence of pulmonary edema   Keywords: still. No pleural effusions. No areas of atelectasis. No evidence of pneumonia. Normal hilar and mediastinal contours.


SubjectID: 15447063, StudyID: 54423341, Comparison: None

WET READ: ___ ___ ___ 9:56 PM Low lung volumes. Interval appearance of mild interstitial edema and engorged pulmonary vasculature. Heart size is increased. Bibasilar opacities likely atelectasis. Stomach is distended with gas. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Somnolence, decreased breath sounds, hypoxemia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the cardiac silhouette has slightly increased in size. In addition, subpleural linear opacities, right more than left, have appeared, suggesting the possibility of interstitial lung edema. Moderate hyperdistention of stomach with gas. Mild retrocardiac atelectasis.


SubjectID: 15451693, StudyID: 52493310, Comparison: None

WET READ: ___ ___ ___ 2:27 PM no definite acute process. please perform PA and lat when patient is amenable for questionable left suprahilar nodule

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

PORTABLE CHEST: ___

HISTORY: ___-year-old male with seizures.

FINDINGS: Single portable view of the chest was compared to previous exam from ___. The lungs remain grossly clear. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable.

IMPRESSION: No definite acute cardiopulmonary process based on a portable film slightly limited by respiratory motion.


SubjectID: 15477562, StudyID: 59700188, Comparison: worse

FINAL REPORT

PORTABLE CHEST FILM, ___ AT 8:10 CLINICAL

INDICATION: ___-year-old with bacteremia, right ventricular failure and end-stage renal disease, evaluate for pulmonary edema. Comparison is made to the patient's prior study of ___. Portable supine chest film ___ at 8:10 a.m. is submitted.

IMPRESSION: 1. Right internal jugular large-bore dual-lumen catheter with the most distal tip in the right atrium, right internal jugular Swan-Ganz catheter with its tip in the pulmonary outflow tract, and left-sided pacer unchanged. The heart remains enlarged despite marked patient rotation. There is increasing perihilar vasculature which is suggestive of worsening perihilar edema   Keywords: worse. There is likely layering left effusion. At least one old left-sided rib fracture is appreciated. No pneumothorax is seen, although the sensitivity to detect a pneumothorax is diminished given supine technique.


SubjectID: 15477562, StudyID: 59058926, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: History of mitral valve replacement, evaluation for pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Moderate cardiomegaly with mild pulmonary edema as well as areas of atelectasis at both lung bases. No safe evidence of pleural effusions. No new parenchymal opacities   Keywords: new. The monitoring and support devices as well as the left pectoral pacemaker are in unchanged position.


SubjectID: 15477562, StudyID: 54640850, Comparison: same

FINAL REPORT

HISTORY: Bacteremia and renal failure, to assess for line placement.

FINDINGS: In comparison with study of ___, the monitoring and support devices are essentially unchanged. Continued enlargement of the cardiac silhouette with pulmonary edema and probable bilateral effusions and atelectasis at the bases   Keywords: continue.


SubjectID: 15477562, StudyID: 54252999, Comparison: same

FINAL REPORT

PORTABLE CHEST FILM ___ AT 10:32 CLINICAL

INDICATION: ___-year-old with biventricular heart failure, Swan in place, assess for interval change. Comparison to prior study dated ___. Portable AP upright chest film ___ at 10:33 is submitted.

IMPRESSION: 1. Right internal jugular Swan-Ganz catheter, left-sided pacer, right internal jugular dual-lumen catheter, are all unchanged in position. The patient is rotated to the left, limiting evaluation of the cardiac and mediastinal contours. However, the heart remains stably enlarged status post median sternotomy. There continues to be stable mild pulmonary edema that is likely a small left effusion   Keywords: stable, continue. No pneumothorax.


SubjectID: 15477562, StudyID: 57098714, Comparison: same

FINAL REPORT

INDICATION: History of CHF and possible pneumonia. Assess for retrocardiac opacity.

COMPARISON: Chest radiograph, ___ at 8:00 a.m. Chest radiograph, ___. Chest radiograph, ___.

FINDINGS: Old right pacemaker leads and a left pectoral generator are unchanged in appearance. Severe cardiomegaly is stable. Mild edema persists without evidence of pleural effusions   Keywords: persists. A small retrocardiac opacity is unchanged and has the appearance of atelectasis. There is no new consolidation. There is no pneumothorax. Sternal wires are intact.

IMPRESSION: 1. Stable mild pulmonary edema   Keywords: stable. 2. Stable severe cardiomegaly. 3. Unchanged small retrocardiac opacity is most likely atelectasis.


SubjectID: 15477562, StudyID: 55380780, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man with hypoxia, to rule out acute cardiopulmonary pathology.

COMPARISON: Chest radiograph ___. PORTABLE AP CHEST RADIOGRAPH: Severe cardiomegaly, is stable since the prior study. The hilar and mediastinal contours are stable, with a dilated tortuous thoracic aorta. Mild pulmonary congestion is seen. No focal consolidation, pleural effusion, or pneumothorax is seen. A left chest wall pacer with leads in the right atrium and right ventricle are noted. An abandoned lead is seen in the right anterior chest wall. Pulmonary congestion.

IMPRESSION: Chronic severe cardiomegaly and chronic and/or recurrent pulmonary congestion. No edema.


SubjectID: 15497465, StudyID: 58856482, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: evaluate for acute process, abdominal free air. Pain and vomiting.

TECHNIQUE: Chest PA and Lateral

COMPARISON: ___

FINDINGS: The lungs are hyperinflated but clear except for upper lung apex scarring. There is no pleural effusion or pneumothorax. Cardiac size is within normal limits. There is no intra-abdominal free air identified.

IMPRESSION: No evidence of acute cardiopulmonary process. No free air. Hyperinflated lungs.


SubjectID: 15497465, StudyID: 58418234, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with GIB s/p extubation with new onset hypoxia requiring re-intubation // eval for ETT placement, pulmonary edema

COMPARISON: ___

IMPRESSION: As compared to the previous image, the patient has been intubated. The tip of the endotracheal tube projects approximately 3.6 cm above the carinal. No complications, notably no pneumothorax. Moderate cardiomegaly with mild fluid overload. Mild fibrotic changes at the lung apices. No larger pleural effusions. No pneumonia.


SubjectID: 15499838, StudyID: 56090263, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with recent aspiration pneumonia, failure to thrive, new hypoxia this AM // Eval for aspiration

COMPARISON: Chest radiographs dating back to ___ as well as CT chest from ___

FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. No focal consolidation, pleural effusion, or pneumothorax. There may be a right lower lung opacity which could represent pneumonia, however it may also simply be due to patient positioning. IVC is in the inferior cavoatrial junction. Left pleural thickening is better seen on recent CT scan.

IMPRESSION: No definite evidence of aspiration.PA and lateral radiographic examination may be more convincing and is recommended if the patient can tolerate it.

NOTIFICATION: The findings were discussed with Dr. ___ on the telephone on ___ at 4:16 PM.


SubjectID: 15499838, StudyID: 53323906, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with dobhoff, desatted to ___% when coughing up likely tube feeds. // aspiration, dobhoff positioning.

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___ obtained at 08:16

IMPRESSION: The Dobbhoff catheter tip is projecting over the nose no advancement demonstrated. The IVC catheter is very high, unchanged since the prior study, with its superior tip known to be projecting into the right atrium. Right most likely nephrostomy is in place. Bibasal opacities are slightly more pronounced than on the prior study, might represent developing infection or atelectasis.


SubjectID: 15499838, StudyID: 50520400, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with new dobhoff placement // eval placement (interval imaging before advancing) eval placement (interval imaging before advancing)

IMPRESSION: In comparison with the study of ___, initial film shows the Dobbhoff tube in the lower esophagus. However, the final study shows the tube coiled in the fundus


SubjectID: 15499838, StudyID: 54251915, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with new dobhoff replacement // eval dobhoff placement

COMPARISON: Chest radiographs from___

FINDINGS: Tip of the Dobbhoff tube is in the body of the stomach. Right nephrostomy and IVC filter are grossly unchanged in position. Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Bibasilar atelectasis is improved. No focal consolidation, pleural effusion, or pneumothorax.

IMPRESSION: Tip of the Dobbhoff tube is in the body of the stomach.


SubjectID: 15508006, StudyID: 57476455, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man s/p cabg // eval for effusion eval for effusion

COMPARISON: Prior chest radiographs ___.

IMPRESSION: Since ___ patient has been extubated, lung volumes are appreciably lower, there is substantial new right lower lobe atelectasis and moderate right pleural effusion and cardiomediastinal silhouette is appreciably larger. Small left pleural There is no pneumothorax. Left PIC line ends in the upper right atrium.


SubjectID: 15508006, StudyID: 53730280, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p sternal wound drainage // eval for effusion

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: There is marked improvement of aeration in the lower lobes bilaterally. There is no pneumothorax on pulmonary edema. Cardiomegaly is stable. Widening mediastinum has improved. There are no enlarging effusions. The sternal wires are aligned. Left PICC tip cannot be assessed


SubjectID: 15517908, StudyID: 59274135, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman w/ recent abnormal CT suggesting mucous plugging s/p Chest PT // ?interval changes in lung findings

IMPRESSION: There is been little overall change in appearance of the chest since a recent radiograph of 2 days earlier   Keywords: little overall change. Moderate to large right and moderate left partially loculated pleural effusions are similar to the prior exam, and there remains collapse of the right middle and right lower lobes. Left lower lobe atelectasis has slightly improved in the retrocardiac area.


SubjectID: 15517908, StudyID: 50459051, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with recently placed chest tube (post-procedure day #1) // ?placement ?placement

IMPRESSION: In comparison with the study of ___, of the right pigtail catheter remains in place and there is no evidence of pneumothorax. Right PICC line is unchanged. The medial portion of the right hemidiaphragm is not as sharply seen. An this could be related to a more oblique position of the patient, though some atelectatic changes with pleural fluid at the right base are more likely the cause of this appearance. The left lung is essentially clear.


SubjectID: 15517908, StudyID: 58600590, Comparison: better

FINAL REPORT

INDICATION: History: ___F with hypoxia, weakness

TECHNIQUE: Frontal and lateral views of the chest.

COMPARISON: ___.

FINDINGS: Compared to the prior chest radiograph of ___, there has been slight interval improvement in mild pulmonary edema   Keywords: improve. Tiny left and small right pleural effusions have decreased in size since ___. No pneumothorax. There is mild bibasilar atelectasis, without focal consolidation. Moderate cardiomegaly is stable. Compression deformities in the thoracic spine are unchanged. Multiple old left rib fractures are re- demonstrated. Right humeral hardware is partially imaged. Left PICC has been removed.

IMPRESSION: Mild bibasilar atelectasis. Small right and tiny left pleural effusions and mild pulmonary edema are improved since ___   Keywords: improve.


SubjectID: 15517908, StudyID: 52543722, Comparison: None

FINAL ADDENDUM ADDENDUM Findings discussed with Dr. ___ ___ the phone by Dr. ___ at 10:30 a.m. on ___ ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman presenting with diarrhea, hypoxemia // ? pulmonary edema, ? consolidation

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: There is interval development of left lower lobe atelectasis, with subsequent right mediastinal shift. Small right pleural effusion demonstrated. Left lung is essentially clear.


SubjectID: 15517908, StudyID: 57097202, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with recently placed chest tube (post-procedure day #3) // ?placement ?interval change ?placement ?interval change

IMPRESSION: In comparison with the study of ___, the right chest tube remains in place and there is no definite evidence for pneumothorax. Right PICC line is essentially unchanged. Little


SubjectID: 15517908, StudyID: 53194199, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with recently placed chest tube (post-procedure day #2) // ?placement, ?interval changes ?placement, ?interval changes

IMPRESSION: In comparison with the study of ___, the right chest tube remains in place and there is no definite evidence of pneumothorax. Right PICC line is unchanged. Again there is obliquity of the patient which may contribute to the poor definition of the right hemidiaphragm. Nevertheless, the possibility of small pleural effusions with compressive


SubjectID: 15517908, StudyID: 56251555, Comparison: None

FINAL REPORT

INDICATION: Pleural effusion.

COMPARISON: Chest radiograph from ___ at 14:27 and at 11:02.

TECHNIQUE: Frontal chest radiograph.

IMPRESSION: There is unchanged mild rightward deviation of the trachea and mediastinum likely reflecting right lower lobe collapse, which appears worsened since ___ and unchanged throughout the ___ examinations. A moderate right pleural effusion and small left pleural effusion are unchanged. There is no pneumothorax. The aorta is heavily calcified.


SubjectID: 15517908, StudyID: 55649612, Comparison: None

FINAL REPORT

INDICATION: Followup pleural effusion.

COMPARISON: Chest radiograph from ___.

TECHNIQUE: Frontal chest radiograph.

IMPRESSION: A small right pleural effusion is markedly decreased in size since the ___ examination. There is no pneumothorax. A trace left pleural effusion is present. The upper mediastinal contour remains stable. The aorta is tortuous and heavily calcified.


SubjectID: 15517908, StudyID: 54444798, Comparison: None

FINAL REPORT

INDICATION: Hypoxia.

COMPARISON: Chest radiograph ___.

TECHNIQUE: Frontal chest radiograph.

IMPRESSION: Moderate bilateral pleural effusions appear minimally changed since ___. There is adjacent compressive atelectasis. No pneumothorax is detected. There is no interstitial edema. The patient is post ORIF of the proximal right humerus.


SubjectID: 15517908, StudyID: 53775341, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with right pleural effusion and mucous plugging // interval change

IMPRESSION: As compared to ___ radiograph, right pleural effusion has substantially decreased in size. Although overall volume of the right lung has increased, there remains right lower lobe collapse and partial atelectasis of the right middle lobe. The right upper lobe is compensatory early hyperinflated resulting in relative hyperlucency. Exam is otherwise unchanged.


SubjectID: 15517908, StudyID: 51109334, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F w/ h/o asthma, HTN, HLD, pleural effusion, and recent hospitalization for septic shock ___ UTI, presents with worsening dyspnea. While this may be multifactorial, her history and exam seem most consistent with acutely decompensated CHF w/ recurrent right pleural effusion. // Any interval change? Any interval change?

IMPRESSION: In comparison with the study of ___, there is hazy opacification in the left hemithorax consistent with layering effusion and volume loss in the lower lung. Less prominent changes are seen on the right, though there is still evidence of volume loss in the right lower lung. Obliquity of the patient somewhat obscures detail.


SubjectID: 15517908, StudyID: 50190750, Comparison: None

FINAL REPORT

INDICATION: Pleural effusions.

COMPARISON: Chest radiograph from ___.

TECHNIQUE: Frontal chest radiograph.

IMPRESSION: Small bilateral pleural effusions are unchanged since the ___ radiograph. There is no pneumothorax. The upper mediastinal contours are unchanged since the ___ radiograph. Moderate bibasilar atelectasis is again demonstrated.


SubjectID: 15517908, StudyID: 55712593, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with hypoxia

TECHNIQUE: Portable upright AP view of the chest

COMPARISON: ___

FINDINGS: Right pigtail chest tube catheter has been removed. There has been interval reaccumulation of a moderate right pleural effusion. Rightward shift of mediastinal structures is re- demonstrated, and heart size is difficult to assess given the presence of the pleural effusion. Diffuse atherosclerotic calcifications are noted of the thoracic aorta. There is likely mild pulmonary vascular congestion. Right basilar atelectasis is demonstrated. A small left pleural effusion appears relatively constant. Streaky opacity in the left lung base also reflects atelectasis. No pneumothorax is detected. Multiple remote left-sided rib fractures as well as proximal and distal left clavicular fractures are again visualized.

IMPRESSION: Reaccumulation of moderate right pleural effusion and associated right basilar atelectasis. Streaky left basilar opacity, also an area of atelectasis, and relatively similar small left pleural effusion.


SubjectID: 15517908, StudyID: 52506750, Comparison: None

WET READ: ___ ___ 11:01 PM ET tube tip approximately 3 cm above the carina. Small bilateral pleural effusions with associated bibasilar atelectasis. ______________________________________________________________________________

FINAL REPORT

PORTABLE CHEST, ___.

COMPARISON: ___.

FINDINGS: Tip of endotracheal tube terminates approximately 3 cm above the carina. Cardiac silhouette is enlarged and accompanied by pulmonary vascular congestion and bilateral small pleural effusions. Adjacent basilar opacities most likely reflects atelectasis.


SubjectID: 15517908, StudyID: 50255536, Comparison: None

FINAL REPORT

PORTABLE CHEST ___

COMPARISON: Radiograph of one day earlier.

FINDINGS: Endotracheal tube remains in standard position. Cardiomediastinal contours are stable when allowances are made for rotation. Moderate-sized left pleural effusion is apparently slightly larger than on the prior study, but positional differences limit comparison. Small right pleural effusion and right retrocardiac opacity are not appreciably changed.


SubjectID: 15526064, StudyID: 55214472, Comparison: worse

FINAL REPORT

INDICATION: ___F with shortnes of breath // acute procesS?

TECHNIQUE: Single portable view of the chest.

COMPARISON: ___.

FINDINGS: The lungs are hyperinflated. Increased interstitial markings are seen throughout the lungs, similar when compared to prior   Keywords: increase. There is no new confluent consolidation. Blunting of the lateral costophrenic angles is noted, potentially due to scarring or pleural thickening although small effusions would also be possible. Left chest wall dual lead pacing device is noted. Moderate cardiomegaly and atherosclerotic calcifications are noted. Old posterior right rib fractures are seen.

IMPRESSION: Cardiomegaly and chronic changes in the lungs. Superimposed edema would be possible.


SubjectID: 15526064, StudyID: 51277161, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___F with shortness of breath

TECHNIQUE: Chest PA and lateral

COMPARISON: ___

FINDINGS: Patient is status post median sternotomy and placement of a left-sided pacer device with leads terminating in the right atrium and right ventricle, unchanged. Heart size remains mildly enlarged. Mediastinal and hilar contours are similar with tortuosity of the thoracic aorta again noted. Lungs are hyperinflated. Mild interstitial pulmonary edema is new in the interval, superimposed on a background of basilar predominant chronic interstitial lung disease   Keywords: new. Small right pleural effusion is new. No pneumothorax is demonstrated. Widening of the left AC joint is unchanged, with chronic deformity of the distal clavicle compatible with prior trauma. Old right-sided rib fractures are also noted.

IMPRESSION: Mild interstitial pulmonary edema superimposed on a background chronic interstitial lung disease. Small right pleural effusion.


SubjectID: 15538448, StudyID: 58936748, Comparison: same

FINAL REPORT

EXAMINATION: Portable AP chest radiograph

INDICATION: ___ year old woman with HR, ___ to ___% RA // r/o evidence of aspiration/ consolidation

COMPARISON: Chest radiograph dated ___.

FINDINGS: The lungs are well-expanded and overall hyperlucent, similar to the prior exam suggesting chronic pulmonary disease. Compared to ___, right infrahilar opacity with slight blurring of the right heart border more conspicuous, which could be compatible with aspiration given the provided clinical history. Pulmonary vascular redistribution is grossly unchanged   Keywords: unchanged. No edema. Mild-to-moderate cardiomegaly is new. The mediastinum is not widened. No pneumothorax, ___ pulmonary edema.

IMPRESSION: Increased heart size but no pulmonary edema   Keywords: increase.


SubjectID: 15538448, StudyID: 57872021, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF, concern for PNA // r/o consolidation

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Cardiomegaly is moderate, unchanged. Mediastinal silhouette is unremarkable. Bilateral pleural effusions are small and minimally different from the prior study. Bibasal opacities are unchanged and most likely represent atelectasis although right lung consolidation is more pronounced and can potentially represent infectious process.


SubjectID: 15573773, StudyID: 58273532, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with desaturation to low 80s. Evaluate for pneumonia.

COMPARISONS: Multiple prior chest radiographs, most recently of ___.

FINDINGS: Single frontal portable view of the chest was obtained. The heart is enlarged and its right border is silhouetted by right lung base consolidation, which is increased since ___ and compatible with pneumonia, pleural effusion, or a combination of both. The left lung is clear. No pneumothorax is identified. A right central catheter terminates in the low SVC. Left humeral hardware is similar to prior and right humeral hardware is incompletely imaged.

IMPRESSION: Right lung base parenchymal opacity, increased since prior, compatible with pneumonia in the correct clinical setting. Probable superimposed right pleural effusion.


SubjectID: 15573773, StudyID: 55635413, Comparison: same

FINAL REPORT

HISTORY: Respiratory failure.

FINDINGS: In comparison with the study of ___, there is little overall change   Keywords: little overall change. Again there are diffuse areas of opacification bilaterally consistent with multifocal pneumonia. Enlargement of the cardiac silhouette with pulmonary vascular congestion is also seen. Probable bilateral effusions with atelectatic changes at the bases as well.


SubjectID: 15573773, StudyID: 51917159, Comparison: None

FINAL REPORT

CHEST PORTABLE AP

INDICATION: ___-year-old woman with past medical history of recurrent pneumonia, paraplegia, recent admission for hypercarbic respiratory failure, MDR pneumonia, proteus UTI, presenting with altered mental status. Evaluate for new infiltrates. CHEST PORTABLE: Comparison is made to ___. There is cardiomegaly which is unchanged from the prior study. Again noted is consolidation in the right lower and middle lobe. There are air bronchograms in the left lower lobe and patchy opacities as well. A central venous line is identified with its tip at the cavoatrial junction.

IMPRESSION: Slight worsening of multifocal pneumonia which now also involves the left lower lobe.


SubjectID: 15573773, StudyID: 58181880, Comparison: same

WET READ: ___ ___ 12:14 AM 1. New right basilar opacity may represent a small consolidation. 2. unchanged mild pulmonary vascular congestion and interstitial edema as compared to the ___ radiograph.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

INDICATION: Altered mental status.

COMPARISON: Chest radiographs available from ___ through ___. FRONTAL CHEST RADIOGRAPH: The patient is slightly rotated. A right-sided central line terminates at the low SVC. The heart is mildly enlarged. The central pulmonary vessels are engorged, and mild pulmonary edema is present. This is not significantly changed since the ___ examination. There is a new right base opacity concerning for consolidation. There is no pneumothorax or large pleural effusion. Old right-sided rib fractures are present.

IMPRESSION: 1. New right basilar opacity may represent a consolidation. 2. Unchanged mild cariomegaly, pulmonary vascular congestion, and interstitial edema   Keywords: unchanged.


SubjectID: 15573773, StudyID: 57931344, Comparison: None

WET READ: ___ ___ ___ 8:44 PM OGT still w tip in lower esophagus, similar as compared to preceding exam. Other lines and tubes satisfactory. Cardomegaly and bilateral lung opacities unchanged. dw Dr. ___ by ___ at 8p on ___ via phone. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Orogastric tube recently placed, evaluation.

COMPARISON: ___, 0:49 a.m.

FINDINGS: As compared to the previous radiograph, the orogastric tube is still in the lower esophagus, comparable to the position on the previous examination. All other monitoring and support devices are in expected correct position. Unchanged moderate cardiomegaly and bilateral parenchymal opacities.


SubjectID: 15573773, StudyID: 54303833, Comparison: None

WET READ: ___ ___ ___ 1:39 AM 1. OG tube terminates at the distal esophagus. 2. ET tube 3.6 cm above the carina. 3. Right basilar consolidation superimposed on mild interstitial edema.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

INDICATION: Altered mental status, post-intubation.

COMPARISON: Radiograph available from 12:02 a.m. FRONTAL CHEST RADIOGRAPH: An endotracheal tube terminates 3.6 cm above the carina. An orogastric tube terminates at the lower esophagus. The heart is enlarged. A right-sided central venous catheter terminates at the low SVC. A right basilar consolidation is again seen, superimposed on a background of mild pulmonary vascular congestion and interstitial edema. Bilateral humeral hardware is incompletely imaged. Old right rib fractures are present.

IMPRESSION: 1. OG tube terminating at the distal esophagus. This was placed on the urgent wet read dashboard in the emergency room. 2. ET tube terminating 3.6 cm above the carina. 3. Right lower lobe consolidation superimposed on background of mild pulmonary vascular congestion and interstitial edema.


SubjectID: 15573773, StudyID: 53425534, Comparison: None

FINAL REPORT

HISTORY: Respiratory failure and hypotension, for Dobbhoff placement.

FINDINGS: In comparison with the study of ___, the Dobbhoff tube extends to the upper stomach, where it coils upon itself. The tip lies below the esophagogastric junction. The remainder of the study is essentially unchanged.


SubjectID: 15573773, StudyID: 56636063, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with hypoxia // acute process?

COMPARISON: ___

FINDINGS: AP portable upright view of the chest. Overlying EKG leads are present. Hardware projects over the left proximal humerus as on prior. Multiple bilateral rib deformities are chronic. Moderate cardiomegaly persists. There is ill-defined airspace consolidation at the right lower lung which is concerning for pneumonia. Background mild fibrosis is unchanged. A small right pleural effusion is likely present. No large pneumothorax. Mediastinal contour is unremarkable. Old left clavicle deformity is also again seen.

IMPRESSION: Opacity at the right lung base concerning for pneumonia. Additional chronic findings as described above.


SubjectID: 15573773, StudyID: 52907226, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with PNA // interval change, pneumonia

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Status post left shoulder repair. Healed bilateral rib fractures. Moderate cardiomegaly. Small right pleural effusion. Atelectasis at the right lung basis, coexisting pneumonia cannot be excluded. . No overt pulmonary edema.


SubjectID: 15573773, StudyID: 55549013, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Worsening pneumonia, fever, evaluation for acute process.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the monitoring and support devices are constant. The pre-existing parenchymal opacities, described in correct resting on previous examinations, are constant in severity and extent. The opacities are slightly more severe on the left than on the right   Keywords: more severe. Bilateral blunting of the costophrenic sinuses, likely caused by minimal pleural effusions, is also unchanged. Finally, the borderline size of the cardiac silhouette is still present.


SubjectID: 15573773, StudyID: 53726034, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH.

INDICATION: COPD, fever, respiratory failure. Evaluation for pleural effusions.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the parenchymal opacities in the lung, that were present at both the left and the right hemithorax, have slightly decreased in extent and severity. The left costophrenic sinus still shows minimal blunting, suggesting a remnant pleural effusion. On the right, no effusion is seen. Unchanged monitoring and support devices, unchanged moderate cardiomegaly.


SubjectID: 15573773, StudyID: 50262237, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: New fevers, rule out acute process.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the parenchymal opacities, that pre-existed since ___ and has been previously described, have increased in extent and severity. In particular, this is evident in the left perihilar regions. The dynamics and appearance of the changes is suggestive for a combination of pulmonary edema and pneumonia. The monitoring and support devices are constant. There is unchanged moderate cardiomegaly. Blunting of the costophrenic sinuses could be caused by small pleural effusions.


SubjectID: 15573773, StudyID: 50923932, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: New nasogastric tube, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has received a nasogastric tube. The tip of the tube is not included in the film, but likely to be positioned in peripyloric region. No evidence of complications, notably no pneumothorax. Otherwise, the radiograph is unchanged.


SubjectID: 15573773, StudyID: 50719755, Comparison: same

FINAL REPORT

PORTABLE CHEST ___:

HISTORY: ___-year-old female with altered mental status, recent pneumonia.

FINDINGS: Single portable view of the chest was compared to previous exam from ___. When compared to prior, there has been no significant interval change   Keywords: no significant interval change. Bibasilar opacities are again seen, more notably on the right. Superiorly, the lungs are clear. Cardiomediastinal silhouette is stable given differences in technique. Right-sided central line seen with tip in the region of the mid SVC. Multiple bilateral healed rib fractures and bilateral humerus hardware is partially visualized.

IMPRESSION: No significant interval change   Keywords: no significant interval change.


SubjectID: 15574754, StudyID: 59998129, Comparison: better

FINAL REPORT

EXAMINATION: Portable AP chest radiograph.

INDICATION: ___ year old man with acute heart failure vs. septic shock // Interval change?

COMPARISON: Chest radiograph dated ___ at 08:01.

FINDINGS: The patient has now been extubated. The NG tube is been removed. The right internal jugular vein Swan-Ganz catheter tip lies within the mediastinal contours and appropriately positioned in the main pulmonary artery, slightly more proximal than previously. Aeration of the lungs has improved. Interval improvement in right pleural effusion, now minimal in size. Left pleural effusion has resolved. The heart remains moderately to severely enlarged, overall unchanged. Pulmonary vascular congestion is mild and improved   Keywords: improve. No pneumothorax.

IMPRESSION: 1. Resolved left pleural effusion; improved, now small right pleural effusion. 2. Edema is better, now mild   Keywords: better.


SubjectID: 15574754, StudyID: 57707967, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with dyspnea // r/o chf

COMPARISON: ___

FINDINGS: AP portable upright view of the chest. Cardiomegaly is re- demonstrated. There is new consolidation in the right lower lung which is concerning for pneumonia. There is likely an adjacent small pleural effusion. Subtle increased opacity in the right upper lung may also represent additional areas of pneumonia. Left lung is essentially clear. No pneumothorax. No convincing signs of congestion or edema. No acute bony abnormalities. There is chronic appearing deformity involving the left humeral head for which clinical correlation is advised.

IMPRESSION: New consolidation in the right lower lung concerning for pneumonia with likely small adjacent effusion. Possible early consolidation also in the right upper lobe. Stable cardiomegaly. Chronic deformity left humeral head.


SubjectID: 15574754, StudyID: 54021294, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cardiogenic shock and sepsis // Placement of Swan

COMPARISON: ___

IMPRESSION: No relevant change as compared to the previous image   Keywords: no relevant change. Monitoring and support devices are in constant position, with the exception of a newly inserted Swan-Ganz catheter. The tip is in correct position in the right pulmonary artery. Minimal right and left pleural effusions. Bilateral areas of atelectasis. No pulmonary edema. No pneumonia. Moderate cardiomegaly persists.


SubjectID: 15574754, StudyID: 53766056, Comparison: same

FINAL REPORT

EXAMINATION: AP chest x-ray

INDICATION: ___M with c/o SOB s/p intubation verify tube placement // s/p intubation verify tube placement

TECHNIQUE: Portable AP supine chest radiograph.

COMPARISON: Chest x-ray ___.

FINDINGS: There has been interval placement of an endotracheal tube, which terminates in appropriate position approximately 2.6 cm above the carina. Additionally, an enteric tube has been place, which courses inferiorly and whose distal tip projects over the approximate location of the gastric body. Otherwise, no change   Keywords: no change.

IMPRESSION: Appropriately positioned endotracheal and orogastric tubes.


SubjectID: 15574754, StudyID: 50332835, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with undifferentiated shock // interval change?

COMPARISON: ___, 00:03

IMPRESSION: Minimally increasing left pleural effusion. Otherwise unchanged radiograph with constant position of the monitoring and support devices, moderate cardiomegaly and mild pulmonary edema   Keywords: unchanged radiograph. No new parenchymal opacity.


SubjectID: 15574754, StudyID: 58818022, Comparison: None

WET READ: ___ ___ ___ 7:58 AM Right IJ central venous catheter terminates in the mid SVC. There is no evidence of pneumothorax. Moderate cardiomegaly is unchanged. Small right greater than left pleural effusions are seen. There is no focal consolidation.

WET READ VERSION #1 ___ ___ ___ 7:49 PM Right IJ central venous catheter terminates in the mid SVC. There is no evidence of pneumothorax. Moderate cardiomegaly is unchanged. Small right greater than left pleural effusions are seen. There is no focal consolidation. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with recent pneumonia, s/p HD now // interval change after HD

IMPRESSION: Interval replacement of right internal jugular catheter now terminating in the the mid to lower superior vena cava, with no visible pneumothorax. Stable cardiomegaly, improving bibasilar opacities, and persistent small pleural effusions, right greater than left.


SubjectID: 15574754, StudyID: 56505077, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with new shortness of breath // r/o pleural edema

IMPRESSION: As compared to ___ chest radiograph, cardiomegaly is again demonstrated without evidence of pulmonary edema   Keywords: again. Interval improvement in right basilar opacification with persistent small right pleural effusion. Left retrocardiac opacification in small left pleural effusion are unchanged.


SubjectID: 15574754, StudyID: 58269341, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, positioning of Swan-Ganz catheter.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, no relevant change   Keywords: no relevant change. Moderate cardiomegaly, bilateral pleural effusions, right more than left. The Swan-Ganz catheter is located deep in the right pulmonary artery, the line needs to be pulled back by approximately 5 cm. Moderate cardiomegaly. No interval appearance of new parenchymal opacities   Keywords: new. At the time of dictation and observation, 2:19 p.m., on ___, the referring physician, ___. ___ covered by Dr. ___, was paged for notification.


SubjectID: 15574754, StudyID: 52847779, Comparison: None

FINAL REPORT

HISTORY: ___-year-old male with congestive heart failure.

COMPARISON: Prior chest radiograph dated ___. Multiple priors dating back through ___.

FINDINGS: Portable semi erect frontal chest radiograph demonstrates interval removal of Swan-Ganz catheter with persistent right internal jugular sheath in place. Stable moderate cardiomegaly and unchanged mediastinal and hilar contours. Improved aeration of the right lower lobe. No new focal consolidation identified. No pneumothorax.

IMPRESSION: Interval removal of Swan-Ganz catheter. Stable cardiomediastinal silhouette with improved right lower lobe aeration.


SubjectID: 15574754, StudyID: 57211509, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Recent right chest tube placement, new hypoxia, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the right pigtail catheter is in unchanged position. The right pleural effusion has re-occurred, causing homogeneous opacity at the right lung base. The size of the cardiac silhouette and the retrocardiac atelectasis as well as the pre-existing small left pleural effusion are without relevant change. No pneumothorax.


SubjectID: 15574754, StudyID: 54250359, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Pleural effusion, followup.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change in extent of the known right pleural effusion. The pigtail catheter in the right pleural space is in unchanged position. A lucency paralleling the upper and lateral right chest wall is caused by a skinfold and should not be mistaken for a pneumothorax. Unchanged atelectasis at both the left and the right lung bases. Unchanged moderate cardiomegaly.


SubjectID: 15574754, StudyID: 51042223, Comparison: None

WET READ: ___ ___ 6:49 PM Decreased size of right pleural effusion status post placement of right pigtail catheter with small residual right lower lung atelectasis. Moderate left pleural effusion with adjacent atelectasis appears more prominent compared to the prior exam. Pulmonary vascular congestion is stable. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Right pleural effusion, pigtail placement.

COMPARISON: ___, 3:04 a.m.

FINDINGS: Decreased size of the right pleural effusion after right pigtail catheter placement. Small residual right lower lobe atelectasis. Unchanged evidence of a small left pleural effusion with adjacent atelectasis. No pneumothorax. Moderate cardiomegaly is unchanged.


SubjectID: 15574754, StudyID: 50866109, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Heart failure, evaluation for pleural effusion.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the right pleural drain is in unchanged position. The pre-existing pleural effusion has substantially decreased in extent. Unchanged moderate cardiomegaly with retrocardiac and right basal atelectasis. No pneumothorax. No pulmonary edema.


SubjectID: 15574754, StudyID: 56867408, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with respiratory failure // ___ year old man with respiratory failure

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Central venous line tip terminates in the right atrium. Cardiomegaly is substantial, unchanged. Bilateral pleural effusions are small to moderate on the right and moderate on the left. Bibasal consolidations, left more than right are noted, concerning for infectious process. Partially imaged right humeral head is concerning for osteonecrosis.


SubjectID: 15574754, StudyID: 53963104, Comparison: same

WET READ: ___ ___ 5:25 PM No significant interval change   Keywords: no significant interval change. Left greater than right pleural effusion with overlying atelectasis, left base consolidation not excluded. Mild pulmonary edema. Enlarged cardiac silhouette. No new central venous line seen on the image as compared to the most recent prior study. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with cvl, a line in r groin // eval for cvl

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___ at 14:26

FINDINGS: No new central venous line is seen in the chest since the prior study from earlier today, ___ at 14:26. Large bore dual-lumen catheter on the right is stable in position. Partially imaged catheter is seen extending into the left upper quadrant, similar to prior. Bilateral pleural effusions are re- demonstrated, left greater than right, with overlying atelectasis. Mild pulmonary edema persists   Keywords: persists. The cardiac and mediastinal silhouettes remain stable with the cardiac silhouette quite enlarged.

IMPRESSION: No significant interval change. Left greater than right pleural effusion with overlying atelectasis, left base consolidation difficult to exclude. Mild pulmonary edema. Enlarged cardiac silhouette. No new central venous line seen on the image as compared to the most recent prior study.


SubjectID: 15574754, StudyID: 50984086, Comparison: None

FINAL REPORT

EXAMINATION: PORTABLE SUPINE CHEST RADIOGRAPH

INDICATION: History: ___M with lactate ___ // evidence of pna

TECHNIQUE: AP view of the chest

COMPARISON: ___ radiograph

FINDINGS: The cardiomediastinal and hilar contours are stable. A right-sided dual-lumen central venous catheter tip terminates within the proximal right atrium and at the junction of the SVC and right atrium, as before. Moderate cardiomegaly is re- demonstrated. The pulmonary vasculature is within normal limits. A moderate left-sided pleural effusion is minimally decreased in size from the prior examination. Left basal opacity is again demonstrated. The tip of a percutaneous gastrostomy catheter is noted in the left upper quadrant of the abdomen. No pneumothorax. There is irregular lucency and compression deformity of the right humeral head, suggestive of sever degenerative changes with possible avascular necrosis.

IMPRESSION: Left-sided pleural effusion is minimally decreased in size from the prior examination. Persistent left basal opacity may represent compressive atelectasis; however, infection should be considered in the appropriate clinical setting. Irregular lucency and compression deformity of the right humeral head, suggestive of sever degenerative changes with possible avascular necrosis. Recommend clinical correlation.


SubjectID: 15574754, StudyID: 56724794, Comparison: None

FINAL REPORT

HISTORY: ___-year-old male with slurred speech.

COMPARISON: ___ chest x-ray. ___ left shoulder films.

FINDINGS: AP and lateral views of the chest. There is new right basilar consolidation and retrocardiac opacity seen silhouetting the descending thoracic aorta. There is also blunting of the bilateral posterior costophrenic angles. Degree of cardiomegaly is not significantly changed. The left humeral head is partially visualized and appears sclerotic, similar to prior shoulder films.

IMPRESSION: Small bilateral effusions and bibasilar opacities more extensive on the right than on the left concerning for pneumonia.


SubjectID: 15574754, StudyID: 55246648, Comparison: 0.0

FINAL REPORT

HISTORY: Difficulty breathing.

TECHNIQUE: Frontal view of the chest.

COMPARISON: Multiple chest radiographs the most recent on ___.

FINDINGS: A right internal jugular central venous catheter ends in the low SVC. Again seen is opacification of the right lung base consistent with minimally improving moderate pleural effusion. A very dense retrocardiac opacity is again seen which also may represent atelectasis or area of infection. The pulmonary vasculature is not engorged however there is a developing interstitial abnormality concerning for worsening pulmonary edema   Keywords: worse, developing. The cardiomediastinal silhouette and hilar contours are unchanged. There is no evidence of pneumothorax. Unchanged old right 5th rib fracture again seen.

IMPRESSION: 1. Interstitial abnormality suggestive of worsening pulmonary edema in the absence of pulmonary vascular engorgement   Keywords: worse. 2. Dense retrocardiac opacity could represent pneumonia or atelectasis. These findings were communicated to Dr. ___ ___ telephone at 11:15 on ___ by Dr. ___.


SubjectID: 15574754, StudyID: 53673703, Comparison: same

WET READ: ___ ___ ___ 9:24 AM Low lung volumes results in bronchovascular crowding. Small right pleural effusion is unchanged. The heart is persistently enlarged. No definite evidence of pneumonia.

WET READ VERSION #1 ___ ___ ___ 12:09 AM Low lung volumes results in bronchovascular crowding. Small right pleural effusion is unchanged. The heart is persistently enlarged. No definite evidence of pneumonia. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF, ESRD on HD, COPD who is admitted to the MICU for hypoglycemia, lactic acidosis, and leukocytosis. // Eval for PNA

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Low lung volumes. Mild right basilar atelectasis but no evidence of new focal parenchymal opacity suggesting pneumonia. Moderate cardiomegaly. Unchanged normal position of the right PICC line.


SubjectID: 15574754, StudyID: 50072700, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p NGT placement // eval NGT placement

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the patient has received a nasogastric tube. The course of the tube is unremarkable, the tip of the tube projects over the middle parts of the stomach. No complications, notably no pneumothorax. No other changes are noted   Keywords: no other change.


SubjectID: 15578212, StudyID: 59085232, Comparison: better

FINAL REPORT

INDICATION: ___ year old woman history of CAD status post CABG in ___ and recent medically managed NSTEMI, systolic heart failure/ischemic cardiomyopathy (LVEF of 31%), atrial fibrillation on warfarin, right ___ CVA with hemorrhagic transformation status post suboccipital craniotomy in ___ and hydrocephalus status post VP shunt placement with multiple revisions in ___, insulin-dependent diabetes mellitus type 1, hypertension, hyperlipidemia, chronic kidney injury, and seizure disorder who presents with shortness of breath, now w/ vomiting and concern for aspiration

TECHNIQUE: Chest PA and lateral

COMPARISON: ___

FINDINGS: The lung volumes remain low. There are bibasilar opacities with mild interval improvement compared to the most recent prior radiograph   Keywords: improve. Small left pleural effusion persists. No pneumothorax noted. There is stable cardiomegaly and postsurgical changes in the form of sternotomy wires and surgical clips projecting over the midline and left hemi thorax. Right-sided catheter, likely a ventriculoperitoneal shunt remains unchanged. Bony thorax is unchanged.

IMPRESSION: Low lung volumes with improving bibasilar opacities likely atelectasis and/ or consolidation and a small left pleural effusion.


SubjectID: 15578212, StudyID: 52197232, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___-year-old woman with a history of stroke, coronary artery disease status post CABG in ___, congestive heart failure, atrial fibrillation presenting with chronically worsening dyspnea and orthopnea. Evaluate for pulmonary edema.

COMPARISON: None available.

FINDINGS: There are bilateral pleural effusions, worse on the left, with moderate interstitial and alveolar pulmonary edema coupled with central pulmonary venous engorgement. The heart is enlarged. There is no pneumothorax. The patient is status post CABG with intact sternal cerclage wires and multiple anterior mediastinal vascular clips. Ventriculoperitoneal shunt is partially imaged.

IMPRESSION: Left-greater-than-right pleural effusions with moderate pulmonary edema consistent with decompensated congestive heart failure.


SubjectID: 15589519, StudyID: 57262323, Comparison: None

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old woman status post AVR, MVR and CABG post-op day 3 with dropping hematocrit. Evaluate for effusions, hemothorax, or pneumothorax.

FINDINGS: Comparison is made to the previous study from ___. There has been removal of the Swan-Ganz catheter. There is a new left-sided PICC line whose distal tip is in the mid-to-distal SVC. An aortic valve replacement is seen. The heart size is upper limits of normal. There is prominence of the mediastinum, which is stable. There is again seen a triangular area of increased density within the right upper lobe which likely represents loculated pleural fluid. There are small bilateral pleural effusions. There are no signs of overt pulmonary edema.


SubjectID: 15589519, StudyID: 50208134, Comparison: same

FINAL REPORT

INDICATION: Post-extubation evaluation of patient status post AVR and MVR.

COMPARISONS: Chest radiographs from ___ and ___.

FINDINGS: Bedside upright AP radiograph of the chest shows interval removal of the endotracheal tube and orogastric tube. The Swan-Ganz catheter has been advanced to further 1 cm and terminates low within the right pulmonary artery. This catheter needs to be withdrawn by at least 5 cm to be appropriately positioned in the right main pulmonary artery. Mild pulmonary edema as well as small bilateral pleural effusions persists, with fluid once again tracking in the minor fissure on the right   Keywords: persists. The postoperative appearance of the mediastinum and heart are unchanged. Surgical clips, artificial aortic valves, and intact sternal cerclage wires are noted. There is no pneumothorax.

IMPRESSION: 1. The Swan-___ catheter should be withdrawn by 5 cm. Findings regarding the malpositioned Swan-Ganz catheter were communicated to ___ by Dr. ___ by telephone on ___ at 11:20 a.m. 2. Stable small bilateral pleural effusions. 3. Stable mild pulmonary edema   Keywords: stable.


SubjectID: 15589519, StudyID: 57190644, Comparison: None

FINAL REPORT

INDICATION: ___-year-old woman with restrictive/obstructive lung disease and dyspnea, clinical concern for pneumonia and pulmonary edema.

COMPARISON: Chest radiograph ___. PA AND LATERAL CHEST RADIOGRAPHS: The cardiomediastinal and hilar contours are stable with mild cardiomegaly. Aortic and mitral valve prostheses are noted. In comparison to the earlier chest CT of ___, diffuse extensive heterogeneous opacification in both lungs are new. Confluent right apical opacity, likely represents a right upper lobe peripheral consolidation. Left apical pleural thickening is unchanged. No effusions or septal thickening to suggest pulmonary edema.

IMPRESSION: Diffuse multifocal pulmonary opacities with right upper lobe consolidation, is atypical for pulmonary edema. If followup chest radiograph in two days does not show significant improvement, chest CT is recommended for further assessment of these abnormalities.


SubjectID: 15589519, StudyID: 51670426, Comparison: None

FINAL REPORT

HISTORY: Restrictive cardiomyopathy with cough, following diuresis.

FINDINGS: In comparison with the study of ___, there is still enlargement of the cardiac silhouette with diffuse pulmonary edema and more focal areas of opacification in the upper zones and scattered in the right mid and lower lungs, which could represent superimposed pneumonia. Opacification at the right base is consistent with substantial volume loss in the right lower lung.


SubjectID: 15589519, StudyID: 56445927, Comparison: worse

FINAL REPORT

EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Shortness of breath, diffuse swelling, evaluate for CHF versus pneumonia versus COPD.

COMPARISON: ___.

FINDINGS: The patient is status post median sternotomy, CABG, and cardiac valve replacement. In the interval since the prior study, there has been development of diffuse bilateral pulmonary opacities, which could be due to pulmonary edema versus infection depending on the clinical scenario   Keywords: development. Areas of more confluent opacity are seen in the bilateral upper lobes and the right lung base, which could be due to infection. There may be a trace right pleural effusion, although no large pleural effusions are seen bilaterally. The cardiac silhouette is top normal to mildly enlarged. The mediastinal contours are grossly stable.


SubjectID: 15597371, StudyID: 58830622, Comparison: None

FINAL REPORT

PORTABLE CHEST FILM, ___ AT 12:24 A.M. CLINICAL

INDICATION: ___-year-old with Guillain-___ syndrome, now with desaturation into the low 90s, question acute lung process. Comparison is made to the patient's prior study of ___ at ___. A portable AP semi-erect chest film ___ at 12:24 a.m. is submitted. Best possible image was obtained as the patient was confused and had difficulty cooperating for the examination. Patient is markedly rotated.

IMPRESSION: The patient's mandible obscures the right apex. There continues to be elevation of the left hemidiaphragm. There is a patchy opacity at the left base which may reflect partial lower lobe atelectasis, although pneumonia or aspiration should also be considered. Overall, the lung volumes are diminished but the right lung is grossly clear. There is no evidence of pulmonary edema. Heart is stably enlarged. Evaluation of mediastinal contours is limited due to marked patient rotation.


SubjectID: 15597371, StudyID: 52895063, Comparison: None

FINAL REPORT

PORTABLE CHEST FILM, ___ AT ___ CLINICAL

INDICATION: ___-year-old with Guillain-___ syndrome, question resolution of edema. Comparison is made to the patient's previous study dated ___. Portable AP semi-upright chest film ___ at ___ is submitted.

IMPRESSION: 1. Lung volumes remain low. There is persistent stable opacity at the left base which could reflect partial lower lobe atelectasis, pneumonia or aspiration. No pulmonary edema. Low lung volumes. Overall cardiac and mediastinal contours are difficult to assess due to marked patient rotation and the left airspace disease. No pneumothorax, although the sensitivity to detect pneumothorax is diminished given supine technique.


SubjectID: 15605702, StudyID: 58745617, Comparison: same

FINAL REPORT

HISTORY: CHF and tachypnea.

FINDINGS: In comparison with the earlier study of this date, there is again enlargement of the cardiac silhouette with opacification at the left base consistent with pleural effusion and volume loss in the left lower lobe. There is pleural fluid on the right as well tracking along the right lateral chest wall into the minor fissure. Otherwise, little change   Keywords: little change.


SubjectID: 15605702, StudyID: 56826695, Comparison: None

FINAL REPORT

HISTORY: CHF.

FINDINGS: In comparison with the study of ___, there is again enlargement of the cardiac silhouette. The pulmonary vascular congestion appears to be less prominent on the current study. Opacification at the left base is consistent with some combination of pleural effusion and volume loss in the left lower lobe. This information was discussed with the resident on call for ___. If there is serious clinical concern for pneumonia, since the patient is unable to have a lateral view obtained, appropriate antibiotic treatment would seem warranted even though definite consolidative area cannot be demonstrated.


SubjectID: 15605702, StudyID: 50397485, Comparison: same

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___.

FINDINGS: Stable cardiomegaly accompanied by pulmonary vascular congestion   Keywords: stable. Improving bibasilar atelectasis. Persistent small left and improving small-to-moderate right pleural effusions.


SubjectID: 15605951, StudyID: 59546132, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Intubation, questionable interval change.

COMPARISON: ___.

FINDINGS: Compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The monitoring and support devices are in constant position. Constant appearance of the cardiac silhouette. No lung parenchymal changes. The extensive bilateral opacities are still clearly visible   Keywords: still. Unchanged small left pleural effusion. Unchanged size and shape of the cardiac silhouette.


SubjectID: 15605951, StudyID: 58572348, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Acute respiratory failure, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the lung volumes appear to have increased, likely caused by a decrease in extent of the bilateral pleural effusions. However, the parenchymal opacities that preexisted are still clearly visible and present   Keywords: still. They have not substantially changed. Unchanged status post intubation, pacemaker and right PICC line. No pneumothorax.


SubjectID: 15605951, StudyID: 58184280, Comparison: worse

FINAL REPORT

AP CHEST, 4:52 A.M., ___.

HISTORY: ___-year-old woman after intubation, question interval change.

IMPRESSION: AP chest compared to ___: Moderately-severe pulmonary edema has worsened radiographically since ___, but whether this represents a parallel to real clinical changes would depend upon status of positive pressure ventilation   Keywords: worse. Severe cardiomegaly is chronic. Pleural effusions are presumed, but small. Right PIC line ends in the mid-to-low SVC. ET tube is in standard placement and an upper enteric tube ends in the upper stomach. The transvenous right ventricular pacer lead follows the expected course, the right atrial lead denotes a very large right atrium. No pneumothorax.


SubjectID: 15605951, StudyID: 51669459, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: respiratory failure, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous examination, there is no relevant change   Keywords: no relevant change. The extent and severity of the pre-existing parenchymal opacities as well as the cardiac silhouette are of unchanged appearance. Unchanged course of the right PICC line and the left pacemaker leads.


SubjectID: 15605951, StudyID: 51845876, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, questionable pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient now presents with moderate to severe pulmonary edema. There is moderate cardiomegaly, retrocardiac atelectasis, increase in interstitial markings, and peribronchial cuffing. The patient is intubated. The tip of the endotracheal tube projects 3.8 cm above the carina. The course of the nasogastric tube is unremarkable, the tip projects over the proximal parts of the stomach. Sternal wires in correct location. The course of the pacemaker leads is unchanged.


SubjectID: 15608511, StudyID: 56558659, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with shortness of breath

TECHNIQUE: Upright AP view of the chest

COMPARISON: ___ at 16:39

FINDINGS: Mild pulmonary edema may be minimally worse in the interval   Keywords: worse. Cardiac, mediastinal, and hilar contours are unchanged. Patchy opacities in the lung bases likely reflect areas of atelectasis, but aspiration or infection is not completely excluded. No pleural effusion or pneumothorax is identified. Clips from prior cholecystectomy are noted in the right upper quadrant.

IMPRESSION: Mild pulmonary edema, minimally worse in the interval   Keywords: worse. Continued bibasilar patchy opacities, likely atelectasis but aspiration or infection is not excluded.


SubjectID: 15608511, StudyID: 53779400, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with HTN, ESRD on HD, presenting with nausea/vomiting/abdominal and rib pain

TECHNIQUE: Portable upright AP view of the chest

COMPARISON: ___

FINDINGS: Moderate enlargement of the heart remains. The aorta is tortuous and diffusely calcified. Mediastinal and hilar contours are similar. Mild pulmonary vascular congestion is present with minimal streaky bibasilar opacities, likely atelectasis, but aspiration or infection is not excluded. No pleural effusion or pneumothorax is present. No acutely displaced fractures rib fractures are identified. Cholecystectomy clips are noted in the right upper quadrant of the abdomen. No subdiaphragmatic free air.

IMPRESSION: Mild pulmonary vascular congestion and bibasilar opacities, likely atelectasis but aspiration or infection is not excluded.


SubjectID: 15620544, StudyID: 58352493, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with as above // s/p emesis c/o SOB r/o infiltrate/effusion

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the lung volumes have decreased. There is a minimal increase in extent of the known bilateral pleural effusions. Moderate cardiomegaly and minimal fluid overload persists   Keywords: persists. The apical lateral parenchymal opacities are unchanged in appearance.


SubjectID: 15620544, StudyID: 55703033, Comparison: better

FINAL REPORT

INDICATION: ___ year old man with avr // r/o inf, eff

FINDINGS: Since the recent radiograph of ___, a right internal jugular to the vascular sheath has been removed. There is no pneumothorax. Cardiomediastinal contours are stable. Improving aeration at the left lung base, with near resolution of atelectasis and a decrease in pleural effusion. Small to moderate right pleural effusion is unchanged. Bilateral upper lobe subpleural opacities have partially improved and it been more fully characterized by a prior CT of ___   Keywords: improve


SubjectID: 15620544, StudyID: 57981006, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p cabg with increasing right effusion, deep sulcus on left // eval for ptx, increasing effusion

TECHNIQUE: Single frontal view of the chest

COMPARISON: Study performed 2 hr earlier

IMPRESSION: There is no evident pneumothorax. Moderate pulmonary edema is grossly unchanged   Keywords: unchanged. No other interval change from prior study   Keywords: no other interval change.


SubjectID: 15620544, StudyID: 57924623, Comparison: 1.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with s/p avr // eval for ptx

TECHNIQUE: Single frontal view of the chest

COMPARISON: Study performed 3 hr earlier

IMPRESSION: There is no pneumothorax. Moderate pulmonary edema has improved   Keywords: improve. No other interval change from prior study   Keywords: no other interval change.


SubjectID: 15620544, StudyID: 54205568, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with s/p avr // s/p ct removal

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, all monitoring and support devices, with the exception of the right internal jugular venous introduction sheet have been removed. Lung volumes have increased, likely reflecting improved ventilation. Normal appearance of the postoperative cardiac silhouette. Small to moderate bilateral pleural effusions. Areas of apical lateral pleural thickening bilaterally are constant in appearance. Moderate pulmonary edema. Moderate retrocardiac atelectasis.


SubjectID: 15620959, StudyID: 57816462, Comparison: None

FINAL REPORT

HISTORY: Status post MVR, pneumothorax. CHEST, SINGLE AP PORTABLE VIEW. Compared with ___ at 5:46 a.m., the ET tube, NG tube, and Swan-Ganz catheter have been removed. A right IJ sheath remains present, tip over proximal SVC. There is suggestion of kinking of the IJ sheath, perhaps at its entry point at the skin. No pneumothorax detected. Again seen are sternotomy wires. The cardiomediastinal silhouette remains prominent, unchanged allowing for technical differences. Again seen is increased retrocardiac density, consistent with left lower lobe collapse and/or consolidation and a small left effusion. There is atelectasis at the right base, different in configuration from the earlier film. There is probably a small right effusion. There is upper zone redistribution and diffuse vascular blurring, consistent with CHF, similar to prior. Right axillary surgical clips noted.

IMPRESSION: 1) Interval removal of lines and tubes. 2) CHF findings and left lower lobe collapse and/or consolidation and effusion are unchanged. 3) Findings at the right base are slightly different in configuration but overall similar. 4) No pneumothorax detected.


SubjectID: 15620959, StudyID: 56275868, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluation for pleural effusions.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the right central venous introduction sheath has been removed. Extent of the pleural effusions bilaterally is overall unchanged. Also unchanged is the degree of bilateral basal subsequent atelectasis. Unchanged borderline size of the cardiac silhouette, no pneumothorax. The sternal wires are in unchanged alignment. The extent of the pleural effusions is better appreciated on the lateral than on the frontal image.


SubjectID: 15620959, StudyID: 52990942, Comparison: same

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with recent mitral valve repair, hypoxic.

COMPARISON: ___ at 11:49.

FINDINGS: Moderate pulmonary edema has not significantly changed   Keywords: not significantly changed. New left lower lobe opacity is mostly compatible with atelectasis. ET tube ends 3.6 cm above carina. Right-sided Swan-Ganz is in right pulmonary artery. NG tube is in adequate position. There is no pneumothorax. Pleural effusions are small if any.

CONCLUSION: 1. Moderate pulmonary edema is unchanged   Keywords: unchanged. 2. Left lower lobe atelectasis is new.


SubjectID: 15621186, StudyID: 59714805, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with metastatic prostate cancer with history of multiple UTIs presenting with sepsis and new lung infiltrate, s/p fluid resuscitation and on pressors. // please assess for interval change in consolidation or pulmonary edema

TECHNIQUE: Portable AP radiograph of the chest from ___.

COMPARISON: ___.

FINDINGS: The right IJ central line is unchanged in position. There is no pneumothorax. Lung volumes are low with stable elevation of the right hemidiaphragm. Moderate to severe pulmonary edema is unchanged   Keywords: unchanged. A small to moderate layering right pleural effusion is also unchanged. Bibasilar atelectasis has slightly increased at the left lung base. Moderate cardiomegaly is unchanged.

IMPRESSION: Stable moderate pulmonary edema   Keywords: stable. Bibasilar atelectasis has slightly increased at the left lung base. Stable small to moderate layering right pleural effusion


SubjectID: 15621186, StudyID: 58975322, Comparison: same

FINAL REPORT

INDICATION: ___M with hypotension, R-sided crackles // Eval for consolidation/PNA

TECHNIQUE: Single portable view of the chest.

COMPARISON: ___.

FINDINGS: New compared to prior is right basilar consolidation. The lungs are otherwise notable for moderate edema is and prior. Degree of cardiomegaly is grossly unchanged given differences in technique.

IMPRESSION: New right basilar opacity suspicious for pneumonia. Superimposed effusion or atelectasis is possible. Moderate pulmonary edema similar to prior   Keywords: similar. Recommend repeat after treatment.


SubjectID: 15621186, StudyID: 57915916, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with metastatic prostate ca, dchf, a. fib, here with septic shock ___ pulmonary vs uinary source with right sided pleural effusion s/p chest tube. // chest tube placement

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Right pigtail catheter has been inserted with interval substantial decrease in pleural effusion. Right internal jugular line tip is at the level of mid SVC. Cardiomediastinal silhouette is unchanged. No appreciable left pleural effusion is seen. Minimal right apical pneumothorax is present


SubjectID: 15621186, StudyID: 55465532, Comparison: worse

FINAL REPORT

INDICATION: ___ year old man with metastatic prostate ca, dchf, a. fib, here with septic shock ___ pulmonary vs uinary source with right sided pleural effusion s/p chest tube, assess for drainage of pleural effusion.

TECHNIQUE: Portable frontal chest radiograph was obtained in semi upright position.

COMPARISON: Multiple prior chest radiographs with direct comparison made to study from ___.

FINDINGS: A right chest pleural pigtail catheter remains in place without significant re-accumulation of right pleural effusion. There is persistent asymmetric elevation of the right hemidiaphragm. There is mild interstitial edema, increased since prior study   Keywords: increase. Cardiac silhouette is unchanged. A right IJ central venous catheter terminates in the mid SVC.

IMPRESSION: 1. Right pleural pigtail catheter in place without re-accumulation of pleural fluid. 2. Mild pulmonary interstitial edema, slightly increased since prior study   Keywords: increase.


SubjectID: 15621186, StudyID: 53660154, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with metastatic prostate ca, dchf, a. fib, here with septic shock ___ pulmonary vs uinary source with right sided pleural effusion s/p chest tube. Chest tube placement, interval change in pleural effusion.

TECHNIQUE: Single portable AP view of the chest.

COMPARISON: Chest radiographs from ___, ___, ___, and ___.

FINDINGS: Compared with the previous radiograph, the right chest tube has evacuated the majority of the right pleural effusion seen on ___. There may be residual subpulmonic effusion, suggested by lateral elevation of the right hemidiaphragm, and if clinically warranted, right decubitus views could be obtained. However, the patient is rotated on the current study. Right IJ line terminates in the mid SVC, unchanged. No pneumothorax.

IMPRESSION: Interval improvement in the right pleural effusion status post right chest tube placement. There may be a residual right subpulmonic effusion, suggestive bilateral elevation of the right hemidiaphragm. If clinically warranted, right decubitus views could be obtained.


SubjectID: 15621186, StudyID: 54329966, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man admitted for CHF exacerbation, transferred to CCU for hypotension and hypoxia // eval for pna, aspiration, pulmonary edema eval for pna, aspiration, pulmonary edema

IMPRESSION: In comparison with the study of ___, there again are low lung volumes that accentuate the transverse diameter of the heart. Again there is mild elevation of pulmonary venous pressure with elevation the right hemidiaphragm and bibasilar atelectatic changes. Right IJ catheter extends to the upper portion of the right atrium. Metallic bullet is again seen in the soft tissues in the left axillary region.


SubjectID: 15621186, StudyID: 53641052, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with dCHF, HTN, DM, CAD/PVD with new tachycardia and HOTN // acute cardiopulmonary process? acute cardiopulmonary process?

IMPRESSION: In comparison with the study of ___, there again are low lung volumes accentuating the transverse diameter of the heart. Persistent mild elevation of pulmonary venous pressure. Elevation of the right hemidiaphragm is less prominent. Bibasilar atelectatic changes are seen. Of incidental note is the opaque bullet in the left axillary region.


SubjectID: 15621186, StudyID: 52501917, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with s/p pulling out his central line. // Please assess for pneumothroax Please assess for pneumothroax

IMPRESSION: In comparison with the earlier study of this date, the patient is removed the right central catheter. Specifically, there is no evidence of pneumothorax. The degree of pulmonary vascular congestion appears more prominent on the current study.


SubjectID: 15621186, StudyID: 50948875, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (AP AND LAT)

INDICATION: ___M with hx CHF, CAD presenting with hypoxia ___% on RA this morning // eval for pna or volume overload

COMPARISON: ___.

FINDINGS: Upright AP and lateral views of the chest provided. There is stable elevation of the right hemidiaphragm. Mild pulmonary edema is noted. No large effusions are seen. No pneumothorax. No convincing signs of pneumonia. The heart is mildly enlarged. The mediastinal contour is normal. A bullet-shaped metallic density projects over the soft tissues of the left axilla, appearing unchanged from ___, 0 likely representing an embedded foreign object.

IMPRESSION: Mild pulmonary edema, mild cardiomegaly. Bullet-shaped foreign body in the left axillary soft tissues.


SubjectID: 15623806, StudyID: 58771205, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluate for interval change in pulmonary edema.

TECHNIQUE: AP upright chest view was read in comparison with prior chest radiograph from ___.

FINDINGS: Over the last 24 hours, mild to moderately severe asymmetric pulmonary edema, predominantly involving the mid and lower lungs and right side more than left, has improved with predominant improvement appreciated on the left side. Residual opacities could be unresolved pulmonary edema; however, if any of this represents infection, cannot be determined based on radiograph alone and needs to be reviewed in conjunction with clinical history   Keywords: resolve. Increased retrocardiac density may reflect atelectasis and/or consolidation and is similar. Mild to moderately enlarged heart size and probable small bilateral pleural effusions are unchanged. There is no pneumothorax. Mediastinal and hilar contours are unremarkable. Minimal calcification in the aortic arch is unchanged.


SubjectID: 15623806, StudyID: 54670646, Comparison: None

WET READ: ___ ___ 6:53 PM ET tube 6 cm above the carina. Lower lungs excluded from the examination. Moderate pulmonary edema unchanged since ___:___. ______________________________________________________________________________

FINAL REPORT

CHEST ON ___

HISTORY: Intubated. Note from the technologist indicates that the patient was very agitated and was not able to hold still.

FINDINGS: This chest x-ray is centered over the neck and upper chest. The right lateral chest and the entire lower chest is off the film. There is severe pulmonary vascular redistribution and hazy bilateral infiltrates in the visualized portions of the lungs compatible with fluid overload. The ET tube is 5.5 cm above the carina.


SubjectID: 15623806, StudyID: 52385464, Comparison: better

FINAL REPORT

INDICATION: ___-year-old man with active CAD with worsening hypoxia interval changes.

TECHNIQUE: Single portable semi-erect chest view was reviewed in comparison with prior chest radiographs through ___ with the most recent from ___.

FINDINGS: Bilateral airspace opacities in the mid and lower lung previously concerning for pulmonary edema has progressively improved between ___ and ___, but over last 29 hours, there is no significant interval change   Keywords: improve. Mildly enlarged heart size is unchanged. Mediastinal and hilar contours are unremarkable. There is no pleural effusion. Mildly increased retrocardiac opacity is likely from atelectasis and/or consolidation.


SubjectID: 15623806, StudyID: 50562372, Comparison: better

FINAL REPORT

STUDY: Chest radiograph.

INDICATION: Patient with recent MI/pulmonary edema resolving clinically. For evaluation.

TECHNIQUE: Single portable AP radiograph was obtained.

COMPARISON: ___. REPORT: The heart size is normal. There is some canalization of vessels, but not as pronounced than the prior study as well as more dependent interstitial changes again not as pronounced on prior study. The patient has been extubated in the interim from prior study. NG tube has also been removed. The right costophrenic sulcus now appears clear.

CONCLUSION: Findings are consistent with clinical impression of resolving pulmonary edema   Keywords: resolving.


SubjectID: 15623806, StudyID: 50532909, Comparison: worse

FINAL REPORT

CHEST ON ___

HISTORY: New CHF, shortness of breath.

FINDINGS: ET tube is 4.7 cm above the carina. NG tube tip is in the stomach. There is bilateral pulmonary vascular redistribution with hazy bilateral infiltrates compatible with CHF. The alveolar infiltrates have increased compared to the prior study   Keywords: increase. There is a small right effusion and no definite left effusion.


SubjectID: 15623806, StudyID: 57485262, Comparison: same

FINAL REPORT

INDICATION: ___-year-old man with VAP and hypoxic respiratory failure, question interval right pleural effusion and ET tube placement.

COMPARISON: Multiple prior radiographs including portable AP radiograph from ___.

FINDINGS: ET tube is 5.1 cm from the carina, appropriately positioned. NG tube courses below the diaphragm. Since the prior radiograph, there right pleural effusion is smaller and opacity in the right upper lobe is improved. Pulmonary vascular congestion is unchanged   Keywords: unchanged. Left lung is incompletely imaged on this film.

IMPRESSION: ET tube 5 cm from the carina. Slight decrease in right pleural effusion and slightly improved right upper lobe opacity.


SubjectID: 15623806, StudyID: 57170848, Comparison: better

FINAL REPORT

HISTORY: Flash pulmonary edema.

FINDINGS: In comparison with study of ___, there has been substantial improvement in the pulmonary edema, with some continued mild elevation of pulmonary venous pressure   Keywords: improve. The cardiac silhouette remains somewhat prominent. ET tube remains in standard position, and the nasogastric tube extends to at least the antrum of the stomach.


SubjectID: 15623806, StudyID: 56118397, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: COPD, chronic heart failure. Intubation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has been intubated. The tip of the endotracheal tube projects 4.5 cm above the carina. Course of the nasogastric tube is unremarkable, the tip is not included on the image. Minimal improvement of the still massive pulmonary edema   Keywords: improve. Unchanged size of the cardiac silhouette. Unchanged absence of pleural effusions or pneumothorax.


SubjectID: 15623806, StudyID: 55504286, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: NSTEMI, shortness of breath, concern for pulmonary edema.

COMPARISON: ___, 7:48 a.m.

FINDINGS: As compared to the previous radiograph, the pre-existing signs of pulmonary edema have increased in severity   Keywords: increase. The edema now has also a clear interstitial component. Unchanged moderate cardiomegaly. No pleural effusions. Minimal retrocardiac atelectasis, no other parenchymal opacities.


SubjectID: 15623806, StudyID: 50772434, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Flash pulmonary edema, reintubation. Evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Minimal fluid overload, but no overt pulmonary edema at the current time point. The presence of a mild left pleural effusion cannot be excluded. Retrocardiac atelectasis that is constant. No pneumonia. Moderate cardiomegaly. Unchanged appearance of the endotracheal tube.


SubjectID: 15623806, StudyID: 57013984, Comparison: better

FINAL REPORT

INDICATION: ___-year-old male with recent NSTEMI post-intubation, with poor respiratory status.

COMPARISON: ___. CHEST, AP UPRIGHT: Endotracheal tube has migrated distally, and now terminates 2.5 cm above the carina. Nasogastric tube terminates in the stomach. There is no pneumothorax. Moderate right and small left pleural effusions persist. Continued hazy bibasilar opacities, right greater than left. Central venous congestion and mild interstitial edema have improved. Mild cardiomegaly is unchanged. The aorta is tortuous and calcified.

IMPRESSION: 1. Slight improvement in pulmonary edema   Keywords: improve. 2. Persistent bibasilar opacities, better characterized on prior CT   Keywords: better.


SubjectID: 15623806, StudyID: 53018308, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with congestive heart failure.

COMPARISON: ___. CHEST, AP: Nasogastric tube again terminates in the stomach. There has been near-complete resolution of the right pleural effusion and adjacent atelectasis. Mild cardiomegaly, central venous congestion, and interstitial edema are unchanged. Heart size is normal. The aorta is tortuous and calcified.

IMPRESSION: Decreased right effusion. Mild pulmonary edema.


SubjectID: 15623806, StudyID: 52902375, Comparison: same

FINAL REPORT

INDICATION: ___-year-old man with CHF, status post NSTEMI, presenting with decreased respiratory status.

COMPARISONS: ___ to ___ and CT, ___.

FINDINGS: Right basilar opacity and effusion are unchanged since yesterday's exam. Mild pulmonary vascular congestion is also similar   Keywords: similar. Cardiomegaly is stable. There is no new consolidation, effusion, or pneumothorax. A nasogastric tube extends into the stomach. Mild cardiomegaly is unchanged.

IMPRESSION: Stable appearance of right basilar consolidation and small effusion. Stable mild pulmonary edema   Keywords: stable.


SubjectID: 15623806, StudyID: 56922956, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with altered mental status, status post extubation and aspiration pneumonia.

COMPARISONS: ___.

FINDINGS: A single portable semi-erect chest radiograph was obtained. There is progressively increased aeration to the right base. A nasoenteric tube extends inferiorly off the film. No new consolidation, effusion or pneumothorax. is present. Cardiac and mediastinal contours are normal.

IMPRESSION: Further improved aeration at the right base.


SubjectID: 15623806, StudyID: 56847587, Comparison: 0.0

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Assessment for chronic heart failure.

COMPARISON: ___, 6:59 a.m.

FINDINGS: As compared to the previous radiograph, there is a further slight improvement of the signs indicative of pulmonary edema   Keywords: improve. However, pulmonary edema is still clearly present   Keywords: still. The endotracheal tube and the nasogastric tube are unchanged. Unchanged moderate cardiomegaly with mild retrocardiac atelectasis. No major pleural effusions.


SubjectID: 15623806, StudyID: 55353671, Comparison: better

FINAL REPORT

INDICATION: ETT and OGT placement.

COMPARISONS: ___ at 6:29 a.m.

FINDINGS: Frontal chest radiograph demonstrates ET tube terminating 6.5 cm above the carina. OG tube courses below the diaphragm and terminates outside the field-of-view. Moderate pulmonary edema has slightly improved from radiograph obtained 30 minutes prior   Keywords: improve.

IMPRESSION: Standard position of ETT and OGT. Slight improvement in pulmonary edema from 30 minutes prior   Keywords: improve.


SubjectID: 15623806, StudyID: 50458609, Comparison: same

FINAL REPORT

INDICATION: Shortness of breath.

COMPARISONS: ___.

FINDINGS: Portal AP chest radiograph. Mild cardiomegaly and moderate interstitial edema, including interlobular septal thickening, are similar in appearance to ___   Keywords: similar in appearance, similar. There is no large pleural effusion or pneumothorax.

IMPRESSION: Moderate pulmonary edema representing cardiac decompensation.


SubjectID: 15623806, StudyID: 56419534, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: CHEST AP PORTABLE SINGLE VIEW.

INDICATION: ___-year-old male patient with ventilator-associated pneumonia and non-ST elevation myocardial event, tubes and lines, evaluate for pneumonia.

FINDINGS: AP single view of the chest has been obtained with patient in supine position. Comparison is made with the next preceding portable chest examination obtained with patient in semi-erect position and dated ___. Cardiac enlargement as before. The pulmonary congestive pattern has further increased. We have now perivascular haze throughout the entire pulmonary circulation. Diffuse hazy densities on the bases obliterate the visibility of the diaphragmatic contours and are indicative of bilateral pleural effusion. When comparison is made with the next preceding examination, the congestive pattern has further increased. No pneumothorax is identified. The patient is intubated, the ETT terminates in the trachea some 5 cm above the level of the carina.


SubjectID: 15623806, StudyID: 55963085, Comparison: None

FINAL REPORT

CLINICAL

HISTORY: ___-year-old man, status post NSTEMI, respiratory failure, and intubated.

COMPARISON: ___.

FINDINGS: ET tube is in appropriate position. Feeding tube is seen with its last port past the GE junction. There is a small right pleural effusion and bibasilar hazy opacities obscuring the diaphragms are again present.


SubjectID: 15623806, StudyID: 51921175, Comparison: None

FINAL REPORT

AP CHEST, 7:45 A.M., ___

HISTORY: ___-year-old man with ventilator-associated pneumonia. Check ET tube placement and progression of pneumonia.

IMPRESSION: AP chest compared to ___: Greater opacification in the right mid and lower lung zones could be due to progressive consolidation in the right lower lobe, but is more likely due to increased right pleural effusion. Although heart is normal size, vascular congestion suggests mild cardiac decompensation. Opacification in the left lower lobe has been present since at least ___, without appreciable change. No pneumothorax. ET tube in standard placement. Nasogastric tube passes below the diaphragm and out of view. No pneumothorax.


SubjectID: 15623806, StudyID: 54572052, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: Chest, AP portable single view.

INDICATION: ___-year-old male patient intubated for respiratory failure, evaluate for interval change.

FINDINGS: AP single view of the chest has been obtained with patient in semi-upright position. Analysis is performed in direct comparison with the next preceding similar study of ___. The patient remains intubated, the ETT in relatively high position, terminating some 6 cm above the level of the carina. This position is absolutely unchanged in comparison with the previous study. Also, the NG tube remains and reaches well below the diaphragm. Heart size is probably slightly enlarged, but no evidence of pleural effusion or advanced congestive pulmonary vascular pattern. Similar as on the previous portable chest examination, there are some scattered patchy parenchymal densities, mostly on the right lower base but also in the right upper lobe area, suggestive of some inflammatory processes. There is no progression in comparison with yesterday's study, rather slightly regression is noted. No pneumothorax is seen.


SubjectID: 15623806, StudyID: 53737122, Comparison: worse

FINAL REPORT

AP CHEST, 7:15 A.M. ON ___

HISTORY: ___-year-old man intubated after heart failure.

IMPRESSION: AP chest compared to ___: Borderline cardiomegaly and pulmonary vascular congestion persist. There is new mild edema in the right lower lung and probably a small right pleural effusion, but no pneumothorax   Keywords: new. ET tube is in standard placement, and a nasogastric tube ends in the stomach.


SubjectID: 15623806, StudyID: 54318272, Comparison: better

FINAL REPORT

AP CHEST 8:43 A.M. ___

HISTORY: ___-year-old man with three-vessel disease after an MI. Fever, suspect pneumonia.

IMPRESSION: AP chest compared to ___: Minimal pulmonary edema has improved substantially since ___, although small right pleural effusion has increased   Keywords: improve. Heart size is top normal, but improved. There are no findings to suggest pneumonia.


SubjectID: 15623806, StudyID: 52873919, Comparison: worse

FINAL REPORT

AP CHEST AT 8:24 A.M., ___

HISTORY: ___-year-old male with coronary artery disease, pneumonia and worsening dyspnea. Evaluate nasogastric tube.

IMPRESSION: AP chest compared to ___ and 7:24 a.m. today: Mild-to-moderate pulmonary edema has worsened slightly over an hour   Keywords: worse. Small right pleural effusion is stable. The heart is normal size, and the mediastinal veins are not dilated. Nasogastric tube ends in the upper stomach. Left PIC line ends in the low SVC. No pneumothorax.


SubjectID: 15623806, StudyID: 52312901, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Followup of pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has been extubated. The gastric tube has also been removed. The left PICC line is in unchanged position. Unchanged size of the cardiac silhouette. Slight progression of the pre-existing pulmonary edema that is now moderate in severity   Keywords: progression. No evidence of pleural effusions or newly appeared parenchymal opacities.


SubjectID: 15623806, StudyID: 51780316, Comparison: better

FINAL REPORT

AP CHEST, 2:14 P.M., ___

HISTORY: Coronary artery disease. Intubated electively. Evaluate tube placement.

IMPRESSION: AP chest compared to ___ through ___ at 7:52 a.m.: ET tube in standard placement, tip is below the lower margin of the clavicles, but still 6 cm from the carina. Left PIC line ends in the mid to low SVC. Heart size is smaller today than it was on ___, nevertheless pulmonary edema in the lower lobes, right greater than left, has worsened   Keywords: less pulmonary edema. There is also greater opacification in the right upper lobe marginated by the major fissure, probably pneumonia. Dr. ___ was paged at 3:25 p.m., 2 minutes after discovery and we discussed the findings by telephone at 3:30pm.


SubjectID: 15623806, StudyID: 53925986, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Endotracheal tube placement and monitor for effusions and pneumonia.

TECHNIQUE: Semi-erect portable chest view was read in comparison with multiple prior radiographs with the most recent from ___.

FINDINGS: Endotracheal tube tip is approximately 5 cm above the carina and is adequately positioned. Orogastric tube courses below the diaphragm; however, its distal end is off the radiographic view. An ill-defined opacity in the right mid lung unchanged since at least ___ is concerning for pneumonia. Right lower lung opacity is persisting. Previously, this opacity worsened between ___ and ___, but over last 24 hours, it has decreased and the residual opacity is concerning for right lower lobe pneumonia. Increased retrocardiac density on the left side either represents atelectasis and/or consolidation, concurrently associated infection cannot be reliably ruled out on a single frontal view. Left upper lung is clear. Pleural effusions if any are small bilaterally.


SubjectID: 15623806, StudyID: 52823010, Comparison: worse

FINAL REPORT

PORTABLE CHEST OF ___

COMPARISON: ___ chest x-ray.

FINDINGS: Tip of endotracheal tube terminates approximately 4.5 cm above the carina, and a nasogastric tube terminates below the diaphragm. Cardiac silhouette is mildly enlarged and accompanied by new pulmonary vascular congestion and bilateral perihilar haziness suggestive of edema   Keywords: new. More confluent areas of opacity in the right upper and right lower lobes could potentially represent an evolving pneumonia, particularly given findings concerning for right upper lobe pneumonia on recent CT of one day earlier. Small pleural effusions are present, right greater than left.


SubjectID: 15623806, StudyID: 51336433, Comparison: None

FINAL REPORT

HISTORY: Respiratory failure, for endotracheal tube placement.

FINDINGS: In comparison with the study of ___, the tip of the endotracheal tube measures approximately 4.8 cm above the carina. Nasogastric tube extends into the upper stomach where it crosses the lower margin of the image. The area of increased opacification in the lower right lung is less prominent than on the previous study. Mild atelectatic changes are seen at both bases. Little change in the apparent area of increased opacification running essentially horizontally in the right mid zone. In the appropriate clinical setting, pneumonia would have to be considered.


SubjectID: 15629116, StudyID: 58254166, Comparison: worse

FINAL REPORT

INDICATION: Shortness of breath.

COMPARISONS: Chest radiographs dated ___, ___ and CT torso of ___.

FINDINGS: Frontal and lateral views of the chest demonstrate low lung volumes. Moderate right pleural effusion is increased since prior. Right lung base opacities likely reflect compressive atelectasis. There is trace left pleural effusion, unchanged. Mild pulmonary edema is new since ___   Keywords: new. More confluent opacity in the left lung base also appears new. Hilar and mediastinal silhouettes are unchanged. Heart is mildly enlarged. Aortic arch calcifications are noted. Pacemaker leads project over right atrium and ventricle. There is no pneumothorax.

IMPRESSION: Moderate right and trace left pleural effusions increased in size since ___ exam. Mild pulmonary edema is new since prior   Keywords: new. Bibasilar opacities may relate to pulmonary edema, or represent atelectasis or superimposed infection in the appropriate clinical setting.


SubjectID: 15629116, StudyID: 56564858, Comparison: same

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with COPD, congestive heart failure, recurrent pleural effusion and thoracocentesis.

COMPARISON: Multiple chest x-rays from ___ to ___. Chest CT of ___.

FINDINGS: There is no pneumothorax after right thoracocentesis, moderate pleural effusion have slightly decreased in size and right lower lung is slightly more aerated. Mild-to-moderate pulmonary edema has not significantly changed   Keywords: not significantly changed. Focal area of consolidation in left lower lung has completely resolved, which could represent a small area of atelectasis. Mild cardiac contour enlargement is stable in this patient with left-sided atrioventricular pacemaker. Left-sided pleural effusion is small.

CONCLUSION: 1. There is no pneumothorax after right thoracocentesis. Moderate right pleural effusion has slightly decreased. 2. Unchanged mild-to-moderate pulmonary edema   Keywords: unchanged.


SubjectID: 15629116, StudyID: 57984151, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST X-RAY

INDICATION: Patient with PMH, COPD, edema, diabetes, hypertension, rule out reaccumulation of fluid.

COMPARISON: ___.

FINDINGS: Residual small-to-moderate right pleural effusion with adjacent consolidation is unchanged since previous exam. There is no pneumothorax. Left pleural effusion is small with basilar atelectasis. There is mild cardiac congestion and the heart is moderately enlarged in this patient with atrioventricular pacemaker.

CONCLUSION: There is no significant change in small-to-moderate right pleural effusion.


SubjectID: 15629116, StudyID: 57851487, Comparison: same

FINAL REPORT

HISTORY: Evaluation for interval changes in a patient with heart failure, lung cancer, and COPD.

COMPARISON: Multiple chest radiographs the most recent of ___.

FINDINGS: Portable AP semi-upright view of the chest was reviewed and compared to the prior study. Prominence of the interstitial markings is unchanged and suggests mild pulmonary edema   Keywords: unchanged. A small to moderate right pleural effusion and a tiny left pleural effusion are unchanged. Mild cardiomegaly and aortic calcifications are unchanged. Bibasilar atelectasis is greater on the right than on the left.

IMPRESSION: 1. Unchanged mild pulmonary edema, small-moderate right pleural effusion and tiny left pleural effusion   Keywords: unchanged. 2. Unchanged mild cardiomegaly.


SubjectID: 15629116, StudyID: 54690056, Comparison: None

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old man with congestive heart failure and COPD, adenocarcinoma of the lung.

FINDINGS: Comparison is made to the prior study from ___. There is a left-sided pacemaker with distal lead tips in right atrium and right ventricle. There is again seen a right-sided pleural effusion; however, this is decreased slightly since prior. There is a prominence of pulmonary interstitial markings suggestive of pulmonary edema. More confluent opacity in the right base is seen. There are no pneumothoraces. There is some atelectasis at the left lung base as well.


SubjectID: 15629116, StudyID: 52084947, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: ___. CLINICAL

HISTORY: Known lung cancer status post pleural drainage, ___, with acute short of breath, assess for interval change.

FINDINGS: PA and lateral views of the chest provided. Dual-lead pacer is unchanged. There is a right pleural chest tube in place, unchanged in position. The right pleural opacity is unchanged compatible with known effusion and tumor. A small left pleural effusion is stable. There is persistent pulmonary edema and mild cardiomegaly   Keywords: persistent. There is no pneumothorax.

IMPRESSION: No significant change from prior   Keywords: no significant change.


SubjectID: 15629116, StudyID: 52654814, Comparison: worse

FINAL REPORT

INDICATION: Evaluation for interval change in a patient with respiratory failure and history of congestive heart failure and lung cancer.

COMPARISON: Multiple chest radiographs, the most recent of ___.

FINDINGS: Portable AP semi-upright view of the chest was reviewed and compared to the prior studies. Persistent consolidation of the right mid-to-lower lung and a moderate right pleural effusion are slighlty increased. Bilateral increased interstitial markings are consistent with increased moderate pulmonary edema   Keywords: increase. The cardiac and mediastinal silhouettes are relatively unchanged. A left pectoral pacer has leads ending in the right atrium and right ventricle.

IMPRESSION: 1. Increased moderate pulmonary edema   Keywords: increase. 2. Right lung consolidation and moderate right pleural effusion are slightly increased and related to the patient's lung cancer.


SubjectID: 15629116, StudyID: 52533891, Comparison: None

FINAL REPORT

INDICATION: Evaluation for pulmonary edema in a patient with shortness of breath, congestive heart failure and lung cancer.

COMPARISON: Multiple chest radiographs, the most recent of ___ and CTA chest ___.

FINDINGS: Portable AP semi-upright view of the chest was reviewed and compared to the prior studies. Persistence of large scale consolidation in the right lung since ___ is highly suggestive of bronchoalveolar carcinoma or infection. Since ___, profusion of diffuse interstitial abnormality is consistent with known non small cell lung cancer. There is no pulmonary edema or vascular engorgement. Normal heart, mediastinal and pleural surfaces.

IMPRESSION: Persistence of large scale consolidation in the right lung and extensive interstitial abnormaity is suggestive of bronchoalveolar carcinoma or infection in this patient with known lung cancer.


SubjectID: 15634195, StudyID: 58690767, Comparison: None

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Right lower quadrant pain and guaiac-positive stool.

COMPARISONS: Prior chest radiographs are available from ___. A more recent chest CT is also available from ___.

TECHNIQUE: Chest, PA and lateral.

FINDINGS: The heart is mildly enlarged with a left ventricular configuration. There is mild-to-moderate unfolding of the thoracic aorta. The arch is partly calcified. The mediastinal and hilar contours appear unchanged. There are streaky left basilar opacities suggesting minor atelectasis. A small eventration is noted along the anterior right hemidiaphragm. There is an air-fluid level in the stomach. Air-fluid levels are seen in the epigastric region. There is no evidence for free air. Cholecystectomy clips project over the right upper quadrant. Moderate degenerative changes are similar along the mid thoracic spine.

IMPRESSION: No evidence of acute disease. Streaky left basilar opacities suggestive of minor atelectasis. Air-fluid levels in the epigastrium; no evidence of free air.


SubjectID: 15634195, StudyID: 58640120, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with history of prostate cancer, liposarcoma, peripheral vascular disease who presents with transient symptoms of right leg weakness concerning for TIA. AP Chest film demonstrated L retrocardiac opacity. // please further evaluate L retrocardiac opacity

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the pre-existing left retrocardiac opacity, presumably caused by atelectasis, has decreased in both extent and severity. There is no evidence of pulmonary edema or pneumonia. Severe right-sided degenerative changes of the shoulder. Moderate cardiomegaly. A minimal left pleural effusion is present.


SubjectID: 15634195, StudyID: 54145804, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with syncope/TIA // exclude infiltrate

IMPRESSION: As compared to ___ radiograph, cardiomediastinal contours are stable. Pulmonary vascular congestion is new   Keywords: new. Left retrocardiac opacity is also new and may reflect atelectasis and adjacent pleural effusion but coexisting infectious pneumonia is possible in the appropriate clinical setting.


SubjectID: 15640564, StudyID: 52259359, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Chest, AP semi-upright portable.

TECHNIQUE: Chest, portable AP portable.

FINDINGS: Lung volumes are low. The cardiac contours are not well delineated. There is opacification of the right lower hemithorax suggesting a combination of atelectasis, possibly pneumonic consolidation and potentially pleural effusion although not well delineated. Nonspecific patchy left infrahilar opacity is also noted. Allowing for AP portable technique, there is no definite cardiac failure. There is no evidence for pleural effusion on the left. There is no pneumothorax.

IMPRESSION: Basilar opacities, right greater than left, worrisome for pneumonia in the appropriate clinical setting. Particularly on the right a pleural effusion is possible and cannot be excluded.


SubjectID: 15640564, StudyID: 52053947, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Please evaluate for pneumonia.

TECHNIQUE: PA and lateral chest views were reviewed in comparison with prior chest radiograph from ___.

FINDINGS: Bibasal opacities, right side more than left, and mild right pleural effusion concerning for pneumonia with synpneumonic effusions has improved on right, but unchanged on left over last 24 hours. There is no evidence of pulmonary edema. Heart size, mediastinal and hilar contours are unremarkable.

IMPRESSION: Bibasal consolidation, right side more than left, and a small right pleural effusion concerning for bilateral lower lung pneumonia and synpneumonic right effusion have minimally improved on the right side, but if this change is a function of position or a true improvement cannot be differentiated.


SubjectID: 15641930, StudyID: 54055771, Comparison: None

FINAL REPORT

CLINICAL

HISTORY: Atrial fibrillation, myocardial infarct. CHEST AP: Since the prior chest x-ray, there has been some improvement in the degree of failure. The heart remains enlarged.

IMPRESSION: Improving failure.


SubjectID: 15641930, StudyID: 50537762, Comparison: None

FINAL REPORT

HISTORY: Status post VFib arrest. Evaluate interval change.

TECHNIQUE: Single, AP, frontal view of the chest with the patient in the upright position.

COMPARISON: None.

FINDINGS: There is mild to moderate cardiomegaly with evidence of mild pulmonary vascular congestion. No overt pulmonary edema is identified. Minimal bilateral linear scarring is noted. The lungs are otherwise essentially clear without focal consolidation, pneumothorax, or pleural effusion. The mediastinum is not widened. There is no evidence of acute bony abnormality.


SubjectID: 15641930, StudyID: 53248217, Comparison: same

FINAL REPORT

EXAM: CHEST, FRONTAL AND LATERAL VIEWS. CLINICAL INFORMATION: Shortness of breath and cough.

COMPARISON: ___.

FINDINGS: Frontal and lateral views of the chest were obtained. Right greater than left perihilar and basilar opacities are similar as compared to the prior study. Chest CT from ___ characterized findings of amiodarone-related pulmonary toxicity. No large pleural effusion is seen. The cardiac and mediastinal silhouettes are stable. There is moderate compression of a vertebral body at the thoracolumbar junction, stable since the prior study.

IMPRESSION: No significant interval change   Keywords: no significant interval change. Bilateral, right greater than left, perihilar and basilar opacities, similar in distribution and appearance as compared to the prior study from ___   Keywords: similar. Chest CT from ___ described findings as secondary to amiodarone toxicity.


SubjectID: 15641930, StudyID: 52993092, Comparison: same

WET READ: ___ ___ ___ 7:29 PM No significant interval change compared to ___ with redemonstration of the diffuse bilateral opacities similar in distribution and appearance compared to prior examination compatible with history of interstitial lung disease. Relative lucent appearance of the left hemidiaphragm on frontal view likely corresponds to a high-riding bowel as seen on lateral view. Subtle infection cannot be excluded given the proper clinical circumstance. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Interstitial lung disease, compensated systolic heart failure.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Diffuse bilateral opacities with a similar distribution and appearance as compared to the prior image, moderate cardiomegaly persists. No evidence of pulmonary edema. No larger pleural effusions. No pneumothorax.


SubjectID: 15641930, StudyID: 51639826, Comparison: worse

FINAL REPORT

HISTORY: Congestive heart failure. Evaluation for interval change.

TECHNIQUE: Frontal view of the chest.

COMPARISON: Multiple chest radiographs the most recent on ___.

FINDINGS: The heart size is enlarged. There is an interval worsening of the previously noted perihilar opacities   Keywords: worse. There is also worsening of the right upper lobe opacity consistent with mitral regurgitation. There is some subpulmonic fluid at the base of the right lung. There is no evidence of pneumothorax.

IMPRESSION: Evidence of worsening pulmonary edema and mitral regurgitation   Keywords: worse.


SubjectID: 15656571, StudyID: 59838495, Comparison: None

WET READ: ___ ___ 12:47 AM 1. New retrocardiac opacity may represent atelectasis in combination with superimposed tissue however early developing pneumonia cannot be excluded. Clinical correlation recommended. 2. No pulmonary edema. The findings were discussed by Dr. ___ with Dr. ___ on the ___ ___ at 12:37 AM, 5 minutes after discovery of the findings.

WET READ VERSION #1 ___ ___ 12:45 AM 1. New retrocardiac opacity may represent atelectasis however is worrisome for pneumonia in the appropriate clinical setting. 2. No pulmonary edema. The findings were discussed by Dr. ___ with Dr. ___ the ___ ___ at 12:37 AM, 5 minutes after discovery of the findings. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: Chest radiograph.

INDICATION: ___M sCHF (EF ___% ___) w/ multiple admissions, 2 vessel CAD w/ DES to LCx, h/o VT and afib s/p ICD, DM2, htn/hl, now presents with SOB. Assess for acute process, pneumonia, worsening pulmonary edema.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph ___, ___.

FINDINGS: The lungs are hypoinflated with crowding of vasculature. New retrocardiac opacity may represent atelectasis in combination with superimposed tissue however early developing pneumonia cannot be excluded. No pulmonary edema. Stable moderate cardiomegaly. No pleural effusion. Mediastinal contour and hila are unremarkable. A left AICD is unchanged in position since prior examination.

IMPRESSION: 1. New retrocardiac opacity may represent combination of atelectasis and superimposed tissue however early developing pneumonia cannot be excluded. 2. Stable moderate cardiomegaly.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the ___ ___ at 12:37 AM, 5 minutes after discovery of the findings.


SubjectID: 15656571, StudyID: 52743055, Comparison: same

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___ year old man with concern for pna on portable CXR // Please assess for pneumonia vs volume overload

TECHNIQUE: Chest PA and lateral

COMPARISON: Prior chest radiographs from ___, ___, ___, ___

FINDINGS: Since ___, moderate pulmonary congestion is unchanged   Keywords: unchanged. No pulmonary edema, pneumothorax, or pneumonia. Moderate cardiomegaly is unchanged. The pleural surfaces are normal A left pacemaker is seen with leads appropriately placed in the right atrium and right ventricle.

IMPRESSION: 1. Unchanged moderate pulmonary congestion since ___   Keywords: unchanged. No pulmonary edema or pneumonia.


SubjectID: 15656571, StudyID: 58983454, Comparison: None

FINAL REPORT

HISTORY: Pacemaker device.

FINDINGS: In comparison with study of ___, there is little change in the appearance of the dual-channel pacer with leads in the region of the right atrium and apex of the left ventricle. Continued enlargement of the cardiac silhouette with possible mild elevation of pulmonary venous pressure. No acute focal pneumonia or pleural effusion.


SubjectID: 15656571, StudyID: 50513672, Comparison: None

FINAL REPORT

HISTORY: Lead placement.

FINDINGS: In comparison with the study of ___, there are lower lung volumes. Continued enlargement of the cardiac silhouette with engorgement of indistinct pulmonary vessels consistent with elevated pulmonary venous pressure. The pacemaker leads extend to the right atrium and region of the apex of the right ventricle. No acute focal pneumonia.


SubjectID: 15682570, StudyID: 59124253, Comparison: None

FINAL REPORT

PORTABLE CHEST ___

COMPARISON: ___ radiograph.

FINDINGS: Following right Pleurx catheter placement, a right pleural effusion has been evacuated. A moderate-sized right pneumothorax is present, most prominent at the right lung base, with a smaller apical component. Increased opacity within the right lower lung probably represents a combination of atelectasis and re-expansion edema.


SubjectID: 15682570, StudyID: 58435478, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Pneumothorax following PleurX placement.

COMPARISONS: Earlier in the same day.

TECHNIQUE: Chest, portable AP upright.

FINDINGS: There is perhaps slight decrease in a moderate-sized pneumothorax and also increase in opacification of the right costophrenic sulcus that may reflect pleural fluid accumulation, atelectasis or both. The left lung remains clear.

IMPRESSION: Slight decrease in pneumothorax. Increasing right basilar opacification; otherwise unchanged.


SubjectID: 15682570, StudyID: 59056335, Comparison: None

FINAL REPORT

HISTORY: Acute on chronic systolic CHF. Question interval change. CHEST, SINGLE AP VIEW. Allowing for differences in technique, the appearance is quite similar to the film from ___ at 23:57 p.m. Again seen are diffuse bilateral alveolar and interstitial infiltrates, consistent with CHF and pulmonary edema. Volume loss in the right upper lobe indicated by retraction of the minor fissure is again noted, similar to prior. The opacities appear less white on the current study, likely reflecting differences in technique. Of note, no effusion is detected. The extreme left costophrenic angle is excluded from the film.

IMPRESSION: Diffuse interstitial and alveolar opacities, overall similar to prior, with unchanged volume loss in the right upper zone. While, given the history, this presumably reflects pulmonary edema, the lack of effusion raises the possibility of other causes of alveolar opacity, including infection/ARDS and, in the appropriate clinical setting, hemorrhage. Clinical correlation requested.


SubjectID: 15682570, StudyID: 54480047, Comparison: None

FINAL REPORT

PATIENT

HISTORY: ___-year-old man with acute on chronic heart failure.

INDICATION: Please evaluate for interval changes in pulmonary edema and for pleural effusion.

TECHNIQUE: Portable chest x-ray in AP view.

COMPARISON: Exam is compared to ___.

FINDINGS: The patient is after cardiac surgery. Left pectoral pacemaker is unchanged with wires following the expected course. Lung is well inflated with reduced interstitial opacities for reduced pulmonary edema mainly at the lung bases. There is no pleural effusion. Heart size persists enlarged. There is no pneumothorax.

IMPRESSION: Reduced pulmonary edema at the lung bases. No pleural effusion.


SubjectID: 15682570, StudyID: 58470428, Comparison: None

FINAL REPORT

HISTORY: Pacer leads, to assess for pneumothorax.

FINDINGS: In comparison with the study of ___, there is little overall change in the appearance of the pacer leads that extend to the right atrium, apex of the right ventricle, and interventricular region. Specifically, no evidence of pneumothorax. No vascular congestion or acute pneumonia.


SubjectID: 15682570, StudyID: 56533949, Comparison: None

WET READ: ___ ___ ___ 9:05 PM New lead ovelrying the upper left cardiac silhouette; exact location difficult to determine without a lateral. No pneumothorax. Otherwise unchanged of the left pacemaker and wires. Stable mild vascular congestion without overt edema.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

HISTORY: Pacer upgrade.

FINDINGS: In comparison with the study of ___, there is now a three-lead pacer device with the leads in good position. No evidence of pneumothorax. No change in the appearance of the heart and lungs.


SubjectID: 15682570, StudyID: 57936063, Comparison: None

FINAL REPORT

HISTORY: Post-surgery.

FINDINGS: In comparison with the earlier study of this date, there is little change in the appearance of the monitoring and support devices. Hazy opacification on the left suggests some layering effusion with volume loss in the left lower lobe. There is an area of increased opacification in the right mid zone laterally. This raises the possibility of developing consolidation.


SubjectID: 15682570, StudyID: 52447331, Comparison: 1.0

FINAL REPORT

HISTORY: Hypotension after cardiac surgery.

FINDINGS: In comparison with the study of ___, the area of increased opacification in the left upper and mid zone has substantially cleared. This could reflect resolution of asymmetric pulmonary edema or possibly resolving aspiration   Keywords: resolving. The left hemidiaphragm is not as well seen as on the previous study, raising the possibility of volume loss in the left lower lobe. Otherwise, little change   Keywords: little change.


SubjectID: 15682570, StudyID: 50310891, Comparison: same

FINAL REPORT

HISTORY: CAD and CHF.

FINDINGS: In comparison with the study of ___, the patient has taken a better inspiration. Again there is evidence of previous cardiac surgery with dual-channel pacer device in place. Prominence of indistinct pulmonary vessels is again consistent with elevated pulmonary venous pressure   Keywords: again. Relative improvement may merely reflect the better inspiration. No definite pneumonia or pleural effusion.


SubjectID: 15682570, StudyID: 53883586, Comparison: better

FINAL REPORT

PORTABLE CHEST FROM ___ AT 9:04 A.M. CLINICAL

INDICATION: ___-year-old with chest tube, check placement. Comparison is made to the patient's prior study of ___. Portable AP upright chest from ___ at 9:04 a.m. is submitted.

IMPRESSION: 1. Right basilar pleural catheter remains in place. There continues to be an apical lateral pneumothorax with increasing aeration in the right lung suggestive of re-expansion pulmonary edema but overall, the pneumothorax has somewhat decreased in size and there is improved aeration, particularly at the right lung base   Keywords: decrease. Left lung is clear. There are small layering effusions. Status post median sternotomy for CABG with stable postoperative appearance to the cardiac and mediastinal contours. Left-sided pacer remains in place, unchanged.


SubjectID: 15682570, StudyID: 53557330, Comparison: better

FINAL REPORT

INDICATION: History of dyspnea, question acute process.

COMPARISON: Multiple prior chest radiographs, most recently from ___.

TECHNIQUE: PA and lateral chest radiographs provided.

FINDINGS: Compared to the previous exam there has been improvement in pulmonary edema but re-accumulation of a moderate to large right pleural effusion   Keywords: improve. A small left effusion is present. The heart remains mildly enlarged. Atrial and biventricular pacemaker leads are unchanged. Median sternotomy wires are intact.

IMPRESSION: Interval increase of moderate-to-large right pleural effusion.


SubjectID: 15683514, StudyID: 59294294, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hydropneumothorax now s/p chest tube clamping // Evaluate hydropneumothorax

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Small right pleural effusion is unchanged. Moderate right pneumothorax has increased. Right lower lobe atelectasis has increased. No other interval change from prior study   Keywords: no other interval change.


SubjectID: 15683514, StudyID: 58728372, Comparison: same

WET READ: ___ ___ ___ 9:25 AM There is a persistent, small right-sided hydro pneumothorax. In comparison to the most recent examinations from earlier the same day, this does not seem to have increased in size significantly.

WET READ VERSION #1 ___ ___ ___ 12:05 AM There is a persistent, small right-sided hydro pneumothorax. In comparison to the most recent examinations from earlier the same day, this does not seem to have increased in size significantly. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hydropneumothorax with chest tube on water seal. // Evaluate PTX

TECHNIQUE: Single frontal view of the chest

COMPARISON: Study performed 5 hours earlier

IMPRESSION: Small right hydro pneumothorax is stable. No other interval change from prior study   Keywords: no other interval change.


SubjectID: 15683514, StudyID: 57266986, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hydropneumothorax s/p CT placement now clamped. // Evaluate hydropneumothorax Evaluate hydropneumothorax

IMPRESSION: In comparison with the earlier study of this date, with the chest tube clamped, there is little overall change in the moderate right pneumothorax. Remainder the study is unchanged.


SubjectID: 15683514, StudyID: 52866467, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___ year old woman with CHF and hydropneumothorax s/p placement of chest tube, now on water seal as of 10am ___. Please perform repeat CXR at 2pm on ___ ___/ Evaluation of pleural effusion and pneumothorax on right with chest tube on water seal

TECHNIQUE: Portable AP chest radiograph

COMPARISON: Prior chest radiographs from ___, ___, ___, ___ CT chest without contrast from ___

FINDINGS: There is interval increase in the air component of the known right hydropneumothorax. The fluid component is likely stable. The right pigtail catheter appears to be slightly moved in position. Otherwise, the rest of the exam is stable since earlier same day radiograph.

IMPRESSION: 1. Interval increase in the air component of the known right hydropneumothorax. The fluid component appears stable.


SubjectID: 15683514, StudyID: 52748922, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hydropneumothorax s/p CT to water seal for 24 hours. Please perform at 6am on ___ // Evaluate progression or improvement of hydropneumothorax

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Small right pleural effusions and moderate right pneumothorax are unchanged. Right lower lobe atelectasis has worsened. Moderate cardiomegaly is stable. Right basal pigtail catheter remains in place


SubjectID: 15683514, StudyID: 52655756, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with R sided chest tube persistnet PTX. // f/u pneumothorax, chest tube clamped

TECHNIQUE: Single frontal view of the chest

COMPARISON: Study performed 2 hours ago

IMPRESSION: Moderate right pneumothorax is unchanged. No other interval change from prior study   Keywords: no other interval change.


SubjectID: 15683514, StudyID: 51161417, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hydropneumothorax s/p CT placement on water seal. Evaluate for worsening ptx. Please perform portable CXR at 530pm // Evaluate progression of PTX Evaluate progression of PTX

IMPRESSION: In comparison with the study of earlier in this date, there is little overall change in the degree of hydro pneumothorax. Otherwise little change   Keywords: little change.


SubjectID: 15683514, StudyID: 50240301, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___ year old woman with hydropneumothorax s/p CT placement ___. Please perform at 6am on ___. // ? resolution of hydropneumothorax

TECHNIQUE: Portable AP chest radiograph

COMPARISON: Prior chest radiographs from ___, ___, ___, ___ CT chest without contrast very ___

FINDINGS: Mild improvement in known right hydropneumothorax with improved aeration of the right lung base. The right pigtail pleural catheter appears to be slightly moved in positioning. The left lung is essentially clear. The heart size is unchanged. No pulmonary edema.

IMPRESSION: Improvement in known right hydro pneumothorax with improved aeration of the right lung base.


SubjectID: 15683514, StudyID: 50395350, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hydropneumothorax s/p right chest tube // ? residual PTX ? residual PTX

IMPRESSION: In comparison with the study of ___, there has been placement of a pigtail catheter at the right base. There has been some decrease in the degree of pneumothorax, though there still it is a small collection in the apex and a moderate collection in the right costophrenic angle. Otherwise little change   Keywords: little change.


SubjectID: 15683514, StudyID: 57216525, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___F with known PTX/effusion on prior chest radiograph

TECHNIQUE: Chest PA and lateral

COMPARISON: ___

FINDINGS: Moderate hydro pneumothorax on the right with atelectasis of the right lower lobe appears relatively unchanged compared to the previous study. The heart size remains moderately enlarged. Mediastinal and hilar contours are unchanged. Left lung is clear without focal consolidation. No pulmonary vascular congestion is identified. There are no acute osseous abnormalities detected.

IMPRESSION: Unchanged appearance of right moderate size hydropneumothorax without evidence for tension.


SubjectID: 15683514, StudyID: 51228614, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Fluid overload, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, no relevant change is noted   Keywords: no relevant change. Extensive right and moderate left pleural effusion, with subsequent areas of atelectasis at the right lung and left lung bases. Moderate cardiomegaly. Signs of mild pulmonary edema persists   Keywords: persists. In the well-ventilated areas of the lung, there is no evidence for pneumonia. No pneumothorax.


SubjectID: 15691137, StudyID: 56640354, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman s/p dual chamber PPM. // Assess lead placement and r/o PTx.

TECHNIQUE: AP and lateral views of the chest

COMPARISON: Chest radiograph ___

FINDINGS: A dual lead pacemaker is in-situ. There is a cardiac vascular stent positioned at the level of the aortic valve. No pneumothorax seen. There is mild linear right-sided atelectasis, new when compared to the prior study. No consolidation or pneumothorax seen. No evidence of pulmonary edema. There is unchanged mild cardiomegaly.

IMPRESSION: No pneumothorax seen. Expected appearances of a dual lead pacemaker.


SubjectID: 15691137, StudyID: 56377001, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p TAVR with temp pacemaker // Eval position of pacemaker wire

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the patient has been extubated. The temporary pacemaker is in unchanged position. Mild fluid overload but no overt pulmonary edema.


SubjectID: 15691137, StudyID: 53570628, Comparison: same

WET READ: ___ ___ 10:38 PM Interval placement of a left pectoral transvenous pacer with leads ending in the right atrium and right ventricle. No evidence of pneumothorax. No overt pulmonary edema. Cardiomediastinal silhouette is unchanged. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p TAVR s/p PPM placement today // eval for volume overload vs PTX

TECHNIQUE: Portable AP chest radiograph.

COMPARISON: Chest radiographs ___

FINDINGS: There has been interval removal of a right-sided single lead stem for a pacemaker with placement of a purged permanent dual lead pacemaker on the left side. Lead position appears appropriate on this single AP view. A vascular stent is seen at the expected location of the aortic valve. No pneumothorax, consolidation or pleural effusion. Prominent reticular opacities in bilateral lower lobe distribution, unchanged compared to the prior coronary CT and likely reflecting fluid overload   Keywords: unchanged.

IMPRESSION: Interval placement of a left-sided pacemaker.


SubjectID: 15708357, StudyID: 53407030, Comparison: None

FINAL ADDENDUM After further discussion with Dr. ___ ___ the prominence of the apical pleural capping on the left, she will order a CT scan if there is significant clinical suspicion for post-surgical bleeding. ______________________________________________________________________________

FINAL REPORT

HISTORY: Cardiac surgery.

FINDINGS: In comparison with the earlier study of this date, the monitoring and support devices are essentially unchanged. Again there is enlargement of the cardiac silhouette with prominence of the upper mediastinum as well as opacification in the left apical region consistent with pleural fluid. Retrocardiac opacification persists, and the right lung is essentially clear. This information was telephoned to Dr. ___.


SubjectID: 15708357, StudyID: 50624463, Comparison: None

FINAL REPORT

HISTORY: Cardiac surgery.

FINDINGS: In comparison with study of ___, the monitoring and support devices are essentially unchanged. Enlargement of the cardiac silhouette persists with retrocardiac opacification consistent with volume loss in the left lower lobe and pleural effusion. On this view, there is apical pleural capping indicating pleural fluid. The right lung is essentially clear.


SubjectID: 15708357, StudyID: 50324792, Comparison: None

WET READ: ___ ___ ___ 3:15 PM There is no evidence of pneumothorax following removal of the Swan-___ catheter. There is a persistent left pleural effusion and retrocardiac opacity as well as linear atelectasis in the left lower lung. Preliminary findings were communicated to Dr. ___ By Dr. ___, by phone on ___ at 3:00 PM. ______________________________________________________________________________

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph, ___.

FINDINGS: Support and monitoring devices are stable in position except for removal of left-sided chest tubes and midline mediastinal drains. Moderate-to-large amount of loculated pleural fluid at left apex extending along the lateral left hemithorax. Cardiomediastinal contours are stable in the postoperative period. Persistent left lower lobe atelectasis and development of new patchy right lower lobe opacity, which could reflect atelectasis or aspiration.


SubjectID: 15710368, StudyID: 56676809, Comparison: same

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph of earlier the same date.

FINDINGS: There has been little change in the appearance of the chest since the previous study performed several hours earlier   Keywords: little change. Overall lung volumes are slightly increased, and there is slightly improved aeration at the left lung base. Please see separate report under clip ___for full description of radiographic findings.


SubjectID: 15710368, StudyID: 54005927, Comparison: None

FINAL REPORT

PORTABLE CHEST RADIOGRAPH OF ___

COMPARISONS: Chest radiographs dating between ___ and ___.

FINDINGS: There is now near-complete opacification of the right hemithorax, likely due to a combination of worsening right upper lobe pneumonia, right middle and right lower lobe collapse, and a pleural effusion. Known juxtahilar mass is obscured by these findings. Within the left lung, there is worsening diffuse heterogeneous opacification superimposed upon emphysema. It is uncertain whether this represents pulmonary edema or more widespread infection. Small-to-moderate left pleural effusion has slightly increased in size, but there is no evidence of pneumothorax. Focal area of radiodensity in the lower mediastinum is likely located within the esophagus given history of recent esophagram showing retained barium within the esophagus, proximal to the site of compression.


SubjectID: 15727523, StudyID: 55412318, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman s/p l ___, question ptx? // ? ptx on left? ? ptx on left?

IMPRESSION: In comparison with the earlier study of this date, there has been a left thoracentesis with removal of some pleural effusion periods no evidence of post procedure pneumothorax.


SubjectID: 15727523, StudyID: 53972364, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with pleural effusion // eval eval

IMPRESSION: In comparison with the study of ___, there is increase in the left pleural effusion with associated volume loss in the left lower lobe. No evidence of vascular congestion or acute pneumonia.


SubjectID: 15733157, StudyID: 58528720, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with pulmonary edema and heart failure exacerbation. // Interval change? Interval change?

IMPRESSION: In comparison with the study ___ ___, the endotracheal tube and nasogastric tube have been removed. There is still substantial enlargement of the cardiac silhouette with marked improvement in the pulmonary vascular status. The right hemidiaphragm is better seen, which could reflect decreasing pleural effusion or a more upright position of the patient. There is no evidence of superimposed pneumonia, though the region behind the heart cannot be evaluated in the absence of a lateral view.


SubjectID: 15733157, StudyID: 55868060, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with pna and heart failure exacerbation // Interval change? Interval change?

COMPARISON: Prior chest radiographs ___ through ___.

IMPRESSION: Severe left lower lobe atelectasis and moderate left pleural effusion both increased since ___. Moderate to severe cardiac enlargement stable over the past several days. No pulmonary edema in the upper lungs. Right jugular line ends in the low SVC. No pneumothorax.


SubjectID: 15733157, StudyID: 52499606, Comparison: None

FINAL REPORT

In

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF and ?PNA // Intubated Intubated

IMPRESSION: The study ___ ___, the monitoring and support devices are unchanged again there is enlargement of the cardiac silhouette with continued evidence of elevated pulmonary venous pressure, more prominent on the right. Continued obscuration of the right hemidiaphragm suggests some layering pleural effusion. Suggestion of a more coalescent region at the right base could possibly be a sign of developing pneumonia in the appropriate clinical setting. Given the pulmonary changes and the absence of a lateral view, the possibility of retrocardiac consolidation can certainly not be excluded.


SubjectID: 15733157, StudyID: 57448991, Comparison: None

FINAL REPORT

EXAMINATION: PORTABLE CHEST RADIOGRAPH

INDICATION: ___-year-old female with new central line placement.

TECHNIQUE: Frontal supine chest radiograph.

COMPARISON: Chest radiograph performed on outside institution approximately 3 hr prior to this exam.

FINDINGS: A new right-sided central line is present, ending in the lower SVC. There is no evidence of right-sided pneumothorax. There is also a new nasogastric tube which ends PG on the gastroesophageal junction, with the tip out of view. The endotracheal tube is seen appropriate position, unchanged from prior, 3 cm above the carina. Otherwise there is no significant change compared with radiographs performed 3 hr prior, with large confluent consolidations in the right lung, patchy diffuse consolidations in the left lung, moderate to severe cardiomegaly, and small left-sided pleural effusion.

IMPRESSION: New right-sided central line and nasogastric tube in appropriate position. No evidence of right-sided pneumothorax. Otherwise unchanged with radiograph performed 3 hr prior.


SubjectID: 15733157, StudyID: 53234969, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with acute CHF exacerbation and possible health care associated pneumonia. // evalute for interval change evalute for interval change

IMPRESSION: In comparison with the study of ___ from an outside facility, there has been a dramatic decrease in the diffuse bilateral pulmonary opacifications predominantly on the right   Keywords: decrease. This is consistent with substantial clearing of the asymmetric pulmonary edema. Mild residual opacification is seen and there is still enlargement of the cardiac silhouette. Monitoring and support devices are essentially unchanged.


SubjectID: 15741924, StudyID: 58794750, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: Chest radiograph from yesterday. CLINICAL

HISTORY: End-stage renal disease with congestive heart failure and pulmonary edema, assess interval change.

FINDINGS: PA and lateral views of the chest provided. There is improved aeration and resolving pulmonary edema   Keywords: resolving, improve. There persists bibasilar small effusions with consolidation in the retrocardiac region which could represent atelectasis or pneumonia. The heart size cannot be assessed. Mediastinal contour is stable. No pneumothorax. Dual-lead pacer is unchanged.

IMPRESSION: Improvement in pulmonary edema with residual bilateral small effusions and retrocardiac consolidation, likely atelectasis or pneumonia   Keywords: improve.


SubjectID: 15741924, StudyID: 57377635, Comparison: same

FINAL REPORT

HISTORY: ___ breathing pattern of unclear etiology. Evaluate for pulmonary cardiac process.

TECHNIQUE: Single portable AP radiograph of the chest.

COMPARISON: Multiple prior radiographs of the chest most recent ___. CT abdomen pelvis ___.

FINDINGS: Mild-to-moderate pulmonary edema is unchanged   Keywords: unchanged. Worsening opacities in the right lung base are concerning for possible pneumonia. Opacities at the left lung base are stable. Rounded, nonvascular structures scattered throughout the lung bases correspond to known pulmonary nodules which are partially evaluated on CT in ___. The cardiomediastinal silhouette and hilar contours are unchanged. There is no large pneumothorax. The right pectoral pacer has two leads terminating in expected location.

IMPRESSION: 1. Stable mild to moderate pulmonary edema   Keywords: stable. 2. Worsening opacities in the right lung base concerning for pneumonia. 3. Rounded pulmonary nodules bilaterally are partially evaluated on CT in ___. Results telephoned to Dr. ___ by Dr. ___ at 3:10 pm, ___, ___ min after discovery.


SubjectID: 15743778, StudyID: 56999724, Comparison: None

FINAL REPORT

INDICATION: ___ year old man s/p CABG, evaluate for interval change.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiographs from ___ through ___.

FINDINGS: Since prior, there has been a mild interval increase of the moderate left pleural effusion with associated atelectasis. Small right pleural effusion is stable. Cardiomediastinal silhouette is unchanged. There is no pneumothorax. Right IJ central venous catheter ends in the upper SVC.

IMPRESSION: Mild increase of left pleural effusion. Otherwise, stable exam.


SubjectID: 15743778, StudyID: 53256671, Comparison: None

FINAL REPORT

HISTORY: CT on waterseal.

FINDINGS: In comparison with the study of ___, with the chest tube on waterseal, there is no evidence of pneumothorax. Otherwise, little change in the appearance of the heart and lungs.


SubjectID: 15743778, StudyID: 51394029, Comparison: None

FINAL REPORT

HISTORY: CT removal.

FINDINGS: In comparison with the study of earlier in this date, all of the monitoring and support devices have been removed except for a right IJ sheath. Specifically, there is no evidence of pneumothorax after chest tube removal. Little change in the appearance of the heart and lungs.


SubjectID: 15750196, StudyID: 58376582, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: Ms. ___ is an ___ y/o patient with history of significant for newly diagnosed CLL, HTN, HLD, DMII, CVA and dementia presenting with dyspnea,hypoxia and confusion and was found to be FluA positive and possibly to be in heart failure exacerbation. // eval for CHF vs. Flu

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, there is unchanged evidence of mild to moderate pulmonary edema   Keywords: unchanged. A previously described opacity projecting over the left lung apex is no longer seen. Minimal retrocardiac atelectasis. Mild cardiomegaly. Mild elongation of the descending aorta. No pleural effusions. Known millimetric calcified right basolateral calcified granuloma.


SubjectID: 15750196, StudyID: 56310475, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with respiratory distress

TECHNIQUE: Upright AP view of the chest

COMPARISON: Chest CT ___ and chest radiograph ___

FINDINGS: Lungs are hyperinflated with flattening of the diaphragms. Heart size is normal. Aortic knob calcifications are present. Mediastinal contour is unremarkable. There is mild perihilar haziness and vascular indistinctness compatible with mild pulmonary edema. No focal consolidation, pleural effusion or pneumothorax is demonstrated. 7 mm nodular opacity within the left apex appears new in the interval. Hypertrophic changes are demonstrated within the thoracic spine.

IMPRESSION: Mild pulmonary edema. 7 mm nodular opacity projecting over the left apex, not clearly demonstrated on the previous exams. This can be further assessed with a chest CT on a nonemergent basis.


SubjectID: 15752803, StudyID: 59280829, Comparison: None

FINAL REPORT

INDICATION: Status post mini Maze. Evaluate for pulmonary edema.

TECHNIQUE: Single frontal view of the chest was obtained.

COMPARISON: ___.

FINDINGS: Right-sided IJ central venous catheter sheath is seen, with the tip in the superior portion of the SVC. A right-sided drainage catheter is seen, perhaps a mediastinal drain vs chest tube. A left-sided chest tube or mediastinal drain is also seen. The patient has been extubated in the interval. No pneumothorax. A curvilinear radiopacity projecting over the left side of the heart is of uncertain significance, perhaps outside of the patient, but should be correlated clinically. It is in a slightly different location than on the prior radiograph. Pulmonary vascular markings are slightly more prominent than on the prior examination, perhaps indicating slight pulmonary edema. Retrocardiac opacity likely relates to atelectasis.

IMPRESSION: Probable pulmonary edema. Curvilinear radiopacity over the left side of the heart, of uncertain significance and location radiographically from this single view, but unchanged since the prior study.


SubjectID: 15752803, StudyID: 51109810, Comparison: better

FINAL REPORT

HISTORY: Status post mini-maze, evaluate for effusion. CHEST, TWO VIEWS There are low inspiratory volumes. A metallic clamp overlies the left heart. The cardiomediastinal silhouette is enlarged but unchanged. There is borderline upper zone redistribution, but no overt CHF. There is atelectasis at the left base. Apparent linear atelectasis or scarring in the left lung laterally. The right hemidiaphragm is elevated. There is also a small right effusion and some atelectasis at the right base. Small rounded metallic density is again seen over the right upper chest, now actually outside the chest overlying the scapula, ? BB within the patient.

IMPRESSION: 1) Suspect slight improvement in CHF findings, with slightly more atelectasis at the right lung base   Keywords: improve. Otherwise, the findings are overall similar to the radiograph from chest x-ray from ___ at 9:13 a.m. 2) Suspected BB adjacent to the right upper chest -- this may lie inside the patient. Prior film suggsted the presence of a similar "BB".


SubjectID: 15752803, StudyID: 51358448, Comparison: None

FINAL REPORT

HISTORY: Atrophic relation, left lower lobe crackles concerning for pneumonia.

COMPARISON: Comparison is made with chest radiographs from ___ in ___.

FINDINGS: The lungs are well expanded. Bibasliar opacities are again seen, improved from prior exam and likely reflecting resolving atelectasis. There are small pleural effusions bilaterally, similar to prior exam, with a component of loculated pleural effusion seen on the left. There is no pneumothorax. The cardiomediastinal silhouette is mildly increased in size.

IMPRESSION: 1. Bibasliar opacities improved from prior exam and likely reflecting resolving atelectasis. 2. Small pleural effusions bilaterally, similar to prior exam, with a component of loculated pleural effusion seen on the left.


SubjectID: 15754509, StudyID: 59749370, Comparison: None

FINAL REPORT

HISTORY: Patient with COPD and bilateral pleural effusions, assess for pleural effusions.

COMPARISON: ___.

FINDINGS: Frontal and lateral chest radiographs were obtained. The left subclavian line has been removed as well as the NG tube. There are persistent moderate bilateral pleural effusions with the right effusion slightly increased in size compared to prior study. Unchanged compressive atelectasis at bilateral lung bases. The cardiomediastinal silhouette and hilar contours are stable. There is no pneumothorax.

IMPRESSION: Persistent moderate bilateral pleural effusions with right slightly increased in size compared to prior study. Compressive atelectasis at bilateral bases.


SubjectID: 15754509, StudyID: 53577183, Comparison: same

FINAL REPORT

AP CHEST, 6:12 A.M., ___

HISTORY: Gastric resection. Multiple intestinal perforations. Right thoracentesis. Question mucous plug.

IMPRESSION: AP chest compared to ___: Moderate right pleural effusion slightly smaller. Small-to-moderate left pleural effusion and mild interstitial edema both unchanged   Keywords: unchanged. No pneumothorax. The right pigtail catheter is folded several times at mid level in the right hemithorax and could be partially occluded. Right lower lobe is partially obscured by the heart because of patient rotation. There is some volume loss, but none appreciably changed since ___ Left lung is fully expanded and right upper and middle lobes are not atelectatic.


SubjectID: 15754509, StudyID: 52507432, Comparison: None

FINAL REPORT

CHEST ON ___ AT ___

HISTORY: Check Dobbhoff placement. REFERENCE EXAM: ___ at ___.

FINDINGS: The Dobbhoff tube enters the stomach and then has a sharp kink within it with the tip pointed upwards. This should be advanced prior to use. The appearance of the lungs is unchanged.


SubjectID: 15754509, StudyID: 59385047, Comparison: None

FINAL REPORT

HISTORY: Diaphragmatic perforation and pneumothorax after repair, to assess for interval change.

FINDINGS: In comparison with the earlier study of this date, there is again extensive subcutaneous gas with the monitoring and support devices in place. Bibasilar opacifications are consistent with atelectatic change and probable right effusion as well as some elevated pulmonary vascular pressure. Apices are somewhat difficult to evaluate due to overlying bony structures. Although not optimally seen, there appears to be a right pleural line consistent with a small pneumothorax. Small pneumoperitoneum is probably persisting.


SubjectID: 15754509, StudyID: 54513165, Comparison: None

FINAL REPORT

HISTORY: Patient with perforated jejunum and diaphragm, status post repair, evaluate interval change.

COMPARISON: ___.

FINDINGS: Portable single frontal chest radiograph was obtained with the patient in semi-upright position. Support and monitoring devices are in their appropriate positions and unchanged. A left chest tube is in place with the tip projecting over the left apex. There is no pneumothorax. There are increased bibasilar opacities with small bilateral pleural effusions. The cardiomediastinal silhouette is stable. There is again extensive subcutaneous emphysema involving the neck and the entire chest. Pneumoperitoneum is less well seen. There is an old left humeral head fracture.

IMPRESSION: 1. Left chest tube in place without pneumothorax. 2. Increased bibasilar opacities with small bilateral pleural effusion, likely secondary to overhydration. 3. Stable extensive subcutaneous emphysema with improvement in pneumoperitoneum.


SubjectID: 15754509, StudyID: 50980203, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Colonic perforation, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has been extubated. The left chest tube and the central venous access line as well as the feeding tube are in unchanged position. There is unchanged evidence of relatively severe right pleural effusion and a small left pleural effusion. In addition to the known apical left pneumothorax seen on the previous exam, this known pneumothorax now also has a subtle lateral component along the bases of the left lateral chest wall. There is no evidence of tension. The slight mediastinal shift to the right as well as the areas of atelectasis at both lung bases are unchanged. Unchanged massive destructive changes at the level of the left shoulder. Unchanged bilateral air collection in the soft tissues. The size of the cardiac silhouette is constant.


SubjectID: 15754509, StudyID: 54212311, Comparison: None

FINAL REPORT

HISTORY: ___ year old woman with ptx s/p ct, bowel injury recently extubated, copd .

COMPARISON: Exam is compared to chest x-ray of ___.

FINDINGS: The left apical pneumothorax is reduced. The lungs are persistently hyperinflated for severe emphysema. The right bibasilar pleural effusion has mildly increased. Heart size is stable. Left humeral head fracture.

IMPRESSION: Reduced left apical pneumothorax, with increased bibasilar pleural effusion


SubjectID: 15754509, StudyID: 54002300, Comparison: same

FINAL REPORT

TYPE OF

EXAMINATION: Chest AP portable single view.

INDICATION: ___-year-old female patient status post chest tube removal, evaluate for interval change.

FINDINGS: AP single view of the chest has been obtained with patient in semi-upright position. The patient is moderately rotated to the right in similar position as on the next preceding chest examination obtained 10 hours earlier during the same day. During the interval, the left-sided chest tube has been removed. There is a small less than 1 cm wide apical pneumothorax, but the lungs remain well aerated. No other interval change can be seen   Keywords: no other interval change. Unchanged appearance of pleural effusion on the bases.


SubjectID: 15754509, StudyID: 51174503, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: Chest AP portable single view.

INDICATION: ___-year-old female patient with pneumothorax, evaluate for interval change.

FINDINGS: AP single view of the chest has been obtained with patient in semi-upright position. Similar as on the preceding examination of ___, the patient is tilting towards the right. The previously identified minimal apical pneumothorax on the left side has further reduced and is less than 1 cm. Thus left lung appears well aerated and expanded. Bilateral basal pleural effusion remain rather unchanged. No new parenchymal abnormalities.


SubjectID: 15754509, StudyID: 53903781, Comparison: None

FINAL REPORT

HISTORY: Desaturation to mid 70s, on oxygen, rule out pneumothorax. CHEST, SINGLE AP PORTABLE VIEW. There is markedly rotated positioning. Allowing for this, no pneumothorax is detected. Probable prominence of the cardiomediastinal silhouette, similar to ___. There is upper zone re-distribution, mild diffuse vascular blurring, small bilateral effusions and underlying collapse and/or consolidation, consistent with CHF. The lungs are hyperinflated, suggesting background COPD. Surgical clips overlie the lower chest and upper abdomen in the midline. Surgical ___ are also present over the upper abdomen in the midline. An NG tube is present, tip extending beneath diaphragm off film. The sideport appears to lie in the region of GE junction. A left subclavian central line is present, tip over mid/distal SVC. Irregular lucency overlying the right shoulder may represent subcutaneous emphysema -- this was better seen on the ___ radiograph. Deformity of the left proximal humerus again noted.

IMPRESSION: 1. Cardiomegaly and probable background COPD. 2. CHF with bilateral effusions and underlying collapse and/or consolidation. 3. No pneumothorax detected.


SubjectID: 15754509, StudyID: 53245740, Comparison: None

FINAL REPORT

HISTORY: Patient with increasing oxygen requirements, history of COPD, assess for atelectasis versus consolidation.

COMPARISON: ___.

FINDINGS: Frontal and lateral chest radiographs were obtained. A left subclavian central line terminates in the mid SVC. There are persistent small-to-moderate bilateral pleural effusions with compressive atelectasis. The cardiomediastinal silhouette and hilar contours are stable. There is no pneumothorax. Left humeral head fracture is again noted.

IMPRESSION: Unchanged bilateral small-to-moderate pleural effusions with compressive atelectasis.


SubjectID: 15754509, StudyID: 51429004, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with new O2 requirement admitted for c diff colitis // assess interval change

COMPARISON: ___

IMPRESSION: No relevant change as compared to the previous examination   Keywords: no relevant change. Minimal pleural effusions could be present bilaterally. Severe scoliosis. Normal size of the cardiac silhouette. Minimal atelectasis at the left lung bases but no overt pulmonary edema or pneumonia.


SubjectID: 15754509, StudyID: 50885366, Comparison: None

FINAL ADDENDUM ADDENDUM Discussed with Dr ___ ___ the phone by Dr. ___ at the time of dictation. Findings were made ___ min prior to that ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with c diff colitis // r/o pulmonary edema or interval change

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Right mediastinal shift is unchanged, most likely related to prior right lobectomy. There is interval development of right lower lobe aunts left perihilar and lower lobe opacities that might potentially reflect gradual development of pulmonary edema. Infectious process is another possibility. There is most likely present small amount of pleural effusion. A right apical pneumothorax is present, small.


SubjectID: 15760834, StudyID: 54261736, Comparison: same

FINAL REPORT

HISTORY: CHF, to assess for change.

FINDINGS: In comparison with the earlier study of this date, there is continued cardiomegaly with vascular congestion and bilateral layering pleural effusions with compressive atelectasis at the bases   Keywords: continue. Probably little overall change given the difference between the PA and portable studies   Keywords: little overall change.


SubjectID: 15760834, StudyID: 50032803, Comparison: None

FINAL REPORT

INDICATION: Evaluation of patient with swelling and history of congestive heart failure.

COMPARISON: Chest radiograph from ___.

FINDINGS: The cardiac silhouette is moderately enlarged and slightly bigger than before. Bilateral small pleural effusions are increased in comparison to prior study from ___. No focal consolidation or pneumothorax, but bilateral atelectatic changes are visualized with pleural effusions. No acute fractures identified.

IMPRESSION: 1. Moderate cardiomegaly, increased in comparison to the prior study. Pericardial effusion could be present. 2. Bilateral small pleural effusions, also increased in size in comparison to the prior study.


SubjectID: 15765403, StudyID: 59520514, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with chronic resp failure and new increase in WBC // Evidence of pneumonia

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Moderate to severe cardiomegaly and enlargement of the main pulmonary artery are stable. Right lower lobe consolidation is worsened could represent pneumonia superimposed to a large area of previously seen collapse. Right upper lobe consolidation is better seen on prior CT. Large atelectasis in the left lower lobe medially is unchanged. . ET tube is in standard position. Left PICC tip is in the mid to lower SVC. There is no pneumothorax. There is no pleural effusion.


SubjectID: 15765403, StudyID: 56660920, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with VAP // eval for worsening pneumonia

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: Moderate cardiomegaly and enlargement of the main pulmonary artery are stable. There is bilateral lower lobe volume loss and infiltrate, slightly increased compared to prior . Right upper lobe consolidation is also slightly increased. Large . Tracheostomy tube is in standard position. Left PICC tip is in the upper SVC. There is no pneumothorax. Are probable small bilateral pleural effusions.

IMPRESSION: Slightly worse appearance to the chest


SubjectID: 15765403, StudyID: 58681490, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with COPD, OSA, PNA, OHS who p/w hypercarbia and hypoxemia s/p intubation. // Please assess for interval change Please assess for interval change

IMPRESSION: Comparison to ___. No relevant change is noted   Keywords: no relevant change. Low lung volumes. Moderate cardiomegaly. Mild fluid overload. Retrocardiac atelectasis. Stable monitoring and support devices. No new focal parenchymal abnormalities.


SubjectID: 15765403, StudyID: 55980507, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF, COPD, intubated for hypercarbic respiratory failure. // ?worsening pulmonary edema or pneumonia ?worsening pulmonary edema or pneumonia

IMPRESSION: Compared to chest radiographs ___ 7. Progressive consolidation, right lower lung could be dependent pulmonary edema, in the setting of severe cardiomegaly hilar and mediastinal vascular engorgement or, alternatively, pneumonia. Left lower lobe consolidation which developed on ___ is probably collapse. No pneumothorax. ET tube in standard placement. Esophageal drainage tube passes into the stomach and out of view.


SubjectID: 15765403, StudyID: 55831954, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with COPD, HFpEF, ESRD, OSA presenting with hypoxemia // worsening edema?

IMPRESSION: In comparison to ___ chest radiograph, confluent opacities in the right middle and right lower lobes are no longer evident. Pulmonary edema has improved   Keywords: improve. Cardiomediastinal contours are difficult to assess due to marked rightward patient rotation.


SubjectID: 15765403, StudyID: 54416168, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hypercarbic respiratory failure now s/p intubation in the MICU. // Assess for interval changes and ET tube placement.

IMPRESSION: In comparison to the prior radiograph from 2 hr earlier, an endotracheal tube is been placed, terminating 5.2 cm above the carina, and a nasogastric tube is been placed, with the tip extending at least into the stomach, beyond the field of view. No other relevant change   Keywords: no other relevant change.


SubjectID: 15765403, StudyID: 51253828, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with COPD, CHF intubated for hypercarbic respiratory failure // ?Worsening pulmonary edema or pneumonia ?Worsening pulmonary edema or pneumonia

IMPRESSION: ET tube tip is 5 cm above the carinal. NG tube passes below the diaphragm most likely terminating in the stomach. Cardiomediastinal silhouette is unchanged including cardiomegaly. There is mild pulmonary edema and potentially left retrocardiac atelectasis and pleural effusion. There is no pneumothorax PE


SubjectID: 15765403, StudyID: 57682368, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with chronic respiratory failure, now s/p trach replacement, also with worsening secretions (already on VAP treatment) // ? placement of new trach, also ? evolving pneumonia (now has more secretions) ? placement of new trach, also ? evolving pneumonia (now has more secretions)

IMPRESSION: In comparison with the study ___ ___, the endotracheal tube is been removed and replaced with a tracheostomy. No evidence of pneumothorax or pneumo mediastinum. Little overall change in the appearance of the heart and lungs.


SubjectID: 15765403, StudyID: 57313176, Comparison: None

WET READ: ___ ___ ___ 9:59 PM In comparison to the examination from 17 hours prior, there appears to be increase in a left basilar opacity ; otherwise largely stable examination given differences in technique. The endotracheal tube terminates approximately cm above the carina. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman currently intubated, with acute hypoxia. // Please evaluate for interval change. Please evaluate for interval change.

IMPRESSION: In comparison to the examination from 17 hours prior, there appears to be increase in a left basilar opacity ; otherwise largely stable examination given differences in technique. The endotracheal tube terminates approximately cm above the carina.


SubjectID: 15765403, StudyID: 55154898, Comparison: same

WET READ: ___ ___ ___ 7:18 AM The endotracheal tube now terminates 4 cm above the carina. Otherwise, unchanged examination from 1 hour prior.

WET READ VERSION #1 ___ ___ ___ 9:50 PM The endotracheal tube now terminates 4 cm above the carina. Otherwise, unchanged examination from 1 hour prior. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with ET tube advancement. // Please evaluate location of ET tube. Please evaluate location of ET tube.

IMPRESSION: In comparison with the earlier study of this date, the tip of the endotracheal tube is approximately 4 cm above the carina. Otherwise little change from the study of 1 hr previously   Keywords: little change.


SubjectID: 15765403, StudyID: 54029342, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with chronic respiratory failure, with tracheostomy, being treated for VAP but with progressive hypoxemia // please evaluate for worsening of infectious process please evaluate for worsening of infectious process

IMPRESSION: Tracheostomy is in place. Left central venous line tip is at the cavoatrial junction. Cardiomegaly is unchanged. Prominence of the main pulmonary artery consistent with pulmonary hypertension is unchanged. Right basal consolidation has minimal improved. Bilateral pleural effusions are present, small.


SubjectID: 15765403, StudyID: 52781862, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with history of VAP, with new secretions and concern for re-development of VAP. // Please evaluate for new development of pneumonia.

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: In comparison with the study from ___, there is mildly increased pulmonary edema   Keywords: increase. Moderate cardiomegaly is unchanged. Bilateral small pleural effusions and bibasilar atelectasis persist. There has been interval placement of a left PICC terminating in the distal SVC. Tracheostomy is unchanged in position. No pneumothorax.

IMPRESSION: Mildly increased pulmonary edema   Keywords: increase. Interval placement of a left PICC terminating in the distal SVC. No pneumothorax.


SubjectID: 15765403, StudyID: 51276768, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with repeated desats while intubated // repeated desaturations to 80s while intubated, concern re progress of consolidations seen on previous imaging repeated desaturations to 80s while intubated, concern re progress of consolidations seen on previous imaging

IMPRESSION: In comparison with the study ___ ___, there is little overall change   Keywords: little overall change. Endotracheal tube remains in good position. Substantial enlargement of the cardiac silhouette is again seen with some elevation of pulmonary venous pressure. Bibasilar opacification with obscuration of the hemidiaphragm is consistent with pleural effusions and compressive basilar atelectasis. In the appropriate clinical setting, the possibility of superimposed pneumonia would be impossible to exclude, especially in the absence of a lateral view.


SubjectID: 15765403, StudyID: 56725877, Comparison: worse

FINAL REPORT

INDICATION: ___F with COPD presenting from nursing home with hypoxia to 80s and weakness. endorses dry cough and chills. Wheezes on exam, evaluate for pneumonia.

TECHNIQUE: Chest PA and lateral

COMPARISON: Multiple prior chest radiographs dating back to ___.

FINDINGS: Cardiomegaly, pulmonary vascular congestion, and mild interstitial pulmonary edema have increased from the prior study   Keywords: increase. Airspace opacity within the right lower and right middle lobes is concerning for superimposed pneumonia. There is no pneumothorax or pleural effusion.

IMPRESSION: 1. Right lower lobe and right middle lobe opacities are concerning for infectious pneumonia. 2. Interval worsening moderate pulmonary vascular congestion and mild pulmonary edema   Keywords: worse.

NOTIFICATION: The findings were discussed with ___, M.D. by ___ ___, M.D. on the telephone on ___ at 4:25 PM, ___ minutes after discovery of the findings.


SubjectID: 15765403, StudyID: 54611938, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with VAP // Interval change of chest infiltrates

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: The heart is severely enlarged, and is larger than on the prior study. There is no significant change in the tracheostomy tube or PICC line. There is marked improvement in the aeration in the right lower lobe, however there is some persistent alveolar infiltrate in the right lower lobe. The right heart border is very distinctly visualized suggesting that there may be a small amount of pneumomediastinum. The right effusion is decreased. There is increased obscuration of the left hemidiaphragm with dense retrocardiac opacity compatible with volume loss/infiltrate/effusion. This is worsened compared to the study from 2 days ago.

IMPRESSION: Increased cardiomegaly, some improved aeration in the right lower lobe but worsened appearance to a left lower lobe. Sharp margin of the right heart border suggests an element of pneumomediastinum


SubjectID: 15765403, StudyID: 55713586, Comparison: None

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old woman with hypoxemic respiratory failure s/p trach now with concern for left lower lobe atelectasis. // Please ensure proper positioning (as much as possible) to assess for left lower lobe collapse

TECHNIQUE: Portable AP chest

COMPARISON: Portable chest radiograph obtained 3 hours prior

FINDINGS: The tip of the left PICC now follows an abnormal opacities are essentially unchanged, but there is no evidence of midline shift. No new focal opacity. Increased and more conspicuous appearing left basilar opacities. Small left pleural effusion is plausible. Mild cardiomegaly and prominent pulmonary arteries are unchanged.

IMPRESSION: 1. Abnormal course of the left PICC, now terminating in the azygos or directly abutting the lateral wall of the SVC. 2. Persistent left basilar opacities, now more conspicuous and concerning for pneumonia.

NOTIFICATION: The findings were discussed with ___, M.D. by ___, M.D. on the telephone on ___ at 5:31 PM, minutes after discovery of the findings.


SubjectID: 15765403, StudyID: 54242990, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with respiratory failure with trach/PEG now with PICC placement with malposition, reassess for reposition // PICC placement? PICC placement?

IMPRESSION: Comparison to ___. The PICC line has been pulled back. The line now projects over the midline of the patient, at the level of the brachiocephalic vein. To be positioned at the cavoatrial junction, the line needs to be advanced by approximately 8 cm. No pneumothorax or other complications.


SubjectID: 15765403, StudyID: 52739352, Comparison: same

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old woman with left PICC // Repeat CXR to confirm L PICC placement

TECHNIQUE: Portable AP chest

COMPARISON: Portable chest radiograph obtained 2 hours prior.

FINDINGS: A left PICC is likely terminates at the confluence of the brachiocephalic vein and SVC. Increased retrocardiac opacity and apparent leftward mediastinal shift suggests increasing left lower lobe atelectasis. Otherwise, no significant change compared to 2 hours prior   Keywords: no significant change.

IMPRESSION: 1. A left PICC likely terminates at the confluence of the left brachiocephalic vein and SVC. 2. Increased retrocardiac opacity and apparent leftward mediastinal shift suggests increasing left lower lobe atelectasis. Superimposed infection cannot be ruled out. Recommend follow-up radiographs ensuring optimum patient positioning.

NOTIFICATION: The findings were discussed with ___, M.D. by ___, M.D. on the telephone on ___ at 2:51 PM, approximately 20 minutes after discovery of the findings.


SubjectID: 15765403, StudyID: 55297409, Comparison: None

FINAL REPORT

INDICATION: ___F with dyspnea // infiltrate?

TECHNIQUE: Frontal and lateral views of the chest.

COMPARISON: ___.

FINDINGS: Cardiac silhouette is enlarged. There is central pulmonary vascular engorgement and indistinct pulmonary vascular markings. There is no effusion or focal consolidation. No acute osseous abnormalities identified.

IMPRESSION: Cardiomegaly and mild pulmonary edema.


SubjectID: 15765403, StudyID: 51015429, Comparison: None

WET READ: ___ ___ ___ 8:30 AM Low lung volumes. Continued prominence of interstitial markings with cardiomegaly, likely due to pulmonary edema.

WET READ VERSION #1 ___ ___ ___ 8:25 PM Low lung volumes. Continued prominence of interstitial markings with cardiomegaly, likely due to pulmonary edema. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman ESRD on HD with worsening dyspnea and oxygen requirement, febrile, please eval for PNA // please eval for PNA please eval for PNA

COMPARISON: Comparison to ___ at 12:56

FINDINGS: Portable upright chest ___ at 18:14 is submitted.

IMPRESSION: The heart remains enlarged which may reflect cardiomegaly or pericardial effusion. Overall mediastinal contours are stable. There continues to be mild to moderate pulmonary and interstitial edema. There is likely a layering left effusion. No pneumothorax is seen.


SubjectID: 15765403, StudyID: 54594366, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with osa // eval for pulm congestion

COMPARISON: ___.

FINDINGS: Exam is limited by marked could patient rotation and low lung volumes. These factors accentuate the cardiomediastinal contours, limiting assessment. Pulmonary vascular congestion is accompanied by persistent edema   Keywords: persistent. At apparently new confluent opacity is seen in the periphery of the left lung base and may be due to a focal pleural and or parenchymal process in this region, but is difficult to assess in the setting of marked rotation. Repeat nonrotated radiograph would be helpful in this regard.


SubjectID: 15775412, StudyID: 55529631, Comparison: worse

FINAL REPORT

INDICATION: ___ -year-old male with weakness, confusion. Evaluate for infiltrate.

TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position.

COMPARISON: Radiographs from ___ and ___.

FINDINGS: The heart continues to be enlarged, and low lung volumes accentuate the bronchovascular markings. There is mild pulmonary edema, increased from prior exam, and no pleural effusions or focal consolidations are seen   Keywords: increase. There is chronic deformity of the left clavicle.

IMPRESSION: Cardiomegaly with mild pulmonary edema, increased from prior exam of ___   Keywords: increase.


SubjectID: 15775412, StudyID: 53589433, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hx of HFrEF, recent daignosis of PNA, here with AMS, concern for volume overload // volume overload, opacity

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Heart size is enlarged, unchanged. Slight interval progression of bibasilar opacities   Keywords: progression. There is no pulmonary edema. No interval increase in pleural effusion demonstrated.


SubjectID: 15775412, StudyID: 52364954, Comparison: None

WET READ: ___ ___ ___ 2:59 PM 1. Left IJ CVL tip within the left brachiocephalic vein. 2. Persistent small to moderate left pleural effusion with retrocardiac opacity likely combination of atelectasis and pleural effusion however cannot exclude superimposed pneumonia in the appropriate clinical setting. 3. Additional support lines and tubes as described above. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: Chest radiograph.

INDICATION: ___M with cvl placement. Assess left IJ central venous line.

COMPARISON: Chest radiograph ___, ___, ___.

FINDINGS: Single portable supine frontal chest radiograph demonstrates an enteric feeding tube coursing mid line with tip out of field of view. An endotracheal tube is in appropriate position with tip 3.5 cm above the level of the carina. Interval placement of a left internal jugular central venous catheter with tip at the left brachiocephalic vein just proximal to the confluence. Persistently hypoinflated lungs with vascular crowding and right lower lobe atelectasis. No pneumothorax. Persistent small to moderate left pleural effusion with retrocardiac opacity. Aortic arch calcifications noted. Mediastinal contour and hila are otherwise unremarkable.

IMPRESSION: 1. Left IJ CVL tip within the left brachiocephalic vein. 2. Persistent small to moderate left pleural effusion with retrocardiac opacity likely combination of atelectasis and pleural effusion however cannot exclude superimposed pneumonia in the appropriate clinical setting. 3. Additional support lines and tubes as described above.


SubjectID: 15775412, StudyID: 52345531, Comparison: None

WET READ: ___ ___ ___ 11:13 AM 1. Interval increase in small to moderate left pleural effusion with retrocardiac opacity likely representing a combination of atelectasis and pleural effusion however cannot exclude superimposed pneumonia in the appropriate clinical setting. 2. Heterogeneous opacity projecting over the left mid hemi thorax is most likely a combination of atelectasis and vascular crowding. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: Chest radiograph.

INDICATION: ___M with altered mental status and hypotension. Assess for pneumonia.

COMPARISON: Chest radiograph ___, ___, ___.

FINDINGS: Single portable semi upright frontal chest radiograph demonstrates persistently hypoinflated lungs with vascular crowding and right lower lobe atelectasis. No pneumothorax. No right pleural effusion. Interval increase in small to moderate left pleural effusion with retrocardiac opacity. New heterogeneous opacity projecting over the left mid hemi thorax. Persistent mild cardiomegaly which is partially obscured by left pleural effusion. Aortic arch calcifications noted. Mediastinal contour and hila are otherwise unremarkable. Chronic deformity of the left clavicle again noted.

IMPRESSION: 1. Interval increase in small to moderate left pleural effusion with retrocardiac opacity likely representing a combination of atelectasis and pleural effusion however cannot exclude superimposed pneumonia in the appropriate clinical setting. 2. Heterogeneous opacity projecting over the left mid hemi thorax is most likely a combination of atelectasis and vascular crowding.


SubjectID: 15775412, StudyID: 51973398, Comparison: None

WET READ: ___ ___ ___ 8:10 AM As compared to the prior studies from ___, there is persistent retrocardiac opacity which is likely a combination of pleural effusion and atelectasis. However, consolidation secondary to pneumonia cannot be excluded. The endotracheal tube has been pulled back and is a peripherally position. Left IJ CVL and OG tube unchanged.

WET READ VERSION #1 ___ ___ 8:09 PM As compared to the prior studies from ___, there is persistent retrocardiac opacity which is likely a combination of pleural effusion and atelectasis. However, consolidation secondary to pneumonia cannot be excluded. The endotracheal tube has been pulled back and is a peripherally position. Left IJ CVL and OG tube unchanged. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with CAD, sCHF, moderate-severe MR, and PAH, recently discharged from ___ for CAP PNA, who p/w AMS in setting of fall, and is found to have lactate 8.6. // Any interval change after ET tube replaced? Any interval change after ET tube replaced?

IMPRESSION: In comparison with the study of ___, there is again increasing an cardiac size with mild elevation of pulmonary venous pressure. Retrocardiac opacification is consistent with volume loss in the left lower lobe associated with pleural effusion. Nevertheless, in the appropriate clinical setting, a superimposed pneumonia would have to be considered. The endotracheal tube tip lies approximately 4 cm above the carina. Nasogastric tube coils in the upper stomach.


SubjectID: 15775412, StudyID: 51232452, Comparison: None

WET READ: ___ ___ 1:07 PM 1. Endotracheal tube in appropriate position. Enteric feeding tube coursing mid line with tip out of field of view. 2. Small to moderate left pleural effusion with retrocardiac opacity likely representing combination of atelectasis and pleural effusion however cannot exclude superimposed pneumonia in the appropriate clinical setting. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: Chest radiograph.

INDICATION: ___M intubated. Assess endotracheal tube and OGT appeared

COMPARISON: Chest radiograph ___, ___, ___.

FINDINGS: Single portable supine frontal chest radiograph demonstrates interval placement of endotracheal tube 2.7 cm above the level of the carina. An enteric feeding tube is seen coursing mid line with tip out of field of view. Persistently hypoinflated lungs with vascular crowding and right lower lobe atelectasis. No pneumothorax. Persistent small to moderate left pleural effusion with retrocardiac opacity and mild cardiomegaly which is partially obscured by left pleural effusion. Aortic arch calcifications noted. Mediastinal contour and hila are otherwise unremarkable. Chronic deformity of the left clavicle again noted.

IMPRESSION: 1. Endotracheal tube in appropriate position. Enteric feeding tube coursing mid line with tip out of field of view. 2. Small to moderate left pleural effusion with retrocardiac opacity likely representing combination of atelectasis and pleural effusion however cannot exclude superimposed pneumonia in the appropriate clinical setting.


SubjectID: 15775412, StudyID: 50321367, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with CAD, sCHF, moderate-severe MR, and PAH, recently discharged from ___ for CAP PNA, who p/w AMS in setting of fall, and is found to have lactate 8.6. // Any interval change? Any interval change?

IMPRESSION: In comparison with the study of ___, the monitoring and support devices are essentially unchanged. This again substantial enlargement of the cardiac silhouette with some elevation of pulmonary venous pressure. Bilateral pleural effusions with compressive basilar atelectasis, more prominent on the left.


SubjectID: 15775412, StudyID: 50767478, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with intubation // eval ? interval changes eval ? interval changes

IMPRESSION: In comparison with the study of ___, the monitoring and support devices are essentially unchanged. Continued enlargement of the cardiac silhouette though the pulmonary vascularity has decreased. Continued left pleural effusion with volume loss in the lower lung. The right base appears essentially clear on this study.


SubjectID: 15782217, StudyID: 59486931, Comparison: better

FINAL REPORT

INDICATION: ___F with dyspnea // r/o pna

TECHNIQUE: Single portable view of the chest.

COMPARISON: ___.

FINDINGS: Prominence of the interstitial markings has improved since prior but persists   Keywords: improve. There is no consolidation or large effusion. The cardiomediastinal silhouette is stable. Old healed left lateral rib fractures are noted. Kyphoplasty changes in the lower thoracic spine is noted.

IMPRESSION: Mild pulmonary edema.


SubjectID: 15782217, StudyID: 56586972, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with pulmonary edema, worsening hypoxia // interval change interval change

IMPRESSION: Comparison to ___. Unchanged evidence of moderate cardiomegaly with elongation of the descending aorta. No signs indicative of pulmonary edema. Mild right basal atelectasis. No pleural effusions. No pneumonia.


SubjectID: 15782217, StudyID: 51133819, Comparison: better

FINAL REPORT

EXAMINATION: Chest radiograph.

INDICATION: ___ year old woman with NHL, sCHF, asthma and afib presenting with afib with RVR now with SOB, productive cough, and wheezing on exam, assess for pulmonary edema vs. PNA

TECHNIQUE: Portable chest radiograph.

COMPARISON: Chest radiograph ___.

FINDINGS: Pulmonary edema has resolved since yesterday   Keywords: resolve. Moderate cardiomegaly persists, with significant left atrial enlargement. There is no pleural effusion or pneumothorax. There is no focal lung consolidation. Compared to prior examination, mild to moderate interstitial edema has resolve   Keywords: resolve.

IMPRESSION: Resolution of interstitial edema.


SubjectID: 15782217, StudyID: 52544573, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with worsening severe AS // interval changes

COMPARISON: Chest x-ray from ___ at 11:42

FINDINGS: Allowing for differences in technique, I doubt significant interval change. Again seen is cardiomegaly, with upper zone redistribution, but no overt CHF. Minimal bibasilar atelectasis, without frank consolidation. Possible minimal blunting of the right costophrenic angle which, if real, is new. Old healed left sided rib fractures again noted. Irregular density overlying a compressed vertebral body in the region of the thoracolumbar junction is compatible with vertebroplasty with extruded cement, better visualized on CT from ___.

IMPRESSION: Equivocal minimal blunting of the right costophrenic angle. Otherwise, I doubt significant interval change.


SubjectID: 15782217, StudyID: 53495611, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Atrial fibrillation.

COMPARISONS: ___.

TECHNIQUE: Chest, AP upright.

FINDINGS: The cardiac, mediastinal and hilar contours appear stable allowing for differences in technique. There is a vague rounded opacity projecting over the right lower lung, not clearly visualized on the recent prior study, although this may be due to differences in orientation of image acquisition. Peribronchial cuffing and interstitial thickening could be seen with mild vascular congestion or possibly other conditions such as airway inflammation or atypical infection. Regarding the focal right lower lung opacity, one concern is a possible mass. There is no pleural effusion or pneumothorax.

IMPRESSION: 1. Mild interstitial abnormality, new since the prior study   Keywords: new. Correlation with clinical findings is suggested. The findings would be compatible with pulmonary vascular congestion. 2. Focal right lower lung opacity, vague and possible new over the short interval, but somewhat rounded, suggesting infectious consolidation versus mass. Depending on clinical circumstances, if infection is suspected, then short-term follow-up radiographs, preferably with standard PA and lateral technique, if possible, are recommended, and otherwise short-term chest CT.


SubjectID: 15782217, StudyID: 52815827, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST, ___ AT 15:13 CLINICAL

INDICATION: ___-year-old with productive cough. Evaluate for pneumonia. Comparison is made to the patient's previous study dated ___.

IMPRESSION: The heart remains stably enlarged, likely reflecting cardiomegaly. The interstitium remains slightly prominent, reflecting age-related changes or small airways disease. No focal airspace consolidation is seen to suggest pneumonia. No pulmonary edema. Mediastinal contours are unchanged. No pneumothorax. There is deformity of the left lateral rib cage, likely reflecting remote trauma. In addition, there is evidence of vertebroplasty of one of the lower thoracic vertebrae. No acute bony abnormality is appreciated. The aorta remains unfolded and tortuous.


SubjectID: 15783916, StudyID: 59380619, Comparison: None

FINAL REPORT

INDICATION: Neck and back pain, hypoxic.

COMPARISON: ___. PORTABLE SEMI-UPRIGHT AP VIEW OF THE CHEST: There is moderate enlargement of the cardiac silhouette which is stable. The mediastinal contours are unchanged. The pulmonary vascularity is mildly engorged suggesting an element of elevated pulmonary venous pressure. No consolidation, pleural effusion or pneumothorax is identified, though the left costophrenic angle is excluded from the field of view. There are no acute osseous abnormalities.

IMPRESSION: Mild pulmonary vascular congestion.


SubjectID: 15783916, StudyID: 56363350, Comparison: better

FINAL REPORT

AP CHEST, 3:44 P.M., ___

HISTORY: ___-year-old female with hypotension and bradycardia. Check line placement.

IMPRESSION: AP chest compared to ___: Tip of the new right internal jugular line projects over the mid-to-low SVC. No pneumothorax, pleural effusion or mediastinal widening. Left infrahilar opacification is slightly more pronounced today than in ___, probably atelectasis, but mild pulmonary edema has nearly resolved since earlier in the day   Keywords: resolve.


SubjectID: 15783916, StudyID: 56715069, Comparison: better

FINAL REPORT

INDICATION: New pleural effusion on right side. Assess for interval change.

COMPARISON: Comparison is made to multiple prior chest radiographs, most recently dated ___.

FINDINGS: Frontal and lateral chest radiographs demonstrate stable severe cardiomegaly. Unchanged prominence of the main pulmonary artery suggests pulmonary arterial hypertension. There has been a substantial improvement in previously noted layering pleural effusion with only a small residual effusion noted on the right. No focal opacification concerning for pneumonia. No pneumothorax identified.

IMPRESSION: Stable severe cardiomegaly. Substantial improvement in pulmonary edema and pleural effusions with only small residual right pleural effusion   Keywords: improve. Findings suggest pulmonary arterial hypertension.


SubjectID: 15794797, StudyID: 59337371, Comparison: None

FINAL REPORT

HISTORY: Thoracentesis, to assess for pneumothorax.

FINDINGS: In comparison with the earlier study of this date, there has been right thoracentesis with removal of a substantial amount of fluid from the right pleural space. Some residual atelectasis is seen, though in the appropriate clinical setting, supervening pneumonia would have to be considered. Specifically, there is no evidence for pneumothorax. Substantial enlargement of the cardiac silhouette persists.


SubjectID: 15794797, StudyID: 54796678, Comparison: None

WET READ: ___ ___ 7:17 PM A small right apical pneumothorax persists. Compared to 11:47 this AM, there has been some reaccumulation of right pleural fluid.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with pneumothorax, interval change.

COMPARISON: ___ to ___.

FINDINGS: Small right pneumothorax has minimally increased in size and measuring 9 mm at the apex. Right small pleural effusion has reaccumulated. Moderate cardiomegaly in this patient with prior sternotomy for CABG is unchanged.

CONCLUSION: Small right pneumothorax after thoracocentesis has slightly increased in size. Small right pleural effusion has reaccumulated.


SubjectID: 15794797, StudyID: 54659433, Comparison: None

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with pneumothorax, assess interval change.

COMPARISON: ___ to ___.

FINDINGS: Right small pneumothorax is unchanged since yesterday after thoracocentesis. Right pleural effusion has reaccumulated and is now small-to-moderate. There is mild volume overload without pulmonary edema. Prior sternotomy was done for CABG. Moderate cardiac contour enlargement is stable.

CONCLUSION: Unchanged right small pneumothorax after thoracocentesis.


SubjectID: 15794797, StudyID: 50097671, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST X-RAY

INDICATION: Bilateral pleural effusion, thoracocentesis, pneumothorax.

COMPARISON: ___.

FINDINGS: Because today's exam is erect PA and lateral the exact comparison of the pneumothorax is hard to assess. It has not changed significantly and is still small at apex measuring 9 mm. There is now air-fluid level seen inferiorly. Prior sternotomy was done for CABG in this patient with moderate cardiomegaly, left lung is unremarkable.

CONCLUSION: No significant change in small right hydropneumothorax considering the difference in positioning of the patient.


SubjectID: 15794797, StudyID: 52177203, Comparison: same

FINAL REPORT

HISTORY: Cardiac surgery, to assess for pulmonary edema.

FINDINGS: In comparison with the study of ___, there is little overall change   Keywords: little overall change. The monitoring and support devices remain in good position. Stable cardiac enlargement, probable small bibasilar effusions and atelectasis. There may be minimal elevation of pulmonary venous pressure.


SubjectID: 15794797, StudyID: 51560021, Comparison: None

FINAL REPORT

CHEST PORTABLE

INDICATION: ___-year-old woman status post MVR/TV repair, evaluate for pneumothorax status post chest tube removal. CHEST PORTABLE: Comparison is made to ___. The ET tube has been removed. Right chest tube has been removed. There is no evidence for a pneumothorax. A Swan-Ganz catheter is identified with its tip in the right pulmonary artery. There is some atelectasis at the left lung base.

IMPRESSION: Status post ET tube removal and right chest tube removal. There is no evidence for pneumothorax. Otherwise, stable examination.


SubjectID: 15803381, StudyID: 59929276, Comparison: None

WET READ: ___ ___ 8:51 PM No significant change since the prior exam earlier today. Stable position of the support lines and tubes. Stable small bilateral pleural effusions, left greater than right. Stable left atelectasis.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

HISTORY: Tachypnea and low saturation, to assess for lung collapse.

FINDINGS: In comparison with study of earlier in this date, the monitoring and support devices remain in place. Continued opacification at the left base is consistent with volume loss in the lower lobe and pleural effusion. Indistinctness of prominent pulmonary vessels is consistent with elevated pulmonary venous pressure.


SubjectID: 15803381, StudyID: 57798366, Comparison: None

FINAL REPORT

HISTORY: Abdominal aortic aneurysm repair, to assess for pleural effusion.

FINDINGS: In comparison with the study of ___, the opacification at the left base has decreased, consistent with improvement of the pleural effusion and probably the degree of volume loss in the left lower lobe. Mild residual atelectasis and possibly small pleural effusion on the right. The monitoring and support devices are essentially unchanged.


SubjectID: 15803381, StudyID: 59448467, Comparison: None

FINAL REPORT

HISTORY: Status post aneurysm repair.

COMPARISON: ___.

FINDINGS: The endotracheal tube is 5 cm above the carina. There is dense retrocardiac opacity compatible volume loss/infiltrate/effusion. Left upper lung is slightly better aerated than on the prior exam. There continues to be some volume loss/infiltrate in the right lower lung with some minimal obscuration of the right hemidiaphragm. The remainder of the appearance of the chest is unchanged compared to prior.

IMPRESSION: Dense retrocardiac opacity compatible with volume loss/infiltrate/effusion and right lower lobe volume loss/infiltrate.


SubjectID: 15803381, StudyID: 50164800, Comparison: same

FINAL REPORT

HISTORY: Aneurysm repair and respiratory failure.

COMPARISON: ___.

FINDINGS: Compared to the prior study. There is no significant interval change   Keywords: no significant interval change.


SubjectID: 15803381, StudyID: 59372115, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Assessment for pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. No pulmonary edema. Unchanged mild cardiomegaly, elevation of the left hemidiaphragm and atelectasis at the left lung bases. The left subclavian line and the nasogastric tube are in unchanged position. No new parenchymal opacities   Keywords: new.


SubjectID: 15803381, StudyID: 52726603, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Shortness of breath, pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has been extubated. The nasogastric tube remains in situ, the course of the left subclavian vein catheter is unchanged. Unchanged elevation of the left hemidiaphragm with enlarged left ventricle and a relatively extensive retrocardiac atelectasis. Left pleural effusion is also present. No overt pulmonary edema. No evidence of pneumonia in the well-ventilated lung areas.


SubjectID: 15803381, StudyID: 50510104, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Dobbhoff placement, assessment for position.

COMPARISON: ___, 7:07 p.m.

FINDINGS: Compared to the previous radiograph, the Dobbhoff catheter has been pulled back. The tip of the catheter now projects over the proximal parts of the stomach. The device is still securely positioned in the stomach but could be advanced by approximately 5 cm. No other relevant changes on the chest image   Keywords: no other relevant change.


SubjectID: 15803381, StudyID: 50159763, Comparison: None

WET READ: ___ ___ ___ 10:16 PM Dobbhoff terminates within the ___ portion the duodenum. Unchanged elevation left hemidiaphragm with overlying atelectasis and probable small pleural effusion. There is worsened pulmonary edema, moderate. Left subclavian catheter in satisfactory position. Findings paged to Dr. ___. ______________________________________________________________________________

FINAL REPORT

HISTORY: ___-year-old male status post abdominal aortic aneurysm repair, now status post Dobbhoff tube placement.

COMPARISON: Chest radiographs dating back to ___, most recent from ___. PORTABLE SUPINE CHEST RADIOGRAPH: A Dobbhoff catheter courses below the diaphragm, crosses midline, and terminates in the region of the gastroduodenal junction. There is increased opacity within the left lung base, which likely reflects increasing pleural fluid. There is increased pulmonary vascular congestion as compared to most recent prior examination, though no overt interstitial edema. Mediastinal and hilar contours appear similar to prior. There is no pneumothorax.

IMPRESSION: 1. Dobbhoff catheter at the gastroduodenal junction. 2. Probable mild increase in moderate left pleural effusion.


SubjectID: 15803381, StudyID: 59100517, Comparison: None

WET READ: ___ ___ 9:20 PM Unchanged moderate left pleural effusion and small right pleural effusion.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

PORTABLE CHEST ___ ___

COMPARISON: Radiograph of earlier the same date.

FINDINGS: Allowing for differences in technique and projection, there has not been an appreciable short interval change in the appearance of the chest since the recent study of a few hours earlier.


SubjectID: 15803381, StudyID: 57863554, Comparison: None

FINAL REPORT

INDICATION: AAA repair, query placement of Dobbhoff tube.

COMPARISON: Chest radiograph, ___, ___.

FINDINGS: Patient has been extubated. There is interval placement of Dobbhoff tube coiled in the stomach with tip pointing cephalad. Again seen is a left subclavian venous catheter with tip in the left brachiocephalic vein, near the junction with the superior vena cava, pointing towards the wall of the SVC. The left pleural effusion has increased in size, now moderate. A left retrocardiac opacity, likely atelectasis, is present. There is a new small right pleural effusion.

IMPRESSION: 1. Dobbhoff tube in the stomach with significant coiling but tip pointing cephalad. 2. Worsening, now moderate, left pleural effusion with associated atelectasis. 3. Increasing small right pleural effusion. 4. Left subclavian venous catheter with tip in the left brachiocephalic vein pointing towards the wall of the SVC.


SubjectID: 15803381, StudyID: 55447613, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___ radiograph.

FINDINGS: Indwelling support and monitoring devices are in standard position. Increasing homogeneous opacity in the left mid and lower lung probably represents an enlarging now moderate pleural effusion with adjacent atelectasis and/or consolidation in the adjacent left lower lobe and lingula. Improved right lower lobe atelectasis with minimal residual linear atelectasis remaining, as well as an apparent small right pleural effusion.


SubjectID: 15803381, StudyID: 53274712, Comparison: same

FINAL REPORT

HISTORY: Status post triple AAA repair. Evaluate for effusion.

COMPARISON: ___.

TECHNIQUE: Portable frontal chest radiograph, single view.

FINDINGS: There is no significant change compared to prior examination with redemonstration of mild interstitial pulmonary edema with a small left effusion   Keywords: no significant change. Cardiomediastinal silhouette and hilar contours are unchanged. Endotracheal tube and a left subclavian central venous catheter are in standard position. There is no pneumothorax.

IMPRESSION: No significant change compared to prior study with unchanged mild edema and small left effusion   Keywords: no significant change, unchanged.


SubjectID: 15803381, StudyID: 51860826, Comparison: same

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph of earlier the same date.

FINDINGS: Interval placement of endotracheal tube, with tip terminating about 6 cm above the carina. Otherwise, no relevant short interval changes since the recent radiograph performed a few hours earlier   Keywords: no relevant short interval change.


SubjectID: 15803381, StudyID: 58307266, Comparison: worse

FINAL REPORT

HISTORY: Evaluate for effusions. CHEST, SINGLE AP PORTABLE VIEW.

COMPARISON: ___ at 17:35 p.m. An ET tube is present, carina is not well delineated, but the tip of the tube lies approximately 7 cm above the carina. An NG tube appears to be present, but is poorly delineated and therefore difficult to trace below the diaphragm. Right IJ central line is present, tip in the region of the proximal SVC. A left IJ central line tip overlies the left brachiocephalic vein immediately proximal to its confluence with the SVC. There is probable background COPD. There are increased vascular markings, consistent with CHF. There is left lower lobe collapse and/or consolidation, with a small left effusion. There is probable atelectasis at the right base and minimal blunting of the right costophrenic angle. There is probable cardiomegaly. The left hilum is very prominent. The aorta is calcified. Incidental note made of old resection of the distal left clavicle, with well-corticated edges.

IMPRESSION: 1. Lines and tubes as described. Please see comment above. 2. Probable background COPD. 3. Left lower lobe collapse and/or consolidation with small effusion, similar to one day earlier. 4. Increased vascular and interstitial markings, grossly unchanged   Keywords: increase. This may reflect CHF with interstitial edema. The possibility of background interstitial disease cannot be entirely excluded. 5. Large left hilum with a tapered appearance, ? due to pulmonary hypertension.


SubjectID: 15803381, StudyID: 53819721, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: aortic repair, evaluation for pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is a minimal improvement of the pre-existing parenchymal opacities, with improved ventilation, notably at the right lung base. The left lung base, including the retrocardiac atelectasis and the small pleural effusion, is unchanged. The previously coiled nasogastric tube is the esophagus has been pulled, a new nasogastric tube can be followed to the level of the mid-to-lower esophagus but is not visible more distally. The other monitoring and support devices are constant. No pneumothorax.


SubjectID: 15803381, StudyID: 51011783, Comparison: same

FINAL REPORT

HISTORY: Status post AAA repair, evaluate for pleural effusions.

COMPARISON: ___.

TECHNIQUE: Portable frontal chest radiograph.

FINDINGS: Compared to immediate prior exam, there has been little interval change except for interval placement of a Dobbhoff tube with the majority of the tube is coiled within the cervical esophagus and the tip terminating just proximal to the GE junction. There is otherwise stable positioning of a right internal jugular Swan-Ganz catheter. Positioning of endotracheal tube is difficult to ascertain with multiple loops of coiling of the Dobbhoff tube within the cervical esophagus. There is otherwise unchanged cardiomediastinal silhouette, bilateral layering pleural effusions and moderate pulmonary edema.

IMPRESSION: Coiling of Dobbhoff tube within the cervical esophagus with tip just proximal to the GE junction. Otherwise, no significant interval change   Keywords: no significant interval change. Results were discussed over the telephone with Dr. ___ by Dr. ___ at 11:36 a.m. on ___ at time of initial review.


SubjectID: 15803381, StudyID: 51232487, Comparison: same

FINAL REPORT

HISTORY: Volume overload graphics exam: ___.

COMPARISON:

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.


SubjectID: 15803381, StudyID: 50277647, Comparison: 0.0

FINAL REPORT

HISTORY: Respiratory failure status post AAA repair, evaluate for pneumonia.

COMPARISON: ___.

TECHNIQUE: Portable frontal chest radiograph single view.

FINDINGS: There has been no significant interval change in findings since ___ with re-demonstration of bilateral layering pleural effusions, perihilar and bibasilar opacities and increased interstitial markings compatible with pulmonary edema   Keywords: increase. Again appreciated is a right IJ Swan-Ganz catheter in unchanged position in a central right pulmonary artery. A left internal jugular Cordis remains in place. Endotracheal tube is unchanged. There is no new consolidation or pneumothorax.

IMPRESSION: No significant change compared to prior examination with re-demonstration of findings compatible with congestive heart failure   Keywords: no significant change.


SubjectID: 15811456, StudyID: 59951253, Comparison: None

FINAL REPORT

HISTORY: Intubation for respiratory distress.

FINDINGS: In comparison with the study of ___, there are somewhat lower lung volumes. Diffuse bilateral pulmonary opacifications could reflect vascular congestion, widespread pneumonia, or some combination of each. Monitoring and support devices remain in place.


SubjectID: 15811456, StudyID: 56499621, Comparison: None

FINAL REPORT

HISTORY: Tachycardia.

FINDINGS: In comparison with the study of ___, there is little change in the diffuse bilateral pulmonary opacifications, although the lung volumes are slightly better. This could reflect pulmonary edema, widespread infection, or even underlying ARDS. Monitoring and support devices remain in good position.


SubjectID: 15811456, StudyID: 51133475, Comparison: same

FINAL REPORT

HISTORY: ARDS.

FINDINGS: In comparison with study of ___, the monitoring and support devices are essentially unchanged. Diffuse bilateral pulmonary opacifications persist, again consistent with the clinical diagnosis of ARDS   Keywords: again. Widespread pneumonia or severe pulmonary edema could cause somewhat similar appearance   Keywords: similar, similar appearance.


SubjectID: 15811456, StudyID: 58641174, Comparison: same

FINAL REPORT

INDICATION: ___-year-old female, hypoxic respiratory failure. Evaluate for change.

COMPARISONS: Multiple prior chest radiographs, most recently of ___.

FINDINGS: Endotracheal tube terminates 3.2 cm above the carina. Dobbhoff tube terminates below the diaphragm. Catheter of a right chest wall port terminates in the right atrium. Right pleural tube terminates in similar position. PA catheter has been removed. Widespread heterogeneous opacities are similar to prior, and compatible with pulmonary edema   Keywords: similar. Bibasilar atelectasis is present. No pneumothorax.

IMPRESSION: Stable mild pulmonary edema and bibasilar atelectasis   Keywords: stable. PA catheter has been removed.


SubjectID: 15811456, StudyID: 58356955, Comparison: worse

FINAL REPORT

HISTORY: ___-year-old woman with respiratory failure and worsening tachypnea. Evaluate for interval change.

COMPARISON: CTA from ___ and radiographs from ___.

FINDINGS: A right-sided Port-A-Cath terminates in the right atrium. NG tube is seen with tip off the view of the film. In comparison to the previous two radiographs, there is a a significant increase in right-sided opacities, previously worrisome for edema, but it should also be noted that this can be seen in an typical infection   Keywords: increase. The patient's underlying fibrosis made it conceivable that this is also a exacerbation of this condition. A right-sided apical chest tube is in place. Endotracheal tube is in correct position. Left lung is clear of any focal opacities concerning for infectious process.

IMPRESSION: Increase in the opacities on the right side since the prior two radiographs, most concerning for asymmetric edema, less likely infection   Keywords: increase. Underlying fibrosis is also present.


SubjectID: 15811456, StudyID: 57260827, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post right lung biopsy, rule out pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the monitoring and support devices, including the right chest tube, are unchanged. The lung volumes have minimally decreased. There is evidence of diffuse fibrotic lung disease with reduced lung volumes overall. Moderate cardiomegaly without pulmonary edema. No convincing evidence of pneumothorax.


SubjectID: 15811456, StudyID: 55529369, Comparison: None

FINAL REPORT

PORTABLE UPRIGHT SEMI-ERECT CHEST RADIOGRAPH ON ___ AT 5:30 A.M. CLINICAL

HISTORY: Hypoxemic respiratory failure. Evaluate interval change.

TECHNIQUE: Single portable chest radiograph was performed with comparison to the examination from one day previous.

FINDINGS: There is interval development of a right apical pneumothorax, measuring approximately 1.8 cm on maximum measurement. The right hemithorax remains relatively well aerated, but with diffuse alveolar opacities, similar in extent and degree to the prior examination. There appears to be slight increased volume loss in the left retrocardiac region, which may represent slight worsening atelectasis, although the possibility of a worsening alveolar process cannot be excluded. The cardiac silhouette remains enlarged. Endotracheal tube remains in place, with the tip approximately 4 cm above the carina. Left-sided subclavian central venous catheter is again seen, with the tip at the junction of the brachiocephalic veins. Right-sided implanted catheter is present with the tip at the cavoatrial atrial junction. A feeding tube remains in place, NG type, extending beyond the inferior confines of this film.

IMPRESSION: Interval development of right apical pneumothorax. This was called by telephone to Dr. ___ at 11:55 a.m., ___, within five minutes after discovery of the finding.


SubjectID: 15811456, StudyID: 54060378, Comparison: better

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with respiratory failure, pneumothorax.

COMPARISON: ___ at 5:33 a.m.

FINDINGS: ET tube ends 4 cm above carina. Left jugular line ends in mid SVC and right-sided Port-A-Cath ends at cavoatrial junction. Left PICC line is in upper atrium. Feeding tube is unchanged. Right small apical pneumothorax measuring 1 cm is stable since this morning, but new since yesterday. Mild pulmonary edema has improved, but residual abnormalities of ARDS, widespread ground-glass opacity, reticulation and low lung volumes, are unchanged   Keywords: improve.

CONCLUSION: 1. Tube and lines are in adequate position. 2. Small right apical pneumothorax is stable. 3. Improved, transient pulmonary edema   Keywords: improve.


SubjectID: 15811456, StudyID: 51146516, Comparison: better

FINAL REPORT

HISTORY: ___-year-old woman status post right lung biopsy.

COMPARISON: ___.

TECHNIQUE: Semi-erect portable view of the chest.

FINDINGS: In comparison with prior exam, there is still mild pulmonary edema although this appears to have slightly improved   Keywords: improve. Bilateral basilar opacities are consistent with atelectasis. Endotracheal tube terminates 4 cm from the carina. Right chest tube has been repositioned apically since the prior study. There is no pneumothorax.


SubjectID: 15811456, StudyID: 57874276, Comparison: None

FINAL REPORT

HISTORY: Severe pneumonia with intubation.

FINDINGS: In comparison with the study of ___, there has been placement of an endotracheal tube with its tip approximately 3 cm above the carina. The tip appears to project directly facing the left wall of the trachea. Diffuse bilateral pulmonary opacifications persist. Again this could reflect widespread pneumonia with some component of pulmonary edema. Central catheter again extends to the lower portion of the SVC.


SubjectID: 15811456, StudyID: 55877047, Comparison: None

FINAL REPORT

HISTORY: OG tube placement.

FINDINGS: In comparison with the study of earlier in this date, an orogastric tube has been introduced extending to the body of the stomach with the side hole distal to the esophagogastric junction. Diffuse bilateral pulmonary opacifications persist. Endotracheal tube and right subclavian catheter are in unchanged position.


SubjectID: 15811456, StudyID: 52972877, Comparison: 1.0

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Bilateral opacities, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the monitoring and support devices are in constant position. Mild decrease of the still severe and diffuse parenchymal opacities   Keywords: decrease. The size of the cardiac silhouette is constant, there is mild increase in extent of the pre-existing retrocardiac atelectasis. Otherwise, no relevant changes   Keywords: no relevant change.


SubjectID: 15811456, StudyID: 56371125, Comparison: None

FINAL REPORT

EXAM: Chest, single AP upright portable view. CLINICAL INFORMATION: ___-year-old female with history of cirrhosis, presenting with worsening shortness of breath, evaluate for fluid overload.

COMPARISON: ___.

FINDINGS: Single AP upright portable view of the chest was obtained. There are diffuse bilateral alveolar opacities. Blunting of the costophrenic angles may be due to trace pleural effusions. Cardiac and mediastinal silhouettes are stable. There is a right-sided Port-A-Cath terminating in the distal SVC.

IMPRESSION: Diffuse bilateral alveolar opacities, given history, consistent with significant fluid overload; suggest repeat radiograph after diuresis to further evaluate for additional underlying process. Trace bilateral pleural effusions.


SubjectID: 15811456, StudyID: 57671205, Comparison: None

FINAL REPORT

INDICATION: ___-year-old woman status post splenectomy, status post nasogastric tube adjustment.

FINDINGS: A single portable frontal chest radiograph was obtained. The endotracheal tube tip terminates at the superior margin of the clavicles. A nasogastric tube has been advanced with the tip in the stomach. The side hole is at or around the gastroesophageal junction. Right-sided Port-A-Cath tip is in the superior right atrium. Bibasilar left greater than right atelectasis is again seen. No new focal consolidation or pneumothorax is present. Pneumoperitoneum has resolved.

IMPRESSION: NG tube has been advanced into the stomach. The side hole is at the diaghragm hiatus; consider further advancement into the stomach.


SubjectID: 15811456, StudyID: 52099671, Comparison: same

FINAL REPORT

STUDY: AP chest radiograph.

COMPARISON EXAM: AP chest radiograph ___.

FINDINGS: There is placement of a Dobbhoff in satisfactory position in the stomach. There remains a left PICC with tip terminating in the mid SVC and a Port-A-Catheter with tip terminating in the cavoatrial junction. There remains diffuse bilateral lung opacities, stable compared to prior exam   Keywords: stable, remains. The cardiomediastinal and hilar silhouettes remain stable.

IMPRESSION: Satisfactory placement of Dobbhoff tube with tip in the stomach.


SubjectID: 15811456, StudyID: 51091820, Comparison: same

WET READ: ___ ___ ___ 8:02 PM 1. ETT 1.3 cm from the carina and should be withdrawn and repositioned. 2. left central line tip and left picc overlap and can't be clearly differentiated, although appears that left central line tip projects over expected region of mid svc. lateral view may be obtained for further clarification. 3. right portacath at cavoatrial ___. 4. feeding tube in stomach, tip not seen. 5. bilateral diffuse parenchymal opacities, right slightly more than left, improved since prior. Unchanged appearance of the moderately enlarged cardiac silhouette. d/w dr. ___ at 6:50pm on ___ via tel. ______________________________________________________________________________

FINAL REPORT

PORTABLE SUPINE CHEST RADIOGRAPH CLINICAL

HISTORY: Acute respiratory failure, recently discharged to rehab, please evaluate left central venous line tip location and interval change in pulmonary abnormalities.

FINDINGS: The patient is intubated, with the tip of endotracheal tube approximately 1.3 cm above the carina. Left-sided subclavian central venous catheter is present, with the tip in the lower SVC. Left-sided PICC is present, the tip is difficult to visualize due to its superimposition over the left central venous catheter. A right-sided implanted catheter is present, with the tip in the region of the cavoatrial junction. A feeding tube is present, extending into the stomach, and extending beyond the inferior confines of this examination. Again seen is a diffuse opacification in the right and left hemithoraces, within predominantly alveolar pattern, but with some reticulation seen at the lung bases, this may represent a combination of alveolar edema and some degree of interstitial edema or lung disease at the bases   Keywords: again. No significant pleural effusion. No new consolidation. Overall, the degree of opacification of the lungs is similar to the prior examination allowing for differences in lung volumes   Keywords: similar.

IMPRESSION: Endotracheal tube approximately 1.3 cm above the carina, a relatively low location; suggest some degree of withdrawl. Left central venous catheter appears to project over the mid SVC. If further clarification is desired, lateral view may also be considered.


SubjectID: 15812823, StudyID: 57563159, Comparison: same

FINAL REPORT

INDICATION: ___M with new CVL // line placement

TECHNIQUE: Single portable view of the chest.

COMPARISON: Previous film from earlier the same day at 09:17.

FINDINGS: There has been interval placement of right-sided central venous catheter. Tip projects over the brachiocephalic vein. There is no pneumothorax. Otherwise, there has been no change   Keywords: no change.


SubjectID: 15812823, StudyID: 56034989, Comparison: same

WET READ: ___ ___ ___ 9:53 AM Stable single view of the chest without definite superimposed pulmonary process. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with SOB // PNA?

TECHNIQUE: Chest PA and lateral

COMPARISON: ___, ___

FINDINGS: Image quality is compromised due to motion. The cardiomediastinal silhouette is unremarkable for technique and not significantly changed since prior. Again seen are prominent interstitial markings bilaterally, not significantly changed since prior examinations   Keywords: not significantly changed, again. No definite consolidation is identified. No pneumothorax or pleural effusion is identified on this examination. The visualized bones are unremarkable. A vascular stent is noted in the region of the abdominal aorta.

IMPRESSION: Stable single view of the chest without definite superimposed pulmonary process.


SubjectID: 15819509, StudyID: 56953269, Comparison: None

FINAL REPORT

HISTORY: Stroke, hypotension.

FINDINGS: No previous images. Cardiac silhouette is enlarged heart. Pulmonary vascularity is essentially within normal limits. Blunting of the costophrenic angles with hazy opacification at the bases suggests some pleural effusion and compressive atelectasis at the base. There is somewhat elliptical opacification in the region of the right cardiophrenic angle, worrisome for a mass. Comparison with previous images would be most helpful. A relatively dense vertical opacification just lateral to the descending aorta could well represent previous fibrosis.


SubjectID: 15819509, StudyID: 55767239, Comparison: None

FINAL REPORT

HISTORY: Hypoxia and effusion.

FINDINGS: In comparison with the earlier study of this date, the soft tissue masses in the region of the cardiophrenic angle is more sharply seen. CT would be recommended for further evaluation. This information has been conveyed to a member of the clinical team. The remainder of the study is essentially unchanged.


SubjectID: 15819509, StudyID: 50085744, Comparison: None

FINAL REPORT

EXAM: Chest single semi-erect AP portable view. CLINICAL INFORMATION: Stroke, hypoxia.

COMPARISON: ___.

FINDINGS: Patient is rotated to the left. Dobbhoff tube is seen, which has been advanced since the prior study, terminating in the stomach, however, does not appear post-pyloric. Bilateral pleural effusions and bibasilar atelectasis persist. Rounded opacity at the right lung base is again seen.


SubjectID: 15826218, StudyID: 57252768, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Amyloid cardiomyopathy. Desaturation, shortness of breath.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is an increase in vascular diameter and perihilar haze that has newly occurred and is strongly suggestive of mild-to-moderate pulmonary edema   Keywords: new, increase. No evidence of pneumonia. No pleural effusions. Unchanged moderate cardiomegaly. The observation was made at 1:22 p.m. on ___ and at the same time point, the referring physician, ___. ___, was paged for notification and the findings were subsequently discussed on the telephone.


SubjectID: 15826218, StudyID: 56625816, Comparison: same

FINAL REPORT

HISTORY: CHF with possible aspiration.

FINDINGS: In comparison with the study of ___, there is little overall change   Keywords: little overall change. Continued enlargement of the cardiac silhouette with mild-to-moderate pulmonary edema. No evidence of supervening pneumonia.


SubjectID: 15826218, StudyID: 56698360, Comparison: better

WET READ: ___ ___ 4:06 AM Increased left basilar ill-defined opacity, which is non-specific. Differential diagnosis includes pneumonia. No evidence for worsening pulmonary edema. Discussed with Dr. ___ by phone at 3:50 a.m. on ___. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___-year-old woman with congestive cardiac failure who presents from rehab with right thigh pain and shortness of breath. Assess for pulmonary edema, pneumonia or other abnormalities.

COMPARISON: ___. PORTABLE CHEST RADIOGRAPH: Mild cardiomegaly is increased compared to the prior exam. Bilateral interstitial edema is improved. New focal nodularity particularly within the left lung are concerning for disseminated infection. Prominence and some minimal opacification at the right lung base may represent atelectasis or worsening pulmonary edema, although infection cannot be entirely excluded in the correct clinical setting.

IMPRESSION: 1. Interstitial edema is improved compared to the prior exam   Keywords: improve. 2. Mild cardiomegaly is increased compared to the prior exam. 3. Focal nodularity predominantly in left lung, new since the prior exam, is concerning for disseminated infection. A dedicated CT of the chest is recommended for further evaluation. Findings were discussed with Dr. ___ at 11:30am on ___ via telephone.


SubjectID: 15826218, StudyID: 51330563, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior study from ___. CLINICAL

HISTORY: Hyponatremia, recent admission for CHF due to amyloid, assess for CHF.

FINDINGS: PA and lateral views of the chest were obtained. Cardiomegaly is again noted with mild pulmonary edema   Keywords: again. There are small bilateral pleural effusions which appear similar to prior study. Bony structures are intact. No free air below the right hemidiaphragm.

IMPRESSION: Cardiomegaly, mild pulmonary edema. Small bilateral pleural effusions.


SubjectID: 15835176, StudyID: 58961769, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hypotension, new o2 requirement // eval for acute process

COMPARISON: ___, 13:59

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The lung volumes have minimally decreased, causing increased crowding of vascular structures at the lung bases. Unchanged extent of the moderate right and small left pleural effusion and of the subsequent basal areas of atelectasis. Mild fluid overload. No pneumothorax. Unchanged size of the cardiac silhouette.


SubjectID: 15835176, StudyID: 52723717, Comparison: better

FINAL REPORT

HISTORY: Increased oxygen requirement and pulmonary edema.

FINDINGS: In comparison with study of ___, there has been some decrease in the degree of pulmonary edema   Keywords: decrease. The pleural effusions bilaterally with compressive atelectasis at the bases appear to have improved, though this could be related to a more erect position of the patient.


SubjectID: 15835176, StudyID: 57976103, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with acute resp distress s/p intubation // eval ETT placement

COMPARISON: ___, 21:44

IMPRESSION: As compared to the previous radiograph, the patient was intubated. The tip of the endotracheal tube projects 9 cm above the carinal, the tube could be advanced by approximately 4 cm. The other monitoring and support devices are in constant position. No change in appearance of the cardiac silhouette, the bilateral pleural effusions, the moderate pulmonary edema and the areas of bilateral atelectasis   Keywords: no change.


SubjectID: 15835176, StudyID: 56924841, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with // ETT placement

COMPARISON: ___, 0 ___

IMPRESSION: As compared to the previous radiograph, the endotracheal tube has been slightly advanced. The tip of the tube now projects 4 cm above the carina. The appearance of the lung parenchyma, the cardiac silhouette and the other monitoring and support devices is unchanged.


SubjectID: 15835176, StudyID: 55987103, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with aspiration and sob // eval for acute process

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Moderate pulmonary edema with substantial interstitial component. Moderate cardiomegaly with bilateral areas of atelectasis. No new focal parenchymal opacities   Keywords: new. Nasogastric tube and right internal jugular vein catheter in unchanged position.


SubjectID: 15835176, StudyID: 52732009, Comparison: worse

FINAL REPORT

INDICATION: Hypotension, question pneumothorax or pneumonia.

COMPARISON: ___.

FINDINGS: Portable frontal semi upright radiograph of the chest demonstrates stable severe cardiomegaly and large right effusion with interval worsening of interstitial edema now moderate   Keywords: worse. A left PICC ends in the low SVC. No large pneumothorax or left pleural effusion.

IMPRESSION: Interval worsening of moderate pulmonary edema   Keywords: worse.


SubjectID: 15835176, StudyID: 57710939, Comparison: None

FINAL REPORT

HISTORY: Hypoxic respiratory distress, assess interval change. CHEST, SINGLE AP PORTABLE VIEW. No previous films on PACS record for comparison. An ET tube is present, tip approximately 15 mm above the carina, slightly low. An NG tube is present, tip extending beneath diaphragm off film. A right IJ central line is present, tip overlying distal SVC. There is moderate to moderately severe cardiomegaly, with a prominent left hilum. There is upper zone redistribution and diffuse vascular blurring, with alveolar opacity, consistent with CHF and pulmonary edema. Suspect bilateral effusions, with underlying collapse and/or consolidation.

IMPRESSION: 1. CHF with pulmonary edema and suspected bilateral effusions with underlying collapse and/or consolidation at both bases. 2. ET tube approximately 15 mm above the carina. Clinical correlation regarding retraction by approximately 5 mm is requested.


SubjectID: 15835176, StudyID: 55637427, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pneumonia and chf, intubated // eval for interval change, tube and line placement

COMPARISON: Chest radiograph ___:56.

IMPRESSION: Lung volumes have improved despite ET tube remova either because of or reflecting a decrease in right internal jugular line ends in lower SVC. Mild to moderate pulmonary edema. Moderate to large right pleural effusion has increased, moderate cardiomegaly is stable.


SubjectID: 15835317, StudyID: 58522793, Comparison: None

FINAL REPORT

HISTORY: New AFib.

TECHNIQUE: Frontal and lateral views of the chest.

COMPARISON: ___ at 10:33.

FINDINGS: There are low lung volumes, which accentuate the bronchovascular markings. Given this, questionable right perihilar opacity is no longer appreciated and most likely related to vascular structures. Blunting of the costophrenic angles suggest small pleural effusions. There is likely left base atelectasis. Slight prominence of the vasculature may be due to mild pulmonary vascular congestion.

IMPRESSION: Right perihilar opacity is no longer well seen and likely due to vascular structures. Low lung volumes and likely trace bilateral pleural effusions. Left base atelectasis. Possible mild pulmonary vascular congestion.


SubjectID: 15835317, StudyID: 57637737, Comparison: None

FINAL REPORT

HISTORY: Crackles on examination, to assess for pneumonia.

FINDINGS: In comparison with the study of ___, the left hemidiaphragmatic contour is silhouetted, consistent with substantial volume loss in the left lower lobe and pleural effusion. Blunting of the right costophrenic angle is consistent with small effusion and there are mild atelectatic changes at the bases. The low lung volumes accentuate the transverse diameter of the heart. The apparent pulmonary congestion on one view probably also is a manifestation of low lung volumes rather than appreciable elevation of the pulmonary venous pressure.


SubjectID: 15837207, StudyID: 57484716, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with sepsis and increased o2 requiremnet // please eval for pna or voluem overload

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Moderate cardiomegaly. Mild fluid overload but no overt pulmonary edema. Minimal retrocardiac atelectasis. The alignment of the sternal wires is constant.


SubjectID: 15837207, StudyID: 57438719, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with history of heart failure and increased SOB. // Please assess for pneumonia/volume overload.

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: Mild to moderate cardiomegaly is a stable. Mild pulmonary edema has worsened   Keywords: worse. Bibasilar opacities consistent with atelectasis left greater than right have increased. Presumed bilateral pleural effusions are small. Calcified mediastinal lymph nodes are again noted.

IMPRESSION: Worsening in mild pulmonary edema   Keywords: worse


SubjectID: 15837207, StudyID: 56931352, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with worsening dyspnea and cough // ?Pulmonary process

COMPARISON: ___.

FINDINGS: AP portable upright view of the chest. Midline sternotomy wires again noted. Interval removal of a right IJ introducer and right PICC line. Calcified lymph node projects over the right mediastinal border. Lungs are hyperinflated with upper lobe lucency suggesting emphysema. Retrocardiac opacity persists which could represent pneumonia. There is mild interstitial prominence in lower lungs which could reflect mild interstitial edema. Small bilateral pleural effusion is difficult to exclude. Cardiomediastinal silhouette appears stable. Bony structures are intact.

IMPRESSION: Findings as above.


SubjectID: 15837207, StudyID: 50106227, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with acutely worsening SOB // Please eval for worsening effusion

TECHNIQUE: Portable upright chest radiograph

COMPARISON: ___ at 16:41

FINDINGS: Compared to the prior radiograph there is no significant change in the moderate cardiomegaly, left pleural effusion, and mild interstitial edema   Keywords: no significant change. Calcified paratracheal lymph node is unchanged. Left basal opacity might represent atelectasis. Bilateral pleural effusions, left more than right are better characterized on a CT chest obtained several hours prior. Sternal wires are intact. Aortic arch is moderately calcified.No significant right pleural effusion.

IMPRESSION: Unchanged moderate cardiomegaly, moderate left pleural effusion, and mild interstitial edema. Atelectasis


SubjectID: 15840907, StudyID: 56097707, Comparison: None

FINAL REPORT

EXAM: Chest single AP upright portable view. CLINICAL INFORMATION: ___-year-old male with history of hypoxia, evaluate for fluid overload.

COMPARISON: ___.

FINDINGS: Single AP upright portable view of the chest was obtained. There has been interval placement of a large-bore dual-lumen right central venous catheter, distal aspect not well seen, but likely terminating at the cavoatrial junction/proximal right atrium. The cardiac silhouette is mildly enlarged. There is a left base opacity, likely represents combination of pleural effusion and atelectasis. There is a moderate pulmonary vascular congestion. No pneumothorax seen.

IMPRESSION: Left base opacity likely represents combination of pleural effusion and atelectasis although underlying consolidation cannot be entirely excluded in the appropriate clinical setting. The above findings with mild enlargement of the cardiac silhouette and pulmonary vascular congestion suggest fluid overload/CHF.


SubjectID: 15840907, StudyID: 50031776, Comparison: None

PROVISIONAL

FINDINGS

IMPRESSION (PFI): ___ ___ 11:13 AM Retrocardiac consolidation and new left upper lobe density; atelectasis or pneumonia are considerations. PFI VERSION #1 ___ ___ ___ 11:11 AM Retrocardiac consolidation; atelectasis or pneumonia are considerations. ______________________________________________________________________________

FINAL REPORT

HISTORY: ___-year-old male with cough, heart failure and elevated white count while on immunosuppression. STUDY: PA and lateral chest radiograph.

COMPARISON: ___.

FINDINGS: The central venous catheter from a right IJ approach tip is at the cavoatrial junction. The heart size is at the upper limits of normal. The mediastinal contours are within normal limits. Mild pulmonary vascular congestion is seen. The lungs demonstrate improving consolidation of the retrocardiac space, either representing improving atelectasis or pneumonia. Additionally, a new left upper lobe opacity is seen, concerning for a developing pneumonia. There is no large pleural effusion or pneumothorax. Degenerative changes are seen in the spine.

IMPRESSION: New left upper lobe opacity which may represent a developing pneumonia in the appropriate clinical setting. Improving retrocardiac consolidation may represent improving atelectasis or pneumonia.


SubjectID: 15862014, StudyID: 58296280, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (a PA AND LAT)

INDICATION: ___M with dyspnea // ? pneumonia or CHF

COMPARISON: ___.

FINDINGS: AP upright and lateral views of the chest provided. Midline sternotomy wires again noted. Bilateral lung opacities appear most consistent with edema. Small pleural effusions are suspected. Difficult to exclude a superimposed pneumonia. Cardiomediastinal silhouette is unchanged. No acute bony abnormalities.

IMPRESSION: As above.


SubjectID: 15862014, StudyID: 55451724, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with COPD, CHF, h/o DVT with hypoxia. Evaluate for worsening edema, consolidation.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiographs from ___, ___, ___, ___.

FINDINGS: Compare to ___, there is increased in the bilateral pleural effusion, right worse than left. Right basal atelectasis likely unchanged. Left basal atelectasis is unchanged. Pulmonary edema is unchanged   Keywords: unchanged. Cardiomegaly is stable. Sternotomy wires are aligned and intact. No pneumothorax is seen.

IMPRESSION: 1. Increase in right pleural effusion. 2. Stable pulmonary edema   Keywords: stable.


SubjectID: 15862403, StudyID: 59987995, Comparison: better

FINAL REPORT

HISTORY: Pneumonia.

FINDINGS: In comparison with study of ___, the monitoring and support devices are unchanged. Diffuse bilateral pulmonary opacifications may be slightly less prominent than on the previous study. This would be consistent with some improvement in the pulmonary edema and layering effusions   Keywords: improve.


SubjectID: 15862403, StudyID: 57394924, Comparison: None

FINAL REPORT

HISTORY: Tracheostomy tube.

FINDINGS: In comparison with the study of ___, the endotracheal tube has been removed and replaced with a tracheostomy tube. No evidence of pneumomediastinum or pneumothorax. Diffuse bilateral pulmonary opacifications persist.


SubjectID: 15862403, StudyID: 56374967, Comparison: same

FINAL REPORT

HISTORY: Congestive failure with diuresis.

FINDINGS: In comparison with study of ___, the monitoring and support devices remain in place. The degree of pulmonary edema is stable and there are bilateral pleural effusions with compressive atelectasis at the bases   Keywords: stable.


SubjectID: 15862403, StudyID: 54225919, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Desaturations, rule out pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the signs indicative of pulmonary edema has massively increased   Keywords: increase. The patient is now in severe pulmonary edema. Monitoring and support devices are constant. No larger pleural effusions. Unchanged size of the cardiac silhouette.


SubjectID: 15862403, StudyID: 53724019, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Pneumonia, intubation, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The monitoring and support devices are constant. Moderate cardiomegaly. Unchanged extensive bilateral parenchymal opacities   Keywords: unchanged. No new opacities   Keywords: new. No pneumothorax.


SubjectID: 15862403, StudyID: 51919311, Comparison: same

FINAL REPORT

HISTORY: NG tube placement.

FINDINGS: Nasogastric tube extends well into the stomach. Otherwise, little change from the earlier study of this date   Keywords: little change.


SubjectID: 15862403, StudyID: 59761719, Comparison: worse

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Chronic heart failure versus sepsis. NG tube.

COMPARISON: ___ at 6:07 p.m.

FINDINGS: ET tube is 4.8 cm above the carina. Right jugular line in mid SVC. Mild pulmonary edema and overlaying pleural effusion has slightly worsened   Keywords: worse. Cardiac contour is mildly enlarged in this patient with sternotomy for AVR. NG tube is in the stomach.

CONCLUSION: 1. Tubes and lines are in adequate position. 2. Mild pulmonary edema and overlaying pleural effusions have worsened   Keywords: worse.


SubjectID: 15862403, StudyID: 58393387, Comparison: same

FINAL REPORT

INDICATION: ___-year-old man with endocarditis status post aortic valve replacement, now with fever and tachycardia.

COMPARISON: Chest radiograph ___. PORTABLE SEMI-UPRIGHT CHEST RADIOGRAPH: Nasogastric tube courses through the stomach and out of view. ET tube tip terminates 6 cm above the carina. The cardiomediastinal contours are stable, with an aortic valve prosthesis. Mild pulmonary edema and small right pleural effusion are unchanged. No new consolidation or pneumothorax is seen.

IMPRESSION: Stable mild pulmonary edema and small right effusion   Keywords: stable. No new abnormality.


SubjectID: 15862403, StudyID: 58735715, Comparison: 0.0

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Prolonged intubation, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the signs indicative of pulmonary edema have minimally increased in extent and severity   Keywords: increase. Otherwise, there is no relevant change   Keywords: no relevant change. Unchanged size of the cardiac silhouette. Absence of larger pleural effusions. No pneumothorax. The monitoring and support devices are constant.


SubjectID: 15862403, StudyID: 58613856, Comparison: same

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with hypoxemia, probable pneumonia.

COMPARISON: Multiple chest x-rays from ___, to ___.

FINDINGS: Tracheostomy and right-sided PICC line are in adequate position. New right-sided hemodialysis catheter ends in the lower SVC. The lung volumes are lower and new bibasilar opacities, left more than right, is mainly explained by atelectasis. Superimposed infection or aspiration cannot be excluded. There is no pneumothorax. Pleural effusions are small, if any. Diffuse ground-glass opacities in both lungs which could be a mix of pulmonary edema and pneumonia are unchanged   Keywords: unchanged.

CONCLUSION: New bibasilar opacities, left more than right, are probably explained by atelectasis. Superimposed infection or aspiration cannot be excluded in appropriate clinical setting.


SubjectID: 15862403, StudyID: 51081867, Comparison: same

WET READ: ___ ___ ___ 10:16 PM Enteric tube tip is correctly placed in the stomach. Otherwise, little change in comparison to the prior studies from the same day with bilateral opacities likely representing edema and pneumonia. ______________________________________________________________________________

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old man with new nasogastric tube placement.

FINDINGS: Comparison is made to the previous study from ___. The tracheostomy and right-sided PICC line and median sternotomy wires are unchanged in position. There is a enteric tube whose distal tip is not well seen and is likely below the level of the diaphragm. The sideport of the enteric tube appears to be at the GE junction and this could be advanced several centimeters for more optimal placement. There are again seen diffuse airspace opacities throughout both lung fields, likely represents a combination of pulmonary edema and pneumonia   Keywords: again. There are small bilateral pleural effusions, right side worse than left. No pneumothoraces are seen.


SubjectID: 15862403, StudyID: 58147431, Comparison: same

FINAL REPORT

CLINICAL

HISTORY: ___-year-old man with nasogastric tube placement.

FINDINGS: Comparison is made to previous study from ___. There is an endotracheal tube with distal lead tip at the level of the aortic knob. There is a feeding tube whose side port is at the level of GE junction. There is a right-sided central line with distal lead tip at the distal SVC. There are again seen diffuse air space opacities throughout both lung fields   Keywords: again. This can represent a combination of pulmonary edema with pneumonia. Overall, this remains stable. Heart size is enlarged. There are again seen small bilateral pleural effusions. Degenerative changes and scoliosis of the spine is seen.


SubjectID: 15862403, StudyID: 56384556, Comparison: same

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old man with pneumonia, pulmonary edema.

FINDINGS: Comparison is made to prior study from ___. Lines and tube appear unchanged. There are again seen diffuse airspace opacities bilaterally which likely represent a combination of pulmonary edema and pneumonia   Keywords: again. This is unchanged. There are also small unchanged pleural effusions bilaterally. There are no pneumothoraces.


SubjectID: 15862403, StudyID: 53450544, Comparison: same

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old man with pneumonia, nasogastric tube was replaced.

FINDINGS: A comparison is made to the previous study from ___ at 10:37 a.m. There is a nasogastric tube whose side port is at the GE junction. This could be advanced ___ to 15 cm for more optimal placement. The heart size is enlarged but stable. There are again noted diffuse airspace opacities bilaterally   Keywords: again. The tracheostomy tube and the right-sided PICC line are unchanged in position.


SubjectID: 15862403, StudyID: 57093151, Comparison: worse

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Respiratory failure, intubated, pulmonary edema, strep bovis bacteremia, rule out edema

COMPARISON: ___.

FINDINGS: Moderate pulmonary edema has increased since previous exam   Keywords: increase. Pleural effusions are small and unchanged. There is no pneumothorax. Cardiac contour is mildly enlarged and stable. Prior sternotomy was done for AVR. ET tube and left jugular line are in adequate position. The distal end of NG tube is hard to assess. Right jugular line has been removed.

CONCLUSION: Moderate pulmonary edema has significantly worsened since previous exam   Keywords: worse. This was discussed with the medical team.


SubjectID: 15862403, StudyID: 52204395, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Respiratory failure, evaluation for pneumonia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the monitoring and support devices are unchanged. Unchanged size of the cardiac silhouette. Unchanged increased radiodensity in the region of the right middle lobe that could, in the light of a positive clinical history, potentially reflect pneumonia. No pleural effusions. No pulmonary edema. No pneumothorax.


SubjectID: 15862403, StudyID: 56358009, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Respiratory failure, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the two right-sided central venous access lines and the tracheostomy tube are in unchanged position. Unchanged alignment of the sternotomy wires. The very extensive bilateral parenchymal opacities, diffuse in distribution, as well as the small bilateral pleural effusions, are unchanged in severity and distribution. Moderate cardiomegaly persists. No new parenchymal opacities   Keywords: new.


SubjectID: 15862403, StudyID: 56045428, Comparison: worse

FINAL REPORT

INDICATION: Evaluation of nasogastric tube placement in a patient with hypoxia and pulmonary edema.

COMPARISON: Multiple chest radiographs, the most recent of ___.

FINDINGS: Portable AP supine view of the chest was reviewed. The lateral aspect of the right chest was excluded. A tracheostomy ends 5 cm above the carina. Right-sided hemodialysis catheter and PICC line end in the mid superior vena cava. The upper enteric tube enters the stomach and ends off of the radiograph. Increased vascular volume and an interval increase in moderate-to-severe pulmonary edema reflect volume overload or biventricular heart failure. Median sternotomy wires are aligned and intact. Lung volumes are low and there are no pleural effusions or pneumothorax. Top normal heart size is unchanged.

IMPRESSION: 1. Upper enteric tube enters the stomach and ends off of the radiograph. 2. Increased moderate-to-severe pulmonary edema and increased vascular volume could be caused by volume overload or biventricular heart failure   Keywords: increase.


SubjectID: 15862403, StudyID: 53321712, Comparison: None

FINAL REPORT

INDICATION: Evaluation for interval change in a patient with pulmonary edema.

COMPARISON: Multiple chest radiographs, the most recent of ___, performed five hours prior.

FINDINGS: Portable AP semi-upright view of the chest was reviewed. Compared to the most recent study performed five hours prior, there is new bilateral increased heterogeneity of the lungs with diffuse tiny lucencies consistent with interstitial pulmonary emphysema caused by barotrauma. The lines and tubes remain in proper position and the cardiac and mediastinal contours are unchanged. The small left pleural effusion has possibly increased.

IMPRESSION: New interstitial pulmonary emphysema due to barotrauma. COMMENT: Findings were telephoned to Dr. ___ by Dr. ___ at 11:19 a.m., three minutes after the time of discovery.


SubjectID: 15862403, StudyID: 55534803, Comparison: better

FINAL REPORT

HISTORY: Septicemia unknown source, unable to wean from ventilator. Prior chest x-ray on ___ with area suspicious for cavitary lesion. Evaluate for focal consolidation/cavitation, question pulmonary edema or effusions.

COMPARISON: ___.

FINDINGS: ET tube, NG tube and right internal jugular catheter in unchanged satisfactory position. Compared with most recent prior radiograph, widespread pulmonary opacification has greatly improved with minimal residual opacification of the right consistent with improving pulmonary edema and pneumonia   Keywords: improve. No pleural effusion or pneumothorax is present. Stable appearance of the cardiomediastinal silhouette.

IMPRESSION: Interval dramatic improvement in widespread pulmonary opacification with minimal residual right lower lung opacification consistent with improving pulmonary edema and pneumonia   Keywords: improve.


SubjectID: 15862403, StudyID: 54526741, Comparison: same

FINAL REPORT

CLINICAL

HISTORY: Fluid overload, evaluate for change in interstitial edema. CHEST, AP:

COMPARISON FILM: ___. Degree of opacification in both the right and the left is essentially unchanged since the prior chest x-ray of ___ and ___.

IMPRESSION: No change   Keywords: no change.


SubjectID: 15866068, StudyID: 57345309, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman s/p BiV ICD via L subclavian vein // confirm lead placement

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The lateral radiograph only shows a minimal left dorsal pleural effusion. 1 lead projects over the right atrium, 1 over the right ventricle and 1 over the coronary sinus. The pacemaker generator is in unchanged left pectoral position. The size of the cardiac silhouette is constant.


SubjectID: 15866068, StudyID: 56992652, Comparison: None

WET READ: ___ ___ ___ 8:21 PM Status post pacer/ICD. No pneumothorax.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p BiV ICD via L subclavian vein // rule out pneumothorax

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the patient has received a left pectoral pacemaker. The course of the leads is unremarkable. There is no pneumothorax. No pulmonary edema. No pleural effusions. The leads project as expected, over the right atrium, right ventricle, and coronary sinus.


SubjectID: 15866068, StudyID: 56198233, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___:

FINDINGS: Swan-Ganz catheter has been slightly advanced into the right interlobar pulmonary artery. Cardiac silhouette has decreased in size. Mild pulmonary vascular congestion is present without overt pulmonary edema. Improving left basilar atelectasis and persistent small pleural effusion.


SubjectID: 15866068, StudyID: 51981533, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with cardiogenic shock, Swan in place // Eval Swan placement, pulmonary edema

TECHNIQUE: Portable AP view of the chest.

COMPARISON: Chest radiograph on ___

FINDINGS: A Swan-Ganz catheter terminates in the right pulmonary artery and is in adequate position. The heart is substantially enlarged but unchanged. The mediastinal and hilar contours are normal. There is a left basal opacity, minimally increased from prior study which likely represents atelectasis. There is no evidence of hemothorax or mediastinal widening. No pleural effusion or pneumothorax is identified.

IMPRESSION: 1. Increased left basal opacity, which likely represents atelectasis. 2. Swan-Ganz catheter in appropriate position.


SubjectID: 15866889, StudyID: 59356692, Comparison: same

FINAL REPORT

PORTABLE CHEST ___

HISTORY: ___-year-old man with fever and tachycardia.

FINDINGS: Single portable view of the chest is compared to prior exam from ___. There is persistent blunting of lateral costophrenic angles suggesting at least some component of pleural effusion, although given differences in positioning and technique they do appear smaller when compared to prior. There is persistent pulmonary vascular engorgement with indistinct vascular markings   Keywords: persistent. Cardiac silhouette is grossly unchanged. Osseous and soft tissue structures are unremarkable.

IMPRESSION: Apparent interval improvement of the bilateral pleural effusions with persistent interstitial markings bilaterally suggestive of failure; however, bilateral pneumonia could also be considered in this clinical setting.


SubjectID: 15866889, StudyID: 57059266, Comparison: better

FINAL REPORT

HISTORY: CHF, fever or chills. CHEST, SINGLE AP PORTABLE VIEW. There are low inspiratory volumes. The patient is status post sternotomy, with cardiomegaly. There are patchy opacities at both bases with small effusions. Compared with ___ at 20:23 p.m., the CHF findings appear slightly improved and the confluent alveolar opacities are also improved.

IMPRESSION: Partial interval improvement in findings of CHF/pulmonary edema   Keywords: improve. No upper zone redistribution apparent at this time.


SubjectID: 15866889, StudyID: 59089387, Comparison: worse

FINAL REPORT

PORTABLE AP CHEST FILM UPRIGHT CLINICAL

INDICATION: A ___-year-old with intraaortic balloon pump, now with coughing and congestion, increasing oxygen requirements, evaluate for infection or other pathology. Comparison is made to the patient's previous studies dated ___ at ___. Single portable upright chest film ___ at ___ is submitted.

IMPRESSION: 1. Right internal jugular introducer remains in place, unchanged. A nasogastric tube is seen coursing below the diaphragm with the tip not identified. 2. Increasing indistinctness of the pulmonary vascularity consistent with moderate pulmonary and interstitial edema   Keywords: increasing. Status post median sternotomy with stable cardiac enlargement and mediastinal contours. No pneumothorax. Probable layering bilateral effusions.


SubjectID: 15866889, StudyID: 55809232, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: History of flashing, increased dyspnea, questionable pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the nasogastric tube and the right internal jugular vein introduction sheath has been removed. The lung volumes have decreased, there is newly occurred mild blunting of the costophrenic sinuses, potentially reflecting small pleural effusions. The pre-existing mild fluid overload has slightly increased in severity   Keywords: increase. Increasing areas of atelectasis at the lung bases.


SubjectID: 15866889, StudyID: 51128363, Comparison: None

WET READ: ___ ___ ___ 8:14 PM PRELIMINARY REPORT: Right IJ sheath and NG tube appropriate. Moderate b/l effusions with associated atelectasis. A ___ ______________________________________________________________________________

FINAL REPORT

CLINICAL

HISTORY: Nasogastric tube placed, status post cardiogenic shock, evaluate for tube placement. CHEST: Tip of the nasogastric tube lies within the stomach. The position of the right IJ sheath is unchanged and satisfactory. Bilateral pleural effusions are present. The degree of vascular engorgement on the current film appears less than it was on the prior chest x-ray of ___.

IMPRESSION: Position of tubes satisfactory, improvement in degree of failure.


SubjectID: 15866889, StudyID: 57675111, Comparison: worse

FINAL REPORT

PORTABLE CHEST RADIOGRAPH OF ___

COMPARISON: Radiographs ___.

FINDINGS: Intra-aortic balloon pump has been repositioned, with tip now terminating about 3.4 cm below the expected location of the superior aspect of the aortic knob, in the region of the aorticopulmonary window. Endotracheal tube, Swan-Ganz catheter, nasogastric tube, and vascular sheath are unchanged in position. Cardiac silhouette is mildly enlarged, and is accompanied by improving asymmetric perihilar edema, worse on the right than the left   Keywords: worse. Moderate right pleural effusion tracking to the apex is also slightly decreased in size in the interval. Questionable layering left pleural effusion.


SubjectID: 15866889, StudyID: 57502473, Comparison: -1.0

FINAL REPORT

INDICATION: Cardiac shock.

COMPARISONS: Chest radiograph, ___. Chest radiograph, ___. Chest radiograph, ___.

FINDINGS: An endotracheal tube ends approximately 3.8 cm from the carina. A right internal jugular central line ends in the distal internal jugular vein. A Swan-Ganz catheter from the femoral position ends in the proximal portion of right pulmonary artery. An aortic balloon pump sits approximately 1.6 cm from the roof of the aortic arch and could be withdrawn slightly. Sternal wires are intact. Small new bilateral pleural effusions are present. Moderate pulmonary edema is unchanged, and is more prominent on the right than the left, which is likely due to the patient's papillary muscle dysfunction   Keywords: unchanged. Moderate enlargement of the cardiac silhouette is stable.

IMPRESSION: 1. Balloon pump ends about 1.6 cm from the roof of the aortic arch and could be withdrawn slightly. 2. New small bilateral pleural effusions. 3. Stable moderate pulmonary edema, worse on the right than the left   Keywords: worse. Results were discussed with ___ at 11:20 am on ___ via telephone by Dr. ___.


SubjectID: 15866889, StudyID: 52920828, Comparison: worse

WET READ: ___ ___ ___ 7:57 PM Increased opacities extending from the hila consistent with pulmonary edema. ETT placed in standard position. R-IJ unchanged. Esophageal catheter courses inferior to diaphragm with tip out of view of radiograph. ______________________________________________________________________________

FINAL REPORT

PORTABLE CHEST OF ___

COMPARISON: ___ chest radiograph.

FINDINGS: Intra-aortic balloon pump has been placed, with tip terminating in close proximity to the expected location of the origin of the left subclavian artery from the aortic arch. Subsequent chest radiograph performed ___ and dictated separately under clip ___demonstrates repositioning of this catheter to a lower level. Other indwelling devices are in standard position. Cardiac silhouette is mildly enlarged, and accompanied by development of perihilar edema and a moderate right pleural effusion tracking to the right lung apex   Keywords: development.


SubjectID: 15866889, StudyID: 57589717, Comparison: worse

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___ radiograph.

FINDINGS: Cardiomegaly and bilateral perihilar and basilar pulmonary edema are present, with slight worsening of edema since the prior study   Keywords: worse. Moderate-to-large right pleural effusion and small left pleural effusion are also demonstrated, with possible slight increase in right effusion compared to the prior study.


SubjectID: 15866889, StudyID: 55976323, Comparison: better

FINAL REPORT

PORTABLE AP CHEST FILM ___ AT 733 CLINICAL

INDICATION: ___-year-old status post CHF and CABG, flash pulmonary edema, evaluate for interval change. Comparison is made to the patient's previous study dated ___ at 710. Portable AP upright chest film ___ at 733 is submitted.

IMPRESSION: 1. Status post median sternotomy. The heart remains enlarged. Bilateral layering effusions with persistent but somewhat improved mild-to-moderate pulmonary and interstitial edema   Keywords: improve. No pneumothorax.


SubjectID: 15866889, StudyID: 52750773, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Shortness of breath and hypoxia.

COMPARISONS: ___.

TECHNIQUE: Chest, AP portable upright.

FINDINGS: The patient is status post sternotomy. The heart is enlarged, although the cardiac silhouette is not optimally assessed due to superimposed diffuse pulmonary opacification suggesting moderate pulmonary edema. A pleural effusion of small-to-moderate size is suspected on the right side. Hazy opacification of the left lung base is indeterminate but potentially reflects an effusion in part. There is apparently an opacity with air bronchograms in the retrocardiac region. The lung volumes are low.

IMPRESSION: 1. Findings suggesting moderate pulmonary edema with a pleural effusion suspected on the right. 2. Low lung volumes with left basilar opacity including air bronchograms. Although pneumonia is not excluded, atelectasis could provide an alternative explanation. Clinical correlation is recommended and consideration of followup radiographs, preferably with PA and lateral technique, if needed clinically.


SubjectID: 15866889, StudyID: 54394641, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post MI, status post intubation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is marked improvement with reduction of the pre-existing parenchymal opacities   Keywords: improve. The opacities are now confined to the lingula in the right lung base, overall to the more central areas of the lung. Unchanged retrocardiac atelectasis. The Swan-Ganz catheter has been removed. Also removed is the aortic balloon pump. The remaining monitoring and support devices are unchanged. Unchanged size of the cardiac silhouette. No pneumothorax.


SubjectID: 15866889, StudyID: 54499710, Comparison: None

WET READ: ___ ___ ___ 7:42 PM Mild progression of moderate bilateral effusions with associated atelectasis. Right IJ sheath and NG tube are appropriate. A ___ ______________________________________________________________________________

FINAL REPORT

HISTORY: Extubation.

FINDINGS: In comparison with the earlier study of this date. There is increasing haziness bilaterally consistent with layering pleural effusions with associated compressive atelectasis. Some engorgement of pulmonary vessels is consistent with elevated pulmonary venous pressure. Monitoring and support devices remain in place.


SubjectID: 15866889, StudyID: 50010065, Comparison: same

FINAL REPORT

PORTABLE CHEST, ___.

COMPARISON: Study of earlier, but same date.

FINDINGS: Nasogastric tube terminates within the stomach. The distal tip is not included on the radiograph, but is at least within the body of the stomach. Endotracheal tube has been removed. Cardiac silhouette is mildly enlarged. Lung volumes are lower compared to the recent study. Allowing for this factor, the degree of pulmonary edema is probably similar   Keywords: similar. There are likely small bilateral pleural effusions present, left greater than right.


SubjectID: 15870527, StudyID: 58577181, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female, status post biventricular ICD placement. Assess lead placement.

COMPARISON: Chest radiograph, ___.

TECHNIQUE: Frontal and lateral chest radiographs.

FINDINGS: Transsubclavian atrio-biventricular ICD leads run from the left pectoral power pack with to the right atrial appendage, right ventricular apex and surface of the left ventricle, respectively. The lungs are clear and the pleural surfaces are normal. Heart size is top normal with normal mediastinal contour and hila.

IMPRESSION: Standard courses, new ICD leads. No complications.


SubjectID: 15871582, StudyID: 59719859, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with cough for 2 weeks with wheezing. // PNA?

COMPARISON: Chest radiograph ___

FINDINGS: PA and lateral views of the chest provided. Left atrioventricular pacemaker is unchanged. Lungs are well inflated and grossly clear. No pleural effusion or pneumothorax. The aorta is mildly tortuous, otherwise the hilar and cardiomediastinal contours are normal.

IMPRESSION: Normal chest radiograph.


SubjectID: 15871582, StudyID: 52209682, Comparison: None

FINAL REPORT

INDICATION: Shortness of breath and crackles. Evaluate edema.

COMPARISON: Chest radiographs from ___, ___, and ___.

FINDINGS: A portable frontal chest radiograph demonstrates a left chest wall pacer device with leads overlying the right atrium and ventricle. The cardiomediastinal silhouette is normal and the lungs clear, without edema, congestion, focal consolidation, pleural effusion, or pneumothorax. The visualized upper abdomen is clear.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 15871582, StudyID: 55913073, Comparison: worse

FINAL REPORT

EXAMINATION: CXR

INDICATION: ___-year-old female with dyspnea. Evaluate for infiltrate or congestive heart failure.

TECHNIQUE: Frontal and lateral chest radiographs were obtained.

COMPARISON: Chest radiograph from ___ and ___

FINDINGS: The heart is intervally enlarged, and there is central pulmonary vascular congestion. There are bilateral small pleural effusions. A cardiac pacing device is in stable position with its leads terminating over the right atrium and ventricle. No focal consolidation or pneumothorax is seen. There is mild elevation of the right hemidiaphragm.

IMPRESSION: New cardiomegaly with central pulmonary vascular congestion and small bilateral pleural effusions   Keywords: new.


SubjectID: 15871582, StudyID: 52444682, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with Ms. ___ is a an ___ PMHx AFib on apixiban, tachy-brady s/p PPM placement, dCHF, diverticulosis, h/o recurrent LGIB, desatting when ambulating. // Is there any acute pulmonary process which would contribute to desatting when ambulating?

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, bilateral pleural effusions continue to be visible. The extent of the effusions is better appreciated on the lateral than on the frontal radiograph and has not substantially changed as compared to the previous image. Moderate cardiomegaly and mild fluid overload persists but no overt pulmonary edema is present   Keywords: persists. Moderate tortuosity of the thoracic aorta. No pneumonia. Unchanged position of the left pectoral pacemaker.


SubjectID: 15871582, StudyID: 54057461, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF exacerbation. // desat overnight, assess for effusions

COMPARISON: ___.

IMPRESSION: No relevant change as compared to the previous image   Keywords: no relevant change. Low lung volumes. Small right pleural effusion. Elevation of both the left and the right hemidiaphragm. Subsequent areas of atelectasis at both lung bases. Moderate cardiomegaly with mild fluid overload. Unchanged position of the left pectoral defibrillator


SubjectID: 15871582, StudyID: 51026407, Comparison: None

FINAL REPORT

INDICATION: ___F with dyspnea // r/o pna

TECHNIQUE: Frontal and lateral views the chest.

COMPARISON: ___.

FINDINGS: Again seen are bilateral pleural effusions, right greater than left, and slightly increased from prior. Fluid seen within the right minor fissure. There is pulmonary vascular congestion without overt edema. Moderate cardiomegaly is again noted as well as a dual lead left chest wall pacing device. Tortuosity of the descending thoracic aorta with atherosclerotic calcifications at the arch. No acute osseous abnormalities.

IMPRESSION: Bilateral pleural effusions, right greater than left and slightly larger when compared to prior. Pulmonary vascular congestion without overt edema.


SubjectID: 15894036, StudyID: 59579597, Comparison: None

WET READ: ___ ___ ___ 4:17 AM No acute cardiopulmonary process. Chronic cardiomegaly. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___-year-old woman with dyspnea on exertion. Evaluate for acute process.

COMPARISON: Chest radiograph from ___.

FINDINGS: The lungs are clear. Moderate cardiomegaly is unchanged. There is no pneumothorax. There is no pleural effusion. Pulmonary vascularity is normal.

IMPRESSION: No acute cardiopulmonary process. Chronic cardiomegaly.


SubjectID: 15894036, StudyID: 54147998, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ yo F with h/o HTN, mod/sev MR, mod/sev TR and A-fib on coumadin s/p several failed cardioversions, admitted for acute dCHF decompensation in the setting of Severe MR and persistent A.___ with worsening sob // interval change

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the patient has been intubated. Whereas the first radiograph shows the tube being to low, the second radiograph documents correct tube position, with the tip projecting approximately 3.5 cm above the carinal. The patient has also received the nasogastric tube. The course of the tube is unremarkable. The tip of the tube is located in the middle parts of the stomach. Moderate cardiomegaly. Mild pulmonary edema. No larger pleural effusions. Moderate retrocardiac atelectasis.


SubjectID: 15894036, StudyID: 59069928, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with sp arrest // edema/

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: There is a new ET tube with the tip in the right mainstem bronchus. The right IJ line tip is at the cavoatrial junction. There continues to be severe cardiomegaly that is slightly increased compared to the prior study. There is interstitial edema with increased lung markings   Keywords: increase. There patchy areas of atelectasis

IMPRESSION: Right mainstem bronchus intubation.

NOTIFICATION: This finding was immediately called to the nurse caring for the patient, ___, at the time of discovery by Dr. ___ at 09:10 on ___ at the time of interpretation of the films


SubjectID: 15894036, StudyID: 55860204, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with TR, MR, pulmonary edema // pulm edema

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: Compared to the prior study the ET tube has been removed. There is mild improved aeration bilaterally. Otherwise there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: Slight improved aeration bilaterally.


SubjectID: 15894036, StudyID: 53564922, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF // tube placement

TECHNIQUE: Portable chest

COMPARISON: ___ at 06:37

FINDINGS: The endotracheal tube is been pulled back and is now 6 cm above the carina. the right IJ line is unchanged. This is a rotated film and therefore it is difficult to assess for the degree of right lower lobe volume loss. A 4 cm rounded opacity is seen projecting to the right of the spine. It is unclear where this originates from. Is not been visualized on prior studies however we have not had a prior exam in this rotation. A CT scan would be needed for further assessment.

IMPRESSION: 1. Improved location of the ET tube 2. 4 cm mass projecting to the right of the spine. Recommend CT

NOTIFICATION: Findings were discussed with ___ in the ICU at the time of discovery by Dr. ___ on ___ at 10:45


SubjectID: 15894036, StudyID: 57372924, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with concern for PNA, pulm edema, spiking fevers despite abx // pls eval for interval change

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the monitoring and support devices are unchanged. Moderate cardiomegaly persists but the pre-existing pulmonary edema has minimally decreased in severity   Keywords: decrease. Lung volumes with bilateral areas of atelectasis at the lung bases are unchanged.


SubjectID: 15894036, StudyID: 56996910, Comparison: None

WET READ: ___ ___ ___:___ AM The endotracheal tube is in the right mainstem bronchus and could be retracted 3.5 cm. Bilateral pleural effusions and basilar opacities are stable. ___ discussed with ___ ___.

WET READ VERSION #1 ___ ___ ___:___ PM The endotracheal tube is in the right mainstem bronchus and could be retracted 3.5 cm. Bilateral pleural effusions and basilar opacities are stable. ___ discussed with ___ ___. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF, hypoxic arrest, intubated // Evaluate ET tube placement Evaluate ET tube placement

IMPRESSION: In comparison with the study of ___, the endotracheal tube lies within the right mainstem bronchus and must be pulled back at least 4 cm. This information was discussed with the resident on call by the Radiology resident. Opacification in the retrocardiac region is consistent with substantial volume loss in the left lower lobe. Opacification at the right base is consistent with some combination of pleural effusion and atelectatic changes.


SubjectID: 15894036, StudyID: 53933040, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with ETT // evalualte ETT placement evalualte ETT placement

IMPRESSION: In comparison with the study of ___, the endotracheal tube has been pulled back so that the tip now lies approximately 2.5 cm above the carina. There is substantial enlargement of the cardiac silhouette with pulmonary vascular congestion and bilateral pleural effusions. Its the left hemidiaphragm is completely obscured, consistent with substantial volume loss in the left lower lobe. Monitoring and support devices are otherwise unchanged.


SubjectID: 15894036, StudyID: 51563052, Comparison: same

WET READ: ___ ___ ___:___ AM The endotracheal tube is at the right mainstem bronchus and could be retracted 3.5 cm. Bilateral pleural effusions and basilar opacities are stable. ___ discussed with ___ ___.

WET READ VERSION #1 ___ ___ ___:___ PM The endotracheal tube is at the right mainstem bronchus and could be retracted 3.5 cm. Bilateral pleural effusions and basilar opacities are stable. ___ discussed with ___ ___. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman intubated for hypoxic arrest, pulled back ET tube. // Evaluate ET tube placement Evaluate ET tube placement

IMPRESSION: In comparison with the previous study, the endotracheal tube lies in the right mainstem bronchus and should be pulled back at least 5-6 cm. Otherwise little change   Keywords: little change.


SubjectID: 15894036, StudyID: 50701547, Comparison: None

WET READ: ___ ___ ___:___ AM The endotracheal tube is at the right mainstem bronchus and could be retracted 3.5 cm. Bilateral pleural effusions and basilar opacities are stable. ___ discussed with ___ ___.

WET READ VERSION #1 ___ ___ ___:___ PM The endotracheal tube is at the right mainstem bronchus and could be retracted 3.5 cm. Bilateral pleural effusions and basilar opacities are stable. ___ discussed with ___ ___. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hypoxic arrest, s/p intubation and OGT placement // Evaluate ET and OGT placement Evaluate ET and OGT placement

IMPRESSION: The endotracheal tube is in the right mainstem bronchus and must be pulled back about 5-6 cm.


SubjectID: 15894036, StudyID: 56421286, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hypoxic resp failure ___ MVR // ? ETT tube placement and lung fields

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: ET tube tip is low, approximately 2 cm above the carinal and might be pulled back for additional 1.5 cm. NG tube tip is in the stomach. Cardiomegaly is substantial but unchanged. Retrocardiac consolidation in the left lower lung and smaller right basal opacities are unchanged since that most recent prior examination and appear to be potentially progressed as compared to ___ chest CT. There is no pneumothorax.


SubjectID: 15894036, StudyID: 51404078, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hypoxic resp failure ___ MVR // lung fields

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The tip of the endotracheal tube has been pulled back by approximately 1 cm. Mild fluid overload but no overt pulmonary edema. Platelike retrocardiac atelectasis. No pleural effusions. No pneumonia. Moderate cardiomegaly.


SubjectID: 15894036, StudyID: 53968627, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF MR / TR with hypoxia, acute resp failure now reintubated // intubation, resp failure

TECHNIQUE: Single frontal view of the chest

COMPARISON: Study performed 6 hours earlier

IMPRESSION: ET tube is in standard position. Right IJ catheter tip is at the cavoatrial junction. Improved bibasilar atelectasis left greater than right. Mild vascular congestion is stable   Keywords: stable. There is no pneumothorax.


SubjectID: 15894036, StudyID: 55197455, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ yo F PMHx significant for HTN, mod/sec MR, mod/sev TR and A-fib on coumadin with several failed cardioversions, most recent on ___, who presented w/ lightheadedness and SOB, was found to be in decompensated CHF and is now sp PEA arrest. // please assess for mucous plugging, infiltrate, edema

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the patient has been extubated and all monitoring and support devices have been removed. The lung volumes have increased. Moderate cardiomegaly and minimal fluid overload persist. The presence of a small left pleural effusion cannot be excluded. No new parenchymal opacities   Keywords: new. No evidence of pneumothorax.


SubjectID: 15894036, StudyID: 53667827, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hypoxic respiratory failure s/p intubation // please eval for pulm edema vs pna

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Cardiomegaly is substantial, unchanged. ET tube tip is 4.5 cm above the carinal. Right central venous line tip terminates at the level of cavoatrial junction. Bibasal consolidations in bilateral pleural effusions are unchanged. No pneumothorax is seen.


SubjectID: 15904250, StudyID: 55416721, Comparison: worse

FINAL REPORT

HISTORY: Abdominal pain, nausea, vomiting, diarrhea.

COMPARISON: Comparison made with chest radiographs from maintenance, ___ and ___.

FINDINGS: AP and lateral views of the chest. The lungs are well expanded. There is increased interstitial markings from prior exam, suggestive of a mild interstitial pulmonary edema   Keywords: increase. There is a small left pleural effusion. There is a trace right pleural effusion. No pneumothorax is seen. The cardiomediastinal silhouette is enlarged, unchanged from prior exam. A pacer is seen overlying the left anterior chest with intact leads in appropriate positions.

IMPRESSION: 1. Increase interstitial markings from prior exam, suggestive of a mild interstitial pulmonary edema   Keywords: increase. 2. Small right pleural effusion and trace left pleural effusion.


SubjectID: 15904250, StudyID: 52130376, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: SHORTNESS OF BREATH

TECHNIQUE: Chest PA and Lateral

COMPARISON: ___

FINDINGS: DUAL LEAD LEFT-SIDED PACEMAKER IS AGAIN SEEN WITH LEADS EXTENDING THE EXPECTED POSITIONS OF THE RIGHT ATRIUM AND RIGHT VENTRICLE. THERE ARE SMALL BILATERAL PLEURAL EFFUSION. THE PATIENT IS STATUS POST MEDIAN STERNOTOMY. THE CARDIAC SILHOUETTE REMAINS MODERATELY ENLARGED. THE AORTA IS CALCIFIED. NO DEFINITE FOCAL CONSOLIDATION IS SEEN. THERE IS NO PNEUMOTHORAX. PROMINENCE OF THE RIGHT HILUM IS GROSSLY STABLE.

IMPRESSION: PERSISTENTLY MODERATELY ENLARGED CARDIAC SILHOUETTE. SMALL BILATERAL PLEURAL EFFUSIONS. NO OVERT PULMONARY EDEMA.


SubjectID: 15904475, StudyID: 58833709, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with HFpEF, AF on anticoagulation, R. MCA stroke ___ AF ___, DM2 c/b neuropathy who presents with worsening shortness of breath after self-discontinuation of her home torsemide in the setting of diarrhea now with worsening confusion and lethargy // PNA r/o PNA r/o

IMPRESSION: As compared to ___, no relevant change is seen   Keywords: no relevant change. No evidence of pneumonia. Moderate cardiomegaly. No pulmonary edema, no pleural effusions.


SubjectID: 15904475, StudyID: 51056794, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___F with shortness of breath. Evaluate for pulmonary edema.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiographs of ___, ___, and ___.

FINDINGS: Compared with the prior study, marked cardiomegaly, pulmonary vascular congestion, and edema have improved, but are persistent   Keywords: improve. Lungs demonstrate improved aeration. No new focal consolidation or pleural effusions. No pneumothorax identified.

IMPRESSION: Interval improvement, but persistence of, marked cardiomegaly, pulmonary vascular congestion, and pulmonary edema   Keywords: improve. No new focal consolidation.


SubjectID: 15904475, StudyID: 56509173, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with dCHF and new ?Takasubo's // pulmonary edema? infiltrate?

IMPRESSION: As compared to ___ chest radiograph, marked cardiomegaly is now accompanied by pulmonary vascular congestion and mild edema.


SubjectID: 15904475, StudyID: 53678498, Comparison: None

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPH

INDICATION: Status post recent fall.

TECHNIQUE: Chest, AP upright.

COMPARISON: ___.

FINDINGS: The heart is moderately enlarged. The cardiac, mediastinal and hilar contours appear stable. There is suspicion for minor right basilar atelectasis. Otherwise, the lungs appear clear. Soft tissue attenuation limits visualization of bony structures, but no displaced fracture is visualized.

IMPRESSION: Findings suggest minor right basilar atelectasis with no definite evidence of injury.


SubjectID: 15906836, StudyID: 57913049, Comparison: None

WET READ: ___ ___ ___ 9:41 PM Enteric tube remains malpositioned. Dr ___ ___ Dr. ___ ___ telephone at 9:37 PM on ___ who confirmed the tube had been removed. Some interval improvement in bibasilar opacity. New small left pleuraleffusion.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with NG tube // NG tube placement

COMPARISON: ___, 17:16.

IMPRESSION: As compared to the previous radiograph, the malpositioned nasogastric tube has been slightly pulled back but the tube remains malpositioned. Telephone contact with the referring physician's, documented in the

WET READ, confirms that the tube was later removed. Unchanged moderate cardiomegaly with tortuosity of the thoracic aorta. No pneumothorax, minimally improved transparency of the lung parenchyma.


SubjectID: 15906836, StudyID: 57147158, Comparison: None

FINAL REPORT

HISTORY: NG placement.

FINDINGS: Nasogastric tube extends to the mid chest, before reversing so that the tip lies in the lower neck. Subsequent film previously dictated shows the tube in good position.


SubjectID: 15906836, StudyID: 52895942, Comparison: None

FINAL REPORT

INDICATION: Desaturations, question acute process.

COMPARISON: ___.

FINDINGS: Portable frontal radiograph of the chest demonstrates interval removal of the feeding tube. Bilateral lower lung opacities and right mid lung opacity low could slightly worse than ___ which may be related to lower lung volumes but appear similar to ___. No pleural effusion or pneumothorax.


SubjectID: 15906836, StudyID: 51195720, Comparison: None

FINAL REPORT

HISTORY: NG placement.

FINDINGS: In comparison with the earlier study of this date, the intestinal tube has been redirected with the opaque tip just distal to the esophagogastric junction.


SubjectID: 15906836, StudyID: 50005748, Comparison: None

WET READ: ___ ___ ___ 9:39 PM Enteric tube malpositioned in a right bronchus. At the time of this study, the tube had already been repositioned. Lung fields appear similar to the most recent prior with bilateral lower lung and right mid lung opacities. Dr ___ ___ Dr. ___ ___ telephone at 9:37 PM on ___.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with NG tube placement // NG tube placement

COMPARISON: ___, 8:40 a.m.

IMPRESSION: As compared to the previous radiograph, the patient has received a nasogastric tube. The tube is malpositioned in the right bronchial system and needs to be withdrawn immediately. Later films will show a correction and finally a complete retrieval of the device. At telephone message was delivered at the time of image acquisition. There is no evidence for the presence of a pneumothorax or other complications. Bilateral parenchymal opacity at both lung bases pre existed. Unchanged appearance of the mediastinum and of the cardiac silhouette.


SubjectID: 15906836, StudyID: 51913184, Comparison: None

FINAL REPORT

EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Hypoxia and fevers.

COMPARISON: ___.

FINDINGS: Frontal and lateral views of the chest were obtained. There are patchy bibasilar mid lung opacities bilaterally, raising concern for multifocal infection. Alternatively, the superimposed aspiration is not excluded. No large pleural effusion is seen. There is no pneumothorax. The cardiac silhouette is top normal. The aorta is calcified.

IMPRESSION: Multifocal mid and lower lung opacities raise concern for multifocal infection. Recommend followup to resolution.


SubjectID: 15934572, StudyID: 55321360, Comparison: None

FINAL REPORT

CXR PORTABLE FILM

HISTORY: Pulmonary edema.

FINDINGS: Prior CABG. Bilateral hazy opacities without significant change from examination done at 12:55. Findings are consistent with CHF/pulmonary edema. ET tube tip is satisfactory.


SubjectID: 15934572, StudyID: 54666487, Comparison: None

FINAL REPORT

PORTABLE CHEST X-RAY, ___ Compared to previous study of earlier the same date.

FINDINGS: Tip of left PICC is now terminates within the lower superior vena cava. Interval extubation. Slight interval improvement in aeration in the lung bases with otherwise no additional relevant changes since the recent study performed less than two hours earlier.


SubjectID: 15934572, StudyID: 52504822, Comparison: 1.0

FINAL REPORT

PORTABLE CHEST ___

COMPARISON: ___ radiograph.

FINDINGS: Endotracheal tube and nasogastric tube are in standard position. Cardiac silhouette remains enlarged and is accompanied by pulmonary vascular congestion   Keywords: remains. Overall, the degree of pulmonary edema has improved, and a layering right pleural effusion is slightly smaller   Keywords: improve.


SubjectID: 15934572, StudyID: 51095058, Comparison: worse

FINAL REPORT

PORTABLE CHEST X-RAY, ___

COMPARISON: Radiograph of earlier the same date.

FINDINGS: Endotracheal tube and nasogastric tube remain in standard position. Persistent cardiomegaly and slight worsening of pulmonary edema accompanied by a moderate layering right pleural effusion and small left pleural effusion   Keywords: worse.


SubjectID: 15934572, StudyID: 50381837, Comparison: None

FINAL REPORT

CXR PORTABLE FILM

HISTORY: Shortness of breath.

FINDINGS: Sternotomy. ET tube tip is satisfactory. There is diffuse haziness throughout both lung fields along with prominent vessels. Findings suggest congestive heart failure as well as pleural effusions. No focal consolidation is identified.

CONCLUSION: Sternotomy and prior CABG. CHF. These are worse from the previous examination of ___.


SubjectID: 15945590, StudyID: 58433184, Comparison: None

FINAL REPORT

HISTORY: Evaluation for infection or edema.

TECHNIQUE: Frontal view of the chest.

COMPARISON: Multiple chest radiographs, most recent on ___.

FINDINGS: An endotracheal tube is seen in standard position. Alimentary tube is seen passing into the stomach and out of view. A right internal jugular line terminates in the low SVC. The lung volumes are low and there is atelectasis at the bases. An opacity in the right mid lung is suggestive of pneumonia. The heart is enlarged and there is minimal vascular engorgement. No pleural effusions are identified and there is no pneumothorax.

IMPRESSION: Worsening right mid lung opacity concerning for pneumonia.


SubjectID: 15945590, StudyID: 58280874, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with resp distress // intubation

TECHNIQUE: Single portable AP view radiograph of the chest.

COMPARISON: Prior chest radiographs dating back to___.

FINDINGS: There is new white-out of the left hemithorax, with only minimal remaining aeration of the left upper lobe. In the absence of mediastinal shift, this is likely a combination of increasing pleural effusion and collapse. The moderate layering right pleural effusion is stable. The endotracheal tube ends 5.3 cm necrotic, the enteric tube extends outside of the field of view in a decompressed stomach. The right-sided PICC line ends in the mid SVC.

IMPRESSION: 1. New white-out of the left hemithorax, likely a combination of pleural effusion and collapse. 2. Stable moderate right pleural effusion. 3. All tubes and lines in satisfactory position.


SubjectID: 15945590, StudyID: 53533673, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CKD // s/p reintubation s/p reintubation

IMPRESSION: In comparison with the earlier study of this date, the tip of the endotracheal tube lies approximately 5.3 cm above the carina. There is improved aeration of the left hemithorax, though some opacification at the left base is consistent with volume loss in the lower lobe and pleural effusion. Opacification at the right base with silhouetting of the hemidiaphragm is consistent with pleural effusion and volume loss on this side as well. Some indistinctness of pulmonary vessels suggests some element of elevated pulmonary venous pressure.


SubjectID: 15945590, StudyID: 52144432, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man intubated with heart failure, volume overload, acidosis, renal failure // interval change

COMPARISON: ___

IMPRESSION: As compared to the previous image, no relevant change is seen   Keywords: no relevant change. The bilateral pleural effusions, bilateral areas of atelectasis and signs of mild pulmonary edema are constant. Constant monitoring and support devices. No new parenchymal opacities   Keywords: new.


SubjectID: 15945590, StudyID: 57801173, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Septic knee, evaluation for pneumonia.

COMPARISON: ___.

FINDINGS: The lung volumes are unchanged. The atelectasis at the right and left lung base are constant in appearance. No overt pulmonary edema but mild fluid overload may be present. No evidence of newly appeared parenchymal opacities in the interval.


SubjectID: 15945590, StudyID: 57481786, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Respiratory failure, endotracheal tube placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has been intubated. The tip of the endotracheal tube projects approximately 5.5 cm above the carina. The tube could be advanced by 1-2 cm. The left PICC line is in unchanged position. Unchanged appearance of the cardiac silhouette and of the lung parenchyma. No pneumothorax or other complications.


SubjectID: 15945590, StudyID: 52956058, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hypercapneic respiratory failure // assess for ET tube placement following intubation as well as OG tube

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the patient has been intubated. The tip of the endotracheal tube projects 3.7 cm above the carinal. The course of the nasogastric tube is unremarkable. The tip projects over the proximal parts of the stomach. No complications, notably no pneumothorax. Otherwise unchanged radiograph   Keywords: unchanged radiograph.


SubjectID: 15945590, StudyID: 51549151, Comparison: same

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPH

INDICATION: Hypoxia. Right mid line.

TECHNIQUE: Chest, AP portable.

COMPARISON: ___.

FINDINGS: The tip of a PICC line terminates over the right axilla. The lung volumes are low. Allowing for differences in technique, the cardiac, mediastinal and hilar contours appear stable. There are probably pleural effusions of moderate size, although not well characterized, in addition to confluent opacities at the lung bases, greater on the left than right. There is mild pulmonary congestion, but not as severe as on the prior exam. Findings are little if at all change compared to the prior study.

IMPRESSION: Similar findings suggesting mild pulmonary edema, moderate bilateral pleural effusions, and extensive basilar opacities, greater on the left than right, atelectasis versus pneumonia   Keywords: similar.


SubjectID: 15945590, StudyID: 52718106, Comparison: better

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPH

INDICATION: Fever.

COMPARISON: ___.

TECHNIQUE: Chest, portable AP upright.

FINDINGS: The patient is intubated. An endotracheal tube terminates about 8 cm above the carina. The portion with the balloon is not well visualized, lying superior to the films. A dialysis catheter terminates in the uppermost right atrium. A right-sided PICC line is been removed. The cardiac, mediastinal and hilar contours appear unchanged including marked enlargement of the main pulmonary artery contour. Incidental note is made of an azygos fissure, a common normal variant. There is mild opacification in the retrocardiac area but markedly decreased   Keywords: decrease. Elsewhere, the lungs appear clear. Small pleural effusions are likely but also markedly decreased.

IMPRESSION: 1. Persistent left basilar opacity but markedly decreased. Although active infection is not excluded, this appearance could be explained by resolving atelectasis or recent prior infection. 2. Status post endotracheal intubation with high-lying endotracheal tube, not fully visualized including its balloon. Advancing the tube by several cm may be appropriate.


SubjectID: 15945590, StudyID: 51522730, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with afib, bacteremia, fever. // Any evidence of pneumonia, pulmonary edema?

COMPARISON: Radiographs from ___.

IMPRESSION: There is a tracheostomy whose distal tip is 8.5 cm above the carina at the level of the clavicular heads. There is an unchanged right-sided subclavian central line. Heart size is enlarged but stable. There is mild improved aeration of the left base. There is a small left-sided pleural effusion. There is some prominence of the pulmonary interstitial markings without overt pulmonary edema.


SubjectID: 15958024, StudyID: 59722598, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with ?PNA vs flash pulm edema s/p dialysis session today // Please evaluate for pneumonia vs pulmonary edema

TECHNIQUE: CHEST (PA AND LAT)

COMPARISON: ___

IMPRESSION: Hemorrhage ___ catheter terminates in the right atrium. Since the prior study there is overall unchanged appearance of the large left pleural effusion. There is no evidence of pulmonary edema. Mediastinal silhouette is unchanged. Pacemaker leads appear to be unchanged. No pneumothorax


SubjectID: 15958024, StudyID: 58588173, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with h/o CHF, CAD, ESRD, COPD - presented with 1d nonproductive cough, SOB, orthopnea // evaluate L sided pleural effusion

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Moderate pleural effusion on the left, occupying approximately ___ of the left hemi thorax. Subsequent left basal and retrocardiac atelectasis. Moderate cardiomegaly. Monitoring and support devices are constant in appearance. No abnormalities are noted in the left lung.


SubjectID: 15958024, StudyID: 51106442, Comparison: None

WET READ: ___ ___ 11:12 PM Left pleural effusion is now small. Retrocardiac opacity obscuring the left hemidiaphragm persists, likely atelectasis, but infection cannot be excluded. There is no pneumothorax. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___-year-old male status post left thoracentesis.

TECHNIQUE: Portable AP radiograph of the chest from ___.

COMPARISON: Earlier the same day at 10:38.

FINDINGS: A right-sided dialysis catheter enters the right atrium. A left pectoral AICD remains in place with lead placement reflecting variant anatomy, including a persistent left SVC. The layering left pleural effusion has decreased, and is now small. Small right pleural effusion is unchanged. There is no pneumothorax. Unchanged retrocardiac opacification is due to unchanged left lower lobe collapse. The right lung remains clear.

IMPRESSION: Interval decrease in left pleural effusion, which is now small. Unchanged small right pleural effusion. No pneumothorax. Unchanged left lower lobe collapse.


SubjectID: 15958024, StudyID: 59414729, Comparison: None

WET READ: ___ ___ 12:43 AM Left sided pacemaker-defibrillator with leads terminanting in expected locations of right atrium and right ventricle. Modified course of RV lead seems to correlate with provided history and recent intervention. Evaluation of the right lung base limited by overlying hand. No large pneumothorax identified, although limited in this supine radiograph.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

HISTORY: Lead extraction.

FINDINGS: In comparison with the study of ___, the left pacemaker leads terminate in the expected locations of the right atrium and right ventricle. Modified course of the right ventricular lead is consistent with the recent intervention. No evidence of pneumothorax. The lungs are essentially clear, though the right base is obscured by an overlying hand.


SubjectID: 15958024, StudyID: 50104160, Comparison: None

FINAL REPORT

INDICATION: Right ventricle lead extraction via left subclavian and reimplantation of right via the right axillary vein, here to evaluate lead position and evaluate for pneumothorax.

COMPARISON: ___.

TECHNIQUE: PA and lateral radiographs of the chest.

FINDINGS: A left pectoral pacemaker re-demonstrates leads terminating in the right atrium and right ventricle with a modified course of the right ventricular lead consistent with recent intervention. The left lead courses through a persistent left SVC through the coronary sinus into the right atrium. There is no definitive evidence of pneumothorax. However, there is a small left pleural effusion, which is new from the prior study with a left lower lobe consolidation. There is no right pleural effusion. The cardiac silhouette is top normal in size. The mediastinal and hilar contours are within normal limits with mild tortuosity of the thoracic aorta.

IMPRESSION: 1. No definitive evidence of pneumothorax. 2. New small left pleural effusion and left lower lobe consolidation. Recommend clinical correlation to exclude pneumonia.

NOTIFICATION: Findings were communicated by Dr. ___ to Dr. ___ ___ telephone at 12:45 p.m. on ___.


SubjectID: 15958024, StudyID: 59255736, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with dyspnea on exertion, evaluate for fluid.

COMPARISON: Multiple chest radiographs, the latest from ___. TWO VIEWS OF THE CHEST: The lungs are well expanded and show a retrocardiac opacity with a moderate effusion. The cardiac silhouette is enlarged. The mediastinal silhouette and hilar contours are normal. There is a moderate left pleural effusion. A left-sided pacer wire right atrial lead traverses the left-sided SVC and the coronary sinus. The right ventricular lead is appropriate.

IMPRESSION: Increased moderate left-sided effusion with associated atelectasis.


SubjectID: 15958024, StudyID: 55845475, Comparison: None

FINAL REPORT

HISTORY: Thoracentesis.

FINDINGS: In comparison with the study of ___, there has been left thoracentesis with some decrease in opacification of the left base. Specifically, no evidence of pneumothorax. Generally lower lung volumes.


SubjectID: 15958024, StudyID: 57744571, Comparison: worse

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old man with hypotension. Evaluate for intrathoracic process.

FINDINGS: Comparison is made to previous radiographs from ___. There is a left-sided pacemaker which is unchanged. Heart size is enlargement and stable. There is interval development of pulmonary edema and increase in interstitial markings   Keywords: increase, development. More focal area of consolidation within the left base is seen, and may represent pneumonia or atelectasis. There are no pneumothoraces. There is a right-sided central venous catheter with the distal lead tip in the proximal right atrium.


SubjectID: 15958024, StudyID: 52895259, Comparison: better

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph of one day earlier.

FINDINGS: ICD lead terminates in the right ventricle, and a right atrial lead terminates in the region of the right atrial appendage via a left SVC approach. Heart has decreased in size, with associated improvement in pulmonary vascular congestion and near resolution of pulmonary edema   Keywords: decrease, improve. Small left pleural effusion is present with adjacent left basilar atelectasis. No pneumothorax.


SubjectID: 15958024, StudyID: 57658302, Comparison: None

FINAL REPORT

INDICATION: Hypotension. Evaluate for pneumonia.

COMPARISONS: CT chest ___. Chest radiograph ___.

FINDINGS: The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. The cardiac silhouette is moderately enlarged, and unchanged from the prior exam. The mediastinal contours are normal. A pacemaker is present with the wires in unchanged position. Noted is a wire extending through a duplicated SVC and terminating within the coronary sinus.

IMPRESSION: 1. No acute cardiopulmonary process. 2. Stable moderate cardiomegaly.


SubjectID: 15958024, StudyID: 55562738, Comparison: same

FINAL REPORT

INDICATION: ___-year-old male with right IJ central line placement. Evaluate for line placement.

COMPARISONS: Same-day radiograph of ___ at 15:45 p.m.

FINDINGS: Single frontal view of the chest was obtained. A new right IJ central catheter terminates in the upper aspect of the right SVC. No pneumothorax is seen. Otherwise, no relevant change from study one hour prior   Keywords: no relevant change.


SubjectID: 15958024, StudyID: 53011266, Comparison: None

FINAL REPORT

HISTORY: Hypotension, leukocytosis, question infiltrate. CHEST, SINGLE AP VIEW. A pacemaker is present. The battery pack and lower left chest wall are excluded from the film. The appearance of the leads is smilar to the ___ CXR. A right IJ central line is present, tip over proximal-most SVC. No pneumothorax is detected. There is cardiomegaly with prominence of the mediastinum, probably with an unfolded aorta. There is upper zone redistribution and diffuse vascular blurring, which could reflect CHF. There is patchy opacity with obscuration of the left hemidiaphragm, progressed compared with ___, consistent with left lower lobe collapse and/or consolidation. Subtle patchy opacity in the right mid/upper zone, new compared with ___. Possible minimal blunting of the right costophrenic angle.

IMPRESSION: 1. Progressive left lower lobe collapse and/or consolidation. The differential diagnosis includes a pneumonic infiltrate. 2. Upper zone redistribution and mild diffuse blurring could reflect an element of CHF. 3. Hazy opacity right mid/upper zone, ? early confluent CHF or pneumonic infiltrate.


SubjectID: 15958024, StudyID: 57630270, Comparison: worse

WET READ: ___ ___ ___ 10:58 AM There has been an interval increase in asymmetric opacification overlying the left hemi thorax, as well as a left basilar consolidation. There has also been an interval increase in a small left-sided pleural effusion. Although this may be secondary to asymmetric pulmonary edema, worsening left-sided atelectasis/ pneumonia is of concern   Keywords: worse. No pneumothorax.

WET READ VERSION #1 ___ ___ ___ 11:51 PM There has been an interval increase in asymmetric opacification overlying the left hemi thorax, as well as a left basilar consolidation. There has also been an interval increase in a small left-sided pleural effusion. Although this may be secondary to asymmetric pulmonary edema, worsening left-sided atelectasis/ pneumonia is of concern. No pneumothorax. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with shortness of breath // ?pe ?flash edema

TECHNIQUE: Chest single view

COMPARISON: ___

IMPRESSION: There has been an interval increase in asymmetric opacification overlying the left hemi thorax, as well as a left basilar consolidation. There has also been an interval increase in a small left-sided pleural effusion. Although this may be secondary to asymmetric pulmonary edema, worsening left-sided atelectasis/ pneumonia is of concern. No pneumothorax.


SubjectID: 15958024, StudyID: 56928572, Comparison: None

FINAL REPORT

INDICATION: History: ___M with PMHx including COPD, CHF s/p AICD, CAD, MI, CKD on HD, now with cough and SOB // pleave eval for fluid overload, pneumonia.

TECHNIQUE: AP upright and lateral radiograph of the chest

COMPARISON: Multiple prior chest radiographs dated back to ___, most recently from ___.

FINDINGS: A right double lumen hemodialysis line terminates in the lower right atrium, overall unchanged compared to the prior exam. Left-sided pacemaker leads terminate in the right atrium and right ventricle unchanged in position compared to the prior exam. Mild cardiomegaly is been stable compared to exams dated back to at least ___. The hilar and mediastinal contours are normal. Obscuration of the left hemidiaphragm is concerning for a left lower lobe consolidation. There may be a small left pleural effusion. There is no evidence of a pneumothorax. The visualized osseous structures are unremarkable.

IMPRESSION: Consolidation of the left lower lobe is concerning for pneumonia.


SubjectID: 15958024, StudyID: 53499383, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with central line placement // ?pneumo

TECHNIQUE: Chest single view

COMPARISON: ___ at 17:40.

IMPRESSION: There is a new right IJ line with tip in the distal SVC. There has been interval increase in the left-sided effusion that is layering posteriorly. There is no change in the large bore right IJ catheter with tip in the right atrium or the single lead pacemaker appear


SubjectID: 15958024, StudyID: 50485665, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with shortness of breath // ?worsening pulmonary edema

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: Compared to the prior study there is mild increase in the left effusion. Otherwise the appearance of the lungs are unchanged. Pacemaker large bore catheter


SubjectID: 15974128, StudyID: 59220907, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old F with PMHx CHF, possible sarcoid, OSA, obesity, atrial fibrillation on coumadin, and DM, presenting with worsening dyspnea and hypoxia likely ___ CHF exacerbation. // Evaluation of interval change, esp vascular congestion

TECHNIQUE: CHEST (PA AND LAT)

COMPARISON: ___

IMPRESSION: Cardiomegaly is substantial. Interstitial opacities are bilateral perihilar and at lower lobes and are concerning for interval development of vascular congestion   Keywords: development. No masses or focal consolidations demonstrated in addition to the pre-existing findings. No pneumothorax.


SubjectID: 15974128, StudyID: 55434955, Comparison: None

FINAL REPORT

INDICATION: ___F with SOB hypoxia // SOB

TECHNIQUE: AP view of the chest.

COMPARISON: ___.

FINDINGS: The lungs are grossly clear without focal consolidation based on exam with rotation to the right. Pulmonary vascular congestion is mild. The cardiomediastinal silhouette is widened but similar when compared to previous exam.


SubjectID: 15974128, StudyID: 55272929, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: Prior exam from ___. CLINICAL

HISTORY: ___-year-old female with history of congestive heart failure and reported shortness of breath, assess for fluid overload or pneumonia.

FINDINGS: AP and lateral views of the chest were performed with the patient positioned upright. There is a mild pulmonary edema with stable cardiomegaly   Keywords: stable. Left basal opacity could reflect atelectasis, likely with small effusion. There is no pneumothorax. Mediastinal contour appears stable. The bony structures appear unchanged with a compression deformity at the thoracolumbar junction seen on lateral view, unchanged.

IMPRESSION: Mild edema with left basal opacity, likely a combination of atelectasis and effusion. Mild edema unchanged   Keywords: unchanged.


SubjectID: 15974128, StudyID: 56929447, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F w DM2, sarcoidosis, bronchiectasis, HFpEF, atrial fibrillation and influenza PNA now with worsening SOB // Assess for pulmonary edema or other new cardiopulmonary process Assess for pulmonary edema or other new cardiopulmonary proc

IMPRESSION: In comparison with the study of ___, there is little overall change in the degree of enlargement of cardiac silhouette and pulmonary edema   Keywords: little overall change.


SubjectID: 15974128, StudyID: 50954903, Comparison: worse

FINAL REPORT

INDICATION: ___ year old woman with increased respiratory effort, diffusewheezes // r/o pulmonary edema, r/o PNA interval assessment of pneumonia

COMPARISON: Radiographs from ___.

IMPRESSION: There is stable cardiomegaly. There is slight worsening of the pulmonary edema   Keywords: worse. There is a persistent left retrocardiac opacity. There are no pneumothoraces.


SubjectID: 15985181, StudyID: 59943020, Comparison: same

FINAL REPORT

INDICATION: NG tube placement.

COMPARISON: ___, 4:15 a.m.

TECHNIQUE: Portable frontal chest radiograph.

FINDINGS: There has been interval advancement of the NG tube; however, the side port still terminates at the GE junction, although the tip terminates in the mid gastric body. There is otherwise no significant interval change compared to exam from four and a half hours prior   Keywords: no significant interval change.

IMPRESSION: Interval advancement of NG tube; however, the side port is still at the level of the gastroesophageal junction. Recommend further advancement by another 5 to 10 cm. Otherwise, no significant interval change   Keywords: no significant interval change.


SubjectID: 15985181, StudyID: 59571160, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Nasogastric tube, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the nasogastric tube has been advanced. It now projects over the middle parts of the stomach. There is no evidence of complications, notably no pneumothorax. Otherwise, the radiograph is unchanged.


SubjectID: 15985181, StudyID: 57938551, Comparison: same

FINAL REPORT

INDICATION: NG tube placement advanced.

COMPARISON: ___, 8:43 a.m.

TECHNIQUE: Portable frontal chest radiograph.

FINDINGS: There has been interval advancement of the NG tube which is now properly placed with the side port residing in the proximal stomach and the tip in the mid gastric body. There is otherwise no significant interval change compared to exam from four and half hours prior   Keywords: no significant interval change.


SubjectID: 15985181, StudyID: 57790363, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Nasogastric tube, questionable displacement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the nasogastric tube is better visualized. Its tip projects over the lower third of the esophagus, the tube should be re-positioned and advanced by at least ___ to 20 cm. The size of the right PICC line is unchanged. No evidence of aspiration or other lung parenchymal abnormalities. No evidence of pneumothorax.


SubjectID: 15985181, StudyID: 56444695, Comparison: None

FINAL REPORT

INDICATION: NG tube placement.

COMPARISON: ___.

TECHNIQUE: Portable frontal chest radiograph.

FINDINGS: Cardiac silhouette is moderately enlarged. A right PICC remains in place at the high right atrium. There is mild edema with left greater than right bibasilar atelectasis mildly improved compared to prior exam. There is no large pleural effusion or pneumothorax. There has been interval placement of an NG tube with the tip terminating at the expected location of the GE junction.

IMPRESSION: 1. NG tube with tip terminating at the GE junction. Recommend advancement by at least 10 cm. 2. Mild pulmonary edema with left greater than right bibasilar atelectasis mildly improved.


SubjectID: 15985181, StudyID: 59083783, Comparison: -1.0

FINAL REPORT

INDICATION: ___-year-old male with congestive heart failure, aortic regurgitation and mitral regurgitation, presents with respiratory failure. Question acute heart failure and pneumonia.

COMPARISON: Multiple radiographs, most recently ___. CT dated ___.

FINDINGS: A right internal jugular approach central venous catheter has tip terminating in the mid SVC. An enteric tube has tip in the stomach. The cardiac silhouette remains enlarged, increased since one day prior, but slightly improved since two days prior. Perihilar vascular congestion persists   Keywords: persists. Retrocardiac consolidation is similar in extent as compared to recent preceding exam. Ill-defined right upper lobe opacity is unchanged, reflecting underlying calcified lesion as seen on prior CT dated ___.

IMPRESSION: Interval worsening of pulmonary edema and cardiac enlargement   Keywords: worse. Similar extent of left lower lobe consolidation.


SubjectID: 15985181, StudyID: 57800060, Comparison: None

FINAL REPORT

HISTORY: CHF.

FINDINGS: In comparison with the study of ___, the monitoring and support devices are in unchanged position. The patient has taken a slightly better inspiration. Nevertheless, there is continued enlargement of the cardiac silhouette with relatively mild pulmonary vascular congestion. The possibility of cardiomyopathy or pericardial effusion would have to be considered. Hazy opacification at the bases could reflect small layering effusions with compressive atelectasis. Patchy area of increased opacification in the right upper zone is consistent with mass with calcification seen on prior CT study.


SubjectID: 15985181, StudyID: 54370661, Comparison: better

FINAL REPORT

INDICATION: ___-year-old male with atrial fibrillation found to have multifocal pneumonia complicated by pulmonary edema. Question interval change in pulmonary edema and lung opacities.

COMPARISON: CT dated ___ and radiograph dating back to ___.

FINDINGS: Single frontal view of the chest demonstrates a right internal jugular approach central venous catheter with tip extending to the cavo-brachiocephalic junction. An enteric tube is in place, extending inferiorly out of view. Since two days ago, there has been significant improvement of pulmonary edema, with interval decrease of pleural effusions   Keywords: improve, decrease. There is, however, persistent severe cardiomegaly. There is persistent consolidation in the left lower lobe and confluent opacity in the right upper lung, at least in part due to known underlying apical mass lesion with calcifications as correlated with prior CT. There is no pneumothorax. Patient is turned slightly to the right. There is no new acute process.

IMPRESSION: 1. Interval improvement of pulmonary edema and pleural effusions   Keywords: improve. 2. Persistent cardiomegaly. While this could represent cardiac decompensation, rapid course of development of cardiomegaly raises question of a pericardial effusion, which remains to be considered. 3. Persistent left lower lobe consolidation and right upper lobe pulmonary lesion, better delineated on prior CT dated ___. Findings reported to Dr. ___ at 11:20 a.m. on ___ via phone by Dr. ___.


SubjectID: 15985181, StudyID: 52200329, Comparison: better

FINAL REPORT

INDICATION: ___-year-old male with pneumonia and end-stage dementia.

COMPARISON: Multiple prior radiographs, most recently ___.

FINDINGS: Single frontal portable radiograph demonstrates a left subclavian approach central venous catheter with tip in cavobrachiocephalic junction. An enteric tube traverses inferiorly out of view. The lung volumes remain low, accentuating massive enlargement of cardiac silhouette, which could reflect a component of a failure and/or pericardial effusion. Perivascular congestion is mildly improved   Keywords: improve. Right upper lung opacity is re-demonstrated, compatible with underlying chronic apical mass. Left lower lobe consolidation is re-demonstrated, likely associated with a component of atelectasis. Small bilateral pleural effusions are not excluded.

IMPRESSION: Minimal interval improvement of vascular congestion   Keywords: improve. Persistent massive cardiomegaly could reflect cardiac decompensation versus pericardial effusion. Persistent left lower lobe consolidation and right upper lobe opacity.


SubjectID: 15985181, StudyID: 55313781, Comparison: None

FINAL REPORT

INDICATION: Respiratory insufficiency, status post left brachial artery embolectomy, here to evaluate for interval changes.

COMPARISON: Chest radiograph dated ___ at 05:17.

TECHNIQUE: Portable semi-erect frontal radiograph of the chest.

FINDINGS: In comparison to the most recent prior study, an endotracheal tube is seen terminating at the level of the thoracic inlet. A nasogastric tube extends below the diaphragm with the tip terminating in the left upper quadrant, likely within the stomach. A left internal jugular central venous catheter is unchanged in position with the tip terminating at the confluence with the SVC. Areas of airspace opacity are again noted in the right lung apex and left lung base, which are gradually worsening over multiple prior studies. No significant pleural effusion or pneumothorax is present. The cardiac silhouette is mildly enlarged but stable. The mediastinal and hilar contours are also unchanged.

IMPRESSION: 1. Unchanged position of support devices. 2. Gradually worsening multifocal consolidations concerning for pneumonia. 3. Mild cardiomegaly.


SubjectID: 15985181, StudyID: 54914045, Comparison: worse

FINAL REPORT

HISTORY: Post-operative embolectomy.

FINDINGS: In comparison with the earlier study of this date, the monitoring and support devices remain in place. Areas of increased opacification are again seen at the left base and right upper zones   Keywords: increase. At the left base, the appearance is worrisome for pneumonia with concomitant atelectasis. In the right upper region, malignancy must be seriously considered. CT would be helpful for further evaluation.


SubjectID: 15986499, StudyID: 58380426, Comparison: None

FINAL REPORT

HISTORY: Fatigue, possible pneumonia in left base.

FINDINGS: In comparison with the earlier study of this date, there is again hyperexpansion of the lungs with small bilateral pleural effusions and compressive atelectasis at the bases. Enlargement of the cardiac silhouette persists and there is some engorgement of pulmonary vessels consistent with elevated pulmonary venous pressure. There is poor visualization of the left heart border, though some of this may merely be an overlying external tube. On the lateral view, there is not convincing evidence of a lingular pneumonia.


SubjectID: 15986499, StudyID: 56605120, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Fatigue, getting V/Q scan for PE.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is enlargement of the bilateral pulmonary arteries, potentially consistent with pulmonary hypertension. Areas of atelectasis in the retrocardiac lung regions. Mild fluid overload cannot be excluded. Borderline size of the cardiac silhouette. No evidence of pneumonia.


SubjectID: 15986499, StudyID: 52075706, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female with fatigue and malaise. STUDY: AP upright portable chest radiograph.

COMPARISON: ___.

FINDINGS: The heart size is at the upper limits of normal. The mediastinal contours appear within normal limits. The hila are full and prominence of the pulmonary vasculature is concerning for vascular congestion. Bibasilar opacities likely represent degree of atelectasis with some degree of vascular congetion. There is no large pleural effusion or pneumothorax.

IMPRESSION: Mildly enlarged heart with vascular congestion. Bibasilar opacities most likely atelectasis with some vascular congestion, but underlying early infection is difficult to exclude.


SubjectID: 16006682, StudyID: 55317773, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with relapsed MM, thrombocytopenia, a fib not on coumadin ___ thrombocytopenia, HTN, and HFpEF currently diuresing on lasix demonstrating hypoxemia and AMS. // Assess for signs of acute pulmonary processes

COMPARISON: ___.

FINDINGS: Stable cardiomegaly accompanied by pulmonary vascular congestion and minimal interstitial edema   Keywords: stable. No new areas of consolidation to suggest the site of pneumonia.


SubjectID: 16006682, StudyID: 54654719, Comparison: None

WET READ: ___ ___ 8:20 AM No substantial change from prior radiograph of ___. No pulmonary edema.

WET READ VERSION #1 ___ ___ 8:15 AM No substantial change from prior radiograph of ___. No pulmonary edema. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with multiple myeloma on chemotherapy and CHF decompensated with cough // evaluate for pulmonary edema or PNA

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, there is on going moderate cardiomegaly. A potential small left pleural effusion has completely resolved. There currently is no evidence of pulmonary edema. No pneumonia. No pneumothorax. Non characteristic small apical opacities are likely caused by a sclerotic bone island in the fourth rib on the left and by a calcified granuloma on the right


SubjectID: 16008287, StudyID: 59693551, Comparison: None

WET READ: ___ ___ 6:32 PM Compared to the study of ___ there is no evidence of migration of both esophageal stents. There is mild worsening opacity at the right base which may reflect atelectasis, less likely pneumonia. Moderate cardiomegaly is unchanged. There is no pneumothorax. The findings were telephoned to Dr. ___ by ___ at 18:30, ___, at the time of discovery. ______________________________________________________________________________

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old man with esophageal stent with new-onset abdominal pain. Evaluate interval positioning of the stent.

FINDINGS: There is cardiomegaly. The positioning of the two esophageal stents appears unchanged from the prior radiographs. There is some atelectasis and a small right-sided pleural effusion. There are no pneumothoraces identified.


SubjectID: 16008287, StudyID: 58182354, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old man with worsening oxygen requirement. Evaluate for pulmonary edema.

FINDINGS: Comparison is made to previous study from ___. Esophageal stents appears unchanged in position. There is some worsening of the airspace opacities within the right lung. There is also volume loss on the right side. There is a left retrocardiac opacity with some atelectasis at the left base. Findings may represent asymmetric pulmonary edema or pneumonia/aspiration.


SubjectID: 16008287, StudyID: 52588647, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with shortness of breath and hypoxia.

COMPARISON: Radiograph dated ___.

FINDINGS: Single portable upright image through the chest demonstrates low lung volumes. Basilar opacity may reflect atelectasis and post surgical change, though a focal consolidation cannot be excluded. Cardiomediastinal contour, allowing for subtle change in patient positioning, is stable in appearance when compared to prior examination dated ___. There is splaying of the trachea at its bifurcation which may reflect left artial enlargement. A stent is identified along the right side of the hemithorax presumably within the esophagus. An angulated appearance of what appear to b e two esophageal stents is noted which is unclear if this is a change in position from prior. No pneumothorax is identified. There is persistent blunting of the right costophrenic angle.

IMPRESSION: Low lung volumes. Basilar opacity may reflect atelectasis and post surgical change, though a focal consolidation due to infection and/or aspiration cannot be excluded. Angulated appearance of esophageal stents noted. It is unclear if this represents a change in position from prior since no prior imaging status post stent placement is available for comparison.


SubjectID: 16008287, StudyID: 58375000, Comparison: None

WET READ: ___ ___ ___ 1:17 AM ET tube and right chest tube in expected position. NG tube tip projects over the right heart border - likely in gastric pull-through. Probable left basilar atelectasis and effusion. Mild edema. ___ p___

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

PORTABLE CHEST OF ___.

COMPARISON: Scout images from a CT abdomen ___.

FINDINGS: Tip of endotracheal tube terminates 2.6 cm above the carina, a nasogastric tube terminates in the lower portion of the thorax within a neoesophagus, and a right-sided chest tube is in place. No evidence of pneumothorax. Cardiomegaly is accompanied by pulmonary vascular congestion. Left lower lobe collapse is present as well as a small-to-moderate left pleural effusion. Diffuse haziness in right hemithorax may also reflect a small layering right pleural effusion. Subcutaneous emphysema is present in the right chest wall.


SubjectID: 16008287, StudyID: 53814467, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___ radiograph.

FINDINGS: Right-sided chest tube remains in place, with a tiny right apical pneumothorax. Nasogastric tube terminates within the intrathoracic neoesophagus, and an endotracheal tube has been removed. Stable postoperative cardiomediastinal widening. Worsening opacity in the left mid and lower lung region is likely due to a combination of layering left pleural effusion and adjacent lung parenchymal abnormality, which could be due to either atelectasis, aspiration or infectious consolidation. Small right pleural effusion has increased in size since the previous study and is accompanied by atelectasis at the right base.


SubjectID: 16008287, StudyID: 55675695, Comparison: None

WET READ: ___ ___ 8:41 PM The more proximal esophageal stent has been repositioned. There is continued interval improvement of bilateral airspace opacities. Stable enlargement of the cardiac silhouette. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___-year-old male status post esophageal stent removal and insertion; evaluate for aspiration pneumonia.

TECHNIQUE: Single AP view radiograph of the chest from ___.

COMPARISON: ___.

FINDINGS: The patient is status post esophageal stenting with two radiopaque stents in place. The upper stent has been repositioned, extending from the thoracic inlet into the proximal esophagus to level of the carina; the lower stent extends from the distal esophagus to the level of the GE junction. There is no pneumothorax or pneumomediastinum. Bilateral linear and subsegmental atelectasis is again noted. Previously described airspace opacities have resolved. There is stable cardiomegaly despite the projection. Spinal degenerative changes are present.

IMPRESSION: Status post interval repositioning of esophageal stents as described above. Resolved airspace opacities with bilateral linear and subsegmental atelectasis. Stable cardiomegaly.


SubjectID: 16008287, StudyID: 53788162, Comparison: None

FINAL REPORT

EXAMINATION: PA and lateral chest x-ray.

INDICATION: ___ year old man with esoph ca s/p excision, CHF, suspected aspiration at EGD ___ now with elevated WBC // aspiration pneumonia or pneumonitis?

TECHNIQUE: PA and lateral projections, upright positioning.

COMPARISON: Portable AP chest x-ray dated ___

FINDINGS: There are stable cardiac and mediastinal silhouettes as compared with ___ film. There is cardiomegaly as before. The 2 previously noted esophageal stents are again seen in stable position. There is increased opacification in the right middle and lower lung zones, with associated fluid present in the minor fissure, which is worrisome for aspiration pneumonitis or pneumonia. There is evidence of a small left-sided pleural effusion. No pneumothoraces.

IMPRESSION: Right middle and lower lung zone opacities concerning for aspiration pneumonitis versus pneumonia.


SubjectID: 16008287, StudyID: 54568586, Comparison: worse

FINAL REPORT

HISTORY: Status post esophagectomy with pull-up procedure, right thoracoscopy, right and laparoscopy. Now with worsening respiratory status.

TECHNIQUE: Frontal and lateral chest radiographs were obtained.

COMPARISON: Comparison is made to radiographs dated ___.

FINDINGS: Redemonstrated are a right-sided chest tube and an upper esophageal drain. There is no evidence of pneumothorax. As compared to the study dated ___, there has been interval increase in the opacification of the right middle and lower lung, as well as an interval increase in left perihilar opacity, both of which most likely represent aspiration   Keywords: increase. There is evidence of mild vascular congestion. Stable, bilateral pleural effusions are noted with adjacent atelectatic changes. There is stable widening of the mediastinum from esophagectomy and gastric pull-up procedure. There is evidence of p.o. contrast seen within the bowel in the abdomen and in the retrocardiac region.

IMPRESSION: 1. Interval increase in the opacification of the right middle lobe, right lower lobe, and left perihilar region   Keywords: increase. These findings are suggestive of aspiration, although an infectious etiology cannot be definitively excluded. 2. Small, bilateral pleural effusions with adjacent atelectasis. 3. Mild vascular congestion.


SubjectID: 16008287, StudyID: 52625001, Comparison: better

FINAL REPORT

HISTORY: Pneumothorax after esophagectomy.

FINDINGS: In comparison with the study of ___, the right chest tube remains in place. There is stable widening of the mediastinum following esophagectomy and pull-up procedure. Pulmonary vascularity is only mildly engorged. The left perihilar opacification has decreased, which could reflect improving edema or some resolving aspiration or infectious pneumonia   Keywords: decrease, resolving, improving. There is evidence of bilateral pleural effusions with atelectatic changes at the bases.


SubjectID: 16008287, StudyID: 51041761, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post esophagectomy, removal of right chest tube, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the right chest tube is removed. There currently is no convincing evidence for the presence of a pneumothorax. The left perihilar and right basal parenchymal opacities are unchanged in morphology   Keywords: unchanged. Unchanged appearance of the post-operative right mediastinum and of the cardiac silhouette.


SubjectID: 16008287, StudyID: 50998080, Comparison: same

FINAL REPORT

PORTABLE CHEST X-RAY, ___

COMPARISON: Radiograph of one day earlier.

FINDINGS: Interval removal of nasogastric tube. Right chest tube remains in place. Stable postoperative mediastinal widening following esophagectomy and pull-up procedure. Persistent pulmonary vascular congestion   Keywords: persistent. Slight improvement in left perihilar and basilar airspace opacity, which could reflect asymmetrical edema, aspiration or infectious pneumonia. Bibasilar retrocardiac atelectasis and adjacent small right and small-to-moderate left pleural effusions are unchanged.


SubjectID: 16022077, StudyID: 59770333, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post nasogastric tube placement. Respiratory failure. Evaluation.

COMPARISON: ___, 4:43 a.m.

FINDINGS: As compared to the previous radiograph, the patient has received a nasogastric tube. The course of the tube is unremarkable, the tip of the tube is slightly coiled in the stomach and currently projects over the mid-to-distal parts of the organ. The endotracheal tube remains in situ. A moderate predominantly lateral basal left pneumothorax is seen in unchanged manner with air collection in the soft tissues. The appearance of the right lung and of the cardiac silhouette is unchanged.


SubjectID: 16022077, StudyID: 57799573, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Pneumothorax, left chest tube change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is a pigtail catheter seen in unchanged manner, located in the left pleural space. There also is unchanged evidence of a left basal pneumothorax. Minimal progression of the pleural effusion and atelectasis at the bases of the right lung. Unchanged monitoring and support devices. Unchanged appearance of the cardiac silhouette.


SubjectID: 16022077, StudyID: 53988881, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the left lung is slightly better expanded. Given the very extensive bilateral air collections in the soft tissues, multiple linear structures project over the hemithorax so that the precise size of the pneumothorax is difficult to visualize. However, the basolateral aspects of the pneumothorax appear to still be substantial. Unchanged position of the monitoring and support devices, including the left-sided pigtail catheter in the pleural space.


SubjectID: 16022077, StudyID: 51517587, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Multiple cardiac arrests, evaluation for resolution of pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient is still intubated and the position of the nasogastric tube, the endotracheal tube and the right PICC line are constant. Also constant is the position of the left pleural pigtail catheter. The dimension of the left basolateral pneumothorax is not substantially changed as compared to the previous examination. Extensive air in the soft tissues is visible in unchanged manner. No other relevant changes   Keywords: no other relevant change.


SubjectID: 16022077, StudyID: 57830106, Comparison: None

FINAL REPORT

PORTABLE SEMI-UPRIGHT CHEST, ___ AT 8:00 A.M.

COMPARISON: Radiograph of 6:43 a.m. the same day.

FINDINGS: There is now almost complete opacification of the right hemithorax, with associated shift of the cardiomediastinal contours towards the right. Considering associated cutoff of the right main bronchus, this is likely due to right lung collapse secondary to central mucous plugging as discussed by phone with Dr. ___ at 11:10 a.m. on ___ at time of discovery. Coexisting right pleural effusion is difficult to quantify in the setting of complete lung collapse. On the left, moderate left pleural effusion and adjacent retrocardiac atelectasis are similar. Interval placement of nasogastric tube, with the tip terminating in the stomach. Dr. ___ has been notified of the right lung findings on ___ at 11:10 a.m. at the time of discovery.


SubjectID: 16022077, StudyID: 57268014, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___.

COMPARISON: ___.

FINDINGS: Worsening opacification in the right mid and lower lung regions is accompanied by apparent abrupt cutoff of the distal right main bronchus. These findings are concerning for atelectasis secondary to mucus plugging. Moderate-to-large right pleural effusion is also demonstrated. On the left, there is no substantial change in a small-to-moderate left pleural effusion and adjacent left retrocardiac atelectasis and/or consolidation.


SubjectID: 16022077, StudyID: 56221822, Comparison: None

FINAL REPORT

PORTABLE CHEST OF ___

COMPARISON: Study of ___.

FINDINGS: A radiograph centered at thoracoabdominal junction was obtained for assessment of a nasogastric tube, which has been withdrawn since the prior study. Although the tip is likely in the proximal stomach, the side port is anticipated to be above the GE junction level. Interval removal of endotracheal tube. Stable cardiomediastinal contours. Worsening bilateral pleural effusions, moderate to large on the right and moderate on the left with adjacent areas of lower lung consolidation and/or atelectasis.


SubjectID: 16022077, StudyID: 57749274, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Second pigtail placement. Assessment for lung reexpansion.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, a second PICC line has been inserted into the left pleural space. The previously seen lateral line suggesting pneumothorax is now no longer clearly visible. The bases of the left lung appears better expanded than on the previous image. Also improved distal ventilation of the right lung. However, cardiomegaly and moderate right pleural effusion persists. There are very extensive bilateral air collections in the soft tissues, with the creation of multiple hyperlucent lines, so that the assessment for potential pneumothorax is clearly limited.


SubjectID: 16022077, StudyID: 50155176, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Followup of pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the two left-sided chest pigtail catheters are in unchanged position. No visible pneumothorax; however, assessment is limited by multiple linear structures stemming from extensive soft tissue air accumulations. The appearance of the right lung is constant.


SubjectID: 16022077, StudyID: 56142754, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH.

INDICATION: Evaluation of pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is unchanged evidence of two pigtail catheters in the left pleural space. There is no definite pleural line suggesting left pneumothorax but visualization is extremely difficult, given extensive soft tissue air collections and subsequent formation of multiple linear structures projecting over the thorax. On the left, the pre-existing pleural effusion appears to have slightly decreased. Unchanged moderate cardiomegaly. Unchanged monitoring and support devices.


SubjectID: 16022077, StudyID: 53942774, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: st. p. cardiac arrest

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. No identifiable left pneumothorax, unchanged multiple linear structures projecting over the thorax, caused by the known soft tissue air collection. Moderate cardiomegaly. Known right pleural effusion with right atelectasis. The monitoring and support devices are in constant position.


SubjectID: 16022077, StudyID: 51283209, Comparison: same

WET READ: ___ ___ 12:18 AM 2 left pigtail catheters in place. No appreciable interval increasing pneumothorax. There is no definite right pneumothorax. Right PICC line terminates in the mid SVC. The endotracheal tube and nasogastric tube in appropriate position. Right pleural effusion, stable. ______________________________________________________________________________

FINAL REPORT

HISTORY: ___-year-old female with septic shock and cardiac arrest x5 complicated by bilateral pneumothoraces status post chest tube placement.

COMPARISON: Chest radiograph dated ___ second ___.

FINDINGS: Portable AP chest radiograph demonstrates two left pigtail catheter is in constant position with no appreciable interval increasing pneumothorax. If there is a pneumothorax, it may be anterior which is difficult to detect on supine images. An endotracheal tube is seen terminating 3 cm above the level of the carina in appropriate position. An enteric tube descends and uncomplicated course, it is tip out of view. A right PICC terminates in the level of the mid superior vena cava. Right-sided pleural effusion is minimally increased with adjacent atelectasis. There are no new focal consolidations. The cardiomediastinal and hilar contours are stable allowing for changes in patient positioning.

IMPRESSION: No significant changes   Keywords: no significant change.


SubjectID: 16022077, StudyID: 53090169, Comparison: better

FINAL REPORT

PORTABLE CHEST FILM ___ AT ___ CLINICAL

INDICATION: ___-year-old with chest tube removal, evaluate left pneumothorax. Comparison is made to the patient's previous study dated ___ at ___. A portable AP semi-erect chest film ___ at ___ is submitted.

IMPRESSION: 1. Endotracheal tube has its tip approximately 3 cm above the carina. A right subclavian PICC line ends in the distal SVC. A nasogastric tube is seen coursing below the diaphragm with the tip coiled within the stomach. There continue to be bilateral layering effusions with bibasilar patchy opacities which may represent compressive atelectasis, although a bibasilar pneumonia or aspiration should also be considered. There is a developing opacity in the right peripheral mid lung, which would be concerning for aspiration or early pneumonia. This can be better assessed on followup imaging. There has been interval improvement in the pulmonary edema with residual mild interstitial edema   Keywords: improve. Overall cardiac and mediastinal contours are difficult to assess due to marked patient rotation on the current examination. No definite pneumothorax is seen on the current examination. Marked degenerative changes of both glenohumeral joints unchanged.


SubjectID: 16022077, StudyID: 52475320, Comparison: None

FINAL REPORT

PORTABLE CHEST FILM, ___ AT 15:23 CLINICAL

INDICATION: ___-year-old with left pneumothorax status post removal of two chest tubes. Comparison is made to the patient's previous study dated ___ at 3:52.

IMPRESSION: 1. Interval removal of two left-sided pigtail pleural catheters with interval appearance of a tiny left apical pneumothorax. This can be further evaluated on followup imaging. The endotracheal tube, nasogastric tube, and right subclavian PICC line are unchanged in position. Overall cardiac and mediastinal contours are likely stable given differences in positioning. Bilateral layering effusions with associated patchy right basilar airspace disease, likely reflecting compressive atelectasis, although pneumonia cannot be entirely excluded. Results were communicated to the patient's nurse,___ ___, by phone on ___ at 4:15 p.m. at the time of discovery.


SubjectID: 16022077, StudyID: 51624037, Comparison: None

FINAL REPORT

PORTABLE CHEST FILM ___ AT 3:52 A.M. CLINICAL

INDICATION: ___-year-old with left pneumothorax status post pigtail x 2, evaluate for interval change. Comparison to prior study dated ___ at ___. A portable AP semi-upright chest film ___ at 352 is submitted.

IMPRESSION: Nasogastric tube, right subclavian PICC line and endotracheal tube are likely unchanged in position. Two left-sided pigtail catheters remain in place. No definite left-sided pneumothorax is appreciated, although the patient is only at a ___-degree upright angle which reduces the sensitivity for detection. There is likely a stable layering right effusion. Overall cardiac and mediastinal contours are difficult to assess due to patient rotation on the current examination. Persistent patchy opacity at the right base likely reflects an element of compressive atelectasis. No evidence of pulmonary edema.


SubjectID: 16024669, StudyID: 58830209, Comparison: better

WET READ: ___ ___ 9:27 PM no pneumothorax. right basilar opacity and effusion are similar to 2:57pm. mild pulmonary edema is similar.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

PORTABLE CHEST OF ___

COMPARISON: Study of earlier the same date.

FINDINGS: Stable cardiomegaly, but slight improvement in pulmonary vascular congestion   Keywords: improve. Perihilar haziness and peribronchial cuffing have also slightly improved   Keywords: improve. Asymmetrically distributed consolidation with right perihilar and lower lobe predominance likely represents a pneumonia in the appropriate clinical setting. Followup radiographs would be helpful to document resolution. Adjacent small-to-moderate right pleural effusion is noted.


SubjectID: 16024669, StudyID: 52595499, Comparison: better

FINAL REPORT

PORTABLE CHEST OF ___

COMPARISON: ___.

FINDINGS: Stable cardiomegaly accompanied by improving pulmonary vascular congestion and resolving perihilar edema   Keywords: improving, resolving. Interval development of a confluent left retrocardiac opacity, most likely representing atelectasis and adjacent effusion, but aspiration is an additional consideration in the appropriate clinical setting. Moderate right pleural effusion has slightly increased in size, with persistent area of adjacent consolidation or atelectasis.


SubjectID: 16024669, StudyID: 52217143, Comparison: worse

WET READ: ___ ___ ___ 9:25 PM The ET tube is in satsifactory position 4.3 cm from the carina. The OG tube tip is in the stomach. The side port of the tube is difficult to visualize. Otherwise little change, including minimal vascular congestion, a moderate right pleural effusions, and bibasilar opacities, most likely atelectasis.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph of earlier the same date.

FINDINGS: Tip of endotracheal tube terminates 4.3 cm above the carina, and nasogastric tube terminates in the stomach. Stable cardiomegaly accompanied by slight worsening of pulmonary vascular congestion and mild perihilar edema   Keywords: worse. Moderate right and small-to-moderate left pleural effusions with adjacent lower lobe opacities appear similar allowing for positional differences between the studies.


SubjectID: 16024669, StudyID: 51560264, Comparison: same

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph ___.

FINDINGS: Tip of right internal jugular catheter terminates in the mid superior vena cava, with no detectable pneumothorax. Otherwise, no relevant short interval change since the recent study   Keywords: no relevant short interval change.


SubjectID: 16024669, StudyID: 57491936, Comparison: None

FINAL REPORT

HISTORY: Small pneumothorax after thoracentesis.

FINDINGS: In comparison with the earlier study of this date, there is no convincing evidence of pneumothorax. Continued enlargement of the cardiac silhouette with residual pleural fluid with atelectasis at the right base. Indistinctness of pulmonary vessels is consistent with some elevated pulmonary venous pressure.


SubjectID: 16024669, StudyID: 51176291, Comparison: same

FINAL REPORT

HISTORY: Thoracentesis.

FINDINGS: In comparison with study of ___, there has been a right thoracentesis with removal of some pleural fluid. Residual opacification at the base is consistent with fluid and volume loss. Evidence of cardiomegaly with pulmonary vascular congestion persists   Keywords: persists. Dobbhoff tube again extends at least to the lower stomach.


SubjectID: 16024669, StudyID: 53752897, Comparison: same

FINAL REPORT

REASON FOR EXAM: Placement of NG tube in patient who is a ___ years old woman.

TECHNIQUE: AP single-view chest x-ray.

COMPARISON: Exam is compared with multiple prior chest x-rays, the most recent dated ___.

FINDINGS: New Dobbhoff tube has been placed with tip ending in distal gastric cavity. Persistent right base opacity due to combination of atelectasis and pleural effusion overall unchanged since ___. Mild vascular congestion is also stable   Keywords: stable. Moderate cardiomegaly is unchanged. Left lung is clear. There is no pneumothorax.

IMPRESSION: Correct positioning of NG tube, exam otherwise unchanged.


SubjectID: 16043614, StudyID: 58305738, Comparison: None

WET READ: ___ ___ ___ 6:18 PM Lung volumes remain low. Linear opacities in both lungs are unchanged, probably scarring. Opacities previously seen obscuring the left posterior costophrenic sulcus have improved, albeit, persist. Pneumonia would still have to be considered in this clinical setting. ______________________________________________________________________________

FINAL REPORT

HISTORY: Possible pneumonia.

FINDINGS: In comparison with the study of ___, there again are low lung volumes with dense streaks of atelectasis or scarring at both bases. There again is some retrocardiac opacification with mild obscuration of the posterior aspect of the left hemidiaphragm. Although this most likely represents atelectasis, in the appropriate clinical setting, supervening pneumonia would have to be considered.


SubjectID: 16043614, StudyID: 52635874, Comparison: None

FINAL REPORT

INDICATION: Fever and shortness of breath. Evaluate for infiltrate.

COMPARISON: Multiple prior chest radiographs, most recent on ___.

TECHNIQUE: Frontal upright and lateral chest radiograph.

FINDINGS: Lung volumes are low, accounting for some bronchovascular crowding. Linear opacities across the right upper lung and the left mid lung represent subsegmental atelectasis versus scarring and are unchanged from since at least ___ . Of note, in the lateral view there is a suggestion of opacity which obscures the left costophrenic angle and was not present in prior radiographs. This opacity cannot be properly assessed in the frontal view due to low lung volumes. No other focal opacities are identified. Cardiomediastinal and hilar contours are grossly unremarkable although assessment is limited due to low lung volumes. There is no pleural effusion or pneumothorax.

IMPRESSION: Suggestion of opacity in the lateral view obscuring the left costophrenic angle. Left lower lobe pneumonia cannot be excldued with this appearance. Communicated to Dr ___ on ___ at 7:50 am via phone by Dr ___ ___ after discussion with the Radiology attending (Dr ___).


SubjectID: 16043614, StudyID: 55753775, Comparison: None

FINAL REPORT

HISTORY: Male with fevers and NG tube placement.

TECHNIQUE: Single portable frontal chest radiograph.

COMPARISON: Chest radiograph ___; ___.

FINDINGS: End of NG tube is in proximal stomach. Low lung volumes with unchanged moderate bibasilar atelectasis. Heart size, mediastinal contour and hila are normal. No bony abnormality.

IMPRESSION: 1. End of NG tube is in proximal stomach. 2. Low lung volumes with unchanged moderate bibasilar atelectasis.


SubjectID: 16043614, StudyID: 50125928, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, oxygen desaturation, evaluation.

COMPARISON: ___, 2:26 p.m.

FINDINGS: As compared to the previous radiograph, the lung volumes continue to be lower in areas of atelectasis, primarily in perihilar location, constant in appearance. There also is an unchanged plate-like atelectasis at the left lung bases. Moderate cardiomegaly is unchanged. No larger pleural effusions. No pneumothorax.


SubjectID: 16043614, StudyID: 55615042, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, exacerbation, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the lung volumes remain low. Despite the low lung volumes, the findings are suggestive of mild-to-moderate pulmonary edema. Newly occurred areas of atelectasis at the left lung base.


SubjectID: 16043614, StudyID: 50273987, Comparison: None

FINAL REPORT

INDICATION: ___-year-old with diabetes and respiratory distress.

TECHNIQUE: Single frontal radiograph of the chest was obtained.

COMPARISON: Chest radiograph from ___.

FINDINGS: The lung volumes are low with secondary widening of the cardiomediastinal silhouette. There is no pleural effusion, no pneumothorax. No lung consolidation. Repeat study with deep inspiration is recommended, since assessment of edema is difficult with low lung volumes.


SubjectID: 16054505, StudyID: 57313798, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i

INDICATION: ___ year old woman s/p lap chole, now with elevated creat. // please assess for pulmonary edema

COMPARISON: CHEST RADIOGRAPHS SINCE ___ MOST RECENTLY ___

IMPRESSION: In addition to vascular crowding due to lower lung volumes, there is probably a mild interstitial pulmonary edema and ending in moderate cardiomegaly compared to ___. Pleural effusions are small if any. No pneumothorax.


SubjectID: 16054505, StudyID: 50754787, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with resp distress // eval interval changes eval interval changes

COMPARISON: Comparison to ___ at 12:31

FINDINGS: Portable semi-erect chest film ___ at 06:22 is submitted.

IMPRESSION: Left internal jugular central line has its tip in the distal brachiocephalic near the junction with the SVC. A right internal jugular large bore catheter unchanged in position. Overall cardiac and mediastinal contours remain stably enlarged. Lung volumes are diminished. Interval improvement in mild pulmonary edema   Keywords: improve. No large effusions. No pneumothorax is appreciated. Patchy opacity at the right medial lung base likely reflects atelectasis, although superimposed pneumonia cannot be excluded.


SubjectID: 16055484, StudyID: 59619907, Comparison: better

FINAL REPORT

PORTABLE CHEST FILM ___ AT ___ CLINICAL

INDICATION: ___-year-old with CABG, left pleural effusion, now status post left thoracentesis, question pneumothorax. Comparison is made to the patient's prior study of ___ at 12:34 a.m. Portable AP upright chest film ___ at ___ is submitted.

IMPRESSION: 1. Interval decrease in size of a left pleural effusion with residual patchy opacity at the left base likely reflecting atelectasis, although pneumonia cannot be excluded. There has been interval appearance of a patchy opacity at the right medial lung base, which is concerning for either atelectasis or a developing pneumonia. The interstitial edema has improved   Keywords: improve. The left hemidiaphragm is elevated. The patient is status post median sternotomy, and the cardiac and mediastinal contours are likely unchanged, although the left heart border is obscured by the elevated diaphragm. No pneumothorax is seen.


SubjectID: 16055484, StudyID: 56846694, Comparison: same

FINAL REPORT

INDICATION: Status post four-vessel CABG, presents with dyspnea and chest pain. Assess for infiltrate, pleural effusion or pulmonary edema.

COMPARISON: Comparison is made to multiple prior chest radiographs, most recently dated ___.

FINDINGS: The patient is status post CABG with sternotomy sutures midline and intact. There is stable severe cardiomegaly. There is minimal central pulmonary vascular congestion with mild bronchial cuffing suggesting an element of pulmonary edema. There is interval increase in size of left lung opacification, likely a combination of increasing left effusion and left lower lobe collapse, though superimposed pneumonia is not excluded. There is interval increase in still small right pleural effusion. Faint right lower lobe opacification likely reflects combination of edema and low lung volumes.

IMPRESSION: Stable severe cardiomegaly with increased left lung opacification likely due to worsening, now large, left pleural effusion and atelectasis. Increase in right pleural effusion, though still small. Mild stable if not slightly worsened pulmonary vascular congestion and interstitial edema   Keywords: worse.


SubjectID: 16055653, StudyID: 58996292, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post intubation and new orogastric tube placement.

TECHNIQUE: Semi-erect portable chest view was read in comparison with prior chest radiograph from the same day acquired 1 to ___ hours apart as well as multiple other prior radiographs till ___.

FINDINGS: The patient has received a new orogastric tube, which ends into the stomach but its distal end is looped with its tip reaching up to the fundus of the stomach approximately. Endotracheal tube tip is 4 cm above the carina and is appropriately positioned. Right internal jugular line tip is approximately at the level of the lower SVC/cavoatrial junction. Bilateral lung volumes are low. Mild diffuse haze in both lungs could be mild pulmonary edema, but given the low lung volumes, its appearance and severity may be exaggerated. Prominent hilus and azygos distension suggest increased venous pressure. Bi-basal opacity is due to combination of small effusion and accompanying atelectasis. Heart size is mild-to-moderately large, unchanged since prior studies. Increased retrocardiac density reflecting left lower lung atelectasis has worsened.


SubjectID: 16055653, StudyID: 57513742, Comparison: 1.0

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, status post intubation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has received an endotracheal tube. The tube projects 2.4 cm above the carina. The lung volumes are low. The right internal jugular vein catheter is unchanged. The pre-existing parenchymal opacities at the lung bases are minimally improved   Keywords: improve. No new opacities   Keywords: new. No evidence of complications, notably no pneumothorax.


SubjectID: 16055653, StudyID: 51069079, Comparison: better

FINAL REPORT

AP CHEST, 7:42 A.M., ___

HISTORY: Acute exacerbation of chronic diastolic CHF. Respiratory distress requiring intubation.

IMPRESSION: AP chest compared to ___: Hilar and mediastinal vascular engorgements have improved, mild-to-moderate cardiomegaly has not   Keywords: improve. Substantial bibasilar opacification can be explained by atelectasis. Pleural effusions are presumed but not appreciable. Tip of the endotracheal tube at the thoracic inlet is no less than 5.8 cm from the carina and should be advanced 2 cm for more secured seating. Right internal jugular line ends in the mid-to-low SVC, and a nasogastric tube passes far into the stomach. No pneumothorax.


SubjectID: 16055653, StudyID: 56661177, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

TECHNIQUE: Portable supine chest view was reviewed in comparison with prior chest radiographs through ___ with the most recent from ___.

IMPRESSION: Both lung volumes are very low. Right lower lung consolidation concerning for pneumonia, new since ___, is unchanged. Apparent cardiomegaly, prominent pulmonary vasculature and azygous vein and widened mediastinal contour may be due to very low lung volumes and supine position of patient. There is no pneumothorax or pleural effusion. Right PICC line ends at mid-to-lower SVC.


SubjectID: 16055653, StudyID: 54823444, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Shortness of breath, dyspnea and leukocytosis with leftward shift. Question pneumonia or congestive heart failure.

COMPARISONS: Prior radiographs from ___ and ___, earlier on the same day.

TECHNIQUE: Chest, AP portable upright.

FINDINGS: The tip of a right-sided PICC line is difficult to visualize but is probably unchanged. The lung volumes remain low. There is an extensive consolidation in the right lower lung, probably in the right lower lobe. The appearance is fairly similar to the more recent prior radiographs allowing for differences in technique although pulmonary vasculature is somewhat less prominent. It is difficult to exclude small pleural effusions but no definite pleural effusion is seen. The cardiac, mediastinal and hilar contours appear unchanged, including cardiac enlargement.

IMPRESSION: 1. Persistent consolidation in the right lower lung worrisome for pneumonia. Follow-up radiographs are recommended to show resolution within eight weeks. 2. Findings suggesting mild vascular congestion but seemingly improved   Keywords: improve.


SubjectID: 16056736, StudyID: 58858936, Comparison: same

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old woman with stress cardiomyopathy. Pulled IJ line out by accident.

FINDINGS: Comparison is made to prior study from ___ at 8:06 a.m. Endotracheal tube has been removed. There is a right IJ central line with the distal lead tip in the distal SVC. Enteric tube is no longer seen. There remains mild pulmonary edema   Keywords: remains. No pneumothoraces are seen. Heart size is stable.


SubjectID: 16056736, StudyID: 58384572, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with CHF, intuabted // eval for edema

TECHNIQUE: Portable frontal view of the chest.

COMPARISON: Multiple prior chest radiographs, the most recent of ___.

FINDINGS: The endotracheal tube ends 2-3 cm above the carina. A nasogastric tube terminates in the stomach. A right internal jugular line ends at the cavoatrial junction. There is marked bilateral interstitial abnormality and diffuse parenchymal opacity consistent with moderate pulmonary edema. There are small bilateral pleural effusions. No pneumothorax is identified. The cardiac and mediastinal contours are stable.

IMPRESSION: Moderate, left greater than right, pulmonary edema is stable over multiple prior studies   Keywords: stable.


SubjectID: 16056736, StudyID: 55007051, Comparison: worse

FINAL REPORT

INDICATION: ___ year old woman with CHF, intuabted // ET TUBE

TECHNIQUE: Portable frontal view of the chest.

COMPARISON: Multiple prior chest radiographs, the most recent of ___.

FINDINGS: An endotracheal tube ends at the carina and is pointed down the right mainstem bronchus. A right internal jugular line ends at the cavoatrial junction. Diffuse bilateral interstitial abnormality and bilateral diffuse, left greater than right, parenchymal opacities most likely represent pulmonary edema which is worsened since ___   Keywords: worse. The aortic knob is calcified. The heart size is likely normal. There are small trace bilateral pleural effusions. No pneumothorax is identified. Elevation of the right hemidiaphragm is stable over multiple prior studies.

IMPRESSION: 1. The endotracheal tube ends at the carina, pointed towards the right mainstem bronchus, retraction is recommended. 2. Moderate, left greater than right, pulmonary edema is stable since 1 day prior but worse since ___   Keywords: worse.


SubjectID: 16056736, StudyID: 54516633, Comparison: worse

FINAL REPORT

INDICATION: ___F with dyspnea, tachypnea, ecg changes, ? fever // evaluate for acute changes, interval change from OSH films

TECHNIQUE: Portable chest x-ray.

COMPARISON: Chest radiographs dated ___ through ___.

FINDINGS: Portable semi-upright radiograph of the chest demonstrates interval increase in diffuse bilateral pulmonary opacities, consistent with worsening pulmonary edema   Keywords: worse, increase. Small bilateral pleural effusions are present. Cardiomediastinal contours are unchanged. No pneumothorax. An old posterior left rib fracture is present.

IMPRESSION: Worsening pulmonary edema   Keywords: worse.


SubjectID: 16056736, StudyID: 51686091, Comparison: same

FINAL REPORT

INDICATION: ___F with intubated // central line placement

TECHNIQUE: Single portable view of the chest at 18:44

COMPARISON: Prior film from the same day at 17:17

FINDINGS: Endotracheal tube has been placed and tip is approximately 1 cm from the current and should be withdrawn for optimal positioning. There is a new right IJ line whose tip is at the lower SVC. Otherwise, there has been no change   Keywords: no change. There is no visualized pneumothorax based on this supine film. Diffuse bilateral parenchymal opacities are again seen, likely edema   Keywords: again

IMPRESSION: ET tube approximately 1 cm from the cranium. Withdrawal by several cm suggested. New right IJ line with no visualized pneumothorax based on a supine film.

NOTIFICATION: Dr. ___ was notified by page at 20:35 on ___ at time of discovery


SubjectID: 16056736, StudyID: 58379608, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: New respiratory distress, evaluation for pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the left-sided parenchymal opacity and the right apical opacity are unchanged in extent. A minimal intrafissural pleural effusion on the right might have newly occurred. The size of the cardiac silhouette continues to be minimally enlarged and the right hemidiaphragm is elevated. Known healed left rib fracture.


SubjectID: 16056736, StudyID: 57825913, Comparison: None

FINAL REPORT

HISTORY: OG tube placement.

FINDINGS: In comparison with the earlier study of this date, there has been placement of an orogastric tube that extends well into the distal stomach and possibly beyond the level of the pylorus. Diffuse bilateral pulmonary opacifications persist.


SubjectID: 16056736, StudyID: 52547858, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Acute hypoxia, post procedure, edema, effusion.

COMPARISON: Outside hospital film from ___.

FINDINGS: As compared to the previous radiograph, bilateral parenchymal airspace opacities with air bronchograms have appeared. There is no substantial interstitial component to the opacities. However, minimal blunting of the right costophrenic sinus is observed, likely caused by a small pleural effusion. The size of the cardiac silhouette has slightly increased. There is perihilar haze bilaterally and an unchanged elevation of the right hemidiaphragm   Keywords: unchanged. The changes could be suggestive of both asymmetric pulmonary edema and pneumonia. Close radiographic followup is recommended. At the time of dictation and observation, 8:24 a.m., on ___, the referring physician, ___. ___, covered by Dr. ___, was paged for notification.


SubjectID: 16056736, StudyID: 56488547, Comparison: same

FINAL REPORT

EXAMINATION: Chest radiograph.

INDICATION: History: ___F with hypotension // Please eval for pna

TECHNIQUE: Portable AP view of the chest.

COMPARISON: Chest radiographs dated ___, CT chest dated ___.

FINDINGS: As compared to the prior examination dated ___, there has been no significant interval change   Keywords: no significant interval change. Lung volumes are again noted to be low with chronic and elevation of the right hemidiaphragm. Linear right basilar and left lower lobe atelectasis is again noted. Mild central pulmonary vascular congestion is largely unchanged   Keywords: unchanged. There has been interval removal of a left-sided PICC line. The heart size is top-normal. There is no large pleural effusion or pneumothorax. The upper lobes are grossly clear.

IMPRESSION: Minimal interval change with persistently low lung volumes, bibasilar atelectasis, and mild pulmonary vascular congestion.


SubjectID: 16056736, StudyID: 54078112, Comparison: better

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___-year-old woman with a history of CHF and concern for discitis or osteomyelitis at T9. Evaluate for pulmonary edema.

TECHNIQUE: Portable AP chest radiograph

COMPARISON: Multiple prior chest radiographs, most recent from ___.

FINDINGS: Chronic elevation of the right hemidiaphragm. Stable, blunting of the left costophrenic angle likely reflects pleural adhesion. Low lung volumes with interval improvement in pulmonary vascular congestion   Keywords: improve. Curvilinear skin fold overlies the right hemithorax. No pneumothorax or acute focal pneumonia. Normal cardiac silhouette.

IMPRESSION: Improvement in pulmonary vascular congestion   Keywords: improve.


SubjectID: 16056736, StudyID: 53495257, Comparison: 0.0

FINAL REPORT

PATIENT

HISTORY: ___ years old woman with recent intubation for pulmonary edema, interval change in pulmonary edema.

COMPARISON: Exam is compared to chest x-ray of ___.

FINDINGS: AP single view of the chest shows persistent asymmetry of the right lung for elevation of the right hemidiaphragm and right lower atelectasis. Minimal improvement of left lung opacification is due to improved pulmonary edema, which has at the same time worsen to right   Keywords: worse. There is no pneumothorax. Blunting of the right costophrenic angle is likely due to a small pleural effusion. Heart size is normal. Aortosclerosis mild.

IMPRESSION: Asymmetric pulmonary edema, exam otherwise stable   Keywords: stable


SubjectID: 16068427, StudyID: 58240526, Comparison: better

FINAL REPORT

HISTORY: ___-year-old female with CHF exacerbation with persistent cough.

COMPARISON: Chest radiographs dated through ___.

FINDINGS: Interpretation of frontal and lateral chest radiograph limited secondary to poor technique. Lungs are essentially unchanged when compared to chest radiograph dated ___ with no obvious new focal opacity. Pulmonary edema appears to be improving   Keywords: improving. Mediastinal and hilar contours are stable in appearance.

IMPRESSION: Radiographic interpretation limited secondary to poor technique. No new obvious focal opacity.


SubjectID: 16068427, StudyID: 57964029, Comparison: better

FINAL REPORT

HISTORY: Severe epigastric pain with hypoxia.

FINDINGS: In comparison with the study of ___, the patient has taken a better inspiration. This may account for most of the apparent improvement in pulmonary vascular congestion   Keywords: improve. Opacification at the left base is most likely related to volume loss in the lower lobe and small pleural effusion. Mild atelectatic changes are seen at the right base.


SubjectID: 16071052, StudyID: 59495653, Comparison: better

WET READ: ___ ___ ___ 10:22 AM Mild improvement of interstitial edema. Left sided effusion and basilar atelectasis. Patchy opacities in the left lung may represent superimposed infection. us

WET READ VERSION #1 ___ ___ 8:04 PM Mild improvement of interstitial edema. Left sided effusion and basilar atelectasis. Patchy opacities in the left lung may represent superimposed infection. us ______________________________________________________________________________

FINAL REPORT

INDICATION: ___ year old woman with dCHF and HCAP now with acute SOB // Please assess for acute cardiopulmonary process

COMPARISON: Radiographs from ___

IMPRESSION: Heart size is upper limits of normal. There is again seen a left retrocardiac opacity. There is slight improvement of the pulmonary interstitial edema   Keywords: improve. There is a left retrocardiac opacity. No pneumothoraces are seen.


SubjectID: 16071052, StudyID: 53383129, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with PICC line in neck // ?re-position of picc

COMPARISON: Compared to prior radiograph from ___ at 14:01.

IMPRESSION: The right-sided PICC line tip remains within the neck and pointing towards the head. This again needs to be readjusted. Rest of the findings are unchanged. There are no pneumothoraces.


SubjectID: 16071052, StudyID: 52908844, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with 44cm PICC placement in right arm // ?placement of picc

COMPARISON: Radiographs from ___.

IMPRESSION: There has been placement of a right-sided PICC line. The distal tip is pointing cephalad and this needs to be readjusted. No pneumothoraces are identified. Heart size is within normal limits. There is prominence of pulmonary interstitial markings suggestive of pulmonary edema. However, superimposed infection is also possible given that the vascular pedicle is not widened. There is atelectasis at the left lung base. Small left-sided pleural effusion is seen.


SubjectID: 16071052, StudyID: 55359578, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with new decompensated CHF also with persistent low-grade temps // eval for evidence of CHF or pneumonia eval for evidence of CHF or pneumonia

IMPRESSION: In comparison with the study of ___, the degree of pulmonary vascular congestion has decreased   Keywords: decrease. Opacification at the left base again is consistent with pleural effusion and underlying atelectasis, though in the appropriate clinical setting superimposed pneumonia would have to be considered.


SubjectID: 16071052, StudyID: 55198772, Comparison: None

FINAL REPORT

INDICATION: Shortness of breath, on BiPAP. Evaluate for CHF.

COMPARISON: Chest radiograph from ___.

FINDINGS: A portable frontal chest radiograph demonstrates low lung volumes. Bilateral opacities are consistent with mild pulmonary edema. A retrocardiac opacity may be secondary to atelectasis/edema, but a superimposed infectious process cannot be excluded. There may be a trace left pleural effusion. No pneumothorax is identified. The visualized upper abdomen is unremarkable.

IMPRESSION: Low lung volumes, with mild pulmonary edema. A retrocardiac opacity may be due to a combination of atelectasis and edema, but superimposed pneumonia cannot be excluded.


SubjectID: 16071052, StudyID: 52279020, Comparison: None

WET READ: ___ ___ 8:33 AM Improved aeration of the lungs compared with radiograph performed 13 hr prior. Interval decrease in interstitial pulmonary edema. Persistent retrocardiac opacity.

WET READ VERSION #1 ___ ___ ___ 9:21 PM Improved aeration of the lungs compared with radiograph performed 13 hr prior. Interval decrease in interstitial pulmonary edema. Persistent retrocardiac opacity. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with shortness of breath // ?worsening edema

COMPARISON: ___, 06:49

IMPRESSION: As compared to the previous radiograph, the lung volumes have increased, likely reflecting improved ventilation. Mild cardiomegaly. Retrocardiac atelectasis. No larger pleural effusions. Mild fluid overload but no overt pulmonary edema.


SubjectID: 16073325, StudyID: 58848071, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluation for opacities or consolidation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the lung volumes have increased, likely reflecting improved ventilation. There are unchanged signs of mild-to-moderate pulmonary edema   Keywords: unchanged. No larger pleural effusions. Borderline size of the cardiac silhouette. Unchanged position of the hemodialysis catheter and the sternal wires.


SubjectID: 16073325, StudyID: 54847711, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: CTA chest from ___. CLINICAL

HISTORY: Altered mental status, question infection.

FINDINGS: Semi-upright portable AP view of the chest was obtained. Midline sternotomy wires and mediastinal clips are again seen as is a dialysis catheter with right IJ approach with tip in the expected location of the right atrium. Cardiomegaly is stable with mild pulmonary edema   Keywords: stable. No definite signs of pneumonia or large effusion. No pneumothorax is seen. Bony structures appear intact.

IMPRESSION: Cardiomegaly, mild edema.


SubjectID: 16073325, StudyID: 56351371, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST RADIOGRAPHS

INDICATION: Cough, shortness of breath and hypoxia. Evaluate for pneumonia.

TECHNIQUE: AP portable chest radiographs were obtained.

COMPARISON: ___. REPORT: A dialysis lies in situ. Patient is status post sternotomy. Midline sutures are in unchanged position. Clips are projected at the level of the aortic hiatus in the right hypochondrium. These are unchanged. There is cardiomegaly and there is evidence of generalized peribronchial cuffing. Findings are consistent with pulmonary edema. This is probably a little more pronounced than on the prior study. There is an enlarging left-sided pleural reaction suggestive of developing effusion. There is probably a small right effusion also.

CONCLUSION: The findings are consistent with fluid overload. The patient may be on dialysis and correlation with dry weight assessment would be appropriate. Appearances are slightly worse than on the prior study.


SubjectID: 16073325, StudyID: 52052195, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with recent cardiac event intraop with ETT in place post op. // ETT position

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Heart size is top-normal is unremarkable. ET tube tip is 4 cm above the carinal. Central venous line tip is in the right atrium. Small bilateral pleural effusions are noted.


SubjectID: 16073325, StudyID: 50956508, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with severe aortic stenosis intubated for aortofem bypass aborted due to severe hypotension preoperatively // compare to prior compare to prior

IMPRESSION: In comparison with the study of ___, the endotracheal tube has been removed. The large-bore catheter tip is in the upper portion of the right atrium. Otherwise, little change   Keywords: little change.


SubjectID: 16076182, StudyID: 59779822, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Hypoxia, chronic heart failure, evaluation for pneumonia or edema.

COMPARISON: ___, 5:11 p.m.

FINDINGS: As compared to the previous radiograph, there is a decrease in lung volume. The diameter of the pulmonary vascular structures has minimally increased   Keywords: increase. This could be an indication for mild pulmonary edema. Unchanged moderate cardiomegaly. No pleural effusions. No evidence of pneumonia.


SubjectID: 16076182, StudyID: 57285793, Comparison: None

FINAL REPORT

CHEST, TWO VIEWS: ___.

HISTORY: ___-year-old female with hypoxia. Question pneumonia or pulmonary edema.

FINDINGS: The lungs are clear of focal consolidation or effusion. Cardiomediastinal silhouette is stable as are the osseous and soft tissue structures. Hypertrophic changes seen throughout the spine.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 16076182, StudyID: 59478879, Comparison: None

WET READ: ___ ___ 8:58 AM Dobbhoff tube tip projecting over the proximal stomach. A tube projecting over the right side of the abdomen and the left mediastinum is likely external to the patient. Otherwise, no significant interval change compared to chest radiograph from ___ min prior.

WET READ VERSION #1 ___ ___ ___ 11:45 PM Dobbhoff tube tip projecting over the proximal stomach. A tube projecting over the right side of the abdomen and the left mediastinum is likely external to the patient. Otherwise, no significant interval change compared to chest radiograph from ___ min prior. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: DOBHOFF PLACEMENT

IMPRESSION: In comparison with the earlier study of this date, the Dobbhoff tube now extends well into the stomach.


SubjectID: 16076182, StudyID: 54982951, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with staged dobhoff placement // ___ dobhoff placement XR ___ dobhoff placement XR

IMPRESSION: In comparison with the earlier study of this date, there has been placement of a Dobbhoff tube with its tip in the mid to upper stomach.


SubjectID: 16076182, StudyID: 54118724, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with COPD, CHF, persistent O2 requirement // interval change of effusion, other acute process interval change of effusion, other acute process

IMPRESSION: In comparison with the study of ___, there is substantial enlargement of the cardiac silhouette with moderate pulmonary edema and bilateral effusions with compressive atelectasis at the bases.


SubjectID: 16076182, StudyID: 53868158, Comparison: same

FINAL REPORT

CHEST, TWO VIEWS: ___

HISTORY: ___-year-old female with chest pain and dyspnea.

FINDINGS: AP and lateral views of the chest are compared to previous exam from ___. Lower lung volumes seen on the current exam. Indistinctness of the pulmonary vasculature is again seen   Keywords: again. There is no effusion. Cardiomediastinal silhouette is unchanged given differences in positioning and lower inspiratory effort.

IMPRESSION: Pulmonary vascular congestion without frank edema, not likely changed given lower inspiratory effort on the current exam.


SubjectID: 16076182, StudyID: 53133816, Comparison: worse

FINAL REPORT

INDICATION: Shortness of breath.

COMPARISON: Chest radiograph from ___.

TECHNIQUE: Frontal chest radiograph.

FINDINGS: The heart size is normal. The hilar and mediastinal contours are unchanged since ___. There is new central pulmonary vascular congestion, with minimal edema   Keywords: new. There is no focal consolidation, pleural effusion, or pneumothorax.

IMPRESSION: New central pulmonary vascular congestion with minimal edema   Keywords: new.


SubjectID: 16076182, StudyID: 50334286, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (AP AND LATERAL)

INDICATION: History: ___F with shortness of breath, dyspnea on exertion

TECHNIQUE: Upright AP and lateral views of the chest

COMPARISON: ___ chest radiograph and ___ chest CT

FINDINGS: Moderate to severe cardiomegaly is re- demonstrated, unchanged. The aorta remains tortuous. Mediastinal and hilar contours are similar, and the pulmonary vasculature is not engorged. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is present. Diffuse idiopathic skeletal hyperostosis is again noted.

IMPRESSION: No acute cardiopulmonary abnormality.


SubjectID: 16078289, StudyID: 53221886, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with new SOB, s/p cath + having received post-cath fluids // ?new effusion

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The sternal wires and the clips projecting over the right lung apex are constant in appearance. No pleural effusions. No pneumonia, no pulmonary edema. Borderline size of the cardiac silhouette.


SubjectID: 16078289, StudyID: 51216826, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___F with history of CAD s/p CABG presenting with dyspnea on exertion // pulmary edema?

COMPARISON: ___.

FINDINGS: PA and lateral views of the chest provided. Midline sternotomy wires and prosthetic cardiac valve are again noted. A coronary artery stent is noted. Tiny clips are noted in the right upper chest wall. The lungs are clear. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen.

IMPRESSION: No acute intrathoracic process


SubjectID: 16103537, StudyID: 58322116, Comparison: worse

FINAL REPORT

INDICATION: ___ year old woman with dCHF, pulm hypertension, new hypotension // Please assess for PNA

COMPARISON: Radiographs from ___

IMPRESSION: Support lines and tubes are unchanged in position. There is unchanged cardiomegaly. There is a very large hiatal hernia which causes increase density at the right base. There is mild pulmonary edema which has developed since the previous study   Keywords: develop. Several old right-sided healed rib fractures are seen. There is a left retrocardiac opacity which has developed as well as likely a small left-sided pleural effusion. The patient's chin obscures the lung apices; however, no definite pneumothoraces are seen.


SubjectID: 16103537, StudyID: 53503405, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with HFpEF exacerbation and ?PNA // assess for interval change assess for interval change

IMPRESSION: In comparison with the study of ___, there is little overall change   Keywords: little overall change. The huge hiatal hernia again extends well to the right of the mediastinum. Dual-channel pacer device remains in place. Continued enlargement of the cardiac silhouette with some elevation of pulmonary venous pressure.


SubjectID: 16103537, StudyID: 51036899, Comparison: None

FINAL REPORT

INDICATION: ___ year old female living in assited living with history of HFpEF (elevated biventricular filling pressures per RHC with predominantly right heart symptoms), pulmonary artery hypertension (diagnosed ___) likely secondary to MCTD, COPD, history of DVT on ?warfarin, atrial tachyarrhytmias, initally presented after experiencing subjective weakness and fall, found to be significantly volume overloaded transferred to zoll service with bilateral lower extremity edema and symptoms of right heart failure. // ? pneumoni

COMPARISON: Radiographs from ___

IMPRESSION: Support lines and tubes are unchanged in position. There is unchanged cardiomegaly. There is again seen a very large hiatal hernia which causes increased opacity at the right base, unchanged. There is a small left-sided pleural effusion and increase density at the left retrocardiac area which may be due to atelectasis or developing infiltrate. There are no signs for pulmonary edema. There are no pneumothoraces.


SubjectID: 16103537, StudyID: 58298140, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___F with fall, weakness, on coumadin // Eval for intracranial hemorrhage; pneumothorax/rib fx; fracture, or injury

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph from ___.

FINDINGS: A left chest wall pacemaker is present with leads within the right atrium and right ventricle. Lungs are well-expanded. Opacity projecting over the left lateral chest may represent overlapping soft tissue. Otherwise there is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal slight is unchanged. Large hiatal hernia is again re- demonstrated. Old right rib fractures are unchanged.

IMPRESSION: Opacity over the left lateral lower lobe may represent overlying soft tissue but atelectasis or early infection is also possible.


SubjectID: 16103537, StudyID: 57409633, Comparison: None

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPH

INDICATION: Central line placement.

TECHNIQUE: Chest, semi-supine AP portable.

COMPARISON: Earlier on the same day.

FINDINGS: A new right internal jugular central venous catheter terminates in the lower superior vena cava. There is no pneumothorax. Again noted also is a two-lead pacemaker/ ICD device. The cardiac, mediastinal and hilar contours appear unchanged. A hiatal hernia is much more prominent on this study and more visible along the right cardiophrenic sulcus. There is persistent opacification obscuring the left costophrenic angle. This may represent pneumonia but with no short-term change. A trace pleural effusion is difficult to exclude on the left side.

IMPRESSION: Persistent opacity in the lateral left lower lung, possible pneumonia. Follow-up radiographs are suggested to show resolution. Large hiatal hernia. New central venous catheter terminating in the superior vena cava; no evidence of pneumothorax.


SubjectID: 16103537, StudyID: 57760582, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with pulm htn, ___'s, now with increased O2 requirement // Eval for pneumonia

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Known hiatal hernia. Minimal left pleural effusion with subsequent atelectasis. No pulmonary edema. No pneumonia. Old right and left rib fractures.


SubjectID: 16103537, StudyID: 56015456, Comparison: None

FINAL REPORT

PORTABLE RADIOGRAPH OF ___ Compared to multiple prior chest radiographs dating back to ___ and prior chest CT of ___.

FINDINGS: Heart is upper limits of normal in size. Large pericardiac mass is due to a known hiatal hernia, more fully evaluated on chest CT of ___. New left retrocardiac opacity may reflect atelectasis, aspiration, or possibly a developing focus of pneumonia. Small pleural effusions are present bilaterally.


SubjectID: 16103537, StudyID: 54698493, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: Ms. ___ is an ___-year-old woman who lives in an assisted-living facility with hx of HFpEF, PAH due to possible MCTD, COPD, h/o DVT on warfarin who now presents for evaluation of AMS and shock with desat 80s on bipap // eval for worsening pulm edema

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the nasogastric tube is now coiled in the large hiatal hernia. Moderate cardiomegaly persists. Small bilateral pleural effusions. Retrocardiac atelectasis. No pulmonary edema. No pneumonia. The left pectoral pacemaker is constant.


SubjectID: 16103537, StudyID: 53416284, Comparison: None

FINAL REPORT

INDICATION: History: ___F with AMS, hypoxia // eval for PNA

TECHNIQUE: Single portable view of the chest.

COMPARISON: None.

FINDINGS: There are bibasilar opacities, likely some combination of layering effusions and atelectasis with possible superimposed consolidation. Superiorly, the lungs are clear. The cardiomediastinal silhouette is enlarged particularly on the left in the region of the AP window. While some of this may be technical due to patient rotation and AP positioning, followup will be necessary. Left chest wall dual lead pacing device seen with lead tips projecting over the right atrium and right ventricle. Old healed right lateral rib fractures are seen.

IMPRESSION: Bibasilar opacities likely in part due to effusions with possible superimposed atelectasis and/or infection. Enlarged cardiomediastinal silhouette as above, potentially accentuated by patient positioning and technique however repeat will be necessary when patient is amenable, preferably with PA and lateral.


SubjectID: 16103537, StudyID: 51343347, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with AMS s/p OG tube placement // ?OG placement //___ year old woman with AMS s/p OG tube placement

TECHNIQUE: 2 sequential AP views of the chest

COMPARISON: Multiple prior radiographs dating back to ___ and a CT from ___

FINDINGS: The NG-tube is seen on the second radiograph curled into the partially intrathoracic stomach to the right of the midline. Pacemaker is in appropriate position. Substantial cardiomegaly remain stable. Bibasilar opacities, a combination of effusions and atelectasis are worse on the left than the right. Old, healing rib fractures are noted.

IMPRESSION:: : NG tube curled in to an intrathoracic stomach.


SubjectID: 16103537, StudyID: 50653794, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with ongoing shortness of breath, new NGT placed. // evaluate placement of NGT

TECHNIQUE: Portable AP radiograph of the chest.

COMPARISON: Multiple prior plain films most recently ___, and chest CT dated ___.

FINDINGS: The nasogastric tube likely enters the left lower lobe bronchus. A left pectoral pacemaker is in place. There is no pneumothorax. Small bilateral pleural effusions with bibasilar subsegmental atelectasis are unchanged. Moderate cardiomegaly despite the projection is unchanged. Large hiatal hernia with intrathoracic stomach is re-demonstrated.

IMPRESSION: New nasogastric tube with course suggestive of malpositioning within the left lower lobe bronchus. Removal or repositioning is advised. Otherwise no significant interval change   Keywords: no significant interval change.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 9:15 AM, 5 minutes after discovery of the findings.


SubjectID: 16108772, StudyID: 59582186, Comparison: None

FINAL REPORT

STUDY: PA and lateral chest, ___. CLINICAL

HISTORY: ___-year-old man with shortness of breath and chest pain.

FINDINGS: Comparison is made to previous study from ___. There is scoliosis of the thoracic spine. This is stable. There is some atelectasis at the lung bases. There remains stable cardiomegaly. Again seen a right basilar opacity which may represent atelectasis or developing infiltrate in the correct clinical setting. The rib deformities may be related to prior trauma or due to the scoliosis. Overall, the findings are unchanged.


SubjectID: 16108772, StudyID: 57386825, Comparison: None

FINAL REPORT

INDICATION: Chest pain. Evaluate for acute process.

COMPARISON: Chest radiograph, ___. Chest radiograph, ___.

FINDINGS: In comparison to the prior exam, the lung volumes are low, accentuating the vascular structures. There is a hazy opacity at the right base, which given the low lung volumes, is likely atelectasis, although in the proper clinical setting, pneumonia cannot be fully excluded. There is no evidence of pulmonary edema, pleural effusion or pneumothorax. The heart is mildly enlarged, and stable from the prior exam. Tortuosity of the aorta is unchanged. The mediastinal contours are within normal limits. Moderate upper thoracic dextroscoliosis is stable. Rib deformities on the right reflect old healed injuries.

IMPRESSION: 1. Hazy opacification at the right base, in the setting of low lung volumes, is likely atelectasis. In the proper clinical setting, pneumonia cannot be completely excluded. 2. Stable mild cardiomegaly.


SubjectID: 16108772, StudyID: 58051417, Comparison: None

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Cough and dyspnea.

COMPARISONS: ___.

TECHNIQUE: Chest, PA and lateral.

FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged including tortuosity of the aorta and borderline cardiomegaly. There is a mild interstitial abnormality suggestive of pulmonary vascular congestion. Patchy opacities are present at both lung bases, not specific although most suggestive of atelectasis. There is no definite pleural effusion or pneumothorax.

IMPRESSION: Findings suggesting mild vascular congestion. In the appropriate clinical setting, atypical pneumonia could also be considered. Also, although it is difficult to exclude focal pneumonia at the lung bases, patchy basilar opacities with low lung volumes could also be seen with atelectasis.


SubjectID: 16108772, StudyID: 56429211, Comparison: None

FINAL REPORT

Shortness of breath, assessment for improvement of pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the lung volumes have minimally increased, likely reflecting improved ventilation. Otherwise, the radiograph is unchanged, including the pre-existing mild-to-moderate cardiomegaly. No pleural effusions are seen. No evidence of pneumonia.


SubjectID: 16108772, StudyID: 53068229, Comparison: same

WET READ: ___ ___ ___ 5:33 PM Persistent mild interstitial edema, possible small bilateral pleural effusions, and cardiomegaly. No pneumothorax detected. Scoliosis and rib deformities are chronic. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Pneumonia, acute worsening of dyspnea, rule out pneumothorax.

COMPARISON: ___, 12:17 a.m.

FINDINGS: As compared to the previous radiograph, there is persistent mild interstitial pulmonary edema, accompanied by potential small bilateral pleural effusions   Keywords: persistent. Moderate cardiomegaly. No pneumothorax. Chronic rib deformities, causing asymmetry of the chest wall.


SubjectID: 16108772, StudyID: 57131850, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with possible aspiration event // please eval for signs of aspiration please eval for signs of aspiration

IMPRESSION: In comparison with the earlier study of this date, the patient has taken a better inspiration. No definite evidence of acute focal consolidation after the aspiration event.


SubjectID: 16108772, StudyID: 56416843, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with chf, cad, code blue called now has pulse had unresponsive hypoxic episode // eval for pulmonary edema, other cardiopulmonary process

COMPARISON: Chest radiograph ___

FINDINGS: Single AP view of the chest provided. Lungs are well inflated and grossly clear. Pulmonary vascular engorgement is improved   Keywords: improve. No pleural effusion or pneumothorax. Hilar and cardiomediastinal contours are stable. Severe dextroscoliosis is unchanged.

IMPRESSION: 1. Prominence of the pulmonary vasculature is improved. No pulmonary edema. 2. Severe dextroscoliosis is unchanged.


SubjectID: 16113543, StudyID: 59354221, Comparison: same

WET READ: ___ ___ ___ 8:19 PM On all images, Dobhoff catheter tip projects over the left upper quadrant, likely within the stomach. No other acute changes. Bilateral pleural effusions with underlying consolidations, likely atelectasis, and patch of left upper lobe opacity persist. Tracheostomy and central venous catheter are similarly positioned. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Perforated duodenal ulcer, Dobbhoff catheter, evaluation for position.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the Dobbhoff catheter has been pulled back. The catheter tip now projects over the middle parts of the stomach. There is no other relevant change   Keywords: no other relevant change. The other monitoring and support devices are constant.


SubjectID: 16113543, StudyID: 56783260, Comparison: same

FINAL REPORT

INDICATION: Respiratory acidosis, status post bronchoscopy.

COMPARISONS: Chest radiograph ___ and multiple chest radiographs dating to ___.

FINDINGS: Since the prior exam performed one day prior, there is no significant change   Keywords: no significant change. Again seen is a layering right pleural effusion with associated atelectasis. A left pleural effusion with atelectasis is also unchanged. There is no new consolidation. There is no pulmonary edema or pneumothorax. The tracheostomy tube is 7.3 cm from the carina. A left internal jugular catheter terminates in the mid SVC. A Dobbhoff tube is in unchanged position overlying the mid stomach.

IMPRESSION: No significant change in the aeration of the lungs   Keywords: no significant change. Stable bilateral pleural effusions and bibasilar atelectasis.


SubjectID: 16113543, StudyID: 55899453, Comparison: None

WET READ: ___ ___ ___ 6:54 PM ng tube curling in stomach. laering right pleural effuion. new opacities in the LUL and LLL lobe. LLL c/w ateltecasis and effuion. LUL concerning for infx. ______________________________________________________________________________

FINAL REPORT

HISTORY: New feeding tube.

FINDINGS: In comparison with the study of ___, the Dobbhoff tube extends to the lower body of the stomach, then coils back on itself so that the tip lies in the upper stomach near the esophagogastric junction. There is layering of a substantial right pleural effusion with increased opacification at the left base consistent with left effusion and volume loss in the left lower lobe. There is also an area of increased opacification in the left mid zone. This and the basilar changes could represent supervening pneumonia.


SubjectID: 16113543, StudyID: 56885421, Comparison: same

FINAL REPORT

HISTORY: For feeding tube.

FINDINGS: In comparison with the earlier study, the feeding tube has been pushed forward so that the entire metallic tip is below the esophagogastric junction. The tip is in the upper portion of the stomach. Otherwise, little change   Keywords: little change.


SubjectID: 16113543, StudyID: 54546166, Comparison: None

FINAL REPORT

HISTORY: Surgery for perforated duodenal ulcer with fluid overload.

FINDINGS: In comparison with study of ___, the monitoring and support devices remain in place. The opacification at the right base is less prominent, as is the volume loss and effusion at the left base.


SubjectID: 16113543, StudyID: 58433008, Comparison: same

FINAL REPORT

HISTORY: Resuscitation after surgery.

FINDINGS: In comparison with study of ___, the monitoring and support devices are essentially unchanged. Bilateral basilar opacifications are consistent with pleural effusion and underlying atelectasis. There may be some mild indistinctness of pulmonary vessels suggesting some elevated pulmonary venous pressure. Overall, there is little change   Keywords: little change.


SubjectID: 16113543, StudyID: 55544762, Comparison: None

FINAL REPORT

PORTABLE AP CHEST FILM ___ AT 537 CLINICAL

INDICATION: ___-year-old with status post resuscitation for perforated duodenal ulcer, now with ARDS versus pulmonary edema, assess for interval change. Comparison to prior study dated ___ at 5:40 a.m. A portable semi-erect chest film ___ at 537 is submitted.

IMPRESSION: 1. Left internal jugular central line with its tip in the mid SVC. Nasogastric tube coursing below the diaphragm with the tip not identified. Endotracheal tube with its tip 4.3 cm above the carina. Interval improvement in aeration of both bases with residual small bilateral effusions and persistent retrocardiac opacity which may represent an area of compressive atelectasis, although pneumonia or aspiration could also have this appearance. Lungs appear hyperinflated suggesting a component of underlying emphysema. Overall, cardiac and mediastinal contours are stable. No pulmonary edema. No pneumothorax.


SubjectID: 16113543, StudyID: 53011275, Comparison: None

FINAL REPORT

AP CHEST, 5:54 A.M., ___

HISTORY: ___-year-old man after resuscitation for a perforated duodenal ulcer and exploratory laparotomy.

IMPRESSION: AP chest compared to ___: Diminished vascularity suggests emphysema although lung volumes are not appreciably enlarged. Thickening of the right apical pleural margin could be a lung tumor, although there is abnormality in the right lung apex that looks like bronchiectasis or scarring. I will discuss with the patient's clinical care team history of possible surgery, tuberculosis, or even lung cancer. ET tube in standard placement. Nasogastric tube ends in the stomach. Heart size normal. Pleural effusion is small on the left, if any. Lower lungs grossly clear.


SubjectID: 16113543, StudyID: 50313653, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post resuscitation for perforated duodenal ulcer, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has developed bilateral moderate pleural effusions. Subsequently, an area of atelectasis is seen in the retrocardiac lung zone. Lung apex continues to be unusually dense, tumor in this region should be excluded by CT. The monitoring and support devices are constant.


SubjectID: 16113543, StudyID: 58289472, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Tracheostomy, oxygen requirements, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the pre-existing parenchymal opacities have substantially decreased in extent   Keywords: decrease. Bilateral pleural effusions distribute in a slightly different manner, but are still clearly visible. A partial pleural component of the left effusion is better visible than on the previous image. Unchanged size of the cardiac silhouette. Unchanged areas of bilateral basal atelectasis. The apicomedial consolidation, partially obscured by the medial aspects of the right clavicle, is unchanged.


SubjectID: 16113543, StudyID: 52724128, Comparison: worse

FINAL REPORT

INDICATION: Shortness of breath.

COMPARISONS: Multiple prior chest radiographs from ___.

FINDINGS: Portable AP chest radiographs demonstrate stable positioning of monitoring and support devices. Bilateral pleural effusions are unchanged. However, parenchymal opacities and interstitial edema has worsened compared to ___, consistent with pulmonary edema   Keywords: worse. There is no pneumothorax.


SubjectID: 16113543, StudyID: 50483607, Comparison: None

FINAL REPORT

AP CHEST, 4:11 A.M. ___

HISTORY: A ___-year-old man with shortness of breath. Evaluate pleural effusions.

IMPRESSION: AP chest compared to ___: Greater opacification in the right lower hemithorax means that in addition to the moderate to large right pleural effusion and right lower lobe collapse there may be new consolidation in the middle lobe, previously fully aerated. A smaller degree of atelectasis at the base of the left lung is unchanged. The fissural pleural collection on the left is stable. CT scan attests to severe emphysema. Tracheostomy tube in standard placement. Feeding tube ends in the stomach. No pneumothorax. At the right apex is a large tumor mass.


SubjectID: 16113543, StudyID: 54506110, Comparison: same

FINAL REPORT

INDICATION: Evaluate for pneumonia. History of low saturations and hypercarbia.

COMPARISONS: Chest radiograph ___. Multiple chest radiographs dating to ___.

FINDINGS: A tracheostomy tube is in unchanged position, 4 cm from the carina. A left internal jugular central venous catheter terminates in the mid SVC. An NG tube is seen coarsening below the diaphragm with the tip of the field of view. A large right and moderate left pleural effusion are not significantly changed. The known right apical mass is stable. The lung volumes are lower in comparison to prior exam with accentuation of bibasilar atelectasis. There is no overt pulmonary edema. There is no new consolidation. There is no pneumothorax.

IMPRESSION: No significant change from the chest radiograph performed one day earlier   Keywords: no significant change. Stable bilateral pleural effusions.


SubjectID: 16113543, StudyID: 53869007, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___ radiograph.

FINDINGS: Indwelling support and monitoring devices are unchanged in position. Moderate, partially layering bilateral pleural effusions are again demonstrated as well as a worsening opacity in the left retrocardiac region. The latter may be due to atelectasis or infectious consolidation. Known right apical lung mass with rib destruction is unchanged and has been more fully evaluated on CT torso of ___. Upper lobe emphysema is again noted.


SubjectID: 16113543, StudyID: 55445985, Comparison: worse

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with abnormal chest x-ray, increased white blood cell.

COMPARISON: Multiple chest x-rays from ___ to ___; CT torso done yesterday.

FINDINGS: Tracheostomy ends 3.5 cm above the carina. Dobbhoff tube is in the stomach. The patient is known with right apical mass invading the ribs and vertebral body. Increased opacification in both lungs since yesterday is compatible with worsening of moderate pulmonary edema   Keywords: worse, increase. Bilateral moderate pleural effusion on the left side and severe on the right side is unchanged. A more focal area around the left hilum is unchanged and could be compatible with loculated pleural effusion in the fissure as seen on yesterday's CT. Right apical pneumonia seen on previous CT is hard to assess on this chest x-ray. Mediastinal and cardiac contours are normal. There is no pneumothorax.

CONCLUSION: 1. Increased opacities in both lungs are compatible with worsening of moderate pulmonary edema   Keywords: worse, increase. 2. Right severe and left moderate pleural effusions are stable. 3. The patient is known with right apical mass invading adjacent bone. 4. Right apical pneumonia described on yesterday's CT is hard to assess on this exam.


SubjectID: 16113543, StudyID: 53025809, Comparison: better

FINAL REPORT

AP CHEST, 6:04 A.M. ___

HISTORY: This is a ___-year-old man with pneumonia, question interval change.

IMPRESSION: AP chest compared to ___ through ___: Moderate-to-large right pleural effusion has not changed appreciably in a week. Small-to-moderate left pleural effusion may be smaller today than yesterday. Severe left lower lobe atelectasis persists. Pulmonary edema has clearly improved   Keywords: improve. Heart size is normal. Feeding tube ends in the upper stomach. No pneumothorax. Biapical pulmonary abnormalities look like radiation-induced scarring.


SubjectID: 16113543, StudyID: 50716425, Comparison: better

FINAL REPORT

HISTORY: Fluid overload after surgery.

FINDINGS: In comparison with the study of ___, the monitoring and support devices are in unchanged position. The endotracheal tube is at the upper clavicular level and could be pushed forward several centimeters. Large right apical mass is again seen with associated rib destruction, consistent with a primary lung malignancy. Progressive decrease in the bibasilar opacification   Keywords: decrease.


SubjectID: 16113543, StudyID: 52213321, Comparison: None

FINAL REPORT

PORTABLE CHEST

COMPARISON: ___ radiograph.

FINDINGS: Tip of endotracheal tube terminates about 7 cm above the carina and could be advanced a few centimeters for standard positioning. Central venous catheter and nasogastric tube remain in standard position. Persistent right apical lung mass with associated rib destruction, consistent with primary lung cancer. Improving bilateral pleural effusions and adjacent basilar lung opacities, which probably reflect atelectasis.


SubjectID: 16113543, StudyID: 52911250, Comparison: None

FINAL REPORT

HISTORY: Intubated.

TECHNIQUE: Semi-upright AP view of the chest.

COMPARISON: None.

FINDINGS: Endotracheal tube tip terminates approximately 4 cm from the carina. Orogastric tube courses through the stomach, with tip off the inferior borders of the film. The heart size is normal. The mediastinal and hilar contours are unremarkable. The lungs appear hyperinflated with severe emphysematous changes. A right apical area of opacification is noted, and a focal mass cannot be excluded. No pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities. Cervical spinal fusion hardware is not completely assessed.

IMPRESSION: 1. Endotracheal and orogastric tubes in standard positions. 2. Right apical opacity for which correlation with CT is recommended as finding may reflect a neoplasm. Severe emphysema.


SubjectID: 16113543, StudyID: 50646533, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post perforated diverticulitis, questionable pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to previous radiograph, the lung transparency has increased, likely reflecting improved ventilation. The monitoring and support devices are constant. Constant in extent are the bilateral pleural effusions and the areas of parenchymal opacities, notably in the left perihilar region. No evidence of pneumothorax.


SubjectID: 16113543, StudyID: 51635246, Comparison: None

WET READ: ___ ___ ___ 9:26 PM Support devices in standard position. Perihilar opacities appear slightly increased, left greater than right, though likely reflect worsening edema. Moderate left pleural effusion appears larger. Large right pleural effusion is unchanged. Presumed basilar atelectasis persists. ___ p_________________________________________________________________________________

FINAL REPORT

HISTORY: Post-operative with increasing oxygen requirement and altered mental status.

FINDINGS: In comparison with the earlier study of this date, the monitoring and support devices remain in standard position. Continued bilateral pleural effusions, more prominent on the left, with compressive atelectasis at the bases and substantial pulmonary edema.


SubjectID: 16113543, StudyID: 50812822, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Unexplained leukocytosis, rule out pneumonia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the monitoring and support devices are unchanged. There is increasing opacity in both perihilar areas. Asymmetry in configuration of these opacities, however, just pulmonary edema rather than pneumonia. Persistent relatively massive right pleural effusion and moderate left pleural effusion. Unchanged borderline size of the cardiac silhouette.


SubjectID: 16123634, StudyID: 51421278, Comparison: worse

FINAL REPORT

INDICATION: Cough and shortness of breath.

COMPARISON: Chest radiograph from ___ and ___.

FINDINGS: PA and lateral views of the chest were reviewed. Compared to the most recent prior, increased interstitial markings, diffuse parenchymal opacities and hazziness of the pulmonary vessels indicates worsening moderate pulmonary edema   Keywords: increase, worse. Mild cardiomegaly and a tortuous aorta are unchanged. There is no pleural effusion or pneumothorax. Mild degenerative changes in the thoracic spine are unchanged.

IMPRESSION: Worsening moderate pulmonary edema   Keywords: worse. Unchanged moderate cardiomegaly.


SubjectID: 16127152, StudyID: 53919055, Comparison: None

FINAL REPORT

INDICATION: History of diastolic dysfunction and CAD, presenting with dyspnea and cough.

COMPARISON: ___; ___.

FINDINGS: Frontal and lateral views of the chest were obtained. Low lung volumes result in bronchovascular crowding. There is no focal consolidation, pleural effusion or pneumothorax. Pulmonary vasculature is slightly indistinct with perihilar fullness, suggesting pulmonary vascular congestion without overt pulmonary edema. Cardiac and mediastinal silhouettes are unchanged.

IMPRESSION: Pulmonary vascular congestion without overt pulmonary edema.


SubjectID: 16127152, StudyID: 50145470, Comparison: same

FINAL REPORT

HISTORY: Coronary artery disease, congestive heart failure, fever and hypotension.

TECHNIQUE: Portable frontal chest radiograph.

COMPARISON: Multiple chest radiographs dating from ___ through ___.

FINDINGS: Cardiomediastinal silhouette and hilar contours are stable. Persistent low lung volumes result in bronchovascular crowding and there is persistent indistinct appearance of pulmonary vasculature and perihilar fullness suggesting congestion. There is no pleural effusion or pneumothorax.

IMPRESSION: Unchanged pulmonary vascular congestion without overt pulmonary edema   Keywords: unchanged.


SubjectID: 16127152, StudyID: 51445394, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with shortness of breath and fever.

COMPARISON: Chest radiograph ___. PA AND LATERAL CHEST RADIOGRAPHS: The cardiomediastinal and hilar contours are within normal limits. The lung volumes are low with resultant crowding of the bronchovascular markings. No large pleural effusion or pneumothorax is detected.

IMPRESSION: Low lung volumes, no acute pathology.


SubjectID: 16130527, StudyID: 59691000, Comparison: worse

FINAL REPORT

HISTORY: Hypoxia.

TECHNIQUE: PA and lateral views of the chest.

COMPARISON: ___.

FINDINGS: Left-sided pacemaker device is noted with lead terminating in the right ventricle. The heart remains moderately enlarged with a left ventricular predominance. There is moderate pulmonary edema, worse when compared to the prior exam, with small bilateral pleural effusions   Keywords: worse. Retrocardiac opacity likely reflects compressive atelectasis though infection is difficult to exclude. No pneumothorax is identified, though the extreme lung apices medially are obscured by the patient's chin projecting over this region. There are no acute osseous abnormalities.

IMPRESSION: Moderate congestive heart failure, worse when compared to the prior study with small bilateral pleural effusions   Keywords: worse. Retrocardiac opacity likely reflects atelectasis though infection is difficult to exclude.


SubjectID: 16130527, StudyID: 55922163, Comparison: better

FINAL REPORT

PORTABLE CHEST X-RAY, ___

COMPARISON: ___ radiograph.

FINDINGS: Cardiac silhouette remains enlarged, but congestive heart failure pattern has improved with residual interstitial edema remaining   Keywords: improve. Persistent small bilateral pleural effusions, left greater than right, with adjacent basilar atelectasis. Single-lead pacemaker is unchanged in position.


SubjectID: 16130527, StudyID: 59318227, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: Chest PA and lateral.

INDICATION: ___-year-old male patient with pneumonia, amyloidosis, persistent ___ liter oxygen requirement, evaluate for edema or pneumonia.

FINDINGS: PA and lateral chest views obtained with patient in upright position. Comparison is made with the next preceding portable AP single chest view of ___. Cardiomegaly as before. Unchanged position of permanent pacer in left anterior axillary position connected to a single electrode, terminating in right ventricular apical portion as before. The pulmonary vascular congestive pattern, upper zone redistribution, mild perivascular haze on the bases and bilateral pleural effusions blunting the lateral and posterior pleural sinuses before. The on the next previous portable chest examination of ___ suspected parenchymal infiltrate in the left upper lobe lateral portion has cleared up completely. Thus, there exists no remaining appreciable parenchymal pneumonic infiltrate. It is unclear whether shift of pleural effusion with appearance of pneumonic infiltrate accounts for this change. The present findings on the chest examination are similar to what has been noted on the next preceding PA and lateral chest examination of ___. Thus, the findings are consistent with chronic left-sided heart failure, pulmonary congestion.


SubjectID: 16130527, StudyID: 54696138, Comparison: worse

FINAL REPORT

INDICATION: Left-sided chest pain in a patient with cardiac amyloidosis, congestive heart failure, and recent pneumonia.

COMPARISON: Multiple chest radiographs, the most recent of ___ and CT chest, ___.

FINDINGS: Portable AP view of the chest was reviewed and compared to the prior studies. Moderate pulmonary edema has increased since ___   Keywords: increase   Keywords: increase. Moderate-to-large left and small right pleural effusions are slightly increased since ___. Severe cardiomegaly and the mediastinal contours are unchanged.

IMPRESSION: 1. Moderate pulmonary edema has increased since ___. 2. Moderate-to-large left and small right pleural effusions have minimally increased since ___. 3. Severe cardiomegaly is unchanged.


SubjectID: 16130527, StudyID: 50696744, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST FILM ___ AT 931

INDICATION: ___-year-old with cardiac amyloid, leukocytosis and crackles, question edema, question infiltrate. Comparison to ___ at ___. PA and lateral views of the chest ___ at 931 are submitted.

IMPRESSION: 1. A single-lead left-sided pacer remains in place with the lead terminating over the expected location of right ventricle. The heart remains enlarged with a somewhat globular configuration which most likely reflects cardiomegaly, although a pericardial effusion should also be considered. There are bilateral effusions, left much greater than the right. There is a persistent patchy retrocardiac opacity with some interval improvement in aeration in this vicinity suggesting resolving atelectasis. The lungs are otherwise grossly clear, although there is prominence of the interstitium which might reflect age-related changes. There has been interval resolution of the interstitial edema. No pneumothorax is seen.


SubjectID: 16131803, StudyID: 57976582, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman with acute desaturation. Evaluate for aspiration.

FINDINGS: Comparison is made to prior study from ___ at 5:52 p.m. There has been removal of the enteric tube. The pacemaker and median sternotomy wires are unchanged in position. There is also hardware within the proximal right humerus. Heart size is upper limits of normal. There is again seen a left retrocardiac opacity with likely left-sided pleural effusion, which is stable. There are no signs for overt pulmonary edema. No pneumothoraces are identified.


SubjectID: 16131803, StudyID: 53593717, Comparison: None

WET READ: ___ ___ 6:04 PM Enteric tube tip at the gastroesophageal junction, further advancement is recommended. Increased left lower lobe atelectasis. Small left pleural effusion. ______________________________________________________________________________

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old woman with ileus and congestive heart failure exacerbation. Now with nasogastric tube placement.

FINDINGS: Comparison is made to previous study from ___. The tip of the nasogastric tube is at the GE junction. This could be advanced for more optimal placement. There are again seen low lung volumes and left retrocardiac opacity which has increased. Pacemaker and median sternotomy wires are again seen and unchanged.


SubjectID: 16131803, StudyID: 51891037, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman with atrial fibrillation and ileus. Nasogastric tube placement.

FINDINGS: Comparison is made to prior study from ___. There has been placement of a nasogastric tube since the previous study. The tip and side port are below the GE junction, appropriately sited. The left-sided pacemaker and median sternotomy wires are unchanged. There is a persistent left retrocardiac opacity and left-sided pleural effusion. There is mild prominence of the pulmonary interstitial markings without significant pulmonary edema. No pneumothoraces are present.


SubjectID: 16142804, StudyID: 59394643, Comparison: nan

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Study of one day earlier.

FINDINGS: Allowing for differences in technique and positioning, there has been slight interval worsening of bilateral diffuse heterogeneous lung opacities, particularly at the lung bases   Keywords: worse. Otherwise, no relevant change since the recent study   Keywords: no relevant change.


SubjectID: 16142804, StudyID: 55326574, Comparison: None

FINAL REPORT

PORTABLE CHEST ___

COMPARISON: Radiograph of one day earlier.

FINDINGS: Allowing for differences in technique and positioning, there has been little change in the appearance of the chest since the recent radiograph except for slight decrease in diffuse bilateral alveolar opacities.


SubjectID: 16142804, StudyID: 57892534, Comparison: 1.0

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Tracheostomy, bilateral opacities. Evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the monitoring and support devices are in unchanged position. The extensive bilateral parenchymal opacities have minimally decreased in extent and severity   Keywords: decrease. The presence of air bronchograms is visually more evident than on the previous image. No new parenchymal opacities   Keywords: new. Unchanged moderate cardiomegaly. No larger pleural effusions. No pneumothorax.


SubjectID: 16142804, StudyID: 57344452, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Pulmonary edema, renal failure, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Extensive parenchymal opacities with air bronchograms are seen bilaterally. No larger pleural effusions. Moderate cardiomegaly. Double-lumen hemodialysis catheter has been newly implanted on the right. The tracheostomy tube is constant in appearance.


SubjectID: 16142804, StudyID: 54733235, Comparison: None

FINAL ADDENDUM These findings were discussed with Dr. ___. ______________________________________________________________________________

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old man with PEA, requiring more oxygenation.

FINDINGS: Comparison is made to previous study from ___. Tracheostomy is again seen in unchanged position. There is a right-sided PICC line whose tip is crossing to the left side into the brachiocephalic vein. This needs to be readjusted. Previously, the PICC line was within the proximal right atrium. Heart size is enlarged and there are diffuse airspace opacities. There are no pneumothoraces. Findings discussed with Dr. ___.


SubjectID: 16142804, StudyID: 51934101, Comparison: 0.0

FINAL REPORT

HISTORY: Volume overload.

FINDINGS: In comparison with the study of ___, there may be mild decrease in the diffuse bilateral pulmonary opacifications   Keywords: decrease. Continued enlargement of the cardiac silhouette with monitoring and support devices unchanged. Again, the appearance could reflect volume overload or diffuse alveolar hemorrhage   Keywords: again. In the appropriate clinical setting, supervening pneumonia would have to be considered.


SubjectID: 16142940, StudyID: 59843451, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with empyema // interval change

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: There is interval decrease in right pleural effusion, potentially due to drainage, substantial. Cardiomediastinal silhouette is unchanged. Left retrocardiac opacity is unchanged. There is no pneumothorax.


SubjectID: 16142940, StudyID: 57516064, Comparison: same

WET READ: ___ ___ ___ 10:14 AM No significant change from the prior study done today at 08:38.

WET READ VERSION #___ ___ ___ ___ 7:59 PM No significant change from the prior study done today at 08:38. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___ year old man with empyema pulled chest tube // CT catheter place

TECHNIQUE: Single AP portable chest radiograph.

COMPARISON: Chest radiograph dated ___ at 08:38

FINDINGS: Unchanged right pleural effusion with underlying consolidation and/or atelectasis with low right lung volume. Right-sided chest tube appears unchanged in position. EKG leads overlie the chest wall. Left lung is clear. Stable cardiomegaly. Visualized bony thorax is unchanged.

IMPRESSION: No significant change from the prior study done at 08:38   Keywords: no significant change.


SubjectID: 16142940, StudyID: 53812003, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with empyema // eval for interval change

TECHNIQUE: APsingle view

COMPARISON: ___

FINDINGS: EKG leads overlie the chest wall. The lung volumes remain low with unchanged right pleural effusion and diffuse right lung opacities. Left lung is clear. Small left pleural effusion. Stable cardiomegaly and calcification of the aortic knob. Unchanged bony thorax and upper abdomen.

IMPRESSION: No significant interval change except for new left pleural effusion.


SubjectID: 16142940, StudyID: 59145226, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with empyema // eval interval change eval interval change

COMPARISON: Previous chest radiographs ___ through ___.

IMPRESSION: Moderate to large right pleural effusion has recurred, replacing a substantial volume of the pleural air that appeared yesterday with many smaller loculations. Small to moderate left pleural effusion and severe cardiomegaly are unchanged. No left pneumothorax. Left upper lung clear. Bibasilar atelectasis unchanged. Right PIC line ends in the upper SVC. Right pleural drainage catheter unchanged in position probably abutting the mediastinum. Now with small


SubjectID: 16142940, StudyID: 55765273, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with empyema // eval interval change

COMPARISON: ___.

IMPRESSION: No relevant change as compared to the previous image   Keywords: no relevant change. Moderate cardiomegaly. Known right pneumothorax with bilateral pleural effusions. Massive cardiomegaly and a right PICC and right chest tube. No interval change   Keywords: no interval change.


SubjectID: 16142940, StudyID: 58144729, Comparison: None

WET READ: ___ ___ ___ 8:16 PM Stable position of right pleural tube with similar appearance of right pneumothorax. Right pleural effusion has slightly enlarged and there is now blunting of left costophrenic angle. Bibasilar opacities are likely atelectasis though infection cannot be entirely excluded. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with PleurX and pleural effusion // eval chest tube

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Stable position of right pleural tube is noted, with similar appearance of right pneumothorax, small. Right pleural effusion has slightly enlarged and there is now blunting of left costophrenic angle. Bibasilar opacities are likely atelectasis though infection cannot be entirely excluded. Cardiomediastinal silhouette is unchanged. There is potentially interval progression of left pleural effusion and left basal consolidation


SubjectID: 16142940, StudyID: 57708036, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with heart failure, now s/p right pleurex catheter placement. // please evaluate for interval change of right pleural effusion

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the position of the right pleural drain is constant. The extent of the right pleural effusion has not changed. No right pneumothorax. Unchanged moderate cardiomegaly with small retrocardiac atelectasis. No overt pulmonary edema. No new focal parenchymal opacities   Keywords: new. Unchanged moderate tortuosity of the descending aorta.


SubjectID: 16142940, StudyID: 53811704, Comparison: None

FINAL REPORT

INDICATION: Status post PleurX catheter placement with apical pneumothorax.

TECHNIQUE: Frontal chest radiograph.

COMPARISON: ___

FINDINGS: Again seen is a catheter overlying the right lung base. There is a small right-sided pneumothorax which is unchanged. There is a small to moderate size right-sided pleural effusion with associated atelectasis. On the left, there is a lucent line within the lateral aspect of the lung fields which may reflect a pneumothorax ___ ___ line from overlapping soft tissue.

IMPRESSION: 1. Stable appearance of right-sided pneumothorax and effusion. 2. Possible left-sided pneumothorax versus artifact. Repeat chest radiographs are recommended.

NOTIFICATION: Findings discussed with Dr. ___ on ___ @ 11:22 am.


SubjectID: 16142940, StudyID: 52274362, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pleurx // chest tube in place

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Since the prior study there has been no substantial change in the right pleural effusion, position of the right chest tube with no interval development of pneumothorax.


SubjectID: 16142940, StudyID: 51625976, Comparison: None

FINAL REPORT

INDICATION: Pneumothorax.

TECHNIQUE: Frontal chest radiograph.

COMPARISON: ___

FINDINGS: Again seen is the right PleurX catheter. The small right-sided pleural effusion is stable. The pneumothorax is stable. The heart remains enlarged. There is linear lingular atelectasis.

IMPRESSION: Stable right-sided pneumothorax and pleural effusion.


SubjectID: 16142940, StudyID: 58048122, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cardiac amyloid and recurrent right pleural effusion

COMPARISON: Chest radiograph since ___, most recently ___.

FINDINGS: AP view of the chest provided. Again seen is large right pleural effusion, occupying approximately half of the right hemithorax but not significantly changed from prior study from ___. There is still left base atelectasis. Cardiomegaly is stable.

IMPRESSION: Unchanged large right pleural effusion.


SubjectID: 16142940, StudyID: 55365329, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with large vol right effusion s/p TPC placement ___. Unclear output // ? resolution of effusion

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: Known ___

IMPRESSION: From the previous study there is substantial interval decrease in right pleural effusion with currently present minimal apical and relatively large basal pneumothorax. Cardiomediastinal silhouette is unchanged including substantial cardiomegaly. Left lung appearance is unchanged including left basal areas of atelectasis.

NOTIFICATION: Discussed with nurse ___ Ms. ___ over the phone by Dr. ___ at 15:07, 5 minutes after the findings were made


SubjectID: 16142940, StudyID: 51973658, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with large vol right effusion s/p TPC placement // ? PTX ? PTX

IMPRESSION: In comparison with the earlier study of this date, there has been placement of a tunneled pleural catheter at the right base. There is slight decrease in the degree of opacification consistent with large pleural effusion compressive atelectasis. Specifically, no evidence of pneumothorax. Otherwise little change   Keywords: little change.


SubjectID: 16142940, StudyID: 50710225, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pleural effusion s/p chest tube, apical PTX on prior CXR. // Evaluate apical PTX

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___ obtained at 13:09

IMPRESSION: Cardiomegaly is substantial. A right chest tube is in place. There is interval reaccumulation of right pleural effusion. The apical component of the pneumothorax appears to be slightly decreased.


SubjectID: 16142940, StudyID: 50209565, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF and right pleural effusion, now with pleurx in place

COMPARISON: Chest radiograph from ___.

FINDINGS: AP view of the chest provided. As compared to prior study from 1 day ago, there is no significant change   Keywords: no significant change. Again seen is right sided PleurX catheter in unchanged position. Degree of right pleural effusion is unchanged. Left basilar atelectasis has improved. There is no pneumothorax. Moderate cardiomegaly is stable.

IMPRESSION: No significant change with the degree of right pleural effusion.


SubjectID: 16142940, StudyID: 55180158, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with empyema // eval for interval change

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The right chest tube and the right PICC line and are in constant position. Unchanged appearance of the right pleural fluid collection with multiple air inclusions. Unchanged normal appearance of the left lung. Moderate cardiomegaly is constant in severity.


SubjectID: 16142940, StudyID: 56588861, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with R effusion s/p ___ // r/o ptx r/o ptx

COMPARISON: Comparison to prior study dated ___ at 16 37

FINDINGS: Portable AP upright chest film ___ at 10:59 is submitted.

IMPRESSION: Interval decrease in size but residual small to moderate right pleural effusion status post thoracentesis. No pneumothorax. Heart remains stably enlarged which may reflect cardiomegaly, although pericardial effusion should also be considered. Mediastinal contours are stable. Calcification of the aorta consistent with atherosclerosis. No evidence of pulmonary edema. Streaky opacities at the left base and more focal patchy opacity at the right base likely reflect atelectasis, although superimposed pneumonia cannot be excluded.


SubjectID: 16142940, StudyID: 50393233, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with amyloid cardiomyopathy now with blood tinged sputa and rhonchorous breath sounds. // r/o re-expansion pulmonary edema s/p thoracentesis today r/o re-expansion pulmonary edema s/p thoracentesis today

COMPARISON: Comparison to ___ at 10:58

FINDINGS: Portable AP upright chest film ___ at 14:16 is submitted.

IMPRESSION: There is a persistent small to moderate right effusion with increasing airspace opacity more suggestive of atelectasis rather than an infectious process. Linear opacity in the left lower lung likely reflects scarring. There is no evidence of pulmonary edema. The heart remains enlarged which may reflect cardiomegaly or pericardial effusion. Clinical correlation is advised. No pneumothorax.


SubjectID: 16142940, StudyID: 53916356, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with pleural effusion // eval

TECHNIQUE: CHEST (PA AND LAT)

COMPARISON: ___

IMPRESSION: Large right pleural effusion is similar 2 previous examination or potentially slightly increased. Cardiomegaly and left mediastinal shift are unchanged. Upper lungs are overall clear. No pneumothorax is present.


SubjectID: 16142940, StudyID: 51428848, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with R pleural effusion s/p ___. // ptx

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Large right pleural effusion is demonstrated. Left basal atelectasis is unchanged. Upper lungs are essentially clear. No pneumothorax is seen. The change in right pleural effusion is minimal on the AP radiograph of the chest.


SubjectID: 16143265, StudyID: 58361789, Comparison: None

WET READ: ___ ___ ___ 8:38 PM Dobhoff coiled back into distal esophagus. Otherwise little change. ______________________________________________________________________________

FINAL REPORT

STUDY: AP portable chest radiograph.

COMPARISON EXAM: AP portable chest radiograph, ___.

INDICATION: ___-year-old man status post Dobbhoff placement.

FINDINGS: There has been interval placement of a Dobbhoff tube with tip curling in the esophagus. There is a right internal jugular catheter in good position. There remains patchy infiltration of the left lung and likely small bilateral pleural effusions. The cardiomediastinal and hilar contours are stable.

IMPRESSION: Dobbhoff with tip coiling in the esophagus.


SubjectID: 16143265, StudyID: 54002346, Comparison: None

FINAL REPORT

AP CHEST, 12:03 P.M. ON ___

HISTORY: ___-year-old man with MRSA infection.

IMPRESSION: AP chest compared to ___ through ___: Heterogeneous opacification in the left lung, probably pneumonia, has continued to improve. Small bilateral pleural effusions are still present. Heart size normal. Right jugular line ends in the upper SVC. Gaseous distention of the transverse colon is longstanding.


SubjectID: 16143265, StudyID: 53091810, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Malnutrition, feeding tube, evaluation.

FINDINGS: As compared to the previous radiograph, the Dobbhoff catheter has been advanced. The contour of the gastric air bubble as well as the course of the catheter suggests coiling in the stomach rather than a position in the region of the ileocecal fold. No evidence of complications. Unchanged appearance of the lung bases and the cardiac silhouette.


SubjectID: 16143265, StudyID: 51163833, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Nasogastric tube placement, adjustment.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, coiling of the Dobbhoff catheter in the lower parts of the esophagus has been resolved. The course of the Dobbhoff catheter is now unremarkable. However, the catheter is positioned too proximal, with the tip approximately at the level of the gastroesophageal junction. The catheter should be advanced by approximately 5-10 cm. No other relevant changes, no evidence of complications   Keywords: no other relevant change. Unchanged size of the cardiac silhouette.


SubjectID: 16143265, StudyID: 57167113, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Bacteremia, evidence of pneumonia on chest x-ray, evaluation for interval change, evaluation for free intra-abdominal air.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is improved ventilation at the left lung base, with subsequent decrease in severity of the pre-existing parenchymal opacity. This opacity, mainly reticular in appearance, however, is still clearly visible. It could reflect pneumonia. Unchanged moderate cardiomegaly, unchanged appearance of the right lung base, with persisting blunting of the costophrenic sinus, potentially reflecting a minimal right pleural effusion. Unchanged minimal focal right apical thickening. No evidence of free intra-abdominal air.


SubjectID: 16143265, StudyID: 57144838, Comparison: None

FINAL REPORT

HISTORY: Respiratory distress after diuresis.

FINDINGS: In comparison with study of ___, the patient has taken a somewhat better inspiration. There is still enlargement of the cardiac silhouette with some mild elevation of pulmonary venous pressure. Some of the interstitial prominence could reflect coarse markings secondary to chronic pulmonary disease with hyperexpansion of the lungs. The areas of increased opacification in the left mid and lower zones again are worrisome for supervening pneumonia.


SubjectID: 16143265, StudyID: 51379339, Comparison: better

FINAL REPORT

HISTORY: Respiratory distress with flash pulmonary edema, to assess for worsening pneumonia.

FINDINGS: In comparison with the study of ___, the degree of interstitial edema appears to be improving   Keywords: improving. There are continued small bilateral pleural effusions with underlying compressive atelectasis. Increased opacification in the left mid and lower lung zones again suggests supervening lower lobe pneumonia. The left PICC line is no longer seen.


SubjectID: 16143265, StudyID: 52661177, Comparison: None

FINAL REPORT

HISTORY: ___-year-old male transferred from an outside hospital carrying a diagnosis of fungal pneumonia; while at rehab, had worsening dyspnea on exertion and palpitations while walking; also bilateral lower extremity swelling. STUDY: AP upright and lateral chest radiograph.

COMPARISON: None.

FINDINGS: The heart size is slightly enlarged, possibly exaggerated by AP positioning. The mediastinal contours demonstrate calcified atherosclerotic disease of aortic knob and a mildly tortuous aorta. The lungs demonstrate mildly heterogeneous parenchyma with vascular congestion. Prominence of the interstitial markings is more prevalent on the left with more subtle airspace consolidation at the right base. Small bilateral pleural effusions are present. There is no pneumothorax. Additionally, the left PICC courses across midline into the right brachiocephalic vein.

IMPRESSION: 1. Mild cardiomegaly with mild interstitial edema and small bilateral pleural effusions; subtle left lower lobe airspace opacity. The findings most likely represent mild pulmonary edema with a superimposed left lower lobe pneumonia. Comparison with prior imaging may be helpful. 2. Left PICC tip in right brachiocephalic vein; this finding was discussed with IV nurse ___ by ___ at 9:45 am on ___.


SubjectID: 16168308, StudyID: 59789386, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with a PMH of afib on Coumadin, sCHF (EF ___%) s/p ICD in ___, HTN, CAD, DM2, and COPD requiring home O2 presents with cough, dyspnea and abnormal labs, initial management of UTI, now presenting in cardiogenic shock. // Acute interval changes

COMPARISON: Chest x-ray from ___ at 15:47

FINDINGS: single lead left-sided pacemaker present, with lead tip over right ventricle, not significantly changed. Right IJ Swan-Ganz catheter, tip overlying main pulmonary artery, a retracted compared with the prior study. Again seen is cardiomegaly, with sternotomy wires. There is upper zone redistribution and mild vascular plethora, minimally improved   Keywords: improve. There is atelectasis at both lung bases, slightly improved in retrocardiac region. Otherwise, no focal opacity. No gross effusion.

IMPRESSION: Cardiomegaly, similar to prior. Repositioning of Swan-Ganz catheter, with tip now overlying main pulmonary artery. Retrocardiac opacity is slightly improved. Right cardiophrenic patchy opacity, question atelectasis, is unchanged. No new infiltrate identified. Upper zone redistribution and mild vascular plethora is minimally improved   Keywords: improve.


SubjectID: 16168308, StudyID: 55359736, Comparison: 0.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with a PMH of afib on Coumadin, sCHF (EF ___%) s/p ICD in ___, HTN, CAD, DM2, and COPD requiring home O2 presents with cough, dyspnea and abnormal labs, initial management of UTI, now presenting in cardiogenic shock. // Interval changes

IMPRESSION: Since the recent study of ___, it interstitial edema has slightly improved   Keywords: improve. No other relevant changes   Keywords: no other relevant change.


SubjectID: 16168308, StudyID: 52905341, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cardiogenic shock // s/p Swan placement

COMPARISON: Chest x-ray from ___ at 10:58

FINDINGS: Right IJ Swan-Ganz catheter is present, tip overlying proximal right pulmonary artery. Left-sided pacemaker is present, with lead tip over the right ventricle. No pneumothorax is detected. There is cardiomegaly, with sternotomy wires and mediastinal clips. This appears slightly less pronounced than on the prior film. There is upper zone redistribution and mild vascular plethora, without overt CHF. Bibasilar atelectasis and mild increased retrocardiac opacity. No gross effusion.

IMPRESSION: As above.


SubjectID: 16168308, StudyID: 55872872, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with a past medical history of afib on Coumadin, sCHF (EF ___%) s/p ICD in ___, HTN, CAD, DM2, and COPD who presents with cough, dyspnea now with new dyspnea // evaluate for infiltrate vs. effusion vs congestion

TECHNIQUE: Portable semi-erect frontal chest radiograph

COMPARISON: Chest radiograph ___

FINDINGS: A left chest wall single lead pacing device is unchanged in appearance compared to the prior study. The thoracic aorta demonstrates moderate unfolding. This accounts for at least some of the widening of the mediastinum. This is also likely exaggerated by the technique. No consolidation seen. No pneumothorax or pleural effusion. Elevation of the right hemidiaphragm is unchanged compared to the prior study.

IMPRESSION: Technically limited study. No acute cardiopulmonary process seen.


SubjectID: 16168308, StudyID: 53011990, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with elevated WBC, AMS, cough, and new O2 requirement concerning for pneumonia // ? pneumonia?

TECHNIQUE: AP upright and lateral chest radiographs

COMPARISON: Chest radiograph obtained earlier on the same day

FINDINGS: Moderate cardiomegaly, unchanged compared to the prior study. A single lead pacer is unchanged in appearance. No consolidation, pneumothorax or pleural effusion seen. Previous median sternotomy noted. Visualized bony structures are otherwise unremarkable in appearance.

IMPRESSION: No acute cardiopulmonary process seen.


SubjectID: 16168308, StudyID: 51901470, Comparison: None

FINAL REPORT

INDICATION: ___M with recent dx of RML pna p/w dyspnea and increasing weakness // assess for interval changes, pulmonary edema

TECHNIQUE: Frontal and lateral views the chest.

COMPARISON: ___.

FINDINGS: The lungs are clear without focal consolidation, effusion, or edema. Cardiomediastinal silhouette is stable. Left chest wall single lead pacing device is again seen with lead tip in the right ventricular apex. No acute osseous abnormalities.

IMPRESSION: Cardiomegaly without acute cardiopulmonary process.


SubjectID: 16168308, StudyID: 55398869, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with status post ICD // eval for pneumothorax and lead placement

COMPARISON: ___

FINDINGS: Interval insertion of a left-sided defibrillator with the tip in the right ventricle. Moderate cardiomegaly. No pneumothorax or pleural effusion. Chronic elevation of the right hemidiaphragm.

IMPRESSION: Left-sided defibrillator tip in the right ventricle. No pneumothorax.


SubjectID: 16168308, StudyID: 50371514, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with status post ICD // lead placement

TECHNIQUE: PA and lateral chest

COMPARISON: Portable chest radiograph ___.

FINDINGS: A single lead from an implantable defibrillator is unchanged in position compared to the prior study. Lung volumes are slightly improved compared to the prior study. The heart remains mildly enlarged. Previous median sternotomy noted. With evidence of coronary artery bypass grafting. No consolidation, pneumothorax or pleural effusion seen. Moderate degenerative changes in the thoracic spine.

IMPRESSION: No acute cardiopulmonary process seen.


SubjectID: 16168308, StudyID: 53687681, Comparison: better

FINAL REPORT

INDICATION: ___ year old man with cardiogenic shock // PICC positioning

FINDINGS: Compared to chest radiograph from the same day, right-sided PICC has been pulled back and the tip now at the an low SVC. Implantable defibrillator, and Swan-Ganz unchanged in position. Pulmonary vascular congestion has improved   Keywords: improve. Moderate cardiomegaly persists. No pneumothorax or pleural effusion.

IMPRESSION: New right-sided PICC in the mid to low SVC


SubjectID: 16168308, StudyID: 51457053, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cardiogenic shock and volume overload, swan catheter // interval changes interval changes

IMPRESSION: Comparison to ___. No relevant change   Keywords: no relevant change. Moderate cardiomegaly without pulmonary edema. Pacemaker wires and Swan-Ganz catheter are in correct position. No pleural effusions. No pneumothorax.


SubjectID: 16168308, StudyID: 50830132, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cardiogenic shock and volume overload, swan catheter // interval changes? interval changes?

COMPARISON: Prior chest radiographs ___ through ___.

IMPRESSION: Lung volumes have improved, mild interstitial pulmonary edema has cleared, a mediastinal vasculature not engorged, but severe cardiomegaly is stable   Keywords: improve. There is no pneumothorax or pleural effusion. Swan-Ganz catheter ends in the proximal right pulmonary artery. Right ventricular pacer defibrillator lead unchanged in course or position, continuous from the left pectoral generator.


SubjectID: 16168883, StudyID: 59312374, Comparison: None

FINAL REPORT

HISTORY: History of bilateral pleural effusions. Evaluate for change in size after diuresis.

COMPARISON: ___.

FINDINGS: Frontal and lateral radiographs of the chest demonstrate minimal interval change since the prior study. There continues to be a moderate right subpulmonic effusion and minimal left pleural effusion with continued elevation of the right hemidiaphragm. Bibasilar atelectasis is also seen. Otherwise, the lungs are clear. The cardiac and mediastinal contours are unchanged. Aortic valve is again seen and intact median sternotomy wires are noted. No pneumothorax.

IMPRESSION: Minimal interval change in moderate-to-large right and small left pleural effusions.


SubjectID: 16168883, StudyID: 53763270, Comparison: None

FINAL REPORT

HISTORY: History of bilateral pleural effusions, status post right thoracentesis. Evaluate for pneumothorax.

COMPARISON: ___ at 9:47 a.m.

FINDINGS: Frontal and lateral radiographs when compared to the prior study demonstrated marked improvement in the right pleural effusion with unchanged small left pleural effusion. No pneumothorax is seen. Otherwise, the lungs are clear, and the cardiac and mediastinal contours are unchanged.

IMPRESSION: Status post thoracentesis for right pleural effusion with no evidence of pneumothorax. Unchanged left pleural effusion.


SubjectID: 16168883, StudyID: 58077390, Comparison: None

FINAL REPORT

INDICATION: Shortness of breath, recent pneumonia.

COMPARISON: Chest radiograph ___, ___.

FINDINGS: The cardiomediastinal and hilar contours remain stable. Median sternotomy wires and aortic valve replacement are noted. Elevation of the right hemidiaphragm is new, and a small to moderate right pleural effusion is present, a component of which is likely subpulmonic. Partial obscuration of the right hemidiaphragm likely reflects residual infection. Small left pleural effusion is present. There is no pneumothorax.

IMPRESSION: New elevation of the right hemidiaphragm, which is likely attributable to a small to moderate pleural effusion, a component of which is likely subpulmonic. Small left pleural effusion. Right basilar opacity likely reflects residual pneumonia.


SubjectID: 16173001, StudyID: 57340315, Comparison: worse

FINAL REPORT

HISTORY: ___-year-old female status post biventricular pacemaker upgrade via left subclavian vein approach, rule out pneumothorax.

COMPARISON: ___.

FINDINGS: There has been exchange of the left chest pacemaker, now with two ventricular and a single atrial lead, which appear appropriately positioned. There is interval increase in now mild pulmonary edema, without pneumothorax   Keywords: increase. There is a new small right pleural effusion. The cardiac silhouette remains markedly enlarged, the mediastinal contours are notable for tortuosity of the aorta, with calcification of the aortic knob.

IMPRESSION: 1. Interval pacemaker exchange, no evidence of pneumothorax. 2. Mild pulmonary edema with marked cardiomegaly, slightly increased from ___ ___, with new small left pleural effusion   Keywords: increase.


SubjectID: 16173001, StudyID: 54397558, Comparison: better

FINAL REPORT

HISTORY: ___-year-old female status post biventricular pacemaker upgrade, question lead position.

COMPARISON: ___.

FINDINGS: Frontal and lateral chest radiographs demonstrate appropriate positioning of a right atrial, right ventricular, and left ventricular lead. Small bilateral pleural effusions are again seen, there is resolving mild pulmonary edema   Keywords: resolving. Right basilar opacity may refect atelectasis or infection. There is no pneumothorax. The cardiac silhouette remains markedly enlarged. The mediastinal contours are unchanged.

IMPRESSION: Resolving mild pulmonary edema, with small bilateral pleural effusions   Keywords: resolving. Increased opacity at the right base likely reflects atelectasis, though in the appropriate clinical setting pneumonia should be considered.


SubjectID: 16174132, StudyID: 57622212, Comparison: None

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPH.

INDICATION: History: ___M with ? ICD wire migration seen on portable CXR // Eval ICD wire

TECHNIQUE: Frontal and lateral views of the chest.

COMPARISON: Multiple prior chest radiographs, the most recent prior of ___, two hours prior.

FINDINGS: Compared to the prior chest radiograph performed 2 hours prior, the single lead of a left chest wall generator demonstrates mild retraction of the tip with a redundant loop, remaining within the right ventricle, new since ___. The lungs are clear. There is no pleural effusion or pneumothorax. The cardiac and mediastinal contours are normal.

IMPRESSION: Redundant pacemaker lead with retraction of the tip, still likely within the right ventricle, new since ___. Correlate with pacemaker function.


SubjectID: 16174132, StudyID: 51158323, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiograph.

INDICATION: History: ___M with pacer wire // eval for pace wires

TECHNIQUE: Single frontal view of the chest.

COMPARISON: Multiple prior chest radiographs, most recently of ___.

FINDINGS: The single lead of a left chest wall generator has a different course compared to the most recent prior chest radiograph. The pacer wire previously extended linearly from the right atrium to the right ventricle but currently appears coiled predominantly to the right of midline. Heart size and cardiomediastinal contours are normal. Lungs are clear without focal consolidation, pleural effusion, or pneumothorax.

IMPRESSION: The wire of a single lead left chest wall generator has migrated in position compared to ___ with retraction of the tip. Lateral radiograph recommended to confirm lead tip position. Correlate with pacemaker function.

NOTIFICATION: The findings were discussed via telephone by Dr. ___ with Dr. ___ on ___ at 5:42 AM, 1 minutes after discovery of the findings.


SubjectID: 16174132, StudyID: 57620043, Comparison: better

FINAL REPORT

HISTORY: Shortness of breath with pulmonary edema.

FINDINGS: In comparison with the study of ___, there may be some mild improvement in the severe pulmonary edema with right effusion and compressive atelectasis at the right base   Keywords: improve. Continued enlargement of the cardiac silhouette.


SubjectID: 16174132, StudyID: 50678995, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: Prior CT chest from earlier today from an outside hospital. CLINICAL

HISTORY: Sudden onset shortness of breath, question pulmonary edema.

FINDINGS: There is severe pulmonary edema with a right pleural effusion. These findings are better assessed on the chest CT performed approximately five hours earlier at the outside hospital. There is no pneumothorax. Bony structures appear intact.

IMPRESSION: Edema with right pleural effusion, not significantly changed from same day chest CT performed at outside hospital   Keywords: not significantly changed.


SubjectID: 16181369, StudyID: 54973424, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF s/p intubation for hypoxic resp failure. // interval changes

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: NG tube tip is in the stomach. ET tube tip is approximately 4.5 cm above the carinal. Cardiomediastinal silhouette is stable. Left retrocardiac consolidation and left pleural effusion appears to be unchanged but there is interval progression of interstitial opacities concerning for progression of interstitial pulmonary edema   Keywords: progression.


SubjectID: 16181369, StudyID: 51279076, Comparison: worse

FINAL REPORT

INDICATION: History: ___F with chf exacerbation, intubated transfer // eval ETT placement

COMPARISON: None.

TECHNIQUE: Single frontal view of the chest.

FINDINGS: Endotracheal tube terminates 3.7 cm above the carina. NG tube terminates below the diaphragm. Heart size and cardiomediastinal contours are normal. Blunting of the left costophrenic angle is noted. . Linear opacities in left lung base are consistent with scarring or atelectasis. Increased interstitial markings suggest either edema or chronic interstitial lung disease   Keywords: increase. A vague opacity in the periphery of the right upper lung at the level of the second anterior rib, suboptimally evaluated on this single frontal view. No focal consolidation or pneumothorax.

IMPRESSION: 1. Moderate left pleural effusion or pleural thickening with adjacent linear atelectasis and or scar. 2. Upper and mid lung reticular opacities could reflect acute interstitial edema or chronic interstitial lung disease. 2. Possible right upper lobe nodule versus scar, for which dedicated PA and lateral chest radiographs are recommended following extubation.


SubjectID: 16181369, StudyID: 54395124, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with respiratory distress // eval for worsening edema eval for worsening edema

IMPRESSION: In comparison with the study of ___, the patient has taken a better inspiration. Patchy areas of increased opacification are again seen bilaterally   Keywords: increase. Although some of this could reflect elevated pulmonary venous pressure, more coalescent area of opacification in the right and possibly left upper zones is worrisome for pneumonia in the appropriate clinical setting. There is also suggestion of an area of opacification at the left base that could represent an infectious process. Retrocardiac opacification is consistent with volume loss in the left lower lobe with an associated pleural effusion.


SubjectID: 16181369, StudyID: 51083747, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with h/o HTN, CKD, recent admission to ___ for PNA and NSTEMI presenting with dyspnea, diffuse infiltrates on CXR concerning for pulmonary edema and ?possible PNA with increase O2 requirement and wheezing. // eval for worsening PNA, effusion

COMPARISON: Prior chest radiographs dating from ___ to ___.

IMPRESSION: Stable cardiomediastinal contours. Bilateral, asymmetrically distributed combined alveolar and interstitial opacities are relatively similar to the previous radiograph of ___, except for slight improvement in the right apex and minimal worsening in the left perihilar region   Keywords: similar. Moderate left and small right pleural effusions are similar.


SubjectID: 16181369, StudyID: 52753955, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F in respiratory distress

TECHNIQUE: Upright AP view of the chest

COMPARISON: ___

FINDINGS: Lung volumes are low. Cardiac silhouette size remains mildly enlarged. The mediastinal contours are unchanged. Diffuse hazy ill-defined opacities are noted in the lungs, more extensive than compared to the previous exam. Small bilateral pleural effusions persist, not substantially changed in the interval. Bibasilar atelectasis remains similar compared to the prior exam. Assessment for pneumothorax is limited on this exam due to the patient's chin and neck soft tissues obscuring the lung apices, though no large pneumothorax is detected.

IMPRESSION: Diffuse hazy opacities in the lungs, progressed since the previous study   Keywords: progressed. This could reflect worsening multifocal pneumonia though an element of superimposed pulmonary edema may be present. Small bilateral pleural effusions persist, and there is continued bibasilar atelectasis.


SubjectID: 16181369, StudyID: 50478778, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with acute SOB, wheeze // Eval for pulm edema

COMPARISON: Radiographs from degenerate ___.

IMPRESSION: Heart size is unchanged and within normal limits. There are diffuse airspace opacities which are stable   Keywords: stable. Bilateral moderate size pleural effusions are again seen. There are no pneumothoraces. Overall, there has been no appreciable interval change.


SubjectID: 16196296, StudyID: 59213149, Comparison: None

WET READ: ___ ___ ___ 2:48 AM Moderate cardiomegaly and moderate pulmonary edema.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

INDICATION: ___-year-old woman with shortness of breath.

TECHNIQUE: Single frontal radiograph of the chest was obtained.

COMPARISON: None.

FINDINGS: There is moderate cardiomegaly and mild pulmonary edema. The hila are prominent, likely due to vascular congestion, however repeat CXR after resolution is recommended to ruleo out hilar lymphadenopathy. No significant pleural effusions. There is no pneumothorax. No focal lung consolidation.


SubjectID: 16196296, StudyID: 50182817, Comparison: None

WET READ: ___ ___ ___ 2:13 AM Right lower opacity is unchanged since ___ and similar to ___, likely scarring, but subtle early superimposed PNA cannot be completely excluded.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

INDICATION: ___-year-old with asthma, COPD. Please assess for pneumonia.

TECHNIQUE: Frontal and lateral radiographs of the chest were obtained.

COMPARISON: Chest radiograph from ___.

FINDINGS: There is chronic moderate cardiomegaly. In comparison to CT of the chest from ___, again seen is a right infrahilar streak like opacity, likely due to scarring, unchanged from prior CXR exams dating back to ___ and ___. No pleural effusion and no pneumothorax.

IMPRESSION: No acute cardiothoracic process.


SubjectID: 16196998, StudyID: 59707377, Comparison: better

FINAL REPORT

INDICATION: Coronary artery disease, status post CABG, AFib status post pacemaker, now status post CRTP upgrade via left subclavian. Assess lead placement.

TECHNIQUE: PA and lateral radiograph of the chest.

COMPARISON: Chest radiograph from one day prior.

FINDINGS: Mild pulmonary edema is decreased since the most recent comparison from 12 hours prior   Keywords: decrease. There is no focal consolidation. The heart is mildly enlarged with normal cardiomediastinal silhouette. Appearance of the pacer is unchanged with atrial and biventricular leads noted. There is no pneumothorax.


SubjectID: 16196998, StudyID: 56080619, Comparison: worse

WET READ: ___ ___ ___ 10:24 PM Mild pulmonary edema is increased since ___. A dual lead pacer in the left chest has been replaced with a bi-ventricular pacer with a ___ lead seen within an LV vein. No pneumothorax. ______________________________________________________________________________

FINAL REPORT

AP CHEST, 6:06 P.M. ON ___

HISTORY: Coronary artery disease. CABG. Left subclavian pacer upgrade. Rule out complications.

IMPRESSION: AP chest compared to most recent prior chest radiographs available, ___: Moderate cardiomegaly may have increased slightly, but mild pulmonary edema and mediastinal venous engorgement are both new   Keywords: increase, new. There is no pneumothorax, pleural effusion, or mediastinal widening. Transvenous right atrial and right ventricular leads follow same courses from the new left pectoral pacemaker as they did previously. The new left ventricular lead probably ends along the posterior wall of the left ventricle.


SubjectID: 16196998, StudyID: 53449069, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Severe aortic stenosis, evaluation for pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has received a right internal jugular introduction sheath. The alignment of the sternal wires as well as the position of the left pectoral pacemaker are unchanged. Moderate cardiomegaly and mild pulmonary edema persist. No pleural effusions. No pneumothorax. Tubular structure overlaying the lower aspects of the right ribs is probably located outside the patient.


SubjectID: 16196998, StudyID: 58424637, Comparison: worse

FINAL REPORT

TYPE OF

EXAMINATION: Chest PA and lateral.

INDICATION: ___-year-old male patient with aspiration pneumonia and heart failure. Signs of worsening pneumonia versus pulmonary edema?

FINDINGS: Patient's condition required examination in sitting upright position using AP frontal and left lateral views. Comparison is made with the next preceding similar study of ___. Status post sternotomy, cardiac enlargement and previously identified left-sided permanent pacer with evidence of right atrial and biventricular pacing electrodes in unchanged position. The previously identified advanced interstitial edema with patchy densities in bilateral position has markedly improved. No new local discrete pulmonary parenchymal infiltrates are present, nor is there evidence of increased pleural effusion in either lateral or posterior pleural sinuses. No evidence of pneumothorax in the apical area.

IMPRESSION: Improvement of previously identified chronic pulmonary congestion without evidence of increased pleural effusion or development of acute pulmonary parenchymal infiltrates   Keywords: increase. Position of previously identified aortic valve - ascending aortic stent (CoreValve) appears unchanged.


SubjectID: 16196998, StudyID: 52279607, Comparison: None

FINAL REPORT

HISTORY: Acute on chronic heart failure and pneumonia. Evaluate for fluid overload versus pneumonia.

TECHNIQUE: Portable frontal view of the chest.

COMPARISON: Chest radiographs ___ and ___. CT chest ___.

FINDINGS: A left pectoral pacemaker is present with leads terminating in right atrium and right ventricle. Sternotomy wires and an aortic valve stent (CoreValve) are unchanged. There are new, severe bilateral consolidations. There is no pneumothorax. Assessment of the cardiac silhouette and mediastinum is limited by the severe parenchymal abnormalities.

IMPRESSION: Recurrent, severe diffuse bilateral parenchymal opacities are most consistent with severe pulmonary edema, although, diffuse pulmonary hemorrhage cannot be excluded. Pneumonia is thought less likely. These findings were discussed with Dr. ___ by Dr. ___ at 10:27 on ___ by telephone at the time of discovery.


SubjectID: 16196998, StudyID: 53644664, Comparison: same

FINAL REPORT

HISTORY: CHF.

FINDINGS: In comparison with the study of ___, there is little change in the appearance of the heart and lungs. Continued enlargement of the cardiac silhouette with pulmonary edema and bilateral pleural effusions with compressive atelectasis at the bases   Keywords: continue. In the appropriate clinical setting, supervening pneumonia would have to be considered.


SubjectID: 16204401, StudyID: 59534561, Comparison: None

WET READ: ___ ___ 4:47 AM Left basilar opacity concerning for pneumonia. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___-year-old male with dyspnea, evaluate for acute process.

TECHNIQUE: Frontal chest radiograph was obtained with the patient in the upright position.

COMPARISON: Radiograph from ___ and CT from ___

FINDINGS: The patient is status post right pneumonectomy with associated shift of midline structures. There is opacity within the left mid and lower lung base concerning for pneumonia, less likely pulmonary edema. There is no pleural effusion.

IMPRESSION: Left basilar opacity suspicious pneumonia, although asymmetric edema should also be considered.


SubjectID: 16204401, StudyID: 50362219, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with llpna one lung now increasing hypoxic s/p ___cc of fluids // eval for worsening PNA and pleural effusion eval for worsening PNA and pleural effusion

IMPRESSION: In comparison with the earlier study of this date, there is again evidence of right pneumonectomy with shift of the mediastinum to this side. Continued opacity in the mid and lower portions of the left lung, again most consistent with pneumonia.


SubjectID: 16205152, StudyID: 58970545, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF and intubation for nose bleed // Monitor position of ET tube and interval change in pulm opacities

IMPRESSION: As compared to ___ radiograph, pulmonary edema has nearly resolved   Keywords: resolve. Support and monitoring devices are unchanged in position except for a advancement of a nasogastric tube, now terminating in the region of the gastroduodenal junction. New left retrocardiac opacity likely represents atelectasis with aspiration and early infectious pneumonia less likely considerations.


SubjectID: 16205152, StudyID: 55523477, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with epistaxis, recent respiratory distress // interval change in pleural edema

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Right internal jugular line tip is at the level of lower SVC. Cardiomediastinal silhouette is stable. There is interval improvement of the left retrocardiac opacity most likely representing resolution of atelectasis. Pacemaker leads including biventricular pacing are stable in appearance. There is no pneumothorax, pleural effusion or other abnormality that might be related to reported patient's symptoms ET tube and NG tube have been discontinued in the interim.


SubjectID: 16205152, StudyID: 53131393, Comparison: None

WET READ: ___ ___ ___ 3:39 PM Standard position of the endotracheal tube. Right internal jugular central venous catheter tip in the mid SVC. Suboptimal position of the enteric tube, with tip in the distal esophagus. Advancement by at least 10 cm is advised. Mild pulmonary edema. Focal opacity within the left upper lung field may reflect an area of infection or aspiration. *** ED URGENT ATTENTION *** ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M intubated

TECHNIQUE: PORTABLE AP VIEW OF THE CHEST

COMPARISON: None. Patient is currently listed as EU critical.

FINDINGS: Endotracheal tube is in standard position, with tip terminating approximately 4.9 cm from the carina. An enteric tube is is demonstrated with tip above the gastroesophageal junction, and should be advanced by approximately 10 cm. Left-sided AICD device is noted with leads terminating in the region of the right atrium, right ventricle, and left ventricle. Right internal jugular central venous catheter tip is in the mid SVC. Moderate enlargement of the cardiac silhouette is present. The aortic knob is calcified. The mediastinal contour is unremarkable. There is mild pulmonary edema. No focal consolidation, large pleural effusion or pneumothorax is seen. Focal opacity in the left upper lung field may reflect an area of infection or aspiration. Multilevel degenerative changes are noted in the thoracic spine. There are no displaced fractures are visualized.

IMPRESSION: 1. Standard position of the endotracheal tube. Right internal jugular central venous catheter tip in the mid SVC. 2. Suboptimal position of the enteric tube, with tip in the distal esophagus. Advancement by at least 10 cm is advised. 3. Mild pulmonary edema. 4. Focal opacity within the left upper lung field may reflect an area of infection or aspiration.


SubjectID: 16205152, StudyID: 58350385, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with changes in spikes on telemetry // lead placement? lead placement?

IMPRESSION: In comparison with the study ___ ___, there is no appreciable change in the appearance of the pacer leads. Continued enlargement of the cardiac silhouette without pulmonary vascular congestion or acute pneumonia   Keywords: continue.


SubjectID: 16205152, StudyID: 58117403, Comparison: None

FINAL REPORT

EXAMINATION: Chest, upright AP and lateral.

INDICATION: Evaluate for pulmonary edema in a patient with recurrent epistaxis requiring blood transfusions and a history of congestive heart failure.

COMPARISON: Chest radiograph from ___.

FINDINGS: Lungs are clear. The heart is minimally enlarged but stable. There is a trace left pleural effusion. There is no pneumothorax. A dual lead pacer is unchanged.

IMPRESSION: No evidence of decompensated congestive heart failure.


SubjectID: 16205152, StudyID: 56723030, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with epistaxis, pleural edema // r/o pleural edema

TECHNIQUE: Portable chest

COMPARISON: ___.

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change.


SubjectID: 16216686, StudyID: 52586277, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with s/p evacuation of pericardial effusion via mediansternotomy // eval ptx eval ptx

COMPARISON: Comparison to prior study dated ___ at 22:36

FINDINGS: Portable AP upright chest film ___ at 10:07 is submitted.

IMPRESSION: Interval extubation and removal of the nasogastric tube. Lung volumes remain low with atelectasis at both bases and likely small layering effusions. No evidence of pulmonary edema. Patient is status post median sternotomy. No pneumothorax is appreciated.


SubjectID: 16216686, StudyID: 52486991, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with s/p pericardial patch // eval for ptx

IMPRESSION: As compared to the previous radiograph from less than 2 hr earlier, the endotracheal tube has been withdrawn a few cm, now terminating 7.7 cm above the carina. This could be advanced a few cm for standard positioning. Exam is otherwise remarkable for slight improvement in bibasilar atelectasis and persistent bilateral pleural effusions. No visible pneumothorax.


SubjectID: 16216686, StudyID: 51571307, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man s/p evaluation of tamponade // eval for pleural effusions eval for pleural effusions

IMPRESSION: In comparison with the study of ___, there again are low lung volumes. Bibasilar opacifications are consistent with layering effusions and underlying atelectasis. No evidence of pulmonary edema or increase in cardiac size   Keywords: increase.


SubjectID: 16231771, StudyID: 59533321, Comparison: same

FINAL REPORT

Chronic heart failure, fever.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Small left pleural effusion, bilateral relatively diffuse part alveolar and part interstitial parenchymal opacities, likely reflecting moderate fluid overload. Normal size of the cardiac silhouette, status post CABG, but relatively extensive retrocardiac atelectasis. No interval appearance of new parenchymal opacity suggesting pneumonia.


SubjectID: 16231771, StudyID: 50514160, Comparison: None

FINAL REPORT

INDICATION: Evaluation of patient with shortness of breath.

COMPARISON: Chest radiograph from outside hospital from ___, and CT abdomen and pelvis from ___.

FINDINGS: Prominence of the pulmonary vasculature is suggestive of mild-to-moderate increase in central pulmonary venous pressure. Bilateral small pleural effusions, left greater than right, are likely present. Bilateral atelectatic changes, left greater than right, and an overlying pneumonia, possibly due to aspiration, must be excluded in the proper clinical setting. The cardiomediastinal silhouette is normal. Post-surgical changes are noted with median sternotomy wires and surgical clips.

IMPRESSION: 1. Moderate pulmonary edema with bilateral small pleural effusions, left greater than right. 2. Bibasilar atelectasis, pneumonia must be excluded in the proper clinical setting.


SubjectID: 16233087, StudyID: 58381321, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with anemia // enlarging hemothorax?

IMPRESSION: Since the prior radiograph of 1 day earlier, a moderate left pleural effusion has slightly increased in size with adjacent worsening opacification of the left lung base. No other relevant changes   Keywords: no other relevant change.


SubjectID: 16233087, StudyID: 52656542, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with s/p (L)thoracentesis // eval ptx

TECHNIQUE: Chest PA and lateral

FINDINGS: Since the prior radiograph of earlier today, a moderate left pleural effusion has slightly has not significantly changed. No pneumothorax. No other relevant change   Keywords: no other relevant change.

IMPRESSION: No pneumothorax. Stable moderate left pleural effusion.


SubjectID: 16233087, StudyID: 50403310, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with dyspnea s/p MVreplacement // eval pleural effusions

IMPRESSION: As compared to ___ chest radiograph, postoperative appearance of cardiomediastinal contours stable. Interval decrease in size of left pleural effusion with residual small to moderate effusion remaining. Persistent small right pleural effusion. Improving left lower lobe and lingular atelectasis and development of minor atelectasis at the right lung base.


SubjectID: 16233087, StudyID: 51046843, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p MVR s/p CT removal // eval for pneumo

COMPARISON: Chest x-ray from ___ at 06:42

FINDINGS: Compared with the prior film, the ET tube and NG tube have been removed. The left chest tube has also been removed. Additional linear densities are seen over the upper abdomen, but the mediastinal drain and right chest tube may very well have been removed. No pneumothorax is detected. The right IJ Swan-Ganz catheter is again seen. The tip as been retracted and now overlies the proximal right main pulmonary artery. The patient is status post sternotomy, with cardiomegaly, which appears unchanged. The possibility of pericardial fluid cannot be excluded. There is persistent increased retrocardiac density with obscuration left hemidiaphragm, consistent with left lower lobe collapse and/or consolidation. There is also persistent hazy opacity in the right cardiophrenic region. No right side no significant right-sided pleural effusion. The possibility of a small left effusion cannot be excluded. Minimal upper zone redistribution, but no overt CHF. Note is again made of a normal variant azygos fissure . Much of the detail visible on the ___ chest CT is not apparent radiographically.

IMPRESSION: 1. Cardiomediastinal silhouette is enlarged, but unchanged. 2. No pneumothorax detected. No gross effusion. A small left effusion would be difficult to exclude. 3. Persistent left lower lobe collapse and/or consolidation. Persistent patchy right cardiophrenic opacity. 4. No overt CHF. 5. No pneumothorax detected status post removal of chest tube.


SubjectID: 16233087, StudyID: 50439661, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ yo male s/p MVR ___ mm Epic tissue ___ // eval for fluid overload, hypoxic

COMPARISON: ___ 15:30

FINDINGS: Compared to ___ at 15 30, the tip of the Swan-___ catheter lies slightly more distal in relation to the right pulmonary artery -- clinical correlation is requested regarding positioning. Otherwise, I doubt significant interval change. The ET tube tip lies at the level of the mid clavicular heads.

IMPRESSION: As above.


SubjectID: 16261645, StudyID: 59513332, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with acute respiratory failure // interval change interval change

IMPRESSION: In comparison with the study of ___, the monitoring and support devices essentially unchanged. Continued low lung volumes without definite vascular congestion   Keywords: continue. The right base is clear on this study. Opacification at the left base is consistent with small effusion and atelectatic changes.


SubjectID: 16261645, StudyID: 58141778, Comparison: None

FINAL REPORT

INDICATION: ___M with hypoxia // eval for pna ptx

TECHNIQUE: Single portable view of the chest.

COMPARISON: None.

FINDINGS: Relatively low lung volumes are noted with crowding of the bronchovascular markings. There is no confluent consolidation, effusion or overt pulmonary edema. Cardiomediastinal silhouette is within normal limits for technique. No displaced fractures identified.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 16261645, StudyID: 55738345, Comparison: worse

FINAL REPORT

INDICATION: ___M with resp failure // eval for tube placement

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph ___.

FINDINGS: There is interval placement of an endotracheal tube which terminates approximately 8 cm above the carina. Since the recent prior, and there is interval development of opacities at the lung bases, with lower lung volumes than on the recent prior study   Keywords: development. Gaseous distention of stomach is also noted.

IMPRESSION: ETT terminating 8 cm above the carina. At the time of this dictation, a repeat chest radiograph with ETT in more optimal position has been obtained.


SubjectID: 16261645, StudyID: 54933729, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hypoxemia // Infiltrates, volume status, interval change

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Minimal increase in extent of the retrocardiac atelectasis. Moderate cardiomegaly and low lung volumes persist. No new focal parenchymal opacities   Keywords: new.


SubjectID: 16261645, StudyID: 54254912, Comparison: None

FINAL REPORT

INDICATION: History: ___M with right internal jugular line placement

TECHNIQUE: Semi-erect AP view of the chest

COMPARISON: ___ 14:35

FINDINGS: There has been interval placement of the right internal jugular central venous with tip in the mid SVC. No pneumothorax is present. Endotracheal and enteric tubes remain in unchanged positions. Lung volumes remain low. Cardiac and mediastinal contours appear similar with mild enlargement of cardiac silhouette again noted. Crowding of the bronchovascular structures is re- demonstrated with minimal upper zone vascular redistribution. Patchy opacities in the lung bases persist and may reflect atelectasis. Small bilateral pleural effusions are also likely present.

IMPRESSION: Right internal jugular central venous with tip in the mid SVC. No pneumothorax.


SubjectID: 16261645, StudyID: 52495493, Comparison: same

FINAL REPORT

INDICATION: ___M with hypotension s/p intubation // eval for ptx

TECHNIQUE: Chest AP view.

COMPARISON: Chest radiographs ___.

FINDINGS: Since the interval prior study, there is been a advancement of the ET tube, now more appropriate position approximately 5.5 cm above the carina. However, the cuff of the ET tube appears overinflated. There is also been interval placement NG tube, with tip terminating near the region of the pylorus and resultant improvement in gaseous distention of the stomach. The cardiomediastinal and hilar contours are stable. Persistent low lung volumes with bibasilar opacities are present   Keywords: persistent.

IMPRESSION: 1. ET tube in appropriate position. Cuff may be overinflated. 2. The NG tube in appropriate position. 3. Persistent bibasilar opacities, which may reflect atelectasis or developing consolidation, right greater than left.


SubjectID: 16261645, StudyID: 58727677, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with respiraotry failure // ___ year old man with respiraotry failure

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Right central venous line tip is at the level of mid SVC. Cardiomediastinal silhouette is unchanged there in lungs are essentially clear. No appreciable pleural effusion or pneumothorax is seen and there is interval improvement of bibasal consolidations.


SubjectID: 16261645, StudyID: 50454351, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hypoxemic respiratory failure, concern for myasthenia ___ vs. bulbar ALS. // evaluate for interval changes evaluate for interval changes

COMPARISON: Comparison to ___ at 4:04 am.

FINDINGS: Portable semi supine chest film ___ at 04:30 is submitted.

IMPRESSION: Endotracheal tube has its tip 4 cm above the carina. A right internal jugular central line has its tip in the mid to distal SVC. A nasogastric tube is seen coursing below the diaphragm with the tip not identified. Interval reduction in lung volumes with appearance of patchy bibasilar opacities most likely representing atelectasis, although aspiration or pneumonia should also be considered. There is possibly a layering left effusion. Crowding of the pulmonary vasculature with no overt pulmonary edema. No large pneumothorax is appreciated, although the sensitivity to detect pneumothorax is diminished given semi-supine technique.


SubjectID: 16261645, StudyID: 55379028, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with suspected COPD and neuromuscular disease // Interval change, infiltrates, volume status Interval change, infiltrates, volume status

COMPARISON: Comparison to prior study dated ___ at 08:16

FINDINGS: Portable semi-erect chest film ___ at 04:04 is submitted.

IMPRESSION: Endotracheal tube, right internal jugular central line, and nasogastric tube are unchanged in position, although the tip of the nasogastric tube is not identified but the tube courses below the diaphragm. Overall cardiac and mediastinal contours are unchanged given differences in positioning. Right basilar atelectasis has slightly improved. No pleural effusions or pneumothorax. No pulmonary edema.


SubjectID: 16261645, StudyID: 52685877, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with hypoxemic respiratory failure, suspected neuromuscular etiology, question interval change.

TECHNIQUE: Portable chest x-ray

COMPARISON: Chest x-ray dated ___ at 08:01.

FINDINGS: Low lung volumes persist. Right internal jugular central catheter terminates in the upper/mid SVC. The endotracheal tube is 7 cm above the carina. There is a mild right pleural effusion. Right basilar atelectasis appear slightly worsened. There is mild cardiomegaly.

IMPRESSION: 1. Endotracheal tube 7 cm above the carina. This may be advanced 2 or 3 cm. 2. New small right pleural effusion and right basilar atelectasis.

NOTIFICATION: The findings were discussed by Dr. ___ with MICU ___ intern on the telephone on ___ at 9:52 AM, 5 minutes after discovery of the findings.


SubjectID: 16274426, StudyID: 53312283, Comparison: better

FINAL REPORT

INDICATION: History of AFib on Coumadin, aortic stenosis, please evaluate for pneumonia.

COMPARISON: Multiple chest radiographs dated back to ___.

TECHNIQUE: PA and lateral radiographs of the chest.

FINDINGS: Severe cardiomegaly persists. There is overall stable bilateral pulmonary vascular congestion, however, with slight interval improvement of the mild bilateral pulmonary edema   Keywords: improve. There has been interval worsening of the small bilateral pleural effusions, left worse than right as well as worsening of adjacent bibasilar consolidation. There is no pneumothorax.

IMPRESSION: Overall, worsening of small bilateral pleural effusions along with increased consolidation at the left lung base; this could be secondary to adjacent compressive atelectasis, however, an acute infectious process cannot be excluded.


SubjectID: 16274426, StudyID: 52171302, Comparison: worse

FINAL REPORT

HISTORY: Palpitations, atrial fibrillation.

TECHNIQUE: Upright AP and lateral views of the chest.

COMPARISON: ___ chest CTA and chest radiograph.

FINDINGS: Severe cardiomegaly is increased compared to the previous exam. Mediastinal contours are unchanged. Worsening diffuse interstitial opacities with associated ground-glass opacities in predominantly the perihilar and bibasilar regions are seen, with new bilateral small pleural effusions. More focal opacification in the retrocardiac region also is present. There is no pneumothorax. No acute osseous abnormalities are seen.

IMPRESSION: Worsening diffuse interstitial opacities with new small bilateral pleural effusions and increased cardiomegaly likely reflect superimposed mild to moderate pulmonary edema on a background of known interstitial lung disease which previously was possibly attributable to drug reaction, COPD or vasculitis   Keywords: new, worse, increase. More focal opacification in the left lung base is concerning for infection or aspiration.


SubjectID: 16277550, StudyID: 57423187, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year-old right-handed woman with HTN, DM, A fib (off Coumadin), h/o left BG stroke who presented with sudden onset left face/arm/leg weakness (NIHSS 9) s/p IV tPA with pulmonary edema // eval for interval change

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Pulmonary edema has improved   Keywords: improve. There is no pneumothorax or enlarging pleural effusion. Cardiomegaly is a stable


SubjectID: 16277550, StudyID: 50669784, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with ? pulm edema // assess infiltrate

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Moderate pulmonary edema and moderate cardiomegaly are stable   Keywords: stable. There is probably enlargement of the pulmonary arteries. There is no pneumothorax. If any there is small bilateral effusions


SubjectID: 16277550, StudyID: 56657551, Comparison: None

FINAL REPORT

EXAMINATION: AP chest radiograph

INDICATION: ___F with stroke rule out pna

TECHNIQUE: Portable AP view of the chest

COMPARISON: None available.

FINDINGS: The heart is top-normal in size on this AP projection. The right heart border is not clearly seen which may be due to prominent mediastinal soft tissue or consolidation/atelectasis involving the right middle lobe. There is no pleural effusion or pneumothorax.

IMPRESSION: Right at border is not clearly seen which may be due to prominent mediastinal soft tissue or consolidation/atelectasis within the right middle lobe. No pneumothorax or large pleural effusion.


SubjectID: 16277550, StudyID: 55011465, Comparison: same

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___ year old woman with stroke s/p tPA // infiltrate

TECHNIQUE: Portable AP chest radiograph

COMPARISON: Prior chest radiographs from ___, ___, ___ CT chest without contrast from ___

FINDINGS: Since ___, there is little interval change   Keywords: little interval change. The lungs are essentially clear. Mild bibasilar atelectasis is noted. The heart size is stable. No pneumothorax, pulmonary edema, or pleural effusions.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 16278052, StudyID: 58882176, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cardiogenic shock and cardiac amyloid // Any interval change?

COMPARISON: Chest x-ray from ___ at ___

FINDINGS: Compared with the prior film, a right IJ Swan-Ganz catheter is now present, tip over proximal most right pulmonary artery. No pneumothorax is detected Inspiratory volumes are somewhat low, but similar to the prior film. Allowing for this, there is moderate to moderately severe cardiomegaly, similar to the prior film. There is bibasilar atelectasis, slightly increased. No overt CHF or gross effusion. No definite focal infiltrate.

IMPRESSION: New right IJ Swan-Ganz catheter, with tip over proximal most pulmonary artery. Slightly more pronounced bibasilar atelectasis. Otherwise, I doubt significant interval change.


SubjectID: 16278052, StudyID: 56095170, Comparison: None

FINAL REPORT

INDICATION: ___M with CHF, p/w AMS // eval for pulmonary edema, pneumonia

TECHNIQUE: Single portable view of the chest.

COMPARISON: None.

FINDINGS: Low lung volumes are noted with secondary crowding of the bronchovascular markings. Moderate enlargement of the cardiac silhouette which is likely due to underlying cardiomegaly although this is accentuated by portable technique and low inspiratory effort. No acute osseous abnormalities identified.

IMPRESSION: Cardiomegaly without superimposed acute cardiopulmonary process.


SubjectID: 16289699, StudyID: 57858381, Comparison: worse

FINAL REPORT

CHEST ON ___

HISTORY: New left IJ line.

FINDINGS: There is a new left IJ line, the tip of the line overlies the multiple leads of the pacemaker and thus the full extent of the line is unclear. There is increased alveolar infiltrate, right greater than left with hazy opacity obscuring the entire right lung   Keywords: increase. There are bilateral pleural effusions, right greater than left. There is mild cardiomegaly and pulmonary vascular redistribution. The overall impression is that of worsened pulmonary edema   Keywords: worse.


SubjectID: 16289699, StudyID: 57072584, Comparison: better

FINAL REPORT

HISTORY: CHF.

COMPARISON: ___.

FINDINGS: The right hemidiaphragm. Tip continues to be elevated with probable subpulmonic effusion there is indistinct pulmonary vasculature predominantly on the right. However, the alveolar infiltrate on the right has improved the heart continues to be severely enlarged. Pacemaker and leads are unchanged. Left IJ line is unchanged.

IMPRESSION: slight improvement in CHF with subpulmonic effusion on the right   Keywords: improve.


SubjectID: 16289699, StudyID: 55074446, Comparison: None

FINAL REPORT

HISTORY: ___-year-old male with altered mental status.

COMPARISON: Multiple prior chest radiographs, most recently of ___.

FINDINGS: Single frontal view of the chest was obtained. Right atrial, right ventricular, and left ventricular pacer defibrillator leads of a left chest wall generator terminate in stable position. Moderate sized right pleural effusion is unchanged. No pneumothorax or evidence for pulmonary edema. Moderate cardiomegaly is stable.

IMPRESSION: Unchanged moderate right pleural effusion.


SubjectID: 16289699, StudyID: 57727523, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Worsening cough, worsening effusion.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the right-sided pleural effusion distributes in a slightly different manner, but its overall extent should not have changed. The subsequent areas of atelectasis are constant. The size of the cardiac silhouette is unchanged. Unchanged normal appearance of the left lung and of the left pectoral pacemaker.


SubjectID: 16289699, StudyID: 56219982, Comparison: same

FINAL REPORT

PORTABLE CHEST: ___.

HISTORY: ___-year-old male with shortness of breath and wheeze, history of inferior MI and reactive airway disease. Question effusion.

FINDINGS: Single portable view of the chest is compared to previous exam from ___. When compared to prior, there has been interval increase in size of the right-sided pleural effusion. Right upper lung and left lung remain clear. Triple-lead pacing device is again noted. Cardiac silhouette remains difficult to assess given size of effusion. Osseous and soft tissue structures are grossly unchanged.

IMPRESSION: Interval enlargement of the right-sided pleural effusion. Otherwise, no change   Keywords: no change.


SubjectID: 16289699, StudyID: 57476124, Comparison: None

WET READ: ___ ___ ___ 8:04 PM Stable moderate right pleural effusion and RML collapse. No PTX. No significant change. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, evaluation of pleural effusion.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change in extent of the pre-existing right pleural effusion. Unchanged are the areas of basal atelectasis on both the right side and in the retrocardiac lung areas. Unchanged appearance of the cardiac silhouette and the pacemaker devices. Unchanged alignment of the sternal wires.


SubjectID: 16289699, StudyID: 53986580, Comparison: same

FINAL REPORT

HISTORY: Thoracentesis for right effusion, to assess for pneumothorax.

FINDINGS: In comparison with study of ___, there has been substantial fluid removed from the right pleural space. No definite pneumothorax is appreciated. The patient has taken a somewhat better inspiration. Otherwise, little change   Keywords: little change.


SubjectID: 16289699, StudyID: 50181704, Comparison: None

FINAL REPORT

HISTORY: Fever and recent congestive heart failure. Evaluate for infiltrate.

COMPARISON: Multiple prior chest radiographs, most recently ___.

FINDINGS: Frontal and lateral views of the chest were obtained. Lung volumes are low, exaggerating the cardiac silhouette, which is mildly enlarged. Cardiomediastinal contours are otherwise stable. Increased hazy opacity at the right lung base is compatible with an enlarged right pleural effusion, now moderate in size. Adjacent linear opacities are compatible with atelectasis. Prominence of the pulmonary vascular markings is compatible with vascular congestion. The wires of a atrio-biventricular left chest wall pacer terminates in similar position. Sternotomy wires and mediastinal clips are intact.

IMPRESSION: 1. Increased size of a chronic right pleural effusion, now moderate, with adjacent atelectasis. Unless the etiology of this abnormality is known and understood, CT is recommended for further evaluation. 2. Mildly enlarged cardiac silhouette could represent a pericardial effusion. Findings were communicated via phone call by ___ to ___ on ___ at ___ AM.


SubjectID: 16289699, StudyID: 56279132, Comparison: None

FINAL REPORT

HISTORY: ___-year-old male with congestive heart failure and renal failure.

TECHNIQUE: Single frontal chest radiograph was obtained.

COMPARISON: ___.

FINDINGS: Right mid and lower lung consolidation appears increased compared to prior. Moderate right pleural effusion persists. The left costophrenic angle is incompletely imaged, but no large left pleural effusion is seen. Left lung vascular congestion is seen. Pacing and mediastinal hardware appears similar in position on this single frontal view. Sternal wires appear intact. No pneumothorax is detected. Cardiomediastinal contours are stable, with aortic calcifications.

IMPRESSION: Increased right mid and lower lung consolidation, which could represent compressive atelectasis in the setting of pleural effusion, but pneumonia cannot be excluded.


SubjectID: 16289699, StudyID: 55836042, Comparison: None

FINAL REPORT

INDICATION: Exudative right-sided pleural effusion tapped on ___ with persistent minimally productive cough. Evaluation for reaccumulation.

TECHNIQUE: Portable AP chest radiograph.

COMPARISON: Multiple priors, most recently on ___ at 1:10 p.m.

FINDINGS: There is no recurrence of the right pleural effusion nor is there a left pleural effusion. A tiny linear density at the right apex may represent a small apical pneumothorax. Left-sided pacer leads are in the standard position. A median sternotomy wire and CABG clips are noted. There is obscuration of the right heart border that most likely represents atelectasis in the right middle lobe though pneumonia cannot be completely excluded. Cardiac size is within normal limits. The case was discussed by Dr. ___ with Dr. ___ by phone at 12:01 p.m. on ___.


SubjectID: 16289699, StudyID: 53061740, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure and pleural effusion, thoracocentesis, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is improvement with decrease in extent of the pre-existing right pleural effusion. Unchanged size of the cardiac silhouette. Unchanged bilateral areas of atelectasis. No newly appeared parenchymal opacities   Keywords: new.


SubjectID: 16289699, StudyID: 55612759, Comparison: same

FINAL REPORT

INDICATION: ___-year-old male with a history of CHF, who presents for evaluation of interval change.

COMPARISONS: Chest radiographs from ___, ___, ___, ___ and ___.

TECHNIQUE: Single AP portable exam of the chest.

FINDINGS: Compared to the exam from ___, there appears to be interval improvement of the right middle and lower lobe consolidations. There is evidence of left vascular congestion which appears essentially unchanged compared to the prior exam   Keywords: unchanged. Moderate right pleural effusion persists. The dual pacemaker leads are in appropriate position. Sternal wires appear intact. No pneumothorax is detected. The hilar and mediastinal contours are stable with aortic calcifications.

IMPRESSION: 1. Interval improvement of the right mid and right lower lobe consolidation and effusion compared to the exam from ___, however unchanged compared to the prior exam. 2. Stable right-sided moderate pleural effusion compared to the prior exam.


SubjectID: 16289699, StudyID: 55746763, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Alteration of mental status, rule out pneumonia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the extent of the pleural effusion on the right has minimally increased. There is subsequent atelectasis at the right lung base and mild atelectasis in the retrocardiac lung areas. However, there currently is no evidence of pneumonia. No pulmonary edema. Moderate cardiomegaly. Unchanged course and position of the pacemaker leads.


SubjectID: 16289699, StudyID: 53377750, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___.

FINDINGS: Moderate right pleural effusion and adjacent area of right basilar consolidation or atelectasis remains unchanged. Within the left lung, allowing for patient rotation, there are no new areas of consolidation to suggest the presence of pneumonia. A vertically oriented interface in the periphery of the left lower lung, very likely represents a skin fold. However, considering the history of left-sided chest pain, followup radiograph would be helpful to exclude an atypical manifestation of pneumothorax. These results have been communicated by telephone to Dr. ___ on ___ at 9:45 a.m., 1 hour after the time of discovery.


SubjectID: 16293344, StudyID: 59760228, Comparison: None

FINAL REPORT

INDICATION: Status post aortic dissection and repair. Assess for effusion or pneumothorax

TECHNIQUE: Portable supine radiograph of the chest.

COMPARISONS: Chest radiograph from one day prior.

FINDINGS: Additional history that was not provided is the patient was re-operated on the evening of ___ for postoperative persistent graft-related bleeding. Endotracheal tube position is somewhat obscured by the linear dense likely packing material Endotracheal tube appears to be 3 cm above the carina. Nasogastric tube courses into the stomach likely terminating in the proximal stomach. Swan-Ganz catheter is in the pulmonary outflow tract. The patient's sternal wound is open with removal of sternotomy wires. Bilateral chest tubes are new with unchanged mediastinal drains. Swan-Ganz catheter terminates just proximal to the pulmonic valve. Postoperative mediastinal widening is slightly increased from the prior compatible with repeat procedure. A trace right and small left pleural effusions are likely present along with dense left basal atelectasis.

IMPRESSION: 1. Swan-Ganz catheter with tip likely just proximal to pulmonic valve. 2. Dense left basal consolidation with small left pleural effusion.


SubjectID: 16293344, StudyID: 59128430, Comparison: None

WET READ: ___ ___ ___ 7:54 AM ET tube terminating at 4.8 cm from the carina. Orogastric tube within the stomach. Enlarged aortic knob, as seen on prior chest radiograph, reflecting a ruptured aortic dissection seen on CT. ______________________________________________________________________________

FINAL REPORT

INDICATION: Status post intubation, assess tube position

TECHNIQUE: Portable semi-upright radiograph of the chest.

COMPARISON: Chest radiograph from two hours prior.

FINDINGS: Endotracheal tube is in satisfactory position terminating 4.8 cm above the carina. Orogastric tube courses in the stomach and out of view. Enlarged aortic knob is again noted as on a prior radiograph correlating with ruptured aortic dissection seen on the recent CT. Bibasilar atelectasis or partial lobar collapse is worsened from the prior study.

IMPRESSION: 1. Satisfactory position of monitoring and support devices. 2. Findings compatible with known aortic dissection. 3. Worsened bibasilar atelectasis


SubjectID: 16293344, StudyID: 58628234, Comparison: None

FINAL REPORT

INDICATION: Status post aortic aneurysm repair with hypoxia.

TECHNIQUE: Portable AP supine radiograph of the chest.

COMPARISON: Chest radiograph from five hours prior.

FINDINGS: There has been no appreciable change in this study with unchanged position of bilateral pleural drains, mediastinal drains, endotracheal tube and nasogastric tube. Chest remains open with packing material in the midline obscuring the view of some of the tubes. A Swan-Ganz catheter is likely at the level of the pulmonic valve, though not definitely across it. The lungs remain clear. A small left effusion is not well seen on this study. Dense retrocardiac atelectasis is still present.


SubjectID: 16293344, StudyID: 52372243, Comparison: None

FINAL REPORT

INDICATION: Chest pain.

COMPARISON: Radiograph available from ___. FRONTAL CHEST RADIOGRAPH: The patient is slightly rotated. The heart is mildly enlarged. The aortic knob is substantially increased in size. since ___. There is increased prominence of the central pulmonary vessels with multiple Kerley B lines present, compatible with pulmonary congestion and mild interstitial edema. No large pleural effusions are seen. The aorta appears tortuous. There is no pneumothorax.

IMPRESSION: Substantial increase in the size of the aortic knob. CT is recommended to rule out acute aortic process. Central vascular congestion with mild interstitial edema, worst since ___ examination.


SubjectID: 16293344, StudyID: 59608798, Comparison: 0.0

FINAL REPORT

AP CHEST, 1:16 A.M., ___

HISTORY: Hypoxia.

IMPRESSION: AP chest compared to ___: Moderately severe pulmonary edema, moderate left pleural effusion have worsened, moderate right pleural effusion   Keywords: worse. Severe cardiomegaly and mediastinal vascular congestion unchanged   Keywords: unchanged. No pneumothorax. Right jugular line ends low in the SVC. No pneumothorax.


SubjectID: 16293344, StudyID: 53605790, Comparison: 1.0

FINAL REPORT

INDICATION: History of aortic dissection. Evaluate for infection or effusion.

COMPARISONS: Chest radiograph ___. Chest radiograph ___. Chest radiograph ___. CT torso ___.

FINDINGS: A right internal jugular central line ends in the low SVC. Sternal wires are intact and unchanged. Since the prior radiograph, there has been some reduction of the marked pulmonary congestion. There is stable bibasilar atelectasis. Otherwise there have been no significant changes from the prior radiograph   Keywords: no significant change. The cardiomediastinal silhouette is stably enlarged with the expected post-operative appearance. There are stable bilateral pleural effusions. There is no pneumothorax.

IMPRESSION: 1. Improvement in pulmonary edema   Keywords: improve. 2. Stable bilateral pleural effusions.


SubjectID: 16293344, StudyID: 56162188, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Rule out pneumonia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has undergone aortic repair. In the interval, the left subclavian catheter has been removed, the other monitoring and support devices are in unchanged position. The size of the cardiac silhouette is slightly larger than on the previous film. There is increased fullness of the aortopulmonary window that should receive attention on followup radiographs. As on the previous image, the presence of small pleural effusion cannot be excluded. There is moderate pulmonary edema and relatively extensive bilateral basal atelectasis. No pneumothorax is appreciated on the current image.


SubjectID: 16293344, StudyID: 56004061, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: IJ line placement.

COMPARISON: ___ and ___.

FINDINGS: As compared to the previous radiograph, the patient has received a right-sided internal jugular vein catheter. The tip of the catheter projects over the mid SVC. There is no evidence of complications, notably no pneumothorax. Otherwise, the radiograph is unchanged, unchanged monitoring and support devices, unchanged size of the cardiac silhouette. Unchanged bilateral pleural effusions.


SubjectID: 16293344, StudyID: 52600828, Comparison: None

FINAL REPORT

PORTABLE CHEST FILM ___ AT ___ CLINICAL

INDICATION: ___-year-old with concern for intestinal perforation, upright imaging to evaluate for free air. Comparison is made to the patient's previous study of ___ at ___. A portable AP upright chest film ___ at ___ is submitted.

IMPRESSION: 1. There are multiple loops of dilated bowel. No free intraperitoneal air is seen. Lung volumes remain low with streaky opacities at both bases likely representing bibasilar patchy atelectasis. There is no evidence of pulmonary edema. The patient is status post median sternotomy with stable cardiac and mediastinal contours. The nasogastric tube is coiled within the distal esophagus, and re-positioning would be advised. On a subsequent abdominal plain film performed at ___, the nasogastric tube does course below the diaphragm, and the tip projects over the stomach. No pneumothorax is seen. Clips in the right axilla suggest prior axillary node dissection. Old right-sided posterolateral rib fractures are seen.


SubjectID: 16293344, StudyID: 51452636, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___ Comparison with a prior study from ___ as well as a CT abdomen and pelvis from today. CLINICAL

HISTORY: Chest pain.

FINDINGS: AP upright and lateral views of the chest were provided. There is midline sternotomy wires again noted. The lung volumes are quite low, likely related to marked gaseous distention/dilatation of the bowel in the upper abdomen. Please refer to same-day abdominopelvic CT for further details. Basilar atelectasis is noted. Heart size cannot be assessed. Mediastinal contour is stable. Dextroscoliosis of the T-spine noted. There are old right rib cage deformities with clips in the right axilla.

IMPRESSION: Low lung volumes with basilar atelectasis likely related to bowel pathology in the upper abdomen, better assessed on same-day CT of the abdomen and pelvis.


SubjectID: 16296993, StudyID: 55169915, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Chest pain and tachycardia.

COMPARISONS: ___.

TECHNIQUE: Chest, semi-upright AP portable.

FINDINGS: The heart is enlarged. There is patchy left basilar opacity suggesting minor atelectasis superimposed on a prominent pericardial fat pad, not significantly changed, although it is difficult to exclude a superimposed process. Elsewhere, the lungs appear clear. There is no definite pleural effusion, although again it is difficult to exclude a small pleural effusion on the left side. There is no pneumothorax.

IMPRESSION: Patchy left basilar opacity, probably due to minor atelectasis and the cardiac fat pad, although it is difficult to exclude a small pleural effusion.


SubjectID: 16296993, StudyID: 52937092, Comparison: None

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Fever and shortness of breath.

COMPARISONS: Earlier on the same day.

TECHNIQUE: Chest, AP upright and lateral.

FINDINGS: The heart is mildly enlarged. There is mild unfolding of the thoracic aorta and calcification along the arch. Patchy linear opacification in the left lower lung suggests minor atelectasis or scarring. There is no pleural effusion or pneumothorax. There is a prominent epicardial fat pad near the cardiac apex. Mild leftward convex curvature is noted along the thoracic spine with mild degenerative changes. The bones appear probably demineralized.

IMPRESSION: No evidence of acute disease.


SubjectID: 16296993, StudyID: 50104200, Comparison: same

FINAL REPORT

HISTORY: Asthma and diastolic dysfunction, to assess for pneumonia or consolidation.

FINDINGS: In comparison with the study of ___, there is little overall change   Keywords: little overall change. There is again enlargement of the cardiac silhouette without vascular congestion or pleural effusion   Keywords: again. Mild retrocardiac opacification persists   Keywords: persists. Specifically, no evidence of acute focal pneumonia.


SubjectID: 16296993, StudyID: 50415951, Comparison: None

FINAL REPORT

HISTORY: Hypoxemia in the setting of holding diuretics.

TECHNIQUE: Frontal and lateral chest radiographs were obtained.

COMPARISON: Comparison is made to radiographs dated ___.

FINDINGS: As compared to the prior examination, there are decreased lung volumes and the interval development of a moderate left pleural effusion. There is no definite focal consolidation, right-sided pleural effusion, pneumothorax, or appreciable pulmonary edema. The heart borders are not well visualized. The mediastinal and hilar contours are stable.

IMPRESSION: Interval development of a left moderate pleural effusion. No overt pulmonary edema or focal consolidation. Findings were conveyed by Dr. ___ to Dr. ___ ___ telephone at 14:22 on ___, 5 minutes after discovery.


SubjectID: 16306505, StudyID: 57747434, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man POD2 CABG // CT removal evaluate PTX CT removal evaluate PTX

IMPRESSION: In comparison with the study of ___, the monitoring and support devices have been removed except for the right IJ catheter. Following chest tube removal, there is no evidence of pneumothorax. No acute abnormality.


SubjectID: 16306505, StudyID: 51071006, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man s/p CABG // eval for pleural effusions

TECHNIQUE: Chest PA and lateral

COMPARISON: ___

FINDINGS: Cardiomediastinal contours are unchanged. Patient is status post CABG. . Small bilateral effusions are associated with adjacent atelectasis. There is no pneumothorax. The sternal wires are aligned

IMPRESSION: Small bilateral effusions. No pulmonary edema or pneumothorax


SubjectID: 16311983, StudyID: 58786374, Comparison: -1.0

FINAL REPORT

INDICATION: ___M with dyspnea // Acute cardiopulmonary disease

TECHNIQUE: 2 portable views of the chest.

COMPARISON: ___.

FINDINGS: Right PICC is faintly visualized however tip is not clearly delineated on today's exam. Left chest wall pacing device is again noted. Mild pulmonary edema is again noted   Keywords: again. New retrocardiac opacity silhouetting the hemidiaphragm may be any combination of effusion consolidation or atelectasis. Right basilar opacity is likely atelectasis given change between the 2 films. Posterior right rib fracture is old. Anterior approach cervical fixation hardware is seen as well as chronic right distal clavicular fracture.

IMPRESSION: Mild pulmonary edema with new retrocardiac opacity, likely some combination of effusion and atelectasis with possible infection   Keywords: new.


SubjectID: 16311983, StudyID: 51093292, Comparison: worse

FINAL REPORT

EXAMINATION: AP portable chest x-ray

INDICATION: History: ___M with s/p intubation // s/p intubation

TECHNIQUE: Portable AP supine chest radiograph

COMPARISON: Chest x-ray ___ at 12:58

FINDINGS: Since prior, there has been interval placement of an endotracheal tube with tip 4.2 cm from the carina. Right PICC is again identified. Left chest wall single lead pacing device is noted. Degree of pulmonary edema appears worse   Keywords: worse. Retrocardiac opacity persists and there is more opacity superiorly on the left likely in part due to layering effusion. Cervical spine hardware and partially visualized lumbar spine fixation hardware is visualized.

IMPRESSION: ET tube in appropriate position. Worsening of pulmonary edema   Keywords: worse. Retrocardiac opacity likely in part due to effusion which is also seen layering more superiorly.


SubjectID: 16311983, StudyID: 50367462, Comparison: 0.0

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPH

INDICATION: Endotracheal tube placement.

TECHNIQUE: Chest, supine AP portable.

COMPARISON: Earlier on the same day.

FINDINGS: An endotracheal tube terminates approximately 4.5 cm above the carina. A right-sided PICC line terminates at the cavoatrial junction. Single lead pacemaker/ICD device terminates in the right ventricle. Retrocardiac opacification has mildly improved but pulmonary edema appears not significantly changed   Keywords: improve.

IMPRESSION: Persistent pulmonary edema   Keywords: persistent. Improvement in left basilar opacification, probably improvement in atelectasis associated with a pleural effusion.


SubjectID: 16311983, StudyID: 58404666, Comparison: same

FINAL REPORT

HISTORY: CHF with leukocytosis, to assess for pneumonia.

FINDINGS: In comparison with study of earlier in this date, the left hemidiaphragm is not as sharply seen. This suggests some atelectatic change and possible pleural effusion at the left base. Otherwise, little change   Keywords: little change. In the appropriate clinical setting, it would be difficult to rule out the possibility of retrocardiac consolidation.


SubjectID: 16311983, StudyID: 52608617, Comparison: same

FINAL REPORT

HISTORY: ___-year-old female with shortness of breath. Evaluation for CHF.

COMPARISON: Comparison is made to prior radiograph from ___, dating back to ___.

FINDINGS: Single upright portable radiograph of the chest demonstrates the lungs are mildly hyperexpanded, with mild right basilar atelecatasis and peribronchial wall thickening of the right lower lobe airways. The heart is mildly enlarged, stable compared to prior studies. There is no pneumothorax or large pleural effusion. No overt pulmonary edema is detected. Coarse interstitial markings are unchanged compared to prior studies   Keywords: unchanged. Multiple right-sided rib deformities are unchanged. A dual-lead pacemaker device is in stable position, with leads terminating in the right atrium and right ventricle.

IMPRESSION: Stable mild cardiomegaly. Peribronchial infiltrate in the right lung base is likely due to underlying bronchiectasis or bronchitis, however an oblique or lateral view is recommended for better characterization.


SubjectID: 16311983, StudyID: 57876125, Comparison: None

FINAL REPORT

HISTORY: Hypoxia.

FINDINGS: In comparison with the study of ___ and ___, there is again some enlargement of the cardiac silhouette with prominence of interstitial markings. Although some of this could reflect chronic interstitial lung disease, the possibility of superimposed acute pulmonary vascular congestion would certainly have to be considered. An area of asymmetric opacification at the right base raises the possibility of consolidation in the appropriate clinical setting. Dual-channel pacer device is in place with leads extending to the right atrium and apex of the right ventricle. Of incidental note are at least 2 probable old healed rib fractures in the mid-to-lower right area.


SubjectID: 16311983, StudyID: 52762100, Comparison: None

FINAL REPORT

HISTORY: Pneumonia or pulmonary edema.

FINDINGS: In comparison with the study of ___, there is some increased opacification at the right base. This suggests the possibility of superimposed pneumonia on a pattern of pulmonary edema. Pacer device remains in unchanged position.


SubjectID: 16311983, StudyID: 57861051, Comparison: None

FINAL REPORT

HISTORY: Hypoxia.

TECHNIQUE: Semi-upright AP and lateral views of the chest.

COMPARISON: ___ and ___.

FINDINGS: Left-sided dual-chamber pacemaker with leads terminating in right atrium AND right ventricle IS in unchanged position. There is mild cardiomegaly. The mediastinal contours are unchanged. There is mild pulmonary vascular congestion and small bilateral pleural effusions. No focal consolidation or pneumothorax is present. Remote right humeral neck fracture, right-sided rib fractures, and chronic fracture deformity of the distal right clavicle are again demonstrated. Compression deformity of a mid thoracic vertebral body is also unchanged. Cervical spinal fusion hardware is partially imaged.

IMPRESSION: Mild pulmonary vascular congestion with small bilateral pleural effusions.


SubjectID: 16311983, StudyID: 53854225, Comparison: worse

FINAL REPORT

AP CHEST, 9:21 P.M., ___

HISTORY: A ___-year-old man with shortness of breath after a blood transfusion.

IMPRESSION: PA and lateral chest compared to ___: Minimal interstitial edema may have worsened slightly since ___, moderate cardiomegaly and mediastinal vascular engorgement are unchanged   Keywords: worse. Small bilateral pleural effusion, stable. Transvenous right atrial and ventricular pacer leads unchanged. No pneumothorax.


SubjectID: 16311983, StudyID: 53936307, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___-year-old man with diastolic congestive heart failure, hospitalized for a GI bleed. Evaluate for pulmonary edema after fluid resuscitation.

COMPARISON: Chest radiograph dated ___.

FINDINGS: The left-sided dual lead pacemaker/ICD cardiac device is unchanged in position with one lead terminating in the right atrium and the other in the right ventricle. The lung apices cannot be fully assessed due to flexion of the patient's chin. Moderate pulmonary edema, increased from the prior exam   Keywords: increase. No pleural effusion, focal consolidation to suggest pneumonia, or pneumothorax. Stable top-normal heart size. Stable slightly tortuous descending aorta.

IMPRESSION: Moderate pulmonary edema. No pleural effusions.


SubjectID: 16311983, StudyID: 51118588, Comparison: None

FINAL REPORT

INDICATION: Altered mental status and fever.

TECHNIQUE: Chest, portable AP upright.

COMPARISON: ___.

FINDINGS: There is a dual lead pacemaker/ICD device with leads again terminating in the right atrium and ventricle, respectively. The cardiac, mediastinal and hilar contours appear stable. There is no pleural effusion or pneumothorax. Chin flexion partly obscures the right lung apex, but visualized lung fields appear clear.

IMPRESSION: No evidence of acute cardiopulmonary disease.


SubjectID: 16311983, StudyID: 53854251, Comparison: worse

WET READ: ___ ___ ___ 8:06 AM There is a new single lead left chest wall pacemaker with removal of the previously atrial lead. Heart size is enlarged and there is perihilar atelectasis bilaterally. No evidence of pneumothorax.

WET READ VERSION #1 ___ ___ 6:13 PM There is a new single lead left chest wall pacemaker with removal of the previously atrial lead. Heart size is enlarged and there is perihilar atelectasis bilaterally. No evidence of pneumothorax. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP); CHEST (PA AND LAT)

INDICATION: ___ year old man s/p pacemaker extraction and implantation of a new VVI pacemaker via L subclavian. Eval for PTX // ___ year old man s/p pacemaker extraction and implantation of a new VVI pacemaker via L subclavian. Eval for PTX ; ___ year old man s/p pacemaker extraction and implantation of a new VVI pacemaker via L subclavian. // ___ year old man s/p pacemaker extraction and implantation of a new VVI pacemaker via L subclavian. Eval for PTX

TECHNIQUE: Portable AP radiograph of the chest.

COMPARISON: ___.

FINDINGS: The ___ radiograph shows a single lead from a left pectoral pacemaker projecting over the right ventricle. There is no pneumothorax. A right PICC line terminates in the upper right atrium near the cavoatrial junction. Withdrawal by 1-2 cm would position its tip at the cavoatrial junction if desired. Mild pulmonary edema has slightly increased   Keywords: increase. Moderate cardiomegaly despite the projection is unchanged. A small left pleural effusion is likely present. Increased retrocardiac airspace opacification may be due to atelectasis or infection. Previous cervical spine fusion is partially imaged. The followup PA and lateral radiographs from ___ confirm a left lower lobe airspace opacity, which is most likely due to pneumonia. There is also increased mild pulmonary edema   Keywords: increase.

IMPRESSION: New left pectoral pacemaker with single lead projecting over the right ventricle. No pneumothorax. New left lower lobe pneumonia. Increase mild pulmonary edema   Keywords: increase. Right PICC line tip approximately 2 cm below the estimated location of the cavoatrial junction.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 11:26 AM, 5 minutes after discovery of the findings.


SubjectID: 16311983, StudyID: 52327258, Comparison: worse

WET READ: ___ ___ ___ 8:06 AM There is a new single lead left chest wall pacemaker with removal of the previously atrial lead. Heart size is enlarged and there is perihilar atelectasis bilaterally. No evidence of pneumothorax.

WET READ VERSION #1 ___ ___ 11:28 AM There is a new single lead left chest wall pacemaker with removal of the previously atrial lead. Heart size is enlarged and there is perihilar atelectasis bilaterally. No evidence of pneumothorax. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP); CHEST (PA AND LAT)

INDICATION: ___ year old man s/p pacemaker extraction and implantation of a new VVI pacemaker via L subclavian. Eval for PTX // ___ year old man s/p pacemaker extraction and implantation of a new VVI pacemaker via L subclavian. Eval for PTX ; ___ year old man s/p pacemaker extraction and implantation of a new VVI pacemaker via L subclavian. // ___ year old man s/p pacemaker extraction and implantation of a new VVI pacemaker via L subclavian. Eval for PTX

TECHNIQUE: Portable AP radiograph of the chest.

COMPARISON: ___.

FINDINGS: The ___ radiograph shows a single lead from a left pectoral pacemaker projecting over the right ventricle. There is no pneumothorax. A right PICC line terminates in the upper right atrium near the cavoatrial junction. Withdrawal by 1-2 cm would position its tip at the cavoatrial junction if desired. Mild pulmonary edema has slightly increased   Keywords: increase. Moderate cardiomegaly despite the projection is unchanged. A small left pleural effusion is likely present. Increased retrocardiac airspace opacification may be due to atelectasis or infection. Previous cervical spine fusion is partially imaged. The followup PA and lateral radiographs from ___ confirm a left lower lobe airspace opacity, which is most likely due to pneumonia. There is also increased mild pulmonary edema   Keywords: increase.

IMPRESSION: New left pectoral pacemaker with single lead projecting over the right ventricle. No pneumothorax. New left lower lobe pneumonia. Increase mild pulmonary edema   Keywords: increase. Right PICC line tip approximately 2 cm below the estimated location of the cavoatrial junction.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 11:26 AM, 5 minutes after discovery of the findings.


SubjectID: 16311983, StudyID: 53795607, Comparison: same

FINAL REPORT

HISTORY: ___M with dyspnea and bradycardia.

COMPARISON: ___.

FINDINGS: AP upright and lateral views of the chest were provided. Evaluation limited due to exclusion of the left CP angle on the frontal projection and the posterior CP recess on the lateral view. Fusion hardware is again noted in the lower cervical spine. The heart remains mildly enlarged. There is mild interstitial pulmonary edema which is not significantly changed from the prior exam   Keywords: not significantly changed. Mediastinal contour is unchanged. No pneumothorax. Small bilateral pleural effusions are likely stable from prior. Old distal clavicle injuries are again seen. Multiple old right rib cage deformities are also noted.

IMPRESSION: No significant change with mild cardiomegaly and mild pulmonary edema with small bilateral effusions   Keywords: no significant change.


SubjectID: 16311983, StudyID: 50314636, Comparison: better

FINAL REPORT

HISTORY: Biventricular pacemaker placement, confirm lead locations.

TECHNIQUE: Frontal and lateral chest radiographs were obtained.

COMPARISON: Comparison is made to radiographs dated ___, at 7:47.

FINDINGS: A biventricular pacemaker is noted to be in place with leads identified in the right atrium and right ventricle. There has been interval improvement in the patient's now mild interstitial pulmonary edema   Keywords: improve. There is stable, moderate cardiomegaly. Moderate bilateral pleural effusions are seen. There is no focal consolidation or pneumothorax identified. The mediastinal contours are normal.

IMPRESSION: Biventricular pacemaker with leads identified in the right atrium and right ventricle. Moderate bilateral pleural effusions.


SubjectID: 16311983, StudyID: 53790885, Comparison: -1.0

WET READ: ___ ___ ___ 9:31 AM Low lung volumes, persistent and moderate pulmonary edema, and large left retrocardiac airspace opacity compatible with pneumonia.

WET READ VERSION #1 ___ ___ ___ 7:07 PM Low lung volumes, persistent and moderate pulmonary edema, and large left retrocardiac airspace opacity compatible with pneumonia. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___ year old man with pulmonary edema and PNA // interval change in volume overload and PNA?

TECHNIQUE: APsingle view

COMPARISON: ___

FINDINGS: Lines and Tubes: Left sided pacemaker with a single pacer wires remains unchanged. Right PICC terminates at the cavoatrial junction. Lungs: Persistent low lung volumes and bibasilar opacities, with mild interval worsening compared to the prior radiograph   Keywords: worse. Pleura: There is no pleural effusion or pneumothorax Mediastinum: Stable appearance of mild to moderate cardiomegaly and tortuosity of the thoracic aorta. Bony thorax: No interval change   Keywords: no interval change.

IMPRESSION: Persistent low lung volumes with no interval change in bibasilar opacities, compatible with atelectasis versus pneumonia.


SubjectID: 16312465, StudyID: 57798222, Comparison: None

WET READ: ___ ___ ___ 11:36 AM Linear left basilar opacity c/w atelectasis. Right costophrenic angle density likely due to atelectasis and possible small effusion. No definite consolidation. ______________________________________________________________________________

FINAL REPORT

PORTABLE CHEST FILM ___ AT 10:14. CLINICAL

INDICATION: ___-year-old with multiple myeloma with neutropenic fever, question infection. Comparison to ___ at 12:29. Portable upright chest film ___ at 10:14 is submitted.

IMPRESSION: 1. Interval appearance of linear opacity at the left lung base as well as streaky opacities in the right lung base, favoring atelectasis rather than an early infectious process. Possible small right pleural effusion. No evidence of pulmonary edema or pneumothorax. Right-sided Port-A-Cath remains in place. Overall, cardiac and mediastinal contours are unchanged. An intramedullary rod with screws is seen in the incompletely visualized proximal humerus. No acute bony abnormality is appreciated.


SubjectID: 16312465, StudyID: 52757338, Comparison: None

FINAL REPORT

PORTABLE CHEST FILM ___ AT ___

INDICATION: ___-year-old with neutropenic fever, assess pneumonia. Comparison is made to the patient's prior study dated ___ at ___. Portable AP upright chest film ___ at ___ is submitted.

IMPRESSION: Right-sided Port-A-Cath unchanged in position. No interval change in streaky opacity in the left mid lung and at the right base suggestive of atelectasis rather than an acute infectious process. Clinical correlation, however, is advised. No large effusions. No evidence of pulmonary edema or pneumothorax. Overall, cardiac and mediastinal contours are stable. An intramedullary rod with multiple screws is once again identified within the left proximal humerus.


SubjectID: 16312944, StudyID: 58416083, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: COPD, recurrent anemia, diastolic chronic heart failure, dyspnea. Evaluation for interval progression.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. At larger lung volumes, there still massive bilateral parenchymal opacities that are non-fibrotic in origin   Keywords: still. Given that these opacities persist over several days, a more detailed analysis with CT could be considered. Unchanged size of the cardiac silhouette. Unchanged atelectasis projecting over the left costophrenic sinus.


SubjectID: 16312944, StudyID: 52465480, Comparison: None

FINAL REPORT

EXAM: Chest, single AP upright portable view. CLINICAL INFORMATION: ___-year-old female with history of COPD exacerbation, hypoxia.

COMPARISON: None.

FINDINGS: Single AP upright portable view of the chest was obtained. Diffuse alveolar opacities throughout the lungs, right greater than left, which could represent asymmetric edema and/or infection. Slight blunting of the left costophrenic angle may be due to trace pleural effusion. The patient is status post median sternotomy. The cardiac silhouette is top normal. The aorta is calcified.

IMPRESSION: Diffuse bilateral, right much greater than left alveolar opacities could relate to asymmetric edema and/or infection. Correlate clinically and consider repeat after diuresis. Comparison with prior radiographs would be helpful.


SubjectID: 16313615, StudyID: 58697768, Comparison: same

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with pleural effusion.

COMPARISON: Chest x-rays from ___ to ___.

FINDINGS: Considering the different positioning of the patient, bilateral pleural effusions, more predominant on the right side, are unchanged. Mild pulmonary edema is stable   Keywords: stable. Cardiac contour is mildly enlarged. There is no pneumothorax. The patient has been extubated and NG tube has been removed.

CONCLUSION: 1. Considering the re-distribution of pleural effusion in lower lung on this erect exam, there is no significant change since previous exam. 2. Stable mild pulmonary edema   Keywords: stable.


SubjectID: 16313615, StudyID: 57155158, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the extent of the known right pleural effusion and the associated right basal opacity is constant. Also constant are the peripheral mid lung right parenchymal opacities. The basal opacities are likely reflecting atelectasis, whereas the more apical peripheral opacities are consistent with pulmonary contusion. This is supported by the CT findings obtained on ___. Unchanged moderate cardiomegaly without pulmonary edema   Keywords: unchanged. Unchanged minimal left basal atelectasis. No evidence of pneumothorax.


SubjectID: 16313615, StudyID: 50489306, Comparison: None

FINAL REPORT

STUDY: Chest radiograph.

INDICATION: ___-year-old male patient on aspirin, struck by car. To assess for interval change.

TECHNIQUE: Chest x-ray was obtained using portable AP technique.

COMPARISON: ___. Current radiograph is dated ___ timed at 5:20 a.m. REPORT: The patient is intubated, with the tip of the ET tube in unchanged position just above the carina. Again, this should probably be withdrawn slightly. An NG tube courses throughout the mediastinum to terminate in the left hypochondrium. There is minor blunting of both costophrenic sulci, worse on the right side. There is asymmetric opacification of the right hemithorax versus the left. Much of this may represent effusion though the air space change noted on the CT is also seen. No definitive rib fractures are identified.

CONCLUSION: ET tube should be retracted as it lies too close to the carina. Bilateral pleural effusions, slightly large on the right side. No pneumothorax. The findings of the low lying ET tube telephoned to Dr. ___ at the time of reporting, but the patient has apparently had an interval extubation.


SubjectID: 16313615, StudyID: 58469457, Comparison: None

FINAL REPORT

INDICATION: Shortness of breath. Please evaluate for CHF or pneumonia.

COMPARISON: Comparison made to chest radiograph performed ___.

FINDINGS: Chest PA and lateral radiograph demonstrates unremarkable mediastinal, hilar and cardiac contours. Hazy pulmonary vasculature suggests mild pulmonary edema. Bibasilar opacifications may be a combination of atelectasis and bilateral pleural effusions, right greater than left. However, cannot exclude an infectious process in the appropriate clinical setting.

IMPRESSION: Bibasilar opacifications likely represent combination of effusions and possibly atelectasis versus pneumonia. Background mild pulmonary edema.


SubjectID: 16313615, StudyID: 54332812, Comparison: -1.0

FINAL REPORT

TYPE OF

EXAMINATION: Chest PA and lateral.

INDICATION: ___-year-old male patient with history of lung malignancy, presently with shortness of breath, evaluate for pneumonia, pulmonary congestion.

FINDINGS: PA and lateral chest views were obtained with patient in upright position. Comparison is made with the next preceding portable single view AP chest examination obtained 14 hours earlier during the same day. The patient's previously described pulmonary congestive pattern as well as the bilateral pleural effusions that blunted the lateral pleural sinuses, more on the right than the left, have markedly improved. The lateral pleural sinuses are almost completely free on the frontal view, but small amount of pleural effusions are still collecting in the posterior pleural sinuses as identified on the lateral view. A previously existing perivascular haze in the lungs has normalized with the exception of a small plate atelectasis on the right lung base. There is no evidence of any discrete local pulmonary parenchymal infiltrates that can be identified as a pneumonitis. No pneumothorax exists in the apical area. The heart size is now close to the normal range and the previously identified cardiac enlargement, exaggerated by the AP portable examination technique, appears to have improved. When review comparison is extended to a PA and lateral chest examination dated ___, the chest finding including borderline heart size and absence of significant pulmonary vascular congestion are not too dissimilar   Keywords: similar.

IMPRESSION: Marked improvement of pulmonary congestion diagnosed on preceding portable chest examination performed on the preceding night   Keywords: improve. Mild amount of pleural effusions remaining, but no evidence of acute pneumonia. Referring physician, ___. ___, was informed via ___ at 4:15 p.m.


SubjectID: 16313615, StudyID: 53315400, Comparison: worse

FINAL REPORT

HISTORY: Respiratory failure, to assess for volume status.

FINDINGS: In comparison with the study of ___, there is continued and possibly even worse pulmonary edema with large layering pleural effusions bilaterally, more prominent on the right   Keywords: worse. Compressive atelectatic changes are seen at the bases. Cardiac silhouette remains at the upper limits of normal in size.


SubjectID: 16313615, StudyID: 53702896, Comparison: None

FINAL REPORT

HISTORY: Coronary artery disease, aortic stenosis, struck by a vehicle with worsening respiratory status. Evaluate for pulmonary edema, worsening infiltrate.

COMPARISON: ___.

FINDINGS: Compared with most recent prior radiographs, there has been worsening of bilateral pleural effusions and right greater than left parenchymal opacities which likely represents worsening congestion; although, hemorrhage or contusion could have a similar appearance and with the appropriate clinical symptoms, superimposed pneumonia is also possible. The cardiomediastinal silhouette is unchanged. No pneumothorax

IMPRESSION: Worsening right greater than left parenchymal opacity likely represents worsening congestion; however, hemorrhage or contusion could have similar appearance and with the appropriate clinical symptoms, superimposed pneumonia is also possible.


SubjectID: 16313615, StudyID: 54516228, Comparison: None

FINAL REPORT

HISTORY: Aortic stenosis and CHF.

FINDINGS: In comparison with the study of ___, the endotracheal and nasogastric tubes have been removed. The left subclavian catheter is unchanged. Continued large right pleural effusion, with smaller left effusion and bibasilar atelectatic changes. Cardiac silhouette remains at the upper limits of normal in size.


SubjectID: 16316828, StudyID: 58642086, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Hemodialysis, incidental nodule on chest x-ray.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Status post sternotomy. Severe cardiomegaly with fluid overload and right pleural effusion as well as subsequent atelectasis. The rounded opacity described on the previous chest x-ray is still visible, projecting over the ventral parts of the fifth right rib. The opacity is constant in size and morphology. The constant projection over the rib suggests a bony island of the rib. To exclude that the lesion corresponds to the nipple, a repeat radiograph with nipple marker should be performed. No pneumonia, no pneumothorax.


SubjectID: 16316828, StudyID: 57660347, Comparison: same

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Cough and shortness of breath; history of congestive heart failure.

COMPARISONS: ___.

TECHNIQUE: Chest, PA and lateral.

FINDINGS: The patient is status post coronary artery bypass graft surgery. The heart is mild to moderately enlarged. There is prominent and indistinct central interstitium with prominent pulmonary vascularity suggesting mild-to-moderate vascular congestion. In addition, there is a moderate right-sided pleural effusion which has increased with associated opacity, which can probably be attributed to atelectasis, but underlying pneumonia is also a possibility. A trace left-sided pleural effusion is suspected. There is no pneumothorax. Moderate anterior osteophyte formation is noted along the mid-to-lower thoracic spine.

IMPRESSION: 1. Similar mild-to-moderate pulmonary vascular congestion and cardiomegaly   Keywords: similar. 2. Increasing small-to-moderate right-sided pleural effusion with associated parenchymal opacification and volume loss, possibly atelectasis, although an infectious cause is a possible consideration. 3. Persistent nodular focus projecting over the right mid lung, likely nipple shadow. However, when clinically appropriate, evaluation with an additional PA view with nipple markers is suggested to evaluate further. Recommendation for follow-up PA view with nipple markers discussed with Dr. ___ by telephone on ___ at 6 pm.


SubjectID: 16326093, StudyID: 55957315, Comparison: None

FINAL REPORT

INDICATION: ___F with ESRD, chest pressure, SOB, evaluate for congestive heart failure..

COMPARISON: Comparison is made to chest radiograph from ___.

TECHNIQUE Portable upright view of the chest.

FINDINGS: The cardiac silhouette is mildly enlarged. There is increased opacity at the bilateral lung bases right greater than left. There is blunting of the left costophrenic angle, representing a pleural effusion. There is likely a small right-sided pleural effusion as well. The mediastinal contours is normal. There is no pneumothorax.

IMPRESSION: Cardiomegaly, bilateral pleural effusions, and bibasilar opacities right greater than left, concerning for multifocal pneumonia with pulmonary edema being less likely.

NOTIFICATION: Findings were discussed over the telephone with Dr. ___ by Dr. ___ on ___ at 13:30, 20 minutes after the were made.


SubjectID: 16326093, StudyID: 52044671, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with line placement

TECHNIQUE: Portable upright AP view of the chest

COMPARISON: ___ at 08:56

FINDINGS: Right internal jugular central venous catheter tip terminates at the junction of the SVC and right atrium. No pneumothorax is identified. Moderate cardiomegaly is again noted. Mediastinal and hilar contours are similar. Moderate pulmonary edema is not substantially changed in the interval with small bilateral pleural effusions also re- demonstrated. More focal opacities in the lung bases may reflect areas of pneumonia or atelectasis.

IMPRESSION: Right internal jugular central venous catheter tip at the junction of the SVC and right atrium. No pneumothorax. Moderate pulmonary edema with small bilateral pleural effusions and bibasilar opacities, potentially infection or atelectasis.


SubjectID: 16326093, StudyID: 51716485, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F CHF, ESRD, HTN admitted for sepsis ___ multifocal PNA, NSTEMI, and CHF exacerbation. // Assess for interval change

IMPRESSION: As compared to ___ chest radiograph, pulmonary edema has nearly resolved   Keywords: resolve. More confluent opacities at the lung bases persist and may be related to history of multifocal pneumonia. Small to moderate pleural effusions are also present, with interval increase on the right.


SubjectID: 16346972, StudyID: 59963892, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man with rapid atrial fibrillation and recent cough.

COMPARISON: None. AP PORTABLE CHEST RADIOGRAPH: The heart size is in the upper limits of normal. The hilar and mediastinal contours are normal. The lungs are well expanded and clear, without consolidation, pleural effusion or pneumothorax. The left costophrenic sulcus has not been included in this image.

IMPRESSION: Mild cardiomegaly. Otherwise, no acute cardiopulmonary pathology.


SubjectID: 16346972, StudyID: 57862021, Comparison: None

FINAL REPORT

PORTABLE CHEST FILM ___ AT 821 CLINICAL

INDICATION: ___-year-old with CHF and Swan in place, check position of the Swan. Comparison to ___. A portable AP upright chest film ___ at 821 is submitted.

IMPRESSION: 1. The heart is stably enlarged which may reflect cardiomegaly or pericardial effusion. A dual-lead left-sided pacer remains in place. A right internal jugular Swan-Ganz catheter has its tip in the right pulmonary artery. Lungs appear grossly clear. No pleural effusions, pulmonary edema or focal airspace consolidation to suggest pneumonia. No pneumothorax.


SubjectID: 16346972, StudyID: 55593802, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___ AT 8:24 CLINICAL

INDICATION: CHF with Swan placement, check position. Comparison is made to the patient's previous study dated ___ at 8:21. Portable AP chest film ___ at 8:24 is submitted.

IMPRESSION: 1. Right internal jugular Swan-Ganz catheter has its tip in the proximal right pulmonary artery, unchanged. A dual-lead left-sided pacer remains in place. The heart is stably enlarged which may represent cardiomegaly, although pericardial effusion should also be considered. Lungs are without evidence of focal airspace consolidation, pulmonary edema, pleural effusion or pneumothorax.


SubjectID: 16346972, StudyID: 54518477, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, Swan-Ganz catheter placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the Swan-Ganz catheter has been pulled back by approximately 3-4 cm. The catheter should further be pulled back by about 1-2 cm. No other changes   Keywords: no other change. No complications. No overt pulmonary edema. Unchanged moderate cardiomegaly.


SubjectID: 16346972, StudyID: 52893070, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph, ___.

FINDINGS: Swan Ganz catheter remains in place, with tip terminating in the region of the proximal right pulmonary artery. ICD pacing device also remains in standard position. Stable enlargement of the cardiac silhouette accompanied by mild pulmonary vascular congestion.


SubjectID: 16359332, StudyID: 58497092, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (AP AND LAT)

INDICATION: ___ year old woman with prod cough over past 3 days

TECHNIQUE: Chest AP semi- upright and lateral

COMPARISON: None.

FINDINGS: Elevated right hemidiaphragm again noted. The heart is markedly enlarged with splaying of the carinal suggesting left atrial enlargement. Given lack of prior imaging studies, difficult to assess the the of the cardiac enlargement and clinical correlation for possibility of pericardial effusion advised. No large effusion or pneumothorax. No convincing signs of pneumonia or edema. The mediastinum appears well-defined and mildly prominent likely reflecting a ectatic vasculature. The bony structures are diffusely demineralized with high riding humeral heads noted bilaterally.

IMPRESSION: Marked cardiomegaly. Please correlate clinically for chronicity and possibility of pericardial effusion. No evidence of pneumonia.


SubjectID: 16359332, StudyID: 52587658, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with shortness of breath.

TECHNIQUE: AP and lateral.

COMPARISON: Chest radiograph dated 1 day prior, ___.

FINDINGS: AP and lateral chest radiograph is compared to radiograph performed 1 day prior. A right lower lobe opacity is noted, new and might be concerning for interval aspiration. Lung volumes are improved. Heart size is enlarged though stable. There is no pleural effusion or pneumothorax. Chronic changes at the right shoulder are likely secondary to rotator cuff injury.

IMPRESSION: Improved lung volumes with severe cardiomegaly. No evidence of overt pulmonary edema. A right lower lobe opacity is noted, new and might be concerning for interval aspiration.


SubjectID: 16366110, StudyID: 50970354, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p AVR // eval for pleural effusions

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the patient has developed a moderate right pleural effusion. No left pleural effusion. The lung volumes have decreased. The venous introduction sheet on the right was removed. The alignment of the sternal wires is constant. Moderate cardiomegaly. The current image shows signs of mild to moderate pulmonary edema.


SubjectID: 16366110, StudyID: 50755878, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with avr // r/o ptx, s/p ct d/c r/o ptx, s/p ct d/c

IMPRESSION: In comparison with the study of ___, the monitoring and support devices have been removed except for a right IJ sheath. Following chest tube removal, there is no evidence of pneumothorax. The areas of increased opacification described previously are decreasing   Keywords: increase.


SubjectID: 16382105, StudyID: 58016071, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Dyspnea, evaluation for chronic heart failure.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the lung volumes have decreased. There is evidence of atelectatic changes on both lung bases. The suspicion of small bilateral pleural effusions from the previous report is confirmed on today's image. There is unchanged evidence of mild pulmonary edema   Keywords: unchanged. Unchanged atelectatic areas at the left lung base.


SubjectID: 16382105, StudyID: 57923125, Comparison: better

FINAL REPORT

HISTORY: History of CHF and COPD now with increased work of breathing, here to evaluate for interval changes.

COMPARISON: Chest radiographs dated ___ and ___. Otherwise, no prior studies are available for comparison. Technique: Portable semi-erect AP radiograph of the chest.

FINDINGS: The inspiratory lung volumes are decreased from the most recent prior study. There is increased streaky opacification of the right lung base and blunting of the right costophrenic angle reflecting a combination of small pleural effusion and increased atelectasis. Retrocardiac opacification obscuring the left hemidiaphragm is unchanged compatible with small pleural effusion and underlying atelectasis or consolidation. Mild pulmonary vascular congestion and edema is slightly improved from the most recent prior study   Keywords: improve. No pneumothorax is detected. The cardiac silhouette is mildly enlarged but stable. The mediastinal contours are prominent but unchanged with tortuosity of the thoracic aorta and calcification of the aortic knob. The trachea is deviated to the right by the aortic knob.

IMPRESSION: 1. Slightly improved interstitial edema from ___   Keywords: improve. 2. Unchanged retrocardiac opacification reflecting small left pleural effusion and underlying atelectasis or consolidation. 3. Increased right basilar atelectasis and unchanged small right pleural effusion.


SubjectID: 16382105, StudyID: 53087807, Comparison: None

FINAL REPORT

HISTORY: Dyspnea.

COMPARISON: None.

FINDINGS: PA and lateral views of the chest demonstrate a small to moderate left-sided pleural effusion with adjacent atelectasis. There may be a small right-sided pleural effusion as well. Cardiac size is normal. The trachea is deviated to the right. No focal consolidations worrisome for pneumonia. Mild pulmonary edema.


SubjectID: 16382105, StudyID: 52937288, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Increasing oxygen requirement, evaluation for pneumonia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Known moderate cardiomegaly and mild pulmonary edema, associated with small bilateral pleural effusions. Mild atelectasis at the left lung base. No new parenchymal opacities, no evidence of pneumonia.


SubjectID: 16386591, StudyID: 58878266, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old female with CHF.

COMPARISON: ___.

FINDINGS: A single portable supine chest radiograph was obtained. Interstitial and alveolar opacities, and hilar indistinctness are new since ___   Keywords: new. Pacemaker leads project over the expected location of the right atrium and right ventricle. Endotracheal tube ends in the mid trachea. The aortic arch is calcified. Lower lumbar pedicle screws are intact. Right humeral hardware is partially visualized.

IMPRESSION: Moderate pulmonary edema is new since ___   Keywords: new.


SubjectID: 16386591, StudyID: 50303569, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: To assess tubes and lines, patient with respiratory failure.

TECHNIQUE: Supine portable semi-erect chest view was reviewed in comparison with the most recent radiograph done on the same day acquired four to five hours apart.

FINDINGS: Tip of the endotracheal tube ending 5 cm above the carina and an orogastric tube ending into the stomach, but is looped with its tip at the fundus of the stomach. Dual-lead left pectoral pacemaker device is present with each lead terminating into the right atrium and right ventricle respectively. Since last six hours, mild-to-moderately severe pulmonary edema has significantly improved   Keywords: improve. Bibasilar atelectasis persists, improved on the right side but worsened on the left side. Presumed small left pleural effusion. There is no pleural effusion on the right side.

IMPRESSION: Over last six hours, mild-to-moderately severe pulmonary edema has improved, right lung base atelectasis is better whereas the left lower lung atelectasis is worse   Keywords: improve, better.


SubjectID: 16392858, StudyID: 51542463, Comparison: None

FINAL REPORT

INDICATION: Status post single chamber permanent pacemaker implantation, here to evaluate for pneumothorax and appropriate lead placement.

COMPARISON: Chest radiograph dated ___ at 12:15.

TECHNIQUE: PA and lateral radiographs of the chest.

FINDINGS: A left pectoral single-chamber pacemaker is in place with a single lead terminating in the right ventricle. The cardiac silhouette is moderately enlarged but stable. The mediastinal contours are within normal limits with mild tortuosity of the aorta. The hilar contours are within normal limits and stable. The lungs are clear without focal consolidation, pleural effusion or pneumothorax. The pulmonary vasculature is not engorged. Two screws are noted in the left humeral head. Moderate degenerative changes are noted in the bilateral acromioclavicular joints. Moderate degenerative changes are noted in the lower thoracic spine. There is kyphotic curvature.

IMPRESSION: Appropriate pacemaker lead placement with clear lungs.


SubjectID: 16409774, StudyID: 59101579, Comparison: worse

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph of one day earlier.

FINDINGS: Stable widening of cardiomediastinal contours is accompanied by worsening diffuse interstitial pulmonary edema   Keywords: worse. A more confluent area of opacity in the right lower lobe may reflect superimposed pneumonia. Moderate right and small left pleural effusions are unchanged.


SubjectID: 16409774, StudyID: 52303653, Comparison: same

FINAL REPORT

HISTORY: Increased shortness of breath.

COMPARISON: Chest radiograph from ___.

FINDINGS: Previously visualized right basilar opacity has increased and is most likely representative of an infectious process. Left basal atelectatic changes are again noted. Otherwise, bilateral interstitial markings are again noted, suggesting mild pulmonary edema   Keywords: again. There is no pneumothorax. The mediastinal contours appear stable when the patient is post CABG. No acute fractures are identified.

IMPRESSION: Progression of previously visualized right lower lung opacity consistent with right lower lobe pneumonia. Additionally, there is increased left basilar opacity which represent atelectasis or be a part of a multifocal infectious process. Mild pulmonary edema persists   Keywords: persists.


SubjectID: 16414344, StudyID: 59754614, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with fever, delirium // Evidence of pneumonia Evidence of pneumonia

IMPRESSION: In comparison with the study of ___, the patient has taken a slightly better inspiration. Overall, little change in the appearance of the heart and lungs. No definite evidence of pneumonia.


SubjectID: 16414344, StudyID: 57889454, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with fatigue, tachypnea // evaluate for intrapulmonary process

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, lung volumes remain low. The alignment of the sternal wires is unchanged. Mild centralized pulmonary edema has newly developed   Keywords: new, develop. No pneumonia, no pleural effusions. No pneumothorax.


SubjectID: 16414344, StudyID: 59141017, Comparison: worse

FINAL REPORT

INDICATION: Assess for interval change in pulmonary edema.

COMPARISON: Chest radiograph ___.

FINDINGS: Lung volumes are lower than on the previous study. The cardiomediastinal and hilar contours remain stable accounting for this fact. Mild blunting of the left costophrenic angle is indicative of a small pleural effusion. There is no pneumothorax. Bilateral parenchymal opacities have substantially worsened since the prior study   Keywords: worse. Note is made of a stent in the left axilla, likely in the left subclavian vein.

IMPRESSION: Worsening pulmonary edema with small left pleural effusion   Keywords: worse.


SubjectID: 16414344, StudyID: 56919096, Comparison: None

FINAL REPORT

HISTORY: ___-year-old male with hypoxia and chest pain. Question pneumonia.

COMPARISON: None.

FINDINGS: Single portable view of the chest. There are diffuse bilateral parenchymal opacities in the lungs. Blunting of the costophrenic angles suggestive of pleural effusions. Cardiomediastinal silhouette is within normal limits. Median sternotomy wires and mediastinal clips are seen. No acute osseous abnormalities detected.

IMPRESSION: Bilateral parenchymal opacities and blunting of the costophrenic angle suggestive of pulmonary edema and effusions. Atypical or superimposed infection could also be considered. Recommend repeat after treatment to resolution.


SubjectID: 16414344, StudyID: 50965141, Comparison: same

FINAL REPORT

PORTABLE CHEST ___, ___

COMPARISON: ___ radiograph.

FINDINGS: Cardiac silhouette remains enlarged and is accompanied by widespread pulmonary edema, which continues to involve the left lung to a greater degree than the right   Keywords: continue, remains. Allowing for differences in technique and positioning, the overall severity is likely unchanged.


SubjectID: 16425465, StudyID: 58911575, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPH

INDICATION: ___ year old woman with chest pain and recent dx of chf // eval lungs Surg: ___ (avf r arm) eval lungs

TECHNIQUE: Portable AP Chest radiograph.

COMPARISON: Chest radiograph from ___ and ___.

FINDINGS: The heart is moderately enlarged. Calcifications are seen along the aortic knob. As compared to prior examination, there is worsening pulmonary edema   Keywords: worse. No large pleural effusion identified. Widened mediastinum is likely secondary to lymphadenopathy.

IMPRESSION: Moderate cardiomegaly with worsening pulmonary edema   Keywords: worse.


SubjectID: 16425465, StudyID: 52082956, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with sCHF with chest pain and volume overload. // pulmonary edema? pulmonary edema?

TECHNIQUE: Frontal chest radiograph

COMPARISON: ___

FINDINGS: Vascular engorgement has decreased and appears more defined   Keywords: decrease. There has been interval decrease in pulmonary edema, however is still mildly persistent   Keywords: decrease. Left pleural effusion has improved. Cardiomegaly is stable.

IMPRESSION: Substantial decrease in left pleural effusion and bilateral pulmonary edema   Keywords: decrease.


SubjectID: 16425465, StudyID: 57933252, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with fever, concern for pneumonia // Interval changes Interval changes

IMPRESSION: Comparison to ___. Moderate cardiomegaly persists. Stable moderate right pleural effusion with subsequent right basilar atelectasis. The lung parenchyma is unchanged. No new focal parenchymal opacities   Keywords: new. Stable mild fluid overload   Keywords: stable. The monitoring and support devices are in unchanged correct position.


SubjectID: 16425465, StudyID: 53830916, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F w/ ESRD, CHF, AF, s/p line HD replacement due to clogging, presents from HD with AMS lethargy found to have E coli urosepsis. // please evaluate interval change please evaluate interval change

IMPRESSION: Comparison to ___. Stable moderate cardiomegaly without overt pulmonary edema but with a stable moderate right pleural effusion   Keywords: stable. Subsequent right basilar atelectasis. No pneumonia, no pneumothorax. The monitoring and support devices are in unchanged position.


SubjectID: 16425465, StudyID: 51761875, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with sepsis and known cardiomyopathy // ? interval change, pulmonary edema/effusion ? interval change, pulmonary edema/effusion

IMPRESSION: Comparison to ___. Slight increase in extent of a previously minimal right pleural effusion. Stable moderate cardiomegaly with bilateral areas of atelectasis. Mild fluid overload but no overt pulmonary edema. The correct position of the monitoring and support devices is stable.


SubjectID: 16425465, StudyID: 53969841, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___-year-old woman with recent central venous line placement. Evaluate positioning.

TECHNIQUE: Single portable AP view of the chest.

COMPARISON: CT abdomen and pelvis of the same date. Chest radiographs of ___ and ___.

FINDINGS: A left subclavian HD line has 2 lumens, 1 terminating at the mid SVC, and the other at the cavoatrial junction. A right IJ central line tip also projects at the cavoatrial junction. Moderate cardiomegaly persists, with a small to moderate right pleural effusion and compressive right lower lobe atelectasis. No large left-sided pleural effusion. No evidence of pneumothorax. No overt pulmonary edema. Lung volumes are lower.

IMPRESSION: 1. The left subclavian dialysis line tips terminate at the mid SVC and cavoatrial junction. The right IJ central line tip projects at the cavoatrial junction. No evidence of pneumothorax. 2. Persistent moderate cardiomegaly with a small to moderate right pleural effusion, confirmed on the CT abdomen and pelvis of the same date.


SubjectID: 16425465, StudyID: 51904641, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ with PMH of COPD, HFrEF (EF35-___%), ERSD on HD T/T/___, HTN, afib, pulm HTN, recurrent C diff, h/o diverticulosis, RA on prednisone, PVD s/p CFA endarterectomy and SFT stent, s/p left AT angioplasty, s/p left BKA presents with AMS and hypotension after recent HD line exchange procedure. // please evaluate for interval change please evaluate for interval change

IMPRESSION: Comparison to ___. No relevant change   Keywords: no relevant change. Low lung volumes. Moderate cardiomegaly. Small right pleural effusion with subsequent basilar atelectasis. No overt pulmonary edema. No pneumonia.


SubjectID: 16426569, StudyID: 59991669, Comparison: None

WET READ: ___ ___ ___ 8:28 PM Left chest tube has its tip projecting at the left apex. New right chest wall pacer has leads in the right atrium, right ventricle and over the left ventricle. There is a moderate left pleural effusion. There is no evidence of pneumothorax. Pulmonary vasculature appears mildly congested likely with mild interstitial pulmonary edema. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p L thoracotomy and chest tube // eval for PTX eval for PTX

IMPRESSION: As compared to the previous radiograph, the patient has received a right central venous access line, with the tip projecting over the cavoatrial junction. The patient has also received a right pectoral pacemaker, the leads project over the right atrium and the right ventricle respectively. Finally, a left chest tube has been inserted. There is no evidence of pneumothorax. Apparently displaced left-sided rib fractures. No larger left pleural effusion. Moderate cardiomegaly with small retrocardiac atelectasis.


SubjectID: 16426569, StudyID: 57747058, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman s/p epicardial lead placement via thoracotomy // assess lead placement

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph ___ 09:11 AM

FINDINGS: Right chest tube has been removed and there is a new small left pneumothorax. Increased gastric distension. Moderate cardiomegaly is unchanged. Bibasilar and left retrocardiac atelectasis is unchanged. Right pacemaker, right jugular venous catheter, and left port-a-cath are in unchanged and appropriate locations. No pleural effusions.

IMPRESSION: Since ___ 9:11 AM, new left pneumothorax and increased gastric distension.

NOTIFICATION: The findings were discussed by Dr. ___ with NP ___ on the telephone on ___ at 12:45 PM, 10 minutes after discovery of the findings.


SubjectID: 16426569, StudyID: 56329583, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p epicardial lead placement // eval for pneumothorax with chest tube to water seal eval for pneumothorax with chest tube to water seal

IMPRESSION: As compared to ___, no relevant change is seen   Keywords: no relevant change. The left chest tube is in constant position. Moderate cardiomegaly with retrocardiac atelectasis persists. No evidence for the presence of a pneumothorax. Mild overinflation of the gastric bubble. Unchanged position of the left Port-A-Cath and the right pacemaker.


SubjectID: 16426569, StudyID: 58952438, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman s/p attempted ppm placement // ptx

IMPRESSION: As compared to ___ chest radiograph, there is no evidence of pneumothorax following attempted pacemaker placement. Overall appearance of the chest is unchanged.


SubjectID: 16426569, StudyID: 57627841, Comparison: None

WET READ: ___ ___ ___ 7:53 AM There is a left-sided double-lumen Port-A-Cath terminating in the mid SVC. There is no pneumothorax and no focal consolidation. Cardiomediastinal silhouette is stable.

WET READ VERSION #___ ___ ___ ___ 10:36 PM There is a left-sided double-lumen Port-A-Cath terminating in the mid SVC. There is no pneumothorax and no focal consolidation. Cardiomediastinal silhouette is stable. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p attempted ppm placement // ptx leads

IMPRESSION: Interval placement of left subclavian porta catheter, terminating in the lower superior vena cava, with no visible pneumothorax. Since the prior radiograph of ___, bilateral small pleural effusions have resolved, with no other relevant changes since the prior study.


SubjectID: 16426569, StudyID: 56218308, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: recurrent follicular lymphoma now on c4d1 bendamustine/Rituxan, prior anaphylactic rxn to rituxan s/p desensitization, now presents for cycle 2 of Rituxan with new shortness of breath // interval change interval change

IMPRESSION: In comparison with the study of ___, there is now engorgement of ill-defined pulmonary vessels, consistent with increasing pulmonary venous pressure. Cardiac silhouette remains mildly enlarged. No definite acute focal pneumonia.


SubjectID: 16426569, StudyID: 56042969, Comparison: same

WET READ: ___ ___ ___ 8:12 AM 1. Left Port-A-Cath with the tip terminating at the cavoatrial junction. 2. Low lung volumes without evidence for acute cardiopulmonary process.

WET READ VERSION #1 ___ ___ ___ 7:46 PM 1. Left Port-A-Cath with the tip terminating at the cavoatrial junction. 2. Low lung volumes without evidence for acute cardiopulmonary process. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: recurrent follicular lymphoma now on c4d1 bendamustine/Rituxan, prior anaphylactic rxn to rituxan s/p desensitization, now presents for cycle 2 of Rituxan with new dyspnea on exertion // eval lung pathology

COMPARISON: ___.

IMPRESSION: No relevant change   Keywords: no relevant change. Left Port-A-Cath in constant position. Mild cardiomegaly but no overt pulmonary edema. No pleural effusion. No pneumonia.


SubjectID: 16439884, StudyID: 58907305, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, altered mental status. Evaluation for pneumonia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the signs indicative of pulmonary edema have decreased and now barely present   Keywords: decrease. Minimal atelectasis at the right lung base but no evidence of pneumonia. Unchanged mild cardiomegaly, no pleural effusions.


SubjectID: 16439884, StudyID: 52462401, Comparison: None

FINAL REPORT

INDICATION: ___-year-old woman status post Percocet overdose.

COMPARISON: Chest radiograph, ___. SINGLE AP UPRIGHT CHEST RADIOGRAPH: The cardiomediastinal and hilar contours are stable, with the heart in the upper limits of normal and a tortuous thoracic aorta. The patient is slightly rotated to the right. Again seen is central pulmonary congestion and mild interstitial pulmonary edema. Bibasilar atelectasis, right greater than left is noted. There are no pleural effusions or consolidations.

IMPRESSION: Mild interstitial pulmonary edema.


SubjectID: 16439884, StudyID: 57207413, Comparison: None

WET READ: ___ ___ ___ 10:28 AM No evidence of pneumonia or evidence of volume overload. ______________________________________________________________________________

FINAL REPORT

INDICATION: Woman with CHF and new weakness, evaluate for infection or worsening CHF.

COMPARISON: Chest radiograph on ___.

FINDINGS: ONE PORTABLE SEMI-ERECT AP VIEW OF THE CHEST. The lungs are clear. There is no pleural effusion or pneumothorax. The cardiac, mediastinal, and hilar contours are normal. No pulmonary vascular congestion.

IMPRESSION: No evidence of pneumonia or evidence of volume overload.


SubjectID: 16439884, StudyID: 51898227, Comparison: None

FINAL REPORT

INDICATION: CHF and fatigue, AP did not show pneumonia, rule out underlying pneumonia with PA and lateral.

COMPARISON: Chest radiograph on ___ at 7:39 a.m.

FINDINGS: PA and lateral views of the chest. The lungs are clear. There are no focal parenchymal opacities concerning for pneumonia. There is no pleural effusion or pneumothorax. The cardiac, mediastinal, and hilar contours are normal. No pulmonary vascular congestion or pulmonary edema.

IMPRESSION: No evidence of pneumonia. No pulmonary edema.


SubjectID: 16439884, StudyID: 55667602, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with hypoxia

TECHNIQUE: Portable AP view of the chest

COMPARISON: ___ at 01:11

FINDINGS: Heart size remains moderately enlarged. The mediastinal contour is similar with a moderate size hiatal hernia re- demonstrated. The aorta is diffusely calcified. Mild pulmonary vascular congestion is not substantially changed in the interval. No focal consolidation or pneumothorax is detected of the right costophrenic angle is excluded from the field of view. Trace bilateral pleural effusions likely are unchanged. Several left chest wall clips are again noted.

IMPRESSION: Mild pulmonary vascular congestion with trace bilateral pleural effusions.


SubjectID: 16439884, StudyID: 54579903, Comparison: None

FINAL REPORT

INDICATION: ___F with fever, sob // Eval for volume status, infiltrate

TECHNIQUE: Chest AP and lateral

COMPARISON: Chest x-ray from ___.

FINDINGS: There is mild pulmonary interstitial edema as well as small bilateral pleural effusions. No focal consolidation is identified. The cardiac silhouette is stable. There is no pneumothorax. A moderate hiatal hernia is noted.

IMPRESSION: Mild pulmonary interstitial edema with small bilateral pleural effusions. No focal consolidation.


SubjectID: 16439884, StudyID: 53208984, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with CHF and hypoxemia. // Is there pulmonary edema?

COMPARISON: Compared to radiographs from ___.

IMPRESSION: There is again seen prominence of the pulmonary interstitial markings consistent with mild pulmonary edema   Keywords: again. This is unchanged. No focal consolidation is seen. Heart size is upper limits of normal. There are no pneumothoraces.


SubjectID: 16455067, StudyID: 51576011, Comparison: same

FINAL REPORT

HISTORY: COPD with ET tube placement.

FINDINGS: In comparison with study of ___, the endotracheal tube and nasogastric tube are in essentially unchanged position. Continued enlargement of the cardiac silhouette with pulmonary vascular congestion and bilateral pleural effusions with compressive atelectasis at the bases   Keywords: continue.


SubjectID: 16459432, StudyID: 50641028, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: ___. CLINICAL

HISTORY: Malaise and dyspnea, assess for pneumonia.

FINDINGS: AP upright and lateral views of the chest were obtained. There is blunting of the left CP angle with mild left basilar opacity which could represent atelectasis or possibly an early pneumonia. There is mild cephalization suggesting mild interstitial edema. The heart size is top normal. Aorta is somewhat unfolded with atherosclerotic calcifications. Bony structures appear intact.

IMPRESSION: Mild interstitial edema, top normal heart size, small left effusion, and basilar opacity likely atelectasis versus pneumonia.


SubjectID: 16459432, StudyID: 55945861, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___ radiographs.

FINDINGS: Cardiac silhouette is enlarged and accompanied by pulmonary vascular engorgement and minimal interstitial edema. Small left pleural effusion is also unchanged.


SubjectID: 16459432, StudyID: 53412112, Comparison: None

FINAL REPORT

INDICATION: Fatigue. Chronic anemia. History of congestive heart failure.

TECHNIQUE: Two views of the chest.

COMPARISON: Multiple prior examinations, most recent dated ___.

FINDINGS: No focal opacity to suggest pneumonia is seen. No pneumothorax or significant pleural effusion is present. Mild cardiac enlargement is accompanied by minimal intersitial edema and a small left pleural effusion.


SubjectID: 16472049, StudyID: 53436241, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with NSTEMI and heart failure, now with increasing O2 requirement. // Please assess for effusions, edema, consolidation, acute process, and interval change.

IMPRESSION: As compared to ___ radiograph, enlarged cardiac silhouette and pulmonary vascular engorgement are persistent findings   Keywords: persistent. Asymmetrically distributed combined alveolar and interstitial pattern has slightly worsened. Although possibly due to asymmetrical edema, superimposed infectious process should be considered in the appropriate clinical setting. As some of the opacities in the right lung have a somewhat nodular contour, followup radiographs to ensure complete resolution are suggested. Small right pleural effusion is also demonstrated, but there is no visible pneumothorax.


SubjectID: 16472049, StudyID: 53130866, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with heart failure. // Please eval for pneumonia, vascular congestion, effusions, acute process.

COMPARISON: Radiographs from outside hospital on ___.

IMPRESSION: There is cardiomegaly, stable. There is mild pulmonary edema. There are opacities within the lung bases and within the right upper lobe which may represent asymmetric pulmonary edema versus pneumonia. Followup to resolution is recommended. No pneumothoraces are identified.


SubjectID: 16476559, StudyID: 59543479, Comparison: better

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old man with congestive heart failure and diuresis.

FINDINGS: Comparison is made to previous study from ___. There is again seen a Swan-Ganz catheter whose tip is within the right main pulmonary artery. Median sternotomy wires are seen. There has been improvement of the mild pulmonary edema since the prior study   Keywords: improve. There are no focal consolidations, pleural effusions or pneumothoraces.


SubjectID: 16476559, StudyID: 54207937, Comparison: same

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old man with acute congestive heart failure exacerbation. Evaluate position of Swan-Ganz catheter.

FINDINGS: Comparison is made to previous study from ___. There is again seen a right-sided Swan-Ganz catheter with distal lead tip in the right pulmonary artery, proximal aspect. Median sternotomy wires are seen. There is unchanged cardiomegaly. Lungs are grossly clear without pulmonary edema, focal consolidation or pneumothoraces. Overall, there has been no change   Keywords: no change.


SubjectID: 16476559, StudyID: 53761757, Comparison: None

FINAL REPORT

STUDY: AP chest ___. CLINCAL

HISTORY: ___-year-old male with congestive heart failure. Evaluate Swan-Ganz catheter position.

FINDINGS: The tip of the right Swan-Ganz catheter is in the right main pulmonary artery. This could be pulled back approximately 4-5 cm to be in the main pulmonary artery trunk. Median sternotomy wires are seen. There is mild cardiomegaly. There is minimal pulmonary edema. There are no pneumothoraces.


SubjectID: 16476559, StudyID: 59417814, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with PA catheter // ___ position

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Swan-Ganz catheter tip is at the level of right main pulmonary artery. Cardiomegaly is severe, unchanged as well as there is stable mediastinal contour. Lungs are essentially clear. No appreciable pleural effusion or pneumothorax is seen.


SubjectID: 16476559, StudyID: 58632570, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with smptomatic AAA s/p evar // f/u cxr

TECHNIQUE: Portable chest radiograph

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, a nasogastric tube was inserted. The course of the tube is unremarkable, the tip of the tube is not included on the image. Otherwise the radiograph shows unchanged appearance   Keywords: unchanged appearance. No complications, notably no pneumothorax.

IMPRESSION: New nasogastric tube, no complications.


SubjectID: 16476559, StudyID: 52870391, Comparison: same

WET READ: ___ ___ ___ 8:51 PM Low lung volumes with moderate edema. ET Tube and Swan-Ganz appear in place. Stable enlarged heart. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Intubation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has been intubated. The tip of the endotracheal tube projects 5 cm above the carina, the tube could be advanced by 1 cm. The patient has also received a Swan-Ganz catheter that is in correct position. The sternal wires are showing normal alignment. Low lung volumes. Moderate cardiomegaly with signs of mild fluid overload but no overt pulmonary edema. Blunting of the left costophrenic sinus could suggest the presence of a minimal left pleural effusion. No other relevant changes   Keywords: no other relevant change.


SubjectID: 16476559, StudyID: 58503431, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with shortness of breath and edema // ?chf vs pna

COMPARISON: ___

FINDINGS: AP portable upright view of the chest. Midline sternotomy wires and mediastinal clips are again noted. The heart remains markedly enlarged. The lungs appear clear without focal consolidation, large effusion or pneumothorax. A tiny pleural effusion on the right is suspected. No overt edema. Bony structures are intact.

IMPRESSION: Marked cardiomegaly without overt pneumonia or edema. Probable tiny right pleural effusion.


SubjectID: 16476559, StudyID: 54299496, Comparison: worse

FINAL REPORT

INDICATION: Volume overload.

COMPARISON: Chest radiograph ___.

TECHNIQUE: Frontal chest radiograph.

IMPRESSION: The patient is post CABG. Mild-to-moderate cardiomegaly is unchanged. There is central pulmonary vascular congestion with mild interstitial edema, more pronounced on the right, new since ___   Keywords: new. There is no pneumothorax or pleural effusion.


SubjectID: 16476559, StudyID: 57768808, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man s/___ CRT-D via left subclavian vein // r/o PTX; check lead positions

COMPARISON: Chest radiograph ___

FINDINGS: PA and lateral views of the chest provided. Left pacemaker and leads are in standard positioning, unchanged. Patient is status post median sternotomy with wires intact and properly aligned. Lungs are well inflated and grossly clear. No pleural effusion or pneumothorax. Hilar contours are normal. Severe cardiomegaly is unchanged.

IMPRESSION: 1. No pneumothorax. Left pacemaker and leads are in standard positioning, unchanged. 2. Severe cardiomegaly is unchanged.


SubjectID: 16476559, StudyID: 50557826, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with HF, s/p pacemaker placement today // eval lead palcement (particular RV leads) eval lead palcement (particular RV leads)

IMPRESSION: In comparison with a study of ___, the 3 pacer leads are in standard position. Again there is substantial enlargement of the cardiac silhouette with left ventricular prominence. The indistinctness of pulmonary vessels is less prominent on the current study, consistent with improved pulmonary vascular status   Keywords: improve.


SubjectID: 16476559, StudyID: 56001799, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF // Eval for change in pulmonary edema

TECHNIQUE: Portable AP film was obtained

COMPARISON: ___

FINDINGS: Patient status post sternotomy. There is right-sided IJ line is in good position. Patchy parenchymal opacification is most pronounced in the right lower lobe and concern for evolving infection here is made. Elsewhere, there is mild pulmonary edema.

IMPRESSION: No significant interval change from prior study attention on followup to the right   Keywords: no significant interval change


SubjectID: 16476559, StudyID: 53321963, Comparison: same

FINAL REPORT

INDICATION: ___M with sob // ? chf

COMPARISON: Multiple prior exams, most recently of ___.

TECHNIQUE: Single frontal view of the chest.

FINDINGS: Moderate cardiomegaly and upper mediastinal contours are stable. There is prominence of the pulmonary vasculature, consistent with congestion. No overt pulmonary edema. No large pleural effusion or pneumothorax. Sternotomy wires are intact.

IMPRESSION: Central pulmonary vascular congestion with stable moderate cardiomegaly   Keywords: stable.


SubjectID: 16476559, StudyID: 52810262, Comparison: None

FINAL REPORT

INDICATION: ___M with s/p CVL // PTX?

COMPARISON: Same-day chest radiograph of 10:24.

TECHNIQUE: Single frontal view of the chest.

FINDINGS: New right IJ central venous catheter terminates in the lower SVC. No pneumothorax. Otherwise, stable findings since the radiograph ___ min prior with central vascular congestion and moderate cardiomegaly.


SubjectID: 16476559, StudyID: 50130727, Comparison: None

WET READ: ___ ___ 9:49 AM Since the study of ___ opacities at the bases have partially improved. Residual opacities likely reflect atelectasis. The heart may be slightly smaller although there is still moderate to severe cardiomegaly. There is no new focal airspace opacity suggestive of pneumonia. There is no pulmonary edema. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with CKD stage IV, sCHF (EF ___%), CAD s/p 4vCABG, A Fib here for CHF exacerbation with new cough. // PNA? PNA?

IMPRESSION: In comparison with the study ___ ___, there has been some improvement in the opacification at the bases, which most likely reflect residual atelectasis. Prominent enlargement of the cardiac silhouette process without vascular congestion, suggesting cardiomyopathy.


SubjectID: 16508811, StudyID: 59842151, Comparison: -1.0

FINAL REPORT

INDICATION: ___ year old man with SOB and fever, cough // PNA?

TECHNIQUE: APsingle view

COMPARISON: ___

FINDINGS: Lines and Tubes: Stable right IJ line tip position. Lungs: Low lung volumes with mild worsening of pulmonary edema   Keywords: worse. Pleura: Small left pleural effusion. Mediastinum: Stable cardiomegaly. Bony thorax: No change   Keywords: no change

IMPRESSION: Mild interval worsening of pulmonary edema with unchanged left pleural effusion and cardiomegaly   Keywords: worse.


SubjectID: 16508811, StudyID: 55453302, Comparison: 0.0

FINAL REPORT

INDICATION: ___ year old man with ESRD now with temp and cough // r/o new infiltrate

COMPARISON: Radiographs from ___

IMPRESSION: Support lines and tubes are unchanged in position. Heart size is enlarged but unchanged. There has been worsening of the opacities at the lung bases, right worse than left   Keywords: worse. There remains mild prominence of the pulmonary interstitial markings suggestive of mild fluid overload, stable   Keywords: remains, stable. No pneumothoraces are seen.


SubjectID: 16508811, StudyID: 53845981, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with cough, fever // PNA?

TECHNIQUE: Chest PA and lateral

COMPARISON: ___ at 07:51

FINDINGS: Lines and Tubes: Right IJ line terminates in the SVC. Lungs: Well inflated with unchanged bilateral lower zone linear and hazy opacities   Keywords: unchanged. Pleura: Small left pleural effusion. No pneumothorax. Mediastinum: Stable cardiomegaly and prominence of hilar vasculature. Bony thorax: No interval change   Keywords: no interval change

IMPRESSION: Persistent, unchanged pulmonary edema   Keywords: unchanged, persistent.


SubjectID: 16508811, StudyID: 51985577, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ with ESRD s/p renal transplant x2 (___; ___) now with CKD with baseline Cr ___.4, diastoilc CHF, DM, HTN, HLD, PVD who is admitted to FICU for management ___ ___ on CKD. Now febrile with leukocytosis // please eval for consolidation, edema, or other abnormality please eval for consolidation, edema, or other abnormality

IMPRESSION: In comparison with the study of ___, there is decrease in the diffuse bilateral pulmonary opacifications   Keywords: decrease. This most likely represents improving pulmonary vascular status   Keywords: improving. Monitoring and support devices are unchanged.


SubjectID: 16508811, StudyID: 58890549, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___M with ESRD ___ T1DM and HTN now s/p DDRT (most recently in ___), COPD, DM, PVD, atrial fibrillation on coumadin, congestive heart failure (LVEF = ___%), C diff, and recent NSTEMI (on ___) who presents with one week of URI symptoms and increasing shortness of breath with CXR concerning for PNA. // Eval for volume overload, change in PNA Eval for volume overload, change in PNA

IMPRESSION: In comparison with the study of ___, there is diffuse increase in opacifications bilaterally   Keywords: increase. Although some of this could represent volume overload, much of the opacification, especially on the left, is consistent with superimposed pneumonia.


SubjectID: 16508811, StudyID: 53183813, Comparison: None

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: History: ___M with cough // acute process?

TECHNIQUE: Chest: Frontal and Lateral

COMPARISON: ___

FINDINGS: Left-sided consolidation involving the left upper lobes and possibly portions of the lingula and left lower lobe is seen. There is a trace left pleural effusion. Subtle opacity at the right lung base of is more likely due to atelectasis bone additional site of infection is not excluded. Prominence of the right hilum is stable. The cardiac and mediastinal silhouettes are stable. No pneumothorax is seen.

IMPRESSION: Large area of consolidation involving the left lung, worrisome for pneumonia. Recommend followup to resolution. Possible trace left pleural effusion. Right base opacity may be due to atelectasis, of additional site infection is not excluded in the appropriate clinical setting.


SubjectID: 16508811, StudyID: 58303567, Comparison: None

FINAL REPORT

AP CHEST, 2:45 A.M., ___

HISTORY: COPD and upper GI bleed, evaluate pleural effusion.

IMPRESSION: AP chest compared to ___ through ___: Right upper lobe pneumonia continues to develop. Pulmonary edema is clearing. Bibasilar consolidation, unchanged since ___, could be more pneumonia or combination of edema and basal atelectasis. The heart is partially obscured, probably moderately enlarged. Small-to-moderate bilateral pleural effusions unchanged. No pneumothorax.


SubjectID: 16508811, StudyID: 57231469, Comparison: None

FINAL REPORT

HISTORY: COPD and CHF.

FINDINGS: In comparison with the study of ___, there is continued enlargement of the cardiac silhouette with congestive failure. Poor definition of the hemidiaphragms is consistent with bilateral pleural effusion and compressive atelectasis. There is an area of more coalescent opacification in the right upper zone that is asymmetric with the opposite side. In the appropriate clinical setting, this could well represent a developing focus of pneumonia.


SubjectID: 16508811, StudyID: 53943140, Comparison: None

FINAL REPORT

EXAM: Chest, single AP upright portable view. CLINICAL INFORMATION: ___-year-old male with history of dyspnea.

COMPARISONS: ___.

FINDINGS: There is moderate to severe pulmonary edema. There is a small left pleural effusion with overlying atelectasis. Small right pleural effusion may also be present. Subtle patchy right upper lobe opacity, underlying the EKG lead, may be due to developing consolidation or confluence of vessels. Repeat with removal/repositioning of the EKG lead may be helpful for further evaluation. The cardiac silhouette is enlarged. No pneumothorax.


SubjectID: 16508811, StudyID: 56381590, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___M with cough

TECHNIQUE: Chest PA and lateral

COMPARISON: ___ chest radiograph

FINDINGS: Right-sided double lumen central venous catheter tip terminates in the proximal right atrium. Heart size is mildly enlarged. The mediastinal and hilar contours are unremarkable. Pulmonary vasculature is not engorged. Aeration of the lungs has markedly improved compared to the previous radiograph, with patchy opacities demonstrated in the lung bases, potentially infectious or atelectasis. No pleural effusion or focal consolidation is present. No acute osseous abnormalities detected.

IMPRESSION: Patchy opacities in the lung bases may reflect atelectasis however infection is not excluded.


SubjectID: 16508811, StudyID: 53632136, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with CHF, Afib on Coumadin, AS/MS, COPD T1DM c/b ESRD s/p DDRT s/p graft failure with fever, cough, malaise // eval for infection, interval change eval for infection, interval change

COMPARISON:

FINDINGS:

IMPRESSION: In comparison with the study ___, there again are patchy areas of increased opacification at both bases, very worrisome for bilateral pneumonia. The remainder of the examination is unchanged.


SubjectID: 16508811, StudyID: 54040548, Comparison: None

FINAL REPORT

EXAMINATION: DX CHEST PORTABLE PICC LINE PLACEMENT

INDICATION: ___ year old man with recent dc hd line // PICC line reassess PICC line reassess

IMPRESSION: In comparison with the study in on, the hemodialysis catheter is been removed and replaced with a right subclavian PICC line that extends to almost the junction of the brachiocephalic vein superior vena cava. Otherwise, little change in the appearance of the heart and lungs except for lower lung volumes.


SubjectID: 16508811, StudyID: 50936626, Comparison: None

FINAL ADDENDUM ADDENDUM Right subclavian PICC line extends to the mid portion of the SVC on the study ___ ___. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ with PMHx of ESRD (s/p renal transplant x2 in ___ and ___, on cellcept/tacro/pred), CKD (Cr ___.4), dCHF, DM, HTN, HLD, PVD who was admitted to FICU for ___ on CKD (BUN/Cr ___.2) and hyperkalemia (K 7.2). Requied HD but now making urine. Course also cb CMV viremia, bronchitis and troponinemia. Now w/new fever to 100.5. // r/o PNA r/o PNA

IMPRESSION: In comparison with the study of ___, the patient has taken a better inspiration. Hemodialysis catheter is unchanged. The cardiac silhouette remains at the upper limits of normal in size, although at this time there is no definite pulmonary vascular congestion. The left hemidiaphragm is not well seen, which could reflect small pleural effusion and atelectasis, though also could be related to overlying soft tissues. No evidence of acute focal pneumonia.


SubjectID: 16508811, StudyID: 52761853, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man now with fever // PNA?

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the patient has now received a right-sided PICC line. The course of the line is unremarkable, the tip of the line projects over the mid SVC. In the interval, the patient has developed a relatively widespread left middle and lower lung parenchymal opacity with air bronchograms, likely reflecting pneumonia. There is no evidence of complicating pleural effusions. At the time of dictation and observation, 17:05, ___, the referring physician ___. ___ was paged for notification. The referring physician was also sent an urgent email.


SubjectID: 16508811, StudyID: 52670967, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man h/o renal transplant (___) with chronic non healing L foot ulcers, osteomyelitis, LLL Pneumonia // interval change in pneumonia

IMPRESSION: As compared to ___, bilateral lower lobe predominant airspace opacities have worsened, and may reflect evolving infectious pneumonia. Peripheral interstitial opacities likely reflect coexisting interstitial edema. Small left pleural effusion has increased in size, and a small right pleural effusion is new.


SubjectID: 16508811, StudyID: 50818829, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ with ESRD s/p renal transplant x2 (___; ___) now with CKD with baseline Cr ___.4, diastoilc CHF, DM, HTN, HLD, PVD who is admitted to FICU for management ___ ___ on CKD. Now with wosening tachycardia and new onset oxygen requirement // please eval for pulmonary edema, consolidation, or other abnormality

TECHNIQUE: AP view of the chest.

COMPARISON: ___

FINDINGS: A left-sided internal jugular catheter is stable in position. A right-sided internal jugular dialysis catheter is also stable. There is no pneumothorax. Bibasilar pulmonary opacities are increasing from the prior examination done yesterday and are likely related to increasing pulmonary edema and atelectasis   Keywords: increasing.

IMPRESSION: Bibasilar airspace opacities are increasing and are likely related to worsening pulmonary edema and atelectasis   Keywords: increasing, worse.


SubjectID: 16508811, StudyID: 51780323, Comparison: None

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPH

INDICATION: Cough and renal failure.

TECHNIQUE: Chest, AP upright portable.

COMPARISON: ___ and ___.

FINDINGS: The cardiac and mediastinal contours appear stable. Although less striking than on the last study, there is perihilar congestive change above that of an earlier baseline study from ___. There are also patchy opacities at both lung bases, more prominent in the retrocardiac area than at the right lung base, decreased from ___ but retrocardiac opacity was not present in ___ so is not necessarily chronic.

IMPRESSION: Findings suggest mild vascular congestion. Opacities at the lung bases, particularly the left lower lobe, which are indeterminate as to etiology and chronicity.


SubjectID: 16508811, StudyID: 51274564, Comparison: None

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPH

INDICATION: Status post new central line placement.

TECHNIQUE: Chest, portable AP upright.

COMPARISON: Earlier on the same day.

FINDINGS: A new central venous catheter terminates in the left brachiocephalic vein. There is no pneumothorax. Otherwise, there has been no significant short-term change.

IMPRESSION: Status post placement of new left internal jugular central venous catheter; no pneumothorax identified.


SubjectID: 16514111, StudyID: 57887224, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with SOB and ___F last night. // pna?

COMPARISON: ___ ___.

IMPRESSION: As compared to the previous radiograph, there is a decrease in lung volumes, reflecting a lesser inspiratory effort. The signs indicative of resolving pulmonary edema are constant   Keywords: resolving. Also constant is the slightly denser lung zone at the right lung basis and the small right pleural effusion. Unchanged moderate cardiomegaly with elongation of the descending aorta.


SubjectID: 16514111, StudyID: 56533185, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with liver disease and SOB ? new heart failure. // please assess for volume overload vs pna.

COMPARISON: ___

FINDINGS: Stable cardiomegaly and upper zone vascular redistribution. Improvement in pulmonary edema, with residual mild interstitial edema remaining   Keywords: improve. A more confluent opacity at the right base has also improved and likely reflects resolving asymmetrical of alveolar edema   Keywords: improve, resolving. Small pleural effusions are present, right greater than left.

IMPRESSION: Improving CHF   Keywords: improving.


SubjectID: 16514111, StudyID: 53311031, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with cough, shortness of breath

TECHNIQUE: Frontal chest radiographs were obtained with the patient in the upright position.

COMPARISON: Chest radiograph from ___, ___ and ___. CT from ___.

FINDINGS: The heart size continues to be enlarged, and there is cephalization of vascular markings. There is a right pleural effusion, which appears increased in size from ___.

IMPRESSION: Congestive heart failure with cardiomegaly, pulmonary vascular congestion and a right pleural effusion.


SubjectID: 16514111, StudyID: 57602339, Comparison: None

FINAL REPORT

HISTORY: Poor inspiratory effort on last chest radiograph, suboptimal study, with difficulty speaking and walking.

TECHNIQUE: PA and lateral views of the chest.

COMPARISON: ___ at 12:01.

FINDINGS: Lung volumes are improved compared to the prior study. Heart size is normal. Mediastinal and hilar contours are unremarkable. There is no pulmonary vascular congestion. Previously noted patchy bibasilar airspace opacities have improved, with only minimal residual atelectatic changes seen. No focal consolidation, pleural effusion or pneumothorax is seen. ___ fiducial markers are again seen within the liver.

IMPRESSION: Interval improvement in inspiratory effort within near-complete resolution of the previously seen bibasilar airspace opacities compatible with atelectasis. No focal consolidation.


SubjectID: 16514111, StudyID: 52518676, Comparison: None

FINAL REPORT

HISTORY: Difficulty walking, facial sensation changes, difficulty speaking.

TECHNIQUE: PA and lateral views of the chest.

COMPARISON: ___ chest radiograph and ___ chest CT.

FINDINGS: Lung volumes are low. This causes accentuation of the cardiac silhouette size which is likely within normal limits. The aorta is mildly unfolded. Crowding of the bronchovascular structures is noted, but no overt pulmonary edema is seen. Patchy bibasilar airspace opacities could reflect atelectasis in the setting of low lung volumes, but infection cannot be excluded. No pleural effusion or pneumothorax is present. ___ fudicial seeds are seen within the right upper quadrant of the abdomen, within the liver. Emphysematous changes are re- demonstrated.

IMPRESSION: Low lung volumes limit assessment of the lung bases. Patchy bibasilar airspace opacities could reflect atelectasis but infection is not excluded. Repeat radiographs with improved inspiratory effort is suggested for improved assessment of the lung bases.


SubjectID: 16514111, StudyID: 56498247, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with prior CXR c/f ? free air vs pneumothorax // ? confirmation of prior CXR findings

COMPARISON: ___, 18:06

IMPRESSION: As compared to the previous radiograph, there is unchanged evidence of free intra-abdominal air. Low lung volumes. Moderate cardiomegaly. Bilateral areas of atelectasis are unchanged. No new focal parenchymal opacities   Keywords: new.


SubjectID: 16514111, StudyID: 51980712, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with likely CHF, s/p diuresis // Please eval interval change

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, there is minimal improvement of the known cardiomegaly and a known bilateral areas of atelectasis. Mild fluid overload but no overt pulmonary edema. The previously seen a free intra-abdominal air is


SubjectID: 16514111, StudyID: 51914580, Comparison: None

WET READ: ___ ___ ___ 9:41 AM Lucency along the right hemidiaphragm may represents intra-abdominal air compatible with recent abdominal surgery. There is bibasilar atelectasis. Lucency anterior to the heart and retrosternal could represent a small pneumothorax. Recommend repeat followup chest radiograph. The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 8:37 PM, 5 minutes after discovery of the findings.

WET READ VERSION #1 ___ ___ ___ 8:44 PM Lucency along the right hemidiaphragm may represents intra-abdominal air compatible with recent abdominal surgery. There is bibasilar atelectasis. Lucency anterior to the heart and retrosternal could represent a small pneumothorax. Recommend repeat followup chest radiograph. The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 8:37 PM, 5 minutes after discovery of the findings. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with crackles low oxygen saturation // check for volume overload

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the patient has undergone abdominal surgery. Subsequent air under the right hemidiaphragm. Bilateral basilar atelectasis at slightly decreased lung volumes. No pneumonia, no pulmonary edema. Free air in the lower cervical soft tissues. No pulmonary edema. Moderate cardiomegaly.


SubjectID: 16514111, StudyID: 51585111, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hypoxia // ? compare cxr

TECHNIQUE: AP radiograph of the chest.

COMPARISON: ___.

FINDINGS: There is no appreciable interval change in bibasilar subsegmental atelectasis. Mild pulmonary edema is also unchanged   Keywords: unchanged. Moderate cardiomegaly despite the projection is stable. There is no pneumothorax.

IMPRESSION: No significant interval change in mild pulmonary edema and bibasilar subsegmental atelectasis   Keywords: no significant interval change. Stable moderate cardiomegaly.


SubjectID: 16538543, StudyID: 54774850, Comparison: None

WET READ: ___ ___ ___ 2:29 PM Right middle pleural-based mass corresponds to a metastasis seen on ___ and ___ Atrius Imaging CT examinations (available remotely). No superimposed acute intrathoracic process detected. While no large pulmonary embolus is seen on the ___ CT exam, that protocol was not optimized to evaluate the subsegemental arteries.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

INDICATION: Shortness of breath.

COMPARISON: Atrius CT examination available remotely, performed on ___ and ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: A pleural-based right middle zone mass is better seen on the Atrius CT examinations from ___ and ___ (not currently available on ___ PACS). Coarse reticular opacities throughout both lungs likely reflect mild pulmonary edema. There are trace bilateral pleural effusions. There is no pneumothorax. The heart is mildly enlarged, and the hilar and mediastinal contours are within normal limits.

IMPRESSION: 1. Large right middle-zone pleural-based mass is seen on CT examinations from ___ Imaging on ___ and ___, compatible with metastatic RCC. Of note, no large pulmonary embolus was detected on the ___ CT examination; however, that technique was not optimized for evaluation of the subsegmental arteries. 2. Mild pulmonary edema and small bilateral pleural effusions.


SubjectID: 16538543, StudyID: 51094170, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old male with dyspnea and rigors, concern for pneumonia.

FINDINGS: Comparison is made to prior study from ___. There is again seen an area of parenchymal density in the right mid lung which is pleural-based and consistent with known RCC metastatic deposit. This is stable. There is increased density at the left base suggestive of developing infiltrate or atelectasis. Close attention to this area is recommended on subsequent exams. There are no pneumothoraces. The heart size is enlarged. There is some prominence of the pulmonary interstitial markings suggestive of minimal pulmonary edema.


SubjectID: 16574411, StudyID: 58866776, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: CT torso from ___. CLINICAL

HISTORY: Transfusion reaction with rigors.

FINDINGS: PA and lateral views of the chest are provided. A subtle opacity at the right medial lung base could represent pneumonia. Otherwise, the lungs are clear. No large effusions or pneumothorax. Anchors are noted at the right humeral head. A vascular stent is present in the upper abdomen.

IMPRESSION: Subtle opacity in the right medial lung base could in the right clinical setting represent pneumonia.


SubjectID: 16574411, StudyID: 50912897, Comparison: better

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Hypotension and possible right lower lobe pneumonia.

COMPARISONS: Radiographs from ___.

TECHNIQUE: Chest, PA and lateral.

FINDINGS: Moderate unfolding of the thoracic aorta appears unchanged. It is difficult to exclude trace persistent pleural effusions noting blunting of posterior costophrenic sulci. There is no pneumothorax. Bilateral posterior lower lobe opacities have improved substantially including right infrahilar opacification. Suture anchors are present in the right humeral head. Severe degenerative changes are incompletely characterized along the right glenohumeral joint.

IMPRESSION: Improving basilar opacities   Keywords: improving.


SubjectID: 16574411, StudyID: 58778140, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with recent aspiration // eval for progression of pneumonia/pneumonitis

IMPRESSION: As compared to prior radiograph of 1 day earlier, heterogeneous opacities in the right lung have improved with residual opacification most confluent in the right upper lobe, concerning for pneumonia. New patchy opacities have developed at the left lung base, and a moderate right pleural effusion is a persistent finding. Additional findings previously attributed to metastatic disease in the thorax have been more fully assessed on CT torso of ___.


SubjectID: 16574411, StudyID: 57046657, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with new endotracheal tube

TECHNIQUE: Portable upright AP view of the chest

COMPARISON: Chest radiograph ___

FINDINGS: Endotracheal tube terminates approximately 3 cm from the carina. Heart size is normal. The aorta is tortuous and diffusely calcified. Heterogeneous opacities are again seen within the right upper and mid lung fields, findings which appear worse in the interval, and likely reflect a combination of known metastases and worsening infection and/or aspiration. Small right pleural effusion is unchanged and there is no pneumothorax. Patchy opacity in the left lung base also reflects known metastases with probable superimposed infection or aspiration. Metallic stent is seen in the region of the common bile duct with multiple clips noted in the right upper quadrant. Extensive vascular calcifications are noted within the left upper abdomen. Marked degenerative changes of both glenohumeral joints are seen with right anterior shoulder subluxation and 2 soft tissue anchors projecting over the right humeral head.

IMPRESSION: 1. Endotracheal tube in standard position. 2. Heterogeneous opacities in the right upper and mid lung fields as well as patchy left basilar opacity appear worse in the interval and likely reflect a combination of known metastatic disease with worsening infection or aspiration. Unchanged small right pleural effusion.


SubjectID: 16574411, StudyID: 58300778, Comparison: worse

WET READ: ___ ___ ___ 4:07 AM 1. Interval increase in moderate pulmonary edema with mild cardiomegaly and small bilateral pleural effusions   Keywords: increase. 2. Heterogeneous right lower lobe opacity is most consistent with asymmetric pulmonary edema however differential includes pneumonia in the appropriate clinical setting. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: Hypoxia, tachypnea. Assess for pneumonia.

INDICATION: ___F with hypoxia, tachypnea. Assess for pneumonia.

TECHNIQUE: Single portable frontal chest radiograph.

COMPARISON: Chest radiograph ___, ___, ___, ___.

FINDINGS: The lungs are hypoinflated with crowding of vasculature and retrocardiac atelectasis. New cephalization of vasculature with septal thickening, mild cardiomegaly and small bilateral pleural effusions is most consistent with moderate pulmonary edema   Keywords: new. Heterogeneous right lower lobe opacity noted. The aorta is tortuous. Mediastinal contour and hila are unremarkable. Limited assessment of the upper abdomen is within normal limits. Metallic anchors at the right humeral head are consistent with prior rotator cuff repair.

IMPRESSION: 1. Interval increase in moderate pulmonary edema with mild cardiomegaly and small bilateral pleural effusions. 2. Heterogeneous right lower lobe opacity is most consistent with asymmetric pulmonary edema however differential includes pneumonia in the appropriate clinical setting.


SubjectID: 16574411, StudyID: 50930503, Comparison: same

FINAL REPORT

INDICATION: Evaluate for interval change in a patient with a CHF exacerbation.

COMPARISON: Chest radiographs from ___, ___, ___, ___.

FINDINGS: A portable semi-erect frontal chest radiograph was obtained. The patient is rotated, limiting evaluation of the cardiomediastinal silhouette. Mild to moderate pulmonary edema and small bilateral pleural effusions are likely unchanged, perhaps slightly worse on the left   Keywords: unchanged. No definite new focal consolidation is identified, although the right lower lobe opacity previously noted would be obscured by the patient's current positioning. The visualized upper abdomen is remarkable for a stent projecting over the right upper quadrant, unchanged compared to prior exam.

IMPRESSION: 1. Persistent mild pulmonary edema and bilateral small pleural effusions are similar to slightly increased on the left   Keywords: similar, persistent. 2. No definite new focal consolidation, although patient rotation makes evaluation, including of the previously noted right lower lobe opacity, difficult.


SubjectID: 16574411, StudyID: 56089040, Comparison: None

WET READ: ___ ___ ___ 9:31 AM Slightly worsening aeration with increased and now moderate bilateral pleural effusions and adjacent atelectasis.

WET READ VERSION #1 ___ ___ ___ 6:49 PM Slightly worsening aeration with increased and now moderate bilateral pleural effusions and adjacent atelectasis. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ F w/ dementia, chronic hypoxemia (2L home O2) possibly due to slowly progressive lung mets from pancreatic Ca and CKD who presented from SNF now with worsening hypoxia and tachypnea // ? evidence of heart failure ?evidence of pneumonia

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Moderate to large bilateral effusions have increased from prior study with increasing adjacent atelectasis. Cardiomegaly cannot be evaluated. Widening mediastinum is unchanged. Surgical clips in the a right shoulder are again noted.


SubjectID: 16574411, StudyID: 55886329, Comparison: 1.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with new o2 req // interval change

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Mild vascular congestion has improved   Keywords: improve. Bilateral pleural effusions, adjacent atelectasis are grossly unchanged. Cardiomegaly and widened mediastinum are stable. Right perihilar opacities have minimally in improved   Keywords: improve. No other interval change from prior study   Keywords: no other interval change.


SubjectID: 16574411, StudyID: 55591279, Comparison: worse

WET READ: ___ ___ ___ 9:14 AM Persistent moderate bilateral pleural effusions and multifocal bilateral atelectasis.

WET READ VERSION #1 ___ ___ ___ 6:49 PM Persistent moderate bilateral pleural effusions and multifocal bilateral atelectasis. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with lung mets, now worsened hypoxemia and tachypnea, portable film poor quality // aspiration, pneumonia, post-obstructive pna pulm edema?

TECHNIQUE: Single frontal view of the chest

COMPARISON: Study performed 1 hour earlier

IMPRESSION: Moderate bilateral pleural effusions with adjacent atelectasis and right perihilar opacities are stable. Known small lung nodules are better seen in prior CT from ___. Mild vascular congestion is increased   Keywords: increase. There is no pneumothorax. Cardiomegaly and widened mediastinum are stable


SubjectID: 16574411, StudyID: 50966694, Comparison: None

FINAL REPORT

INDICATION: Evaluate for infiltrate in a patient with worsening shortness of breath and increased oxygen requirement.

COMPARISON: Chest radiographs from ___, ___, ___, ___.

FINDINGS: A portable semi supine frontal chest radiograph again demonstrates a cardiomegaly, unchanged. There is mildly improved aeration of the bilateral lung, with persistent bilateral small pleural effusions and associated atelectasis. There is no new focal consolidation or pneumothorax.

IMPRESSION: Mildly improved aeration with persistent small pleural effusions and associated atelectasis bilaterally. No new focal consolidation.


SubjectID: 16585037, StudyID: 53692296, Comparison: None

FINAL REPORT

HISTORY: Shortness of breath.

TECHNIQUE: Upright AP view of the chest.

COMPARISON: ___.

FINDINGS: The patient is status post median sternotomy and CABG. Mild cardiomegaly is unchanged. The right PICC has been removed. The mediastinal and hilar contours are unchanged. There is mild interstitial pulmonary edema. No focal consolidation, pleural effusion or pneumothorax is present. No acute osseous abnormalities are detected.

IMPRESSION: Mild interstitial pulmonary edema.


SubjectID: 16585037, StudyID: 50121589, Comparison: better

WET READ: ___ ___ 11:53 PM Interval decrease in mild edema. ___ d/w ___ ___

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

HISTORY: Critical aortic stenosis and CHF presents with worsening shortness of breath. Evaluate for edema, infection, interval change.

TECHNIQUE: Portable AP radiograph of the chest.

COMPARISON: Multiple prior radiographs of the chest most recent ___.

FINDINGS: The median sternotomy wires are well aligned. The lungs are well expanded. Mild pulmonary edema is somewhat improved   Keywords: improve. A new right pleural effusion is small. The cardiomediastinal silhouette is unchanged with mild cardiomegaly. There is no pneumothorax.

IMPRESSION: 1. Mild pulmonary edema is partially improved   Keywords: improve. 2. A new right pleural effusion is small. 3. There are no new focal opacities concerning for pneumonia.


SubjectID: 16600921, StudyID: 57095196, Comparison: None

FINAL REPORT

HISTORY: Liver transplant.

FINDINGS: In comparison with study of ___, there is a large-bore central catheter that extends to the right atrium. Cardiac silhouette remains somewhat enlarged and there is mild elevation of pulmonary venous pressure. No evidence of acute focal pneumonia.


SubjectID: 16600921, StudyID: 55463869, Comparison: worse

WET READ: ___ ___ ___ 1:02 AM Moderate interstitial pulmonary edema. Cardiomegally. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: STEMI, chest pain.

COMPARISON: ___, 8:00 a.m.

FINDINGS: As compared to the previous radiograph, there is a minimal increase in interstitial markings, suggesting mild interstitial pulmonary edema   Keywords: increase. Unchanged areas of plate-like atelectasis at the right lung bases. Unchanged moderate cardiomegaly. No pleural effusions. No pneumonia.


SubjectID: 16600921, StudyID: 52897000, Comparison: 0.0

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluation for interval change.

COMPARISON: ___, 6:06 p.m.

FINDINGS: As compared to the previous radiograph, there is mild improvement of the pre-existing evidence of pulmonary edema   Keywords: improve. However, signs of edema are still clearly present   Keywords: still. The severity of edema is mild to moderate. Unchanged moderate cardiomegaly with tortuosity of the thoracic aorta. Mild retrocardiac atelectasis, no pleural effusions.


SubjectID: 16600921, StudyID: 56839301, Comparison: None

FINAL REPORT

PORTABLE CHEST FILM ___ AT 831 CLINICAL

INDICATION: ___-year-old with question pneumonia, assess for interval change. Comparison is made to the patient's prior study of ___ at 731. A portable erect chest film dated ___ at 831 is submitted.

IMPRESSION: The left internal jugular central line is unchanged in position. There is a patchy opacity in the right mid-to-lower lung which has worsened suggesting worsening atelectasis, although an evolving infectious process and asymmetric pulmonary edema would also be in the differential. Heart remains enlarged. Mediastinal contours are likely stable given patient's rotation. Possible layering small right effusion. No pneumothorax.


SubjectID: 16600921, StudyID: 50354342, Comparison: worse

WET READ: ___ ___ ___ 10:27 PM Orogastric tube with tip below the diaphragm, however the tip is not included on this examination. Lung volumes have decreased. There is worsening of right basilar opacity, which may reflect atelectasis, however an underlying infectious process cannot be excluded. There is interval worsening of pulmonary vascular congestion. No pneumothorax. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Cirrhosis, nasogastric tube placement.

FINDINGS: As compared to the previous radiograph, there is an increase in severity of the pre-existing pulmonary edema   Keywords: increase. Moderate cardiomegaly persists. There also is increasing evidence of atelectasis at the lung bases. The lung volumes remain low. In the interval, the patient has received a nasogastric tube. The tip of the tube is not included on the image. The sidehole projects 8 cm below the gastroesophageal junction. A left hemodialysis catheter remains in unchanged position. No pneumothorax.


SubjectID: 16600921, StudyID: 51703147, Comparison: same

FINAL REPORT

PORTABLE CHEST OF ___

COMPARISON: Radiograph one day earlier.

FINDINGS: Interval repositioning of left internal jugular vascular catheter, now terminating in the upper superior vena cava. Stable cardiomegaly with mild pulmonary vascular congestion and resolution of interstitial edema   Keywords: stable. Linear atelectasis in right mid and left lower lung regions.


SubjectID: 16634427, StudyID: 59562287, Comparison: None

FINAL REPORT

INDICATION: ___F with chest pain s/p MVC, hx of heart transplant ___ years ago. Aware she had one done this AM, need another as it was prior to the MVC, evaluate for acute process.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest x-ray ___.

FINDINGS: Multiple median sternotomy wires are again identified. The cardiomediastinal contours are within normal limits. The bilateral hila are unremarkable. The lungs are clear without focal consolidation. There is no evidence of pulmonary vascular congestion. There is no pneumothorax or pleural effusion.

IMPRESSION: No acute cardiopulmonary process. No displaced rib fracture.


SubjectID: 16634427, StudyID: 54968754, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with non-ischemic cardiomyopathy s/p transplant with chronic cough // evaluate for pneumonia evaluate for pneumonia

IMPRESSION: Compared to prior chest radiographs since ___ most recently ___. Patient has had median sternotomy. Heart size normal unchanged. No pulmonary vascular abnormality. Lungs well expanded and clear. No edema or pleural effusion. Sternal wires are intact and aligned.


SubjectID: 16634427, StudyID: 55167165, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, Swan-Ganz placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the Swan-Ganz catheter has been minimally advanced, it is now in the right pulmonary artery, the line should be pulled back by approximately 1-2 cm to avoid a too peripheral catheter position. Moderate cardiomegaly, retrocardiac atelectasis. Right basal atelectasis, no pneumothorax, no overt pulmonary edema.


SubjectID: 16634427, StudyID: 54376277, Comparison: better

FINAL REPORT

HISTORY: Hdiopathic cardiomyopathy, heart failure. Awaiting heart transplantation

TECHNIQUE: Chest x-ray in AP projection.

COMPARISON: Exam is compared to ___ 8:00. am

FINDINGS: The tip of the Swan-Ganz catheter has been pulled back of 1 cm, with tip in the main pulmonary artery. The perihilar vascular drawing has improved with reduction of vascular congestion   Keywords: improve. The other chest findings are unchanged

IMPRESSION: Swan catheter pulled back of 1 cm, now with tip in the main pulmonary artery The vascular congestion has improved   Keywords: improve.


SubjectID: 16634427, StudyID: 52068255, Comparison: None

FINAL REPORT

HISTORY: ___-year-old woman with history of idiopathic cardiomyopathy and class IV heart failure, ejection fraction is ___%, currently listed for heart transplant at outside hospital. Presents status post RHC Swan placement.

TECHNIQUE: Portable semi-erect frontal chest radiographs obtained.

COMPARISON: Chest radiograph from ___.

FINDINGS: Cardiac device is seen with single lead in appropriate position. Right IJ Swan-Ganz catheter is in appropriate position and unchanged. Mild cardiomegaly is seen with minimal vascular congestion. No focal consolidation, pleural effusion or pneumothorax is seen.

IMPRESSION: Swan-ganz catheter in appropriate position.


SubjectID: 16634427, StudyID: 50650290, Comparison: same

FINAL REPORT

TYPE OF

EXAMINATION: Chest AP portable single view.

INDICATION: ___-year-old female patient with idiopathic cardiomyopathy and right heart failure for transplant evaluation, now post right heart catheterization.

FINDINGS: AP single view of the chest has been obtained with patient in semi-upright position. Comparison is made with the next preceding PA and lateral chest examination of ___. Moderate enlargement of the cardiac silhouette is again noted. No typical configurational abnormality is present, and the enlargement appears to take care equally in both ventricles and atria. No evidence of increased pulmonary congestion as patient presents in semi-upright position   Keywords: increase. No evidence of pleural effusion in the lateral pleural sinuses and no pneumothorax in the apical area. Previously described permanent pacer in left anterior axillary position connected to an ICD line continues to terminate in the apical portion of the right ventricle. A new right internal jugular approach sheath has been used to advance a Swan-Ganz catheter which is seen to pass through the dilated right atrium into the enlarged right ventricle and approaches in the central portion of the right lower pulmonary artery. There is no significant interval change with regard to heart size and pulmonary vascular appearance in comparison with the previous PA and lateral chest examination of ___. A chest CT of ___ ruled out pulmonary embolism. The findings of moderately enlarged cardiac chambers are noted, but functional aspect of the cardiomyopathy in this case would benefit from a dynamic cardiac analysis which has not been performed.


SubjectID: 16634427, StudyID: 54065474, Comparison: better

FINAL REPORT

INDICATION: ___-year-old female with ICD placement. Evaluation for position of lead.

COMPARISON: Comparison is made to radiographs of the chest dating back to ___.

FINDINGS: Single erect portable view of the chest demonstrates interval placement of an ICD with single lead terminating in the right ventricle. There is no evidence of pneumothorax or pleural effusion. Since the prior study, there has been interval resolution of pulmonary edema and interval decrease in cardiomegaly   Keywords: decrease. This study appears similar to the patient's estimated baseline study of ___.

IMPRESSION: ICD placement with single lead terminating in the right ventricle. No evidence of pneumothorax.


SubjectID: 16634427, StudyID: 52823974, Comparison: better

FINAL REPORT

TYPE OF

EXAMINATION: Chest PA and lateral.

INDICATION: ___-year-old female patient with dilated cardiomyopathy, status post ICD yesterday. Check lead placement and rule out pneumothorax.

FINDINGS: PA and lateral chest views were obtained with patient in upright position. Significant cardiac enlargement, but the absence of any typical configuration abnormality is compatible with the clinical diagnosis of dilated cardiomyopathy. A permanent pacer is seen in left anterior axillary position connected to a single intracavitary electrode (ICD) seen to terminate in the apical portion of the right ventricle. Inconspicuous appearance of thoracic aorta. Pulmonary vasculature is not congested and there are no signs of acute infiltrates or pleural effusions. No pneumothorax is seen in the apical area. In comparison with the next preceding portable chest examination of ___, findings are completely unchanged. In comparison with a more remote chest examination of ___, the at that time existing more marked cardiomegaly has regressed and the pulmonary vascular congestion has resolved   Keywords: resolve.

IMPRESSION: Unremarkable position of newly placed ICD device.


SubjectID: 16639614, StudyID: 59863894, Comparison: same

FINAL REPORT

PA AND LATERAL CHEST RADIOGRAPH, ___.

COMPARISON: Chest radiographs dating between ___ and ___.

FINDINGS: The heart is normal in size but demonstrates left ventricular configuration. The aorta is tortuous and calcified, without change   Keywords: without change. Recently described left lower lobe abnormality has rapidly improved with small residual opacity remaining. Additional right retrocardiac opacity has slightly improved as well. Bilateral pleural effusions are small and similar to the recent radiograph. Bones are diffusely demineralized.

IMPRESSION: 1. Rapidly improving basilar opacities favor atelectasis or aspiration over infectious pneumonia. 2. Small bilateral pleural effusions.


SubjectID: 16639614, StudyID: 52634021, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female with fatigue and cough status post recent hospitalization.

TECHNIQUE: Frontal and lateral chest radiographs were obtained.

COMPARISON: ___.

FINDINGS: Small bilateral pleural effusions persist. A new left lower lobe consolidation is best seen on lateral view. No pneumothorax is detected. Cardiomegaly and aortic tortuosity persists. The patient is status post CABG with mediastinal clips and median sternotomy wires. The lungs are mildly hyperinflated.

IMPRESSION: New left lower lobe consolidation. Findings were reported to ___ by ___ by telephone at 8:03 a.m. on ___ at the time of discovery of these findings after attending radiologist review.


SubjectID: 16644826, StudyID: 58628788, Comparison: better

FINAL REPORT

HISTORY: Patient with shortness of breath, eval for pulmonary edema or effusion.

COMPARISON: ___.

FINDINGS: Portable single frontal chest radiograph was obtained. A left PICC line terminates in the mid SVC. There is evidence of a prior right mastectomy and axillary node dissection. The previous opacity at the right lung base has markedly improved, although a moderate right-sided pleural effusion remains. Left basilar atelectasis is unchanged with a possible small left pleural effusion. Previous moderate pulmonary edema has improved as well   Keywords: improve. The heart remains moderately enlarged. Mediastinal and hilar contours are unchanged with persistent prominence of the right mediastinum, consistent with known lymphadenopathy. There is no pneumothorax.

IMPRESSION: 1. Interval improvement in pulmonary edema   Keywords: improve. Moderate cardiomegaly. 2. Moderate right pleural effusion with possible small left pleural effusion and bibasilar atelectasis. 3. Stable right mediastinal widening consistent with known lymphadenopathy.


SubjectID: 16644826, StudyID: 56356557, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: History of lung cancer and breast cancer, COPD, chronic heart failure, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is a decrease in lung volume and a newly appeared parenchymal opacity at the right lung base that could reflect pneumonia. In addition, there is increased retrocardiac atelectasis and moderate fluid overload that has newly appeared   Keywords: increase, new. Moderate cardiomegaly. No pneumothorax. The presence of a small right pleural effusion cannot be excluded. At the time of observation and dictation, 8:24 a.m., the ___, the referring physician ___. ___ was paged for notification.


SubjectID: 16644826, StudyID: 58533386, Comparison: same

FINAL REPORT

HISTORY: Lymphadenopathy after biopsy, to assess for pneumothorax.

FINDINGS: In comparison with study of ___, following biopsy, there is no definite pneumothorax. There is some possible additional prominence of the mediastinum on the right, which could reflect some post-procedure bleeding. Dense streak of atelectasis is seen at the right base with a smaller streak at the left base. Otherwise, little overall change   Keywords: little overall change.


SubjectID: 16644826, StudyID: 58465056, Comparison: None

FINAL REPORT

HISTORY: Status post right supraclavicular lymph node biopsy, eval interval progression.

COMPARISON: ___.

FINDINGS: Frontal and lateral chest radiographs were obtained. There is a minimal interval increase in the right pleural effusion. There is stable streaky atelectasis at bilateral lung bases. No focal consolidation, pneumothorax, or pulmonary edema is seen. The heart is mildly enlarged. There is some persistent prominence of the right mediastinum, but unchanged from prior study.

IMPRESSION: Minimal increase in right pleural effusion, otherwise unchanged appearance of heart and lungs.


SubjectID: 16644826, StudyID: 56400044, Comparison: None

FINAL REPORT

HISTORY: Acute short of breath, question edema. CHEST, SINGLE AP PORTABLE VIEW.

COMPARISON: ___. There is hyperinflation, suggesting background COPD. There is moderately severe cardiomegaly, with prominence of the right mediastinal soft tissues. There is a small left effusion with underlying collapse and/or consolidation and a small right effusion. There is upper zone redistribution, without other evidence of CHF. The patient is apparently status post right mastectomy, with right axillary clips.

IMPRESSION: 1. COPD and stable cardiomegaly. 2. New small left effusion with underlying collapse and/or consolidation. Possibility of a pneumonic infiltrate cannot be excluded. 3. Upper zone redistribution, without other evidence of CHF. Mild diffuse prominence of the interstitial markings is noted, while this could relate to mild interstitial edema, it is less pronounced than on the earlier film and may represent background parenchymal scarring. 4. Subsegmental atelectasis at the left base and small right effusion similar to prior. 5. Prominence of the right paratracheal soft tissues apparently reflects mediastinal lymphadenopathy. This is also reflected in loss of the right supraclavicular companion shadow. This is better depicted on a chest CT from ___. The pulmonary nodules seen on the CT are not readily apparent radiographically, though may be related to opacity seen at the right base laterally. 6. Status post right mastectomy with right axillary clips.


SubjectID: 16648621, StudyID: 59162958, Comparison: None

FINAL REPORT

EXAM: Chest, AP upright and lateral views. CLINICAL INFORMATION: Shortness of breath.

COMPARISON: ___.

FINDINGS: Frontal and lateral views of the chest were obtained. The patient is status post median sternotomy. There is continued elevation of the right hemidiaphragm, increased since the prior study and was likely a subpulmonic effusion. Underlying infectious process is not excluded. There is prominence of the pulmonary vasculature bilaterally concerning for fluid overload. Asymmetric right pulmonary opacity could represent asymmetric edema and pleural effusion however, early infectious process is not excluded. The lateral view is suboptimal due to patient motion and overlying soft tissue. Degenerative change is seen in the right shoulder joint and the right acromioclavicular joint.

IMPRESSION: Low lung volumes. Right basilar opacity with perceived elevated right hemidiaphragm is likely due to a subpulmonic pleural effusion. Additional right base opacity is concerning for a possible superimposed infectious process. However, prominence of the bilateral pulmonary vasculature is concerning for fluid overload. Cardiac silhouette remains enlarged. The aortic knob is calcified.


SubjectID: 16648621, StudyID: 51763557, Comparison: None

FINAL REPORT

HISTORY: Renal failure with altered mental status.

FINDINGS: In comparison with study of ___, the patient has taken a much better inspiration. There is generalized haziness of the right hemithorax, consistent with substantial pleural effusion. Less prominent effusion is seen on the left. Bibasilar atelectasis is seen with substantial volume loss in the left lower lobe. Engorgement of pulmonary vessels is consistent with pulmonary vascular congestion in a patient with enlargement of the cardiac silhouette and intact midline sternal wires. In the appropriate clinical setting, superimposed pneumonia can certainly not be excluded.


SubjectID: 16648621, StudyID: 52708284, Comparison: None

FINAL REPORT

INDICATION: Bed-bound patient with worsening wheezing and wet-sounding lungs. Evaluate for interval change in pulmonary edema versus infectious process.

COMPARISON: Chest radiographs from ___ and ___. CT torso from ___.

FINDINGS: The patient is status post midline sternotomy and CABG. There is pulmonary vascular congestion, without frank interstitial pulmonary edema. Heterogeneous right lower lung opacities are likely compressive atelectasis, although infection is not excluded. Minimal left retrocardiac atelectasis is slightly decreased. A moderate layering right pleural effusion is thought likely, slightly decreased in size. There is no pneumothorax. Moderate cardiomegaly is not significantly changed. Bulging of the hilar contours was seen to be marked lymphadenopathy on CT from ___. There is no change in the hilar contours to suggest that the degree of lymphadenopathy has increased.

IMPRESSION: 1. Probable moderate right pleural effusion, slightly smaller than on ___. 2. Unchanged right lower lung heterogeneous opacities, possibly atelectasis versus infection. Further evaluation with a lateral radiograph is recommended. 3. Pulmonary vascular congestion. Findings were discussed with Dr. ___ by Dr. ___ at 11:51 p.m. via telephone on the day of the study.


SubjectID: 16672854, StudyID: 59015305, Comparison: better

FINAL REPORT

AP CHEST, 5:27 A.M. ___

HISTORY: ___-year-old man with cholangitis and pancreatitis, now has increased oxygen requirement after ERCP.

IMPRESSION: AP chest compared to ___ through ___: Moderately severe pulmonary edema on ___ has improved   Keywords: improve. The asymmetric pulmonary opacification with more consolidation at the right lung base could be asymmetric edema, but could also be due to right lower lobe pneumonia. Mild cardiomegaly stable. Pleural effusions are small if any. No pneumothorax.


SubjectID: 16672854, StudyID: 50841626, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH:

TECHNIQUE: Single AP semi-upright chest view was read in comparison with prior chest radiograph from ___.

FINDINGS: Bilateral lung volumes are low. Since ___, mild pulmonary vascular congestion and pulmonary edema has worsened   Keywords: worse. Small bilateral pleural effusions are unchanged. Mildly enlarged heart size and some mediastinal widening is worse than before. Status post median sternotomy with intact sternal sutures.

IMPRESSION: Mild pulmonary edema, mild pulmonary edema and mild-to-moderate cardiomegaly with some mediastinal widening is worsened since ___.


SubjectID: 16674342, StudyID: 57819073, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with right heart failure, PA cath // line placement, interval changes line placement, interval changes

IMPRESSION: In comparison with the study of ___, the endotracheal tube has been removed. The right IJ Swan-Ganz catheter tip is unchanged in the right pulmonary artery. Little change in the appearance of the heart and lungs.


SubjectID: 16674342, StudyID: 55054997, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with central line // ___ year old man with central line ___ year old man with central line

IMPRESSION: In comparison with the study of ___, the right IJ Swan-Ganz catheter has been removed. No new central line is appreciated. Otherwise, little overall change except for a a streak of atelectasis running obliquely in the right mid zone.


SubjectID: 16674342, StudyID: 51020952, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with right heart failure, CVL // line placement, interval changes line placement, interval changes

IMPRESSION: In comparison with the study of ___, there is little change in the appearance of the heart and lungs and the right IJ Swan-Ganz catheter. Atelectatic changes are seen at the left base, though there is no definite pulmonary edema.


SubjectID: 16674342, StudyID: 57448225, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___M with confusion, recent endocarditis

TECHNIQUE: Chest PA and lateral

COMPARISON: ___ chest radiograph, chest CT ___

FINDINGS: Left PICC tip terminates within the proximal right atrium. The patient is status post median sternotomy and mitral valve replacement. Heart size remains moderately enlarged with left atrial and left ventricular calcifications again noted. Mild pulmonary vascular congestion with cephalization is similar compared to the prior study   Keywords: similar. Small bilateral pleural effusions are not substantially changed in the interval. Patchy opacity within the left lung base may reflect atelectasis. No pneumothorax is present.

IMPRESSION: Mild pulmonary vascular congestion, small bilateral pleural effusions, and mild left basilar atelectasis.


SubjectID: 16674342, StudyID: 55030733, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with dyspnea // eval for pulmonary edema

IMPRESSION: As compared to ___ radiograph, marked cardiomegaly is now accompanied by pulmonary vascular congestion and mild to moderate edema. Small left pleural effusion has increased in size and there is also an apparent small left pleural effusion.


SubjectID: 16674342, StudyID: 54365142, Comparison: same

FINAL REPORT

INDICATION: Status post intubation. Evaluate endotracheal tube.

TECHNIQUE: Single semi-upright AP view of the chest.

COMPARISON: Chest radiographs from ___ and ___.

FINDINGS: Since the prior exam, an endotracheal tube has been placed. It is approximately 6 cm from the carina, and could be advanced 1-2 cm for optimal placement. Otherwise, there is little change since the prior exam, including mild to moderate pulmonary edema, marked cardiomegaly, and small bilateral pleural effusions   Keywords: little change.

IMPRESSION: Endotracheal tube 6 cm from the carina. This could be advanced 1-2 cm for optimal placement. Otherwise no change   Keywords: no change.


SubjectID: 16674342, StudyID: 50517743, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF, increasingly SOB // pulmonary edema?

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: ET tube tip 5 cm above the carinal. The patient is after replacement of the mitral valve. Cardiac silhouette including substantial prominence of the main pulmonary artery is unchanged. Mild pulmonary edema is present. Small bilateral pleural effusions are noted. No pneumothorax is seen.


SubjectID: 16674342, StudyID: 54965752, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with OGT and recent intubation // placement

COMPARISON: Chest radiograph ___

FINDINGS: AP view of the chest provided. Interval placement of orogastric tube courses below the level of the diaphragm and appears appropriately positioned. ET tube ends 6.0 cm above the Carina. Patient is status post mitral valve replacement. Cardiac silhouette with prominence of the right atrium, left atrium and main pulmonary artery is unchanged from the examination 5 hours prior. Mild pulmonary edema is unchanged from the examination 5 hours prior   Keywords: unchanged. Small, bilateral pleural effusions are unchanged from the examination 5 hours prior.

IMPRESSION: 1. OG tube courses below the level of the diaphragm and ends in the proximal stomach. 2. ET tube ends 6.0 cm above the Carina. Advancement 2.0 cm is recommended for more standard positioning.


SubjectID: 16680020, StudyID: 53572255, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old man status post CABG. Evaluate for pneumothoraces.

FINDINGS: Comparison is made to previous study from ___. The chest tubes have been removed. There are no pneumothoraces. There is a right-sided IJ catheter with distal lead tip in the mid SVC. The heart size is enlarged but stable. There is a developing left retrocardiac opacity. This is likely due to some atelectasis. No overt pulmonary edema is seen.


SubjectID: 16681170, StudyID: 59614937, Comparison: 0.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with diastolic HF and acute respiratory distress. // Concern for flash pulm edema/ volume overload

COMPARISON: Chest radiograph ___

FINDINGS: Single AP view of the chest provided. The lungs are well-inflated. Prominent interstitial lung markings are unchanged from the prior. Increased generalize radiodensity, likely represents moderate pulmonary edema   Keywords: increase. . There is no pleural effusion, or pneumothorax. The hilar and cardiomediastinal contours are normal.

IMPRESSION: 1. Increased generalized radiodensity is unchanged from the prior on the same date, likely representing moderate pulmonary edema   Keywords: same. 2. C hronic, fibrosing, interstitial lung disease. 3. Mild cardiomegaly is mildly improved from prior exam on the same date, likely representing mild interval diuresis. 4. Mitral annular calcifications unchanged from prior exam on the same date.


SubjectID: 16681170, StudyID: 59177328, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with dHF, increased O2 requirement // r/o pulm edema or volume overload

COMPARISON: Chest radiograph ___.

FINDINGS: Single AP view of the chest provided. The lungs are well-inflated. Prominent interstitial lung markings are unchanged. Generalized increase in radiodensity is worsened from ___. There is no pleural effusion, or pneumothorax. The hilar contours are normal. Mitral annulus calcifications are unchanged. Mild cardiomegaly is mildly worsened.

IMPRESSION: Limited study, the inferior aspect of the thorax is in the imaged. 1. Generalized increase in radiodensity is moderately worsened from ___, likely representing new moderate pulmonary edema   Keywords: worse, new. 2. Prominent interstitial lung markings are unchanged from ___, likely representing chronic interstitial lung disease. 3. Mild cardiomegaly is mildly worsened in comparison to radiographs from multiple years ago. 4. Mitral annulus calcifications are unchanged from ___.


SubjectID: 16681170, StudyID: 53124218, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F AFlutter, DMII, apical hypertrophic CM with chronic dCHF, asymptomatic hypotension found to have an NSTEMI with increasing O2 requirements. // infiltrates, pulmonary edema

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Mild cardiomegaly is stable. Mild to moderate pulmonary edema has improved   Keywords: improve. There is no pneumothorax or pleural effusion. Patient has known interstitial lung disease


SubjectID: 16681170, StudyID: 55686509, Comparison: None

FINAL REPORT

INDICATION: ___F with hypotension

TECHNIQUE: Chest PA and lateral

COMPARISON: CT dated ___ as well as chest radiograph dated ___

FINDINGS: PA and lateral chest radiograph demonstrates diffuse interstitial markings bilaterally in keeping with chronic interstitial lung disease. There is no pleural effusion or pneumothorax. Cardiomediastinal and hilar contours are stable in appearance. No acute osseous abnormality it detected.

IMPRESSION: Chronic interstitial lung disease without definite evidence of an acute intrathoracic abnormality.


SubjectID: 16681170, StudyID: 50461458, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPH

INDICATION: Atrial flutter and shortness of breath.

COMPARISON: ___.

TECHNIQUE: Chest, portable AP upright.

FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged. There is no pleural effusion or pneumothorax. A moderate interstitial abnormality appears to have mildly worsened and suggests pulmonary edema that is superimposed on background interstitial lung disease   Keywords: worse.

IMPRESSION: Moderate interstitial abnormality suggesting pulmonary edema in addition to background interstitial disease.


SubjectID: 16712364, StudyID: 58840308, Comparison: worse

FINAL REPORT

HISTORY: Shortness of breath.

COMPARISON: None.

FINDINGS: AP upright portable chest radiograph was obtained. Increased interstitial markings with fullness of the pulmonary vasculature and mild to moderate cardiomegaly is compatible with moderate to severe pulmonary edema   Keywords: increase. There is no pleural effusion or pneumothorax. Mediastinal and hilar contours are unremarkable.

IMPRESSION: Moderate to severe pulmonary edema.


SubjectID: 16712364, StudyID: 52667603, Comparison: better

FINAL REPORT

INDICATION: Congestive heart failure, presenting with shortness of breath. Evaluate for interval change.

COMPARISON: Multiple prior chest radiographs dating back through ___, including the most recent study from ___. Chest CT from ___.

FINDINGS: Mild interstitial pulmonary edema has substantially improved compared to the prior chest radiograph from ___   Keywords: improve. Mild-to-moderate cardiomegaly is slightly decreased. There may be a small right pleural effusion, not significantly changed. There is no pneumothorax. The mediastinal contours are normal.

IMPRESSION: 1. Substantially improved mild interstitial pulmonary edema   Keywords: improve. Slightly decreased mild-to-moderate cardiomegaly. 2. Possible small right pleural effusion, not significantly changed.


SubjectID: 16712364, StudyID: 58095706, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: COPD and chronic heart failure, questionable pneumonia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has developed interval moderate pulmonary edema   Keywords: develop. The presence of small pleural effusions cannot be excluded. Moderate cardiomegaly. An additional parenchymal opacity, potentially suggestive of pneumonia, is not identified.


SubjectID: 16712364, StudyID: 54741606, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: COPD, leukopenia, questionable infection.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the size of the cardiac silhouette has increased. There is a general bilateral increase of interstitial markings and the lateral radiograph shows subtle fluid markings of the interstitium   Keywords: increase. There are no air bronchograms or pleural effusions. The hilar structures are borderline in diameter. Overall, the image is suggestive of mild-to-moderate interstitial pulmonary edema. No additional areas of consolidation, evocative of pneumonia, are visible on the radiograph. No pneumothorax.


SubjectID: 16712364, StudyID: 57503647, Comparison: None

WET READ: ___ ___ ___ 10:45 PM Interval improvement of pulmonary edema since one day ago. Persistent bilateral effusions and atx. - ___ x _________________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Pulmonary edema, evaluation for disease improvement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is a marked improvement. The pre-existing pulmonary edema has almost completely cleared. There are minimal remnant signs of edema at the lung bases. The size of the cardiac silhouette is normal. The presence of a minimal left pleural effusion cannot be excluded. No pneumothorax. Status post extubation, the nasogastric tube has been removed.


SubjectID: 16712364, StudyID: 54380294, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: ___. CLINICAL

HISTORY: Schizophrenia, COPD, diabetes, hypertension, presents with hypoxia, being treated for pneumonia and COPD, UTI, question new cause of hypoxia.

FINDINGS: AP semi-upright portable chest radiograph was obtained. The patient has been intubated with the tip of the ET tube located at least 2.7 cm above the carina. Nasogastric tube is also seen with its tip in the left upper abdomen. Since the prior exam, there has been interval development of diffuse bilateral pulmonary opacities, predominantly ground-glass and nodular, most likely indicative of pulmonary edema   Keywords: development. In addition, there are likely small bilateral effusions, hilar engorgement is also noted. Overall, cardiomediastinal silhouette appears grossly stable. Bony structures intact.

IMPRESSION: Interval intubation and NG tube placement with appropriate position of tube. Interval development of pulmonary edema with probable small bilateral effusions   Keywords: development.


SubjectID: 16712364, StudyID: 50465503, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: A study performed approximately 15 minutes earlier. CLINICAL

HISTORY: Respiratory distress, ET tube re-positioned. Assess position of ET tube.

FINDINGS: Portable semi-upright AP view of the chest was provided. The endotracheal tube tip resides 4.7 cm above the carina. Tip of the NG tube is visualized in the left upper abdomen. There is diffuse pulmonary edema with probable small bilateral pleural effusions and hilar engorgement. No pneumothorax.


SubjectID: 16712364, StudyID: 56533179, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with a PMHx of schizophrenia, COPD on home O2 (___L), dCHF, T2DM, and HTN with suspected benzodiazepine withdrawal. // Please evaluate for interval change in pulmonary edema

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The monitoring and support devices continue to be in correct position. Moderate cardiomegaly and extensive bilateral parenchymal opacities, predominantly caused by pulmonary edema. Fluid marking of the minor fissure on the right suggests presence of an interstitial component. No pneumothorax. No new focal parenchymal opacities   Keywords: new.


SubjectID: 16712364, StudyID: 51386929, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with severe COPD, intubated for serotonin syndrome, now desaturating. // ?infiltrate /atelectasis /

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The lung volumes have decreased. There is unchanged evidence of moderate to severe predominantly interstitial pulmonary edema. Unchanged moderate cardiomegaly. A small right pleural effusion has developed. Unchanged bilateral areas of basilar atelectasis. The monitoring and support devices are in constant position. No pneumothorax.


SubjectID: 16712364, StudyID: 50035157, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with tachypnea. // Evaluate for pulmonary edema, effusions?

COMPARISON: ___.

IMPRESSION: As compared to the previous image, the patient was extubated and the nasogastric tube was removed. The left subclavian line remains in situ. Improvement of the ventilation of the lung bases, with, however, persisting cardiomegaly, signs of mild pulmonary edema and a retrocardiac atelectasis   Keywords: persisting. The presence of a small pleural effusion on the left cannot be excluded.


SubjectID: 16712364, StudyID: 56042819, Comparison: worse

WET READ: ___ ___ 12:31 PM Mild cardiomegaly and mild pulmonary edema. An underlying pneumonia is difficult to exclude at this time and follow up imaging is recommended after resolution of pulmonary edema.

WET READ VERSION #___ ___ ___ 11:41 AM Mild cardiomegaly and mild pulmonary edema. An underlying pneumonia is difficult to exclude at this time and follow up imaging is recommended after resolution of pulmonary ______________________________________________________________________________

FINAL REPORT

INDICATION: History: ___F with shortness of breath, hypoxia

TECHNIQUE: Portable semi-upright AP chest

COMPARISON: Chest radiographs ___ through ___

FINDINGS: Lung volumes are low. There are increasing interstitial and perihilar opacities suggesting mild pulmonary edema   Keywords: increasing. Opacities at the left base likely reflect atelectasis. The heart is mildly enlarged and the pulmonary artery appears enlarged. There is no large pleural effusion or pneumothorax.

IMPRESSION: Mild cardiomegaly and mild pulmonary edema.


SubjectID: 16712364, StudyID: 55908317, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with h/o COPD, CHF, ?cough acute hypoxic respiratory failure on BiPAP // reeval for acute pulm process

TECHNIQUE: Portable AP chest radiograph.

COMPARISON: Chest radiograph obtained earlier on the same date.

FINDINGS: Lung volumes are unchanged compared to the prior study. The trachea is central. The heart remains enlarged. There is persistent enlargement of the bilateral hila and upper lobe pulmonary vasculature, in addition there is perihilar airspace opacity consistent with pulmonary edema. This is slightly more prominent than on the prior study. Left lower lobe atelectasis. No definite pleural effusion seen. No pneumothorax seen.

IMPRESSION: Pulmonary edema slightly progressed when compared to the prior study   Keywords: progressed. Unchanged cardiomegaly. No pleural effusion seen.


SubjectID: 16712364, StudyID: 55615021, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hypoxemic resp failure // e/o acute process

IMPRESSION: As compared to ___ chest radiograph, cardiomegaly pulmonary vascular congestion and interstitial edema are persistent findings   Keywords: persistent. Marked enlargement of main and central pulmonary arteries is suggestive of pulmonary arterial hypertension. Bilateral small pleural effusions are likely unchanged considering differences in lung volumes.


SubjectID: 16712364, StudyID: 55983093, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with COPD/CHF // Pulmonary edema

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the signs indicative of pulmonary edema have minimally decreased in severity   Keywords: decrease. However, there are still present and needs to be further followed. Moderate cardiomegaly persists. No pleural effusions. No pneumonia.


SubjectID: 16712364, StudyID: 52616744, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: Hypoxia, shortness of breath.

TECHNIQUE: Chest PA and lateral

COMPARISON: ___.

FINDINGS: Lung volumes are slightly decreased compared to the prior exam. Moderate enlargement of cardiac silhouette persists. The mediastinal contour is unchanged. Calcifications of the aortic knob are again demonstrated. There is mild interstitial pulmonary edema, slightly worse compared to the prior exam   Keywords: worse. Streaky opacities in the lung bases likely reflect areas of atelectasis. No pleural effusion or pneumothorax is definitively noted. There are no acute osseous abnormalities.

IMPRESSION: Mild interstitial pulmonary edema. Bibasilar atelectasis.


SubjectID: 16712364, StudyID: 55680394, Comparison: None

FINAL REPORT

INDICATION: COPD exacerbation versus pneumonia.

COMPARISON: Comparison is made to chest radiograph performed ___.

FINDINGS: Exam is limited by patient's inability to cooperate and the lateral view is nondiagnostic. Stable prominence of the interstitium likely due to reported history of COPD. No focal opacification concerning for pneumonia identified on the frontal radiograph. No pleural effusion or pneumothorax evident.

IMPRESSION: No definitive acute intrathoracic process. If continued concern, could repeat conventional radiograph with lateral view.


SubjectID: 16712364, StudyID: 50559174, Comparison: None

WET READ: ___ ___ ___ 8:47 PM No definite acute cardiopulmonary process. - ___ ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: History of COPD and dyspnea as well as productive cough.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is now visibility of a triangular zone of increased density located in the right lower lobe. The abnormality is better seen on the frontal than on the lateral image. In the appropriate clinical context, the abnormality could represent a non-recent pneumonia. No evidence of other abnormalities. Normal size of the cardiac silhouette. No pleural effusions, no pneumothorax. At the time of dictation, 8:35 a.m., this observation was made and referring physician, ___. ___, was paged for notification.


SubjectID: 16712364, StudyID: 53607709, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with AMS // infiltrate?

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___ an ___

FINDINGS: Cardiac and mediastinal silhouettes are stable, with the cardiac silhouette enlarged. No large pleural effusion is seen. There is no evidence of pneumothorax. No definite focal consolidation. There is mild to moderate interstitial pulmonary edema. Prominence of the main pulmonary artery suggests component of pulmonary hypertension.

IMPRESSION: Mild to moderate interstitial edema with persistent enlargement of the cardiac silhouette   Keywords: persistent.


SubjectID: 16712364, StudyID: 52555130, Comparison: better

FINAL REPORT

INDICATION: History: ___F with altered mental status // post-intubation film

TECHNIQUE: 1 supine AP view of the chest.

COMPARISON: ___ at 22:08

FINDINGS: Enteric tube passes into the stomach and out of view. ET tube ends 3.9 cm from the carina. Cardiomegaly is stable. There is mild pulmonary edema, slightly decreased from prior study   Keywords: decrease. No pleural effusion or pneumothorax. No focal consolidation. Mediastinal and hilar contours are unchanged.

IMPRESSION: ET tube is in appropriate position. Slight decrease in pulmonary edema compared to prior study   Keywords: decrease.


SubjectID: 16712364, StudyID: 53483216, Comparison: None

FINAL REPORT

INDICATION: History: ___F with mild dyspnea, incr O2 requirement, hx COPD and CHF // Acute CP process

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest x-ray and CT chest from ___.

FINDINGS: There is pulmonary vascular congestion accompanied by mild pulmonary edema. Asymmetrical right basilar opacity may reflect asymmetrical edema and less likely a ease superimposed pneumonia. . Prominence of the hila is again noted and reflects a combination of enlarged pulmonary arteries and lymphadenopathy as seen on prior CT scan. Known mediastinal lymphadenopathy is also seen to better detail on that study. There is no pleural effusion or pneumothorax.

IMPRESSION: 1. Mild pulmonary edema. Followup radiographs after diuresis may be helpful to exclude the possibility of coexisting right lower lobe pneumonia 2. Enlargement of bilateral hila reflecting a combination of enlarged pulmonary arteries and lymphadenopathy.


SubjectID: 16712364, StudyID: 51501502, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with COPD, congestive heart failure, chronic O2 requirement with increased oxygen requirement

TECHNIQUE: Portable upright AP view of the chest

COMPARISON: ___ at 00:26

FINDINGS: Heart size is mildly enlarged. The mediastinal contours are unchanged. There is a enlargement of the hila bilaterally, which again reflects a combination of pulmonary arterial enlargement and lymphadenopathy. Mild pulmonary edema has slightly improved in the interval   Keywords: improve. No focal consolidation, pleural effusion or pneumothorax is present.

IMPRESSION: Minimal improvement in mild pulmonary edema   Keywords: improve. Continued enlargement of the hila bilaterally suggestive of a combination of pulmonary arterial enlargement and lymphadenopathy.


SubjectID: 16715089, StudyID: 58693080, Comparison: -1.0

FINAL REPORT

PORTABLE CHEST X-RAY, ___

COMPARISON: Radiograph, ___ and earlier radiographs of ___.

FINDINGS: Interval extubation and removal of nasogastric tube. Decrease in extent of pulmonary edema, with residual asymmetrical opacities, now predominantly at the lung bases, right greater than left   Keywords: decrease. This likely reflects asymmetrical edema, but continued followup is suggested to exclude the possibility of basilar pneumonia   Keywords: continue. Moderate right and small left pleural effusions are also demonstrated.


SubjectID: 16715089, StudyID: 55825174, Comparison: worse

FINAL REPORT

HISTORY: ___-year-old male with hypoxia.

TECHNIQUE: Frontal and lateral chest radiographs were obtained.

COMPARISON: ___.

FINDINGS: There is moderate pulmonary vascular congestion with mild interstitial edema, new compared to ___   Keywords: new. Heart size is top normal and mildly increased. No pneumothorax or pleural effusion is detected. Aortic knob calcifications are noted.

IMPRESSION: Mild pulmonary edema with mildly increased top normal heart size compared to ___   Keywords: increase. Reported to ___ by ___ by phone at 2:30 a.m. on ___.


SubjectID: 16715089, StudyID: 53485087, Comparison: worse

WET READ: ___ ___ ___ 9:20 PM No significant interval change from prior study performed earlier the same day.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: History of smoking, increased work of breathing, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is a minimal increase in severity of pulmonary edema   Keywords: increase. The pre-existing right and minimal left pleural effusion has not substantially changed, but there is an improvement with respect to the severity of the left and right basal areas of atelectasis. No pneumothorax. Borderline size of the cardiac silhouette.


SubjectID: 16715089, StudyID: 57631959, Comparison: same

FINAL REPORT

EXAMINATION: Portable AP chest x-ray

INDICATION: ___ year old man with CHF p/w hypoxia, now s/p lasix // evaluate for interval improvement

TECHNIQUE: AP projection.

COMPARISON: Portable AP chest x-ray obtained ___.

FINDINGS: The cardiomediastinal silhouette is unchanged. Evaluation of heart size is limited to the low lung volumes, AP projection, and bilateral airspace opacities. There is again seen a calcified thoracic aorta. There are again seen areas of diffuse bilateral airspace opacities   Keywords: again. In particular, the right lower lobe appears better aerated, with improved visualization of right hemidiaphragm and right heart border. The left upper lobe is worse, and has developed more confluent areas of consolidation. This may reflect redistribution of pulmonary edema, or possibly overlying secondary process involving left upper lobe such aspiration or pneumonia. There is no pneumothorax or effusion.

IMPRESSION: Improved aeration of right lower lobe and worsening of consolidation involving left upper lobe, suggesting either redistribution of pulmonary edema due to change in patient positioning or overlying secondary process involving the left upper lobe such as pneumonia or aspiration pneumonitis.


SubjectID: 16715089, StudyID: 54867469, Comparison: None

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPH.

INDICATION: Pulmonary edema. // Eval for volume overload

TECHNIQUE: Portable AP Chest radiograph.

COMPARISON: None available.

FINDINGS: There is mild to moderate pulmonary edema. Diffuse hazy opacities at the lung bases bilaterally could reflect atelectasis. Evaluation of the cardiac silhouette is somewhat limited due to overlying opacities. However, there is probable mild cardiomegaly. No pneumothorax or focal consolidation identified.

IMPRESSION: Findings suggestive of heart failure which could be secondary to volume overload, among other causes.


SubjectID: 16715089, StudyID: 53545278, Comparison: worse

FINAL REPORT

INDICATION: Cough, evaluate for pneumonia.

COMPARISON: Chest radiograph on ___.

FINDINGS: AP portable upright view of the chest. Compared to prior study, there is increase in interstitial opacities throughout both lungs, which is more symmetric today   Keywords: increase. This most likely represents pulmonary edema. Mild cardiomegaly is stable. Aortic knob calcifications are stable. No large pleural effusion or pneumothorax.

IMPRESSION: Slight increase in bilateral interstitial opacities consistent with pulmonary edema   Keywords: increase.


SubjectID: 16721536, StudyID: 59617311, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with cardiomyopathy s/p ICD // r/o pnuemo and lead placement

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph ___

FINDINGS: Single lead defibrillator with the lead terminating in the right ventricle. There is no pneumothorax. Moderate cardiomegaly and small left pleural effusion is unchanged since ___. No consolidation. Cardiomediastinal borders and hilar structures are normal.

IMPRESSION: Single lead defibrillator in appropriate position without pneumothorax. Stable moderate cardiomegaly and small left pleural effusion.


SubjectID: 16721536, StudyID: 55358488, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with cardiomyopathy s/p ICD // r/o pneumo and lead placement

COMPARISON: ___

FINDINGS: Single lead defibrillator with the tip in the right ventricle. No pneumothorax. Moderate cardiomegaly with small left pleural effusion. The right lung is clear. Prior median sternotomy, AVR and CABG.

IMPRESSION: AICD in good position no pneumothorax.


SubjectID: 16721536, StudyID: 56623624, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p cabg // eval for effusion

COMPARISON: Chest x-ray from ___ at 15:40

FINDINGS: Compared to the prior film, I doubt significant interval change. Again seen is an ET tube, approximately 4.6 cm above the carina; an NG tube, with tip overlying gastric fundus; bilateral chest tubes; a mediastinal drain; and a Swan-Ganz catheter, with tip over the proximal right pulmonary artery. No pneumothorax detected. The patient is status post sternotomy, with prosthetic valve. The cardiomediastinal silhouette is probably unchanged, allowing for technical differences. Again seen is left lower lobe collapse and/or consolidation and mild vascular plethora, without overt CHF.

IMPRESSION: Doubt significant change compared with ___. A small left effusion would be difficult to exclude. No right-sided effusion is identified.


SubjectID: 16721536, StudyID: 51271232, Comparison: worse

FINAL REPORT

INDICATION: ___ year old woman s/pmvr/cabg and rt pleural ct removal // r/o ptx

COMPARISON: ___.

IMPRESSION: Since the recent study, midline drain and right chest tube have been removed, with no visible pneumothorax. Moderate right pleural effusion has increased in size. Stable enlargement of cardiac silhouette accompanied by pulmonary vascular congestion and worsening interstitial edema   Keywords: worse. Left basilar atelectasis and small pleural effusion are not appreciably changed


SubjectID: 16721536, StudyID: 56451852, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p cabg // eval for effusion/ ? widened mediastinum

COMPARISON: ___

IMPRESSION: As compared to the previous image, the patient has been extubated and the nasogastric tube was removed. The Swan-Ganz catheter is in unchanged position. Unchanged alignment of the clips, the valvular replacement and the sternal wires. Minimal increase in extent of the pre-existing pleural effusions. The cardiac silhouette however has not changed in size. The with of the mediastinum has returned for normal. There is no evidence of mediastinal widening and no evidence of an increase in mediastinal radiodensity or the appearance of unexpected mediastinal contours. No pneumothorax.


SubjectID: 16721536, StudyID: 56107003, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with pulmonary edema // assess changes in pul edema

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, an area of atelectasis at the left lung bases has increased in extent. Repeat radiograph should be performed within ___ out was to exclude developing pneumonia. Small bilateral pleural effusions are constant. Moderate cardiomegaly with a tent-like configuration of the heart, echocardiography might be helpful to rule out pericardial effusion.


SubjectID: 16721536, StudyID: 52732832, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with htn, hln, cad, who presented with hypoxemia after administration of benadryl, famotidine, metyhlprednisolone // please assess for pulmonary edema please assess for pulmonary edema

IMPRESSION: In comparison with the study of ___, there is increased prominence of the cardiac silhouette with pulmonary edema as suggested by the clinical history   Keywords: increase. There are bilateral pleural effusions with atelectatic changes at the bases.


SubjectID: 16732638, StudyID: 52671886, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, exacerbation, evaluation for fluid overload.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the previously malpositioned left PICC line is now correctly positioned. The lung volumes remain low. There is no overt pulmonary edema. Minimal retrocardiac atelectasis. Borderline size of the cardiac silhouette. No evidence of pneumothorax.


SubjectID: 16732638, StudyID: 50481139, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, COPD, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Low lung volumes with mild fluid overload but without focal parenchymal opacities indicative of pneumonia. Moderate cardiomegaly. The sternal wires are constant. Constant left PICC line.


SubjectID: 16743676, StudyID: 52782820, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with acute respiratory distress and crackles.

COMPARISON: ___.

TECHNIQUE: Single frontal chest radiograph was obtained portably with the patient in an upright position.

FINDINGS: There are consolidations throughout the right lung, most dense in the right upper ___. There is underlying pulmonary vascular congestion and interstitial edema. No pleural effusion or pneumothorax is detected on this single frontal view. Lung volumes are low. Heart size is enlarged. The aorta is calcified. Deformity of the right humerus is noted.

IMPRESSION: Right lung consolidations, most notable in the right upper ___, ___ represent pneumonia or asymmetric edema. Follow up radiograph is recommended after diuresis and longer-term after treatment to ensure resolution. These findings and recommendations were discussed with Dr. ___ by Dr. ___ by phone at 5:44 a.m. on ___.


SubjectID: 16743676, StudyID: 51272472, Comparison: better

FINAL REPORT

INDICATION: ___-year-old female with atrial fibrillation, hypoxia and new fever. Evaluate for pulmonary edema versus pneumonia.

COMPARISON: ___. UPRIGHT AP VIEW OF THE CHEST: Compared to the most recent exam, lung volumes are slightly lower. Diffuse airspace opacity has diminished, particularly in the right mid lung. In addition, there is improvement in diffuse interstitial edema. Right pleural effusion is small. The cardiomediastinal silhouette is unchanged. Calcification of the aortic arch is present with tortuosity of the descending aorta is noted. There is no pneumothorax.

IMPRESSION: Improving airspace opacity and edema   Keywords: improving.


SubjectID: 16748212, StudyID: 56572427, Comparison: worse

FINAL REPORT

INDICATION: Shortness of breath, evaluate for pulmonary edema.

COMPARISON: ___.

TECHNIQUE: Single AP portable upright chest.

FINDINGS: A right-sided PICC terminates in the mid SVC, having been slightly withdrawn in the interval. Heart size and mediastinal contours are unchanged. Diffuse pulmonary opacities are progressed, consistent with progression of pulmonary edema   Keywords: progressed. No definite pleural effusion. No pneumothorax. Osseous structures are unchanged.

IMPRESSION: Right-sided PICC terminates in mid-to-lower SVC following partial withdrawal. Progression of bilateral opacities consistent with worsening pulmonary edema   Keywords: progression, worse.


SubjectID: 16748212, StudyID: 50328550, Comparison: worse

FINAL REPORT

PORTABLE CHEST X-RAY, ___

COMPARISON: ___ radiograph.

FINDINGS: Cardiac silhouette remains enlarged. Diffuse bilateral airspace opacities have slightly progressed, consistent with worsening pulmonary edema   Keywords: worse, progressed. There are persistent small bilateral pleural effusions.


SubjectID: 16750550, StudyID: 56924772, Comparison: better

FINAL REPORT

INDICATION: Presenting with new CHF. Status post BiPAP and diuresis. Assess for interval change.

COMPARISONS: Chest radiograph, ___ at 00:37. Multiple chest radiographs dating to ___.

FINDINGS: In comparison to prior radiographs performed approximately eight hours earlier, there is very minimal improvement in the moderate-to-severe pulmonary edema   Keywords: improve. Probable small bilateral effusions are unchanged. There is no discrete consolidation. There is no pneumothorax. Moderate cardiomegaly is stable. The mediastinal contours are unremarkable. Mediastinal clips and a prosthetic cardiac valve are unchanged. The sternal wires are intact.

IMPRESSION: Very minimal improvement in the moderate-to-severe pulmonary edema   Keywords: improve. Stable small bilateral pleural effusions.


SubjectID: 16750550, StudyID: 56868074, Comparison: worse

FINAL REPORT

HISTORY: ___-year-old female with shortness of breath and history of congestive heart failure.

COMPARISON: Chest radiographs from ___ and from ___ PORTABLE FRONTAL CHEST RADIOGRAPH: Diffuse alveolar opacities, hilar enlargement, and increased cardiomegaly, suggest interval development of moderate-to-severe pulmonary edema. There are probable layering bilateral pleural effusions as well. There is no pneumothorax. Median sternotomy wires appear intact. A prosthetic cardiac valve is in unchanged position.

IMPRESSION: New moderate-to-severe pulmonary edema with probable bilateral pleural effusions   Keywords: new.


SubjectID: 16750550, StudyID: 53316724, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Dyspnea, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the severity and extent of the bilateral parenchymal changes, right more than left, have decreased. However, the changes are still clearly visible. Moderate cardiomegaly, constant appearance of the sternal wires and post-surgical clips.


SubjectID: 16750550, StudyID: 53226285, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, exacerbation, pneumonia, pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Status post CABG and valvular repair. Moderate cardiomegaly with mild right basal atelectasis. Mild fluid overload. No pleural effusions.


SubjectID: 16750550, StudyID: 51958776, Comparison: None

FINAL REPORT

INDICATION: Shortness of breath.

COMPARISON: Chest radiograph on ___.

FINDINGS: Semi-upright portable AP view of the chest. There are bilateral opacities consistent with pulmonary alveolar edema. In the right lower lung, a more confluent opacity may represent pneumonia. Possible small right pleural effusion. Moderate cardiomegaly is stable. Sternotomy wires, mediastinal clips, and prosthetic valve are unchanged. No pneumothorax.

IMPRESSION: Cardiomegaly and pulmonary edema. Possible superimposed right lower lobe pneumonia.


SubjectID: 16750550, StudyID: 50657543, Comparison: better

FINAL REPORT

PORTABLE CHEST X-RAY, ___

COMPARISON: ___ radiograph.

FINDINGS: Persistent marked cardiomegaly and pulmonary vascular engorgement accompanied by improving asymmetrical pulmonary edema and decreasing bilateral pleural effusions   Keywords: decreasing, improving.


SubjectID: 16750550, StudyID: 52874311, Comparison: better

FINAL REPORT

AP CHEST, 8:09 A.M. ON ___

HISTORY: A ___-year-old woman with CHF exacerbation and possible pneumonia. Assess progression of edema after diuresis.

IMPRESSION: AP chest compared to ___ through ___: Decrease in pulmonary vascular engorgement represents continued improvement in cardiac function which previously produced remission of pulmonary edema   Keywords: improve, decrease. I am not sure that I can see the questioned pneumonia. There is a small area of increased radiodensity in the right lower lung zone, but this looks more like residual edema and overlying bony structures than pneumonia. Moderate-to-severe cardiomegaly and stigmata of previous mitral valve repair noted.


SubjectID: 16755805, StudyID: 59302254, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man s/p AVR // predischarge eval

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph on ___

FINDINGS: Severe cardiomegaly is again demonstrated. The right internal jugular line has been removed. Left-sided dual lead pacemaker is unchanged in position. There is new substantial posterior right lower lobe atelectasis. The cardiomediastinal silhouette is unchanged. There is no evidence of pneumothorax

IMPRESSION: Interval removal of right internal jugular line and substantial right lower lobe atelectasis.


SubjectID: 16755805, StudyID: 54880873, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p ct removal // eval for ptx

TECHNIQUE: Portable chest

COMPARISON: ___.

FINDINGS: Bilateral chest tubes have been removed. There is a small right lateral pneumothorax. Otherwise the appearance of the lungs are unchanged

IMPRESSION: Chest tube removal with small right lateral pneumothorax only


SubjectID: 16772702, StudyID: 59293706, Comparison: same

WET READ: ___ ___ ___ 8:29 PM Further increase in insteritial markings consistent with pulmonary edema. Stable bilateral effusions. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH:

INDICATION: Evaluation for pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is a further mild increase in the otherwise extensive, diffuse and bilateral interstitial opacities. These opacities are accompanied by small bilateral pleural effusions and mild increase in diameters of the pulmonary vasculature. Overall, despite the normal size of the cardiac silhouette, the findings are still strongly suggestive of interstitial lung edema   Keywords: still. No additional newly appeared parenchymal opacities. No pneumothorax.


SubjectID: 16772702, StudyID: 52474242, Comparison: -1.0

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Dyspnea, evaluation for fluid overload.

COMPARISON: ___.

FINDINGS: As compared to the previous examination, the left central venous access line has been removed. There is a marked increase in interstitial markings and increase in vascular diameters   Keywords: increase. Increasing retrocardiac atelectasis and likely new left pleural effusion. Overall, moderate predominantly interstitial pulmonary edema is present. No other relevant changes   Keywords: no other relevant change. At the time of dictation, 1:49 p.m., the referring physician, ___. ___ was notified by telephone and the findings were discussed on ___.


SubjectID: 16772702, StudyID: 55198378, Comparison: same

FINAL REPORT

PORTABLE CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: CTA chest from ___ as well as a chest radiograph from ___. CLINICAL

HISTORY: Chest pain while at dialysis, assess for pleural effusions.

FINDINGS: AP upright portable chest radiograph obtained. There are bilateral small layering pleural effusions, not significantly changed from the prior chest radiograph. There is a metallic stent again noted in the region of the left subclavian vein. Mild interstitial pulmonary edema is likely present. The heart and mediastinal contour appear stable. Bony structures appear grossly intact.

IMPRESSION: Mild interstitial edema with bilateral small pleural effusions, essentially unchanged from the prior exam   Keywords: unchanged.


SubjectID: 16783548, StudyID: 59311116, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with ground glass opacities concerning for pulmonary edema or atypical infectionPlease obtain at ___ // Assess for improvement in ground glass opacities Assess for improvement in ground glass opacities

IMPRESSION: An comparison study ___, there has been some improvement in the degree of bilateral opacities with enlarged cardiac silhouette, consistent with some improvement in pulmonary vascular congestion   Keywords: improve. A similar appearance and course could relate to atypical infection, drug reaction, or toxic inhalation.


SubjectID: 16783548, StudyID: 52471073, Comparison: same

FINAL REPORT

EXAMINATION: CHEST PA AND LATERAL

INDICATION: ___ year old woman with ?pneumonia and signs of volume overload. R/o worsening infiltrate or vascular congestion.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph from ___, ___, and ___. CTA chest from ___.

FINDINGS: Unchanged diffuse bilateral ground-glass opacities with an enlarged cardiac silhouette favor pulmonary edema as the most likely diagnosis   Keywords: unchanged. However, toxic inhalation, drug reaction, and atypical infection like pneumocystis are on the differential. No pneumothorax or effusions.

IMPRESSION: Unchanged diffuse bilateral ground-glass opacities and an enlarged cardiac silhouette favor pulmonary edema   Keywords: unchanged. Toxic inhalation, drug reaction, and atypical infection like pneumocystis are also on the differential.

NOTIFICATION: The above findings were communicated via telephone by Dr. ___ to Dr. ___ at 17:40 on ___, ___ min after discovery.


SubjectID: 16783548, StudyID: 50376139, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (AP AND LAT)

INDICATION: ___F with cough.

COMPARISON: None

FINDINGS: AP upright and lateral views of the chest provided. Diffuse ground-glass opacities are noted within both lungs which may reflect pulmonary edema versus atypical infection. No large effusion or pneumothorax is seen. The cardiomediastinal silhouette is grossly unremarkable. Bony structures are intact.

IMPRESSION: Diffuse ground-glass opacities within the lungs concerning for pulmonary edema, less likely atypical infection.


SubjectID: 16803709, StudyID: 58884527, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Intubation, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has been intubated. There is malposition of the endotracheal tube in the right main bronchus. The tube needs to be repositioned. At the time of dictation and observation, 10:28 a.m., on the ___, the referring physician, ___. ___, was paged for notification and the findings were discussed one minute later over the telephone. Otherwise, the radiograph is unchanged. The patient has also received a nasogastric tube that is correctly positioned. Unchanged distribution and severity of the parenchymal opacities, unchanged size and shape of the cardiac silhouette. Minimally increasing retrocardiac atelectasis.


SubjectID: 16803709, StudyID: 57659303, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: ARDS, evaluation of parenchymal opacities.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has been extubated and the nasogastric tube has been removed. Lung volumes have slightly decreased as compared to the previous image. The right internal jugular vein catheter remains in situ. The extent, severity and overall distribution of the pre-existing parenchymal opacity is constant and has not substantially changed. No pleural effusions. Moderate cardiomegaly.


SubjectID: 16803709, StudyID: 51623959, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female with thyroid storm and respiratory failure

COMPARISON: Chest radiographs dating back to ___, most recent from ___ PORTABLE SEMI-UPRIGHT FRONTAL CHEST RADIOGRAPH: An endotracheal tube, left-approach central venous catheter and ___ ___-___ tube are in expected unchanged positions. Diffuse ground-glass opacities involving both lungs persist; however, there is slight clearing of the lungs bilaterally suggesting improvement. No large pleural effusion is identified. There is no pneumothorax. Cardiomediastinal and hilar contours appear mildly enlarged, though are unchanged.

IMPRESSION: Mild improvement in aeration of the bilateral lungs.


SubjectID: 16803709, StudyID: 50596833, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old female with thyroid storm and respiratory failure

COMPARISONS: Chest radiographs dating back to ___, most recent from ___ PORTABLE SUPINE CHEST RADIOGRAPH: There are diffuse increased ground-glass opacities throughout both lungs, findings likely secondary to increasing non-cardiogenic pulmonary edema. Endotracheal tube and left approach central venous catheter are in unchanged position. There has been interval removal of a right internal jugular central venous catheter. Cardiomediastinal and hilar contours are within normal limits and unchanged. Aeration of the lungs though slightly worse compared to most recent prior is still significantly improved as compared to chest radiograph from ___ at 8:09 a.m.

IMPRESSION: Standard position of support devices. Increasing diffuse pulmonary edema, now moderate   Keywords: increasing.


SubjectID: 16805260, StudyID: 59423512, Comparison: None

FINAL REPORT

HISTORY: CHF exacerbation.

FINDINGS: In comparison with the study of ___, there appears to be some decrease in the still substantial elevation of pulmonary venous pressure. Poor definition of the left hemidiaphragm suggests pleural fluid. Atelectatic changes are seen at the bases. Monitoring and support devices remain in place. No new consolidation is appreciated.


SubjectID: 16805260, StudyID: 57082043, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, pneumonia, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The monitoring and support devices are constant. Borderline size of the cardiac silhouette. Retrocardiac atelectasis and small left pleural effusion. Moderate pulmonary edema. The pre-existing bilateral basal parenchymal opacities are unchanged in severity and extent   Keywords: unchanged.


SubjectID: 16805260, StudyID: 51826743, Comparison: same

FINAL REPORT

INDICATION: ___-year-old man with intubation, hypoxemic respiratory failure.

FINDINGS: A right-sided central internal jugular line tip is in the low SVC. An enteric catheter projects off the film. The endotracheal tube tip remains at the inferior margin of the clavicles. A left subclavian vein line has been removed. A curvilinear right convex thin radiopaque line projects over the right heart border. This line likely represents a heavily calcified aortic arch. A similar linear opaque line is seen on the left side of the ascending aorta. Lung volumes are low. There is stable bilateral perihilar haze, bronchial cuffing, and a small left effusion. No new consolidation or pneumothorax is present.

IMPRESSION: 1. Stable appearance of moderate pulmonary edema   Keywords: stable. 2. Removal of left-sided subclavian line. 3. Heavily calcified ascending aorta.


SubjectID: 16805260, StudyID: 57983616, Comparison: worse

FINAL REPORT

PORTABLE CHEST X-RAY OF ___

COMPARISON: ___ chest x-ray.

FINDINGS: Indwelling support and monitoring devices remain in standard position. Persistent cardiomegaly accompanied by worsening CHF, with increasing perihilar edema and small bilateral pleural effusions   Keywords: worse, increasing. Slight improvement in aeration in the left lower lobe probably reflects improving atelectasis in this region.


SubjectID: 16805260, StudyID: 57537328, Comparison: None

FINAL REPORT

INDICATION: ___-year-old woman with parainfluenza and congestive heart failure.

COMPARISON: Chest radiograph ___. PORTABLE AP UPRIGHT CHEST RADIOGRAPH: Right upper extremity PICC ends at the level of the mid SVC. The lung volumes are low. Diffuse bilateral interstitial opacities and peribronchial thickening, are worse since the prior study. There are no pleural effusions or pneumothorax. The cardio-mediastinal contours are stable, with moderate aortic atherosclerotic calcification.

IMPRESSION: Bilateral interstitial opacities worrisome for viral pneumonia, worse since ___.


SubjectID: 16805260, StudyID: 50182279, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman with parainfluenza and congestive heart failure. Worsening shortness of breath.

FINDINGS: Comparison is made to the prior radiographs from ___. There are again seen diffuse bilateral interstitial densities, which can be seen with pneumonia. There is likely also an element of pulmonary edema, however, the vascular pedicle is not widened, thus an infectious etiology is more likely. There is a right-sided PICC line with distal lead tip at the cavoatrial junction. The tip is better assessed on the prior radiograph. There are no pneumothoraces. Overall, these findings appear stable.


SubjectID: 16805260, StudyID: 53389302, Comparison: better

FINAL REPORT

AP CHEST 8:11 A.M., ___

HISTORY: ___-year-old woman with moderate aortic stenosis and CHF.

IMPRESSION: AP chest compared to ___: The patient has been extubated, but there has been no appreciable loss of lung volume. Left hemidiaphragm has been mildly elevated for several days. Heart borderline enlarged, unchanged. Previous mild pulmonary edema has improved   Keywords: improve. Right jugular line ends in the low SVC. No pneumothorax. Pleural effusions are presumed, but small.


SubjectID: 16805260, StudyID: 53091693, Comparison: worse

FINAL REPORT

AP CHEST, 7:36 A.M., ___

HISTORY: ___-year-old woman with moderate aortic stenosis and restrictive lung disease, resolving CHF.

IMPRESSION: AP chest compared to ___: Left lower lobe atelectasis has improved, but there is new heterogeneous opacification at the base of the right lung which could be asymmetric pulmonary edema, but is quite concerning for new pneumonia   Keywords: new. Patient has been extubated. Right jugular line ends centrally. Heart is normal size. Findings were discussed by telephone with the CCU intern caring for this patient at 1:45 p.m., 3 minutes after discovery. Right internal jugular line ends centrally. No pneumothorax or pleural effusion.


SubjectID: 16805260, StudyID: 52658007, Comparison: None

FINAL REPORT

AP CHEST, 12:53 PM ON ___

HISTORY: ___-year-old woman with a new nasogastric tube.

IMPRESSION: Two images were acquired. The first at 12:54 p.m. shows a nasogastric drainage tube in the right lower lobe bronchus and also suggests mild pulmonary edema. The second acquired at 12:59 p.m. shows the same nasogastric drainage tube in the distal stomach, and no longer shows edema. Dr. ___ was paged at 6:02 p.m., 3 minutes after the findings were recognized, and we discussed the findings at 6:10pm.


SubjectID: 16826047, StudyID: 59395427, Comparison: same

FINAL REPORT

INDICATION: ___-year-old male patient with a right Pleurx catheter for recurrent exudative effusions with large air leak. Study requested to rule out pneumothorax.

COMPARISON: Prior chest radiograph from ___, at 4:40.

TECHNIQUE: Portable chest radiograph.

FINDINGS: As compared to prior chest radiograph from ___, right Pleurx catheter remains in position and there is still substantial layering of pleural effusion with compressive atelectasis at the right base. There appears to be interval engorgement of pulmonary vessels, particularly on the left. The left hemidiaphragm is not as sharply seen, which could represent a small pleural effusion. Stable cardiomegaly.

IMPRESSION: Unchanged right pleural effusion. Stable cardiomegaly with pulmonary vascular congestion   Keywords: stable. Possible small left pleural effusion.


SubjectID: 16826047, StudyID: 51435164, Comparison: None

FINAL REPORT

HISTORY: Right pleural effusion with Pleurx catheter in place.

FINDINGS: In comparison with study of ___, despite the right Pleurx catheter in place, there is still a substantial layering pleural effusion with compressive atelectasis at the right base. The left lung is essentially clear at this time. Continued enlargement of the cardiac silhouette with minimal if any vascular congestion. No acute focal pneumonia on the left.


SubjectID: 16826047, StudyID: 59368305, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluation of pleural effusion.

COMPARISON: ___.

FINDINGS: On the previous radiograph, extent of the known right pleural effusion has increased. The right pleural drain seems to be in unchanged position. The effusion now occupies a little bit more than ___% of the right hemithorax. Unchanged appearance of the cardiac silhouette. Unchanged normal appearance of the left lung.


SubjectID: 16826047, StudyID: 56785550, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Right-sided pleural drain placement. Evaluation.

COMPARISON: ___, 8:44 a.m.

FINDINGS: As compared to the previous radiograph, the patient has received a right chest tube. The chest tube is in correct position. There is a substantial decrease in extent of the pre-existing right pleural effusion. No pneumothorax is seen. Minimal air collection in the soft tissues at the site of drain insertion. Unchanged moderate cardiomegaly, unchanged normal appearance of the left lung. Right Port-A-Cath in situ.


SubjectID: 16826047, StudyID: 58248690, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Pleural effusion, status post thoracocentesis, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has undergone a right thoracocentesis. The extent of the right pleural effusion has substantially decreased. There is an opacity at the right lung base, likely reflecting reexpansion lung edema. No evidence of pneumothorax. No change in appearance of the left lung and of the cardiac silhouette.


SubjectID: 16826047, StudyID: 57361130, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man with HIV/AIDS, CHF, shortness of breath.

COMPARISONS: ___ to ___.

FINDINGS: A right pleural effusion has increased since ___ and is now large. The left lung is clear. No left effusion or pneumothorax is present. A right-sided Port-A-Cath tip remains in the mid SVC. Cardiomegaly is unchanged.

IMPRESSION: Significant progression of a large right pleural effusion. Discussed with Dr ___ ___ phone at ___.


SubjectID: 16826047, StudyID: 56712342, Comparison: None

FINAL REPORT

INDICATION: Right-sided chest pain, shock-like in quality. Does not radiate. Lasts for minutes at a time. Associated with nausea. Please evaluate for acute process.

TECHNIQUE: Chest radiograph from ___.

FINDINGS: Frontal and lateral radiographs of the chest were obtained. Lung volumes are slightly low. A moderate right pleural effusion has increased compared to the prior study from ___, likely with a subpulmonic component. A concomitant consolidative process at the right lung base cannot be excluded. There is mild pulmonary vascular congestion without frank interstitial edema. Mild cardiomegaly is unchanged. The mediastinal contours are normal. There is no pneumothorax. A right Port-A-Cath ends in the mid-to-low SVC.

IMPRESSION: 1. Moderate right pleural effusion with a likely subpulmonic component. A concomitant infectious process at the right base cannot be excluded. 2. Unchanged mild cardiomegaly. 3. Mild pulmonary vascular congestion without interstitial edema.


SubjectID: 16826047, StudyID: 57424140, Comparison: None

FINAL REPORT

INDICATION: Shortness of breath and cough. History of CHF. Assess for acute process.

COMPARISON: Chest radiographs from ___ and ___.

FINDINGS: There is redemonstration of a right pleural catheter, with its tip projecting over the posterior pleural space. A moderate loculated right pleural effusion is slightly increased in size compared to the most recent radiograph from ___. Heterogeneous opacities in the right mid to lower lung are slightly increased, possibly partially due to overlying pleural fluid, although atelectasis or infection in this region is certainly possible. There is borderline pulmonary edema. Mild cardiomegaly is not significantly changed. There is no definite left pleural effusion. No pneumothorax is seen. There is evidence of central adenopathy, increased compared to prior radiographs from ___.

IMPRESSION: 1. Increased moderate right loculated pleural effusion. Unchanged positioning of a right pleural catheter. 2. Slight increase in right mid to lower lung heterogeneous opacities, likely partially due to increased pleural fluid, although atelectasis or infection in this region is certainly possible. 3. Borderline pulmonary edema. 4. Unchanged mild cardiomegaly. 5. Increased central adenopathy compared to prior radiographs from ___. Further evaluation could be performed with CT, if clinically indicated. Findings and recommendations were discussed with Dr. ___ by Dr. ___ at 8:58 a.m. via telephone on the day of the study.


SubjectID: 16826047, StudyID: 56081327, Comparison: same

FINAL REPORT

INDICATION: Pleural effusion, status post drainage of 600 cc through Pleurx.

COMPARISON: ___.

TECHNIQUE: PA and lateral chest radiographs, two views.

FINDINGS: A right Pleurx catheter remains in place with little change in appearance of large loculated right pleural effusion despite large amount of drainage with the majority of fluid loculated in the right major fissure. There is, otherwise, no short-term interval change compared to ___ with mild cardiomegaly and known central adenopathy. There is no edema.

IMPRESSION: No significant change in right large loculated pleural effusion with mostly a major fissural component despite large amount of drainage through Pleurx. Otherwise, no significant interval change compared to ___   Keywords: no significant interval change.


SubjectID: 16826047, StudyID: 50405776, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Pleural effusion, status post drainage, questionable improvement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there has been drainage of pleural fluid. The pleural effusion on the right has mildly decreased. There is no evidence of pneumothorax. The extent of the remaining pleural effusion is still substantial. No change in appearance of the left lung and of the cardiac silhouette.


SubjectID: 16826047, StudyID: 57381701, Comparison: same

WET READ: ___ ___ ___ 10:56 PM Right pneumothorax larger than on ___. Right LL collapse and moderate effusion unchanged. Right chest tube unchanged. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: HIV, Hodgkin's lymphoma, status post chest tube. Evaluation for pneumothorax after pleurodesis.

FINDINGS: The right pneumothorax is slightly larger than on ___. Partial right lower lobe collapse and mild pleural effusion on the right are unchanged. Also unchanged is the position of the right-sided chest tube and the right Port-A-Cath. Unchanged moderate cardiomegaly without pulmonary edema   Keywords: unchanged.


SubjectID: 16826047, StudyID: 57304735, Comparison: None

FINAL REPORT

HISTORY: PleurX catheter with thoracentesis.

FINDINGS: In comparison with the earlier study of this date, there may be some increasing opacification at the right base. It is unclear whether this represents slight increase in pleural fluid or merely difference in patient position. No evidence of pneumothorax. Left lung is essentially clear.


SubjectID: 16826047, StudyID: 55573557, Comparison: same

FINAL REPORT

PORTABLE CHEST X-RAY OF ___

COMPARISON: ___ radiograph.

FINDINGS: Right-sided pleural catheter remains in place. A small lateral pneumothorax is present below the level of the minor fissure. Additionally, a pleural effusion has increased in size and is partially layering on this semi-upright radiograph. A small loculated component has developed medially at the right apex as well. Cardiac silhouette remains enlarged and is accompanied by mild pulmonary vascular congestion   Keywords: remains. Worsening confluent opacity at the right lung base is probably due to atelectasis, though infection should also be considered in the appropriate clinical setting.


SubjectID: 16826047, StudyID: 54140146, Comparison: None

FINAL REPORT

STUDY: AP CHEST, ___. CLINICAL

HISTORY: Patient status post pleural effusion and thoracentesis.

FINDINGS: Comparison is made to the prior study from ___. There is a right basilar chest tube. There remains a moderate to large right-sided pleural effusion which is stable in size. There is a right-sided Port-A-Cath with distal lead tip in distal SVC. There is stable cardiomegaly. The left lung is clear. Overall, there is no appreciable change. No pneumothoraces are seen.


SubjectID: 16826047, StudyID: 52819811, Comparison: better

FINAL REPORT

INDICATION: Evaluate for interval change in a patient with recurrent pleural effusions, status post chest tube placement, Pleurx and pleurodesis.

COMPARISONS: Most recent radiograph from ___.

FINDINGS: A portable AP radiograph of the chest demonstrates resolution of the small right-sided pneumothorax. There is a small layering right-sided pleural effusion which is similar in size to the prior study. The chest tube is unchanged. A small amount of subcutaneous emphysema on the right is unchanged. There is no left-sided effusion or pneumothorax. Severe cardiomegaly is unchanged. The hilar and mediastinal contours are normal. There is very mild interstitial pulmonary edema which is slightly decreased from yesterday   Keywords: decrease.

IMPRESSION: 1. Small right pneumothorax has resolved. 2. Small right pleural effusion is stable. 3. Mild interstitial pulmonary edema has minimally improved   Keywords: improve.


SubjectID: 16826047, StudyID: 52602627, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Diabetes, Burkitt lymphoma, Hodgkin's lymphoma, recent admission for dyspnea. PleurX catheter placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, a right Port-A-Cath and two right chest tubes are visible. The position of chest tubes are constant. The extent of the right pleural effusion is unchanged, the effusion is distributed in a slightly different manner. Unchanged right basal atelectasis. Unchanged moderate cardiomegaly. Unremarkable left lung. There is no evidence of pneumothorax.


SubjectID: 16826047, StudyID: 51777321, Comparison: None

FINAL REPORT

INDICATION: Evaluate chest tube position and residual pneumothorax in the patient who developed hypotension after right thoracoscopy.

COMPARISON: A series of chest radiographs dating back to ___, most recently from ___.

FINDINGS: A bedside AP radiograph of the chest demonstrates interval clearance of the large right pleural effusion with diffuse opacification of the right middle and lower lobes, likely secondary to re-expansion atelectasis. There is now a new small left pleural effusion which was not present four days ago. There is no pneumothorax. Cardiomegaly is stable. Interval widening of the upper mediastinal silhouette secondary to central venous engorgement is suggestive of hypervolemia. There is no pulmonary edema. A right chest wall central venous catheter is appropriately positioned in the lower SVC. The right chest tube is also appropriately positioned, in the right lower pleural space, including the side port.

IMPRESSION: 1. The chest tube is appropriately positioned and there is no pneumothorax. 2. Interval clearance of large right pleural effusion with re-expansion atelectasis of the right middle and lower lobes. 3. New small left pleural effusion not present on the prior study. 4. Findings suggestive of mild hypervolemia.


SubjectID: 16826047, StudyID: 51795923, Comparison: same

WET READ: ___ ___ ___ 8:59 PM Increased opacification of the right hemi thorax, likely worsening pleural effusion. Prominence of the pulmonary vasculature may represent pulmonary vascular congestion. Right chest tube is in place. No pneumothorax. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Dyspnea and chronic heart failure, evaluation for pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The extensive right pleural effusion is constant in distribution and extent. Also constant are the relatively massive subsequent parenchymal opacities in the right hemithorax. On the left, there is no visible change, the appearance of the left heart border, the left costophrenic sinus and the structure of the lung parenchyma is constant. No pneumothorax. No pleural effusions.


SubjectID: 16826047, StudyID: 50448867, Comparison: same

FINAL REPORT

HISTORY: ___-year-old male with pleural effusion, evaluate.

TECHNIQUE: PA and lateral chest radiographs were obtained with the patient in the upright position.

COMPARISON: Chest radiograph from ___.

FINDINGS: Previous multiple loculated right pleural effusions have not changed, and the intrafissural right pleural drainage catheter is stable in position. The cardiac silhouette continues to be mildly enlarged without pulmonary edema   Keywords: continue. Tiny linear and nodular opacities have appeared in the left upper lobe since ___.

IMPRESSION: Multiloculated right pleural effusion unchanged since ___. New linear and nodular opacities in the left upper lobe may represent carcinomatosis. Findings were relayed to Dr. ___ by Dr. ___ ___ following review on ___ at approximiately 11:00 via telephone.


SubjectID: 16842605, StudyID: 58782885, Comparison: None

FINAL REPORT

EXAM: Chest, single AP upright portable view. CLINICAL INFORMATION: ___-year-old, dyspneic and tachypneic.

COMPARISON: ___.

FINDINGS: Single AP upright portable view of the chest was obtained. This study was made available for my interpretation, today, ___ at 11:20 a.m. The patient is status post median sternotomy. Small, right greater than left bilateral pleural effusions are present, better assessed on subsequent CT from ___, with overlying atelectasis. The cardiac and mediastinal silhouettes are stable. No pneumothorax seen.

IMPRESSION: Bilateral pleural effusions.


SubjectID: 16842605, StudyID: 55169824, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Complete heart block, pacemaker evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has received a left pectoral pacemaker. The course of the pacemaker leads is unremarkable, position of the leads in the right atrium and right ventricle are unremarkable. There is no evidence of pneumothorax. Newly occurred small right pleural effusion. Moderate cardiomegaly.


SubjectID: 16842605, StudyID: 53337826, Comparison: None

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Shortness of breath.

COMPARISONS: ___.

TECHNIQUE: Chest, AP and lateral.

FINDINGS: The patient is status post sternotomy and aortic valve replacement. There is also a dual-lead pacemaker/ICD device with leads terminating in the right atrium and ventricle, respectively. The cardiac, mediastinal and hilar contours appear unchanged, including a large hiatal hernia. Aside from streaky atelectasis associated with hernia, the lungs appear clear. There is no pleural effusion or pneumothorax.

IMPRESSION: Left basilar opacity, but probably attributable to atelectasis associated with a large hiatal hernia; no definite interval change.


SubjectID: 16842605, StudyID: 52391264, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male patient with shortness of breath diuresed for mild CHF. Study requested for evaluation of interval change in pulmonary edema.

COMPARISON: Prior chest radiograph from ___.

TECHNIQUE: Portable AP chest radiograph.

FINDINGS: As compared to prior chest radiograph from ___, lungs remain clear. There is no pulmonary edema, focal consolidations, pleural effusions or pneumothorax. Cardiomediastinal and hilar contours are unchanged, including large hiatal hernia. There is a dual-lead ICD device with leads terminating in the right atrium and ventricle respectively.

IMPRESSION: No radiographic evidence of an acute cardiopulmonary process.


SubjectID: 16855430, StudyID: 58324748, Comparison: None

FINAL REPORT

AP PORTABLE CHEST, ___ AT ___ HOURS.

HISTORY: Shortness of breath and hypoxia.

COMPARISON: Multiple priors, the most recent dated ___.

FINDINGS: As similar to multiple prior exams, there is a relative hazy density in the bilateral hilar regions with pulmonary vascular indistinctness. The hemidiaphragms are not well defined. The cardiomediastinal silhouette is markedly enlarged with widening superiorly and an enlarged cardiac silhouette inferiorly. The patient's chin overlies the lung apices, limiting the evaluation. No gross pneumothorax is seen.

IMPRESSION: Limited study due to body habitus. There are low lung volumes which result in bronchovascular crowding, but beyond that there is likely moderate pulmonary edema presumably cardiogenic in etiology. There may also be small bilateral pleural effusions.


SubjectID: 16855430, StudyID: 50348450, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST, ___

HISTORY: ___-year-old woman with CHF, new shortness of breath.

IMPRESSION: PA and lateral chest compared to ___ through ___: Pulmonary edema on ___ has almost entirely cleared, with a small perihilar residual and persistence of small bilateral pleural effusions. Moderate-to-severe cardiomegaly is longstanding.


SubjectID: 16855430, StudyID: 57663243, Comparison: same

WET READ: ___ ___ ___ 11:51 PM persistent mild pulmonary edema with decreased but persistent left pleural effusion and small right pleural effusion. No large focal consolidation, but re-evaluation after diuresis is recommended if there is clinical concern. - discussed with dr. ___ by telephone at 11:50 p.m. on ___. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: Prior study from approximately two hours earlier. CLINICAL

HISTORY: ___ year-old woman with congestive heart failure with recurrent pneumonia, dyspnea; question CHF.

FINDINGS: Frontal and lateral views of the chest were obtained. Bilateral pleural effusions are seen as well as persistent pulmonary edema   Keywords: persistent. Stable mild cardiomegaly noted. No interval changes are seen   Keywords: no interval change.

IMPRESSION: Pulmonary edema, small bilateral pleural effusions, mild cardiomegaly.


SubjectID: 16855430, StudyID: 54733030, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior chest radiograph dated ___. CLINICAL

HISTORY: A ___-year-old woman with CHF, presents with acute onset dyspnea, crackles and wheezing on exam, question pulmonary edema or pneumonia.

FINDINGS: Portable AP upright chest radiograph is obtained. Lung volumes are low. There is mild ground-glass opacity involving both lungs concerning for pulmonary edema. No large pleural effusions are seen, though trace effusions are likely present. Heart size appears top normal. No pneumothorax. Bones appear intact.

IMPRESSION: Pulmonary edema, likely with trace pleural effusions.


SubjectID: 16855430, StudyID: 56956118, Comparison: None

FINAL REPORT

HISTORY: Dyspnea, evaluate for infiltrate.

COMPARISON: Chest radiographs ___, ___ and ___.

FINDINGS: Frontal lateral views chest performed. A left upper extremity PICC has been removed. The cardiac silhouette remains chronically and moderately enlarged. There are small to moderate bilateral pleural effusions which have increased in size from prior. Additionally, enlargement of the azygous vein with indistinctness of the pulmonary vasculature is consistent with congestive failure. More focal appearing consolidations are seen in the middle lobe and a lower lobe, probably left. There is no pneumothorax. The imaged upper abdomen is unremarkable.

IMPRESSION: 1. Moderate pulmonary edema with small to moderate bilateral pleural effusions. 2. Opacities within one of the lower lobes, probably the left, and in the middle lobe could represent more focal consolidations. Either repeating the study after diuresis or obtaining oblique views would be helpful in clarification. These findings were discussed with Dr. ___ by Dr. ___ at 08:37 AM on ___.


SubjectID: 16855430, StudyID: 52509761, Comparison: None

FINAL REPORT

INDICATION: Shortness of breath, afebrile, assess for pulmonary edema.

COMPARISON: Comparison is made to multiple prior chest radiographs, most recently dated ___.

FINDINGS: Semi-upright portable chest radiograph demonstrates interval improved aeration of the bilateral upper lungs; however, there is persistent if not slightly improved bibasilar opacifications, possibly due to atelectasis and bilateral pleural effusions, though superimposed infectious process is not excluded.

IMPRESSION: Improved aeration of upper lungs with stable if not slightly improved bibasilar opacifications, likely a combination of atelectasis and effusions, though pneumonia is not excluded.


SubjectID: 16859201, StudyID: 55050631, Comparison: worse

FINAL REPORT

PORTABLE CHEST FILM, ___ AT 5:42 CLINICAL

INDICATION: ___-year-old with MI, CHF and dyspnea, assess for interval change in pulmonary edema. Comparison is made to the patient's prior study ___ at 11:12. A portable semi-erect chest film ___ at 5:42 a.m. is submitted.

IMPRESSION: The patient is status post median sternotomy for CABG with stably enlarged cardiac and mediastinal contours. There is worsening interstitial and pulmonary edema   Keywords: worse. In addition, there are bilateral layering effusions, left greater than right. No pneumothorax is seen.


SubjectID: 16860825, StudyID: 58283305, Comparison: None

FINAL REPORT

CLINICAL

HISTORY: ___-year-old man with cough and shortness of breath, admitted for volume overload. Status post diuresis.

COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: Previous hazy opacities representing pulmonary edema have now resolved. Small bilateral pleural effusions remain. Cardiac silhouette is mildly enlarged. No focal opacities concerning for an infectious process.

IMPRESSION: Significant resolution of volume overload.


SubjectID: 16860825, StudyID: 57620218, Comparison: None

FINAL REPORT

INDICATION: Asthma exacerbation.

COMPARISONS: Chest radiograph, ___. Chest radiograph, ___.

FINDINGS: Bilateral hazy opacification and interstitial prominence is most consistent with mild-to-moderate pulmonary edema. No large effusion is present. There is no pneumothorax. The cardiac size is mildly enlarged.

IMPRESSION: 1. Mild-to-moderate pulmonary edema. 2. Mild cardiomegaly.


SubjectID: 16865608, StudyID: 58610529, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with HTN emergency, hypercarbic respiratory failure // interval change interval change

IMPRESSION: In comparison with the study of ___, there is again substantial enlargement of the cardiac silhouette with engorgement of the vascular pedicle and evidence of moderate pulmonary edema. There may well be some mild volume loss in the left lower lobe.


SubjectID: 16865608, StudyID: 58030663, Comparison: None

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPH

INDICATION: Dyspnea, weight gain and hypoxia.

COMPARISON: None.

TECHNIQUE: Chest, semi-upright AP portable.

FINDINGS: The heart is mild to moderately enlarged. The superior vena cava is probably distended noting widening of the vascular pedicle. Perihilar congestion is moderate and more generally there is widespread opacification suggesting mild to moderate pulmonary edema. There is no definite pleural effusion or pneumothorax.

IMPRESSION: Findings suggest pulmonary edema.


SubjectID: 16865608, StudyID: 52884660, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hypercarbic respiratory failure // assess interval change assess interval change

IMPRESSION: In comparison with the study of ___, there is little overall change in the cardiomegaly and pulmonary edema   Keywords: little overall change. No acute focal pneumonia.


SubjectID: 16872291, StudyID: 58018692, Comparison: None

FINAL REPORT

HISTORY: Chest pain. Evaluate for cardiopulmonary process.

TECHNIQUE: Frontal and lateral views of the chest.

COMPARISON: Multiple prior chest radiographs, most recently ___.

FINDINGS: The heart is moderately enlarged. The pulmonary vasculature is indistinct, compatible with edema. Bibasilar opacities have increased since the prior examination and remain compatible with atelectasis. Bilateral costophrenic angles are obscured, compatible with small effusions. No pneumothorax. No radiopaque foreign body.

IMPRESSION: 1. Mild pulmonary edema with small bilateral pleural effusions. 2. Bibasilar linear opacities, compatible with atelectasis. 3. Moderate cardiomegaly.


SubjectID: 16872291, StudyID: 55762995, Comparison: worse

FINAL REPORT

HISTORY: Hypoglycemia and recent falls.

TECHNIQUE: Frontal and lateral views of the chest.

COMPARISON: Multiple prior chest radiographs, most recently of ___.

FINDINGS:Mild to moderate cardiomegaly is similar to prior. Cardiomediastinal contours are stable. Lung apices are obscured by the patient's chin. Pulmonary vasculature is indistinct, compatible with edema. Bibasilar streaky opacities are consistent with atelectasis. The left costophrenic angle is obscured, compatible with a small effusion. No pneumothorax. Osseous structures are unremarkable. No radiopaque foreign body.

IMPRESSION: 1. Mild pulmonary edema, worsened since prior, with probable small left pleural effusion   Keywords: worse. Bibasilar opacities, compatible with atelectasis. 2. Stable mild to moderate cardiomegaly.


SubjectID: 16872291, StudyID: 55836242, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Diabetes, increasing angina, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the signs indicative of interstitial lung edema have increased in severity   Keywords: increase. The patient, according to the radiograph, is in moderate pulmonary edema. There are no pleural effusions. Moderate tortuosity of the thoracic aorta. Atelectasis at both the left and right lung bases.


SubjectID: 16872291, StudyID: 51406294, Comparison: None

FINAL REPORT

PORTABLE AP CHEST FILM, ___ AT 9:53 CLINICAL

INDICATION: ___-year-old with CRI, CHF, altered mental status with concern for pneumonia. Evaluate pulmonary edema and pneumonia. Comparison is made to the patient's previous study of ___ at ___. Followup right chest film ___ at 9:53 is submitted.

IMPRESSION: Lung volumes remain somewhat diminished. Overall, when compared to multiple previous studies dating back to ___, there does appear to be increasing interstitial prominence and fullness in the perihilar vessels suggesting an element of mild interstitial edema. Streaky opacities at both bases are again noted, likely reflecting bibasilar atelectasis, although pneumonia cannot be entirely excluded. No large pleural effusions. No pneumothorax is seen, although the patient's mandible obscures part of the apices. Overall, cardiac and mediastinal contours are difficult to assess due to patient rotation on the current study, although the heart likely remains stably enlarged.


SubjectID: 16872291, StudyID: 53561389, Comparison: None

WET READ: ___ ___ 10:11 PM ET tube is 4.3 cm from the carina. Enteric tube courses into the stomach with the tip in the distal stomach or proximal duodenum. Right internal jugular central venous catheter terminates in the low SVC. Bilateral airspace opacities, right greater than left, likely reflect a component of pulmonary edema although a superimposed infection is difficult to exclude. There are small bilateral pleural effusions. Moderate cardiomegaly is unchanged. There is no pneumothorax. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p cardiac arrest // ? interval change ? interval change

COMPARISON: Chest radiographs since ___ most recently ___.

IMPRESSION: New endotracheal tube is in standard placement. Nasogastric tube ends in the region of the pylorus. An intended esophageal temperature probe ends in the midline at the level of the aortic arch and could be in either the upper esophagus or airway. Right internal jugular line ends in the low SVC. Severe somewhat asymmetric bilateral pulmonary consolidation more perihilar on the right and more the basal on the left could be pulmonary edema or because of the asymmetry massive pneumonia or pulmonary hemorrhage. Heart is mildly enlarged but not appreciably changed since ___. At least a small right pleural effusion is present. There is no pneumothorax. Any important findings merit direct notification will be based on the results of the subsequent chest radiograph available to review at the time of this transcription.


SubjectID: 16872291, StudyID: 53099505, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___F with cardiac arrest with ett, cvl // eval ett, CVL

TECHNIQUE: Portable frontal view of the chest.

COMPARISON: None.

FINDINGS: An endotracheal tube ends 4.3 cm above the carina. A nasogastric tube enters the stomach and terminates off of the radiograph. A right internal jugular line ends in the mid to low superior vena cava. Bilateral patchy airspace opacities most likely represent pulmonary edema. There are bilateral small pleural effusions. The mediastinal contours are widened and there is moderate cardiomegaly.

IMPRESSION: Lines and tubes in appropriate position. Patchy bilateral airspace opacities most likely represent pulmonary edema, however, infection cannot be excluded. Small bilateral pleural effusions. Moderate cardiomegaly.


SubjectID: 16872291, StudyID: 51562570, Comparison: None

FINAL REPORT

PORTABLE CHEST FILM, ___ AT 13:52. CLINICAL

INDICATION: ___-year-old with history of hypertension, diabetes, and chronic renal insufficiency, increasing angina. Comparison is made to the patient's prior study of ___ at 8:00 a.m. A portable semi-erect chest film, ___ at 13:52, is submitted.

IMPRESSION: The patient is markedly rotated, limiting evaluation of the cardiac and mediastinal contours. However, the heart remains moderately enlarged. The pulmonary vascularity is indistinct and there are bibasilar airspace opacities. These findings most likely reflect moderate pulmonary edema, although an infectious process cannot be entirely excluded. The patient's mandible obscures the apices. No large pneumothorax is appreciated.


SubjectID: 16872291, StudyID: 51515362, Comparison: better

FINAL REPORT

PA AND LATERAL CHEST FILM, ___ AT 16:34. CLINICAL

INDICATION: ___-year-old with increasing angina, question aspiration or possible pneumonia. PA and lateral views of the chest dated ___ at 16:34 were obtained and compared to prior study of ___ at 13:52. Please note that the lateral film has overlying motion limiting its utility. However, the technologist noted that these are the best possible images that could be obtained at this time.

IMPRESSION: 1. Interval improvement in lung volumes with residual streaky patchy opacities in both lung bases, likely reflecting atelectasis and/or resolving edema, less likely an infectious process   Keywords: improve, resolving. There is a suggestion of pulmonary venous hypertension. Heart remains mildly enlarged. Overall mediastinal contours are likely stable given differences in positioning. Bibasilar pneumonia would be less likely. No pneumothorax. There is widening of the acromiohumeral distance on the right glenohumeral joint and the humeral head appears to be approximated only with the inferior portion of the glenoid. These findings would suggest subluxation. If this is of clinical concern, further imaging evaluation with a dedicated shoulder series could be performed.


SubjectID: 16877397, StudyID: 58420500, Comparison: better

WET READ: ___ ___ ___ 4:53 PM Decreased pulmonary edema with unchanged bilateral pleural effusions   Keywords: decrease. ______________________________________________________________________________

FINAL REPORT

INDICATION: Post CABG and AVR, evaluate effusions.

COMPARISON: Chest radiograph on ___, ___, and ___.

FINDINGS: PA and lateral views of the chest. Compared to most recent study, the previously seen pulmonary edema has decreased   Keywords: decrease. The bilateral pleural effusions, left greater than right, are unchanged. There is no consolidation or pneumothorax. The mediastinal and hilar contours are stable. Sternotomy wires are in appropriate position and surgical clips in the mediastinum are seen. Aortic valve replacement is in appropriate position.

IMPRESSION: Decreased pulmonary edema with unchanged bilateral pleural effusions.


SubjectID: 16877397, StudyID: 57823422, Comparison: worse

FINAL REPORT

INDICATION: Status post CABG, evaluate for effusion.

COMPARISON: Chest radiographs on ___.

FINDINGS: One portable AP upright view of the chest. Sternotomy wires are seen in the appropriate position. There are multiple mediastinal clips from prior CABG. Bilateral peribronchial cuffing and predominantly central confluent opacities consistent with pulmonary edema has progressed compared to ___   Keywords: progressed. There are bilateral pleural effusions, left greater than right. No pneumothorax.

IMPRESSION: Increased pulmonary edema with bilateral pleural effusions   Keywords: increase.


SubjectID: 16877397, StudyID: 51502865, Comparison: None

FINAL REPORT

PORTABLE AP CHEST FILM CLINICAL

INDICATION: ___-year-old status post removal of chest tube, to evaluate for pneumothorax. Comparison is made to the patient's previous study dated ___. A portable AP upright chest film of ___ at ___ hours is submitted.

IMPRESSION: 1. Interval removal of the endotracheal tube, right internal jugular Swan-Ganz catheter, mediastinal drains, left-sided chest tubes, and nasogastric tube in this patient status post median sternotomy for CABG and aortic valve replacement. 2. Bibasilar patchy airspace opacity, left greater than right, likely reflects a combination of patchy atelectasis and pleural fluid. No evidence of pulmonary edema or pneumothorax. Relatively low lung volumes.


SubjectID: 16881590, StudyID: 59993954, Comparison: better

FINAL REPORT

PA AND LATERAL CHEST FILM ___ AT ___ CLINICAL

INDICATION: ___-year-old with congestive heart failure, question improvement in pulmonary edema. Comparison is made to the patient's prior study of ___ at 811. PA and lateral views of the chest dated ___ at ___ are submitted.

IMPRESSION: 1. Bilateral interstitial process which has somewhat improved suggesting resolving interstitial edema   Keywords: improve, resolving. However, there continues to be focal airspace opacity in the right upper lobe, which would be concerning for superimposed pneumonia or aspiration. In addition, there has been interval development of a subtle opacity at the right lung base, which may represent atelectasis, pneumonia, or aspiration. Clinical correlation is advised. No pleural effusions are seen. Heart remains stably enlarged. Mediastinal contours are also unchanged. No evidence of pneumothorax.


SubjectID: 16881590, StudyID: 56995462, Comparison: None

WET READ: ___ ___ 12:59 PM Distinct right upper lobe consolidation worrisome for infection in the background of pulmonary edema. Possible left-sided patchy consolidations and difficult to differentiate from background edema. ______________________________________________________________________________

FINAL REPORT

HISTORY: Shortness of breath.

TECHNIQUE: PA and lateral chest radiograph.

COMPARISON: Multiple chest radiographs dating back to ___.

FINDINGS: The heart size is mildly enlarged. Prominent perihilar and basilar pulmonary vasculature is suggestive of pulmonary edema. There is a focal consolidation in the right upper lobe worrisome for infection. There are possible, subtle patchy consolidations in the left lung difficult to differentiate from underlying edema. No acute bony change is identified.

IMPRESSION: Distinct right upper lobe consolidation worrisome for infection in the background of pulmonary edema.


SubjectID: 16893042, StudyID: 59562628, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pleural effusions // s/p L chest tube

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the patient has received a left-sided chest tube. The pigtail catheter appears correctly positioned. The left pleural effusion has minimally decreased in extent. The right pleural effusion is constant. Constant appearance of the cardiac silhouette, the monitoring and support devices as well as the lung parenchyma.


SubjectID: 16893042, StudyID: 58063623, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with bilateral pleural effusions // eval pleural effusions, chest tubes eval pleural effusions, chest tubes

IMPRESSION: In comparison with the study of ___, the monitoring and support devices are unchanged and there is no evidence of pneumothorax. Some indistinctness of pulmonary vessels suggests underlying elevation of pulmonary venous pressure. There may be minimal pleural fluid and atelectasis at the left base. Monitoring and support devices are unchanged.


SubjectID: 16893042, StudyID: 57415447, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with altered mental status and sepsis with dobhoff feeding tube placeemnt // location of dobhoff feeding tube location of dobhoff feeding tube

IMPRESSION: In comparison with the earlier study of this date, the nasogastric tube is been removed and there has been placement of a Dobhoff tube which on the final image appears to have its opaque tip pointing upward in the fundus of the stomach. The chest tubes appear to have been removed with no evidence of pneumothorax.


SubjectID: 16893042, StudyID: 56052267, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with respiratory failure and pleural effusion // f/u pleural effusions

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the pleural effusions have bilaterally decreased, left more than right. However, the effusions are still mild to moderate in extent. Unchanged retrocardiac atelectasis. Unchanged mild pulmonary edema   Keywords: unchanged. The monitoring and support devices are constant


SubjectID: 16893042, StudyID: 53756021, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with respiratory failure, currently intubated, has b/l pleural effusions // eval for interval change

TECHNIQUE: Portable semi upright chest radiograph.

COMPARISON: Chest radiograph dated ___.

FINDINGS: The ETT terminates 6 cm above the carina. There is a right IJ that terminates at the cavoatrial junction. There is an NG tube that courses below the diaphragm, however the tip is not visualized on this image. The bilateral pleural effusions, and bilateral vascular congestion appears unchanged in comparison to the prior chest radiograph   Keywords: unchanged. Heart size is stable. The mediastinal and hilar contours are stable. No pneumothorax is seen. There are no acute osseous abnormalities.

IMPRESSION: 1. Appropriate positioning of the ET tube, right IJ, and NG. 2. Unchanged appearance of bilateral pleural effusions and vascular congestion due to congestive heart failure   Keywords: unchanged appearance, unchanged.


SubjectID: 16893042, StudyID: 52104140, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ yo M with hx of schizoaffective disorder with respiratory distress, presumed HCAP and bilateral pleural effusions now s/p bilateral chest tube placement. // interval change, eval of chest tubes

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the bilateral chest tubes and the other monitoring and support devices remain in constant position. No pneumothorax. The right pleural space days clear. On the left, small pleural effusion persists. No new focal parenchymal opacities   Keywords: new. Unchanged appearance of the cardiac silhouette.


SubjectID: 16893042, StudyID: 51351264, Comparison: same

WET READ: ___ ___ 8:23 AM Bilateral pleural drainage catheters are present. No pneumothorax. Interval decrease in size of pleural effusions.

WET READ VERSION #1 ___ ___ 12:18 AM Bilateral pleural drainage catheters are present. No pneumothorax. Interval decrease in size of pleural effusions. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with NEW RIGHT SIDED chest tube. // CHEST TUBE , right side

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, a new right chest tube has been inserted. The position of both the left and the right chest tubes are unremarkable. The bilateral pleural effusions have almost completely drained. Otherwise unchanged monitoring and support devices. The lung volumes are low. Borderline size of the cardiac silhouette. No new focal parenchymal opacities   Keywords: new.


SubjectID: 16893042, StudyID: 59278555, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with respiratory failure, intubated, has had atelectasis at the bases. // Evaluate for interval change. Evaluate for interval change.

IMPRESSION: In comparison with the study of ___, the monitoring and support devices remain in place. The cardio mediastinal silhouette is stable and there is no evidence of vascular congestion or pleural effusion   Keywords: stable. Minimal atelectatic changes in the retrocardiac region, with no evidence of acute focal pneumonia.


SubjectID: 16893042, StudyID: 57815605, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with left hip fracture and altered mental status with GNR/GPC bacteremia, also intubated // Assess for interval change Assess for interval change

IMPRESSION: In comparison with the study of ___, the monitoring and support devices are unchanged. Cardiomediastinal silhouette is stable and there is no evidence of vascular congestion, pleural effusion, or acute focal pneumonia   Keywords: stable.


SubjectID: 16893042, StudyID: 54872690, Comparison: worse

FINAL REPORT

INDICATION: ___ year old man with sepsis, respiratory failure, intubated for airway protection // Assess for interval change

TECHNIQUE: Chest PA and lateral

COMPARISON: ___

FINDINGS: he monitoring and support devices are unchanged in standard position. The tip of the nasogastric tube is in the first portion of the duodenum. Interval worsening of asymmetric left-sided pulmonary edema   Keywords: worse. No significant pleural effusions or pneumothorax. The cardiomediastinal silhouette is compared well.

IMPRESSION: Mild worsening of the asymmetric left-sided interstitial edema   Keywords: worse.


SubjectID: 16893042, StudyID: 52036076, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with respiratory failure, altered mental status and sepsis now intubated // Please assess for interval change

COMPARISON: Radiographs from ___

IMPRESSION: Endotracheal tube and feeding tube are unchanged position. Cardiomediastinal silhouette is within normal limits. There is atelectasis at the lung bases. There is no signs for overt pulmonary edema or focal consolidation. There is improved aeration at the left base since prior. There are no pneumothoraces.


SubjectID: 16893042, StudyID: 51582004, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with respiratory failure, intubated // Assess ET tube position

COMPARISON: Radiographs from ___

IMPRESSION: There is an endotracheal tube whose tip is 6 cm above the carina. There is a nasogastric tube whose sideport is just past the GE junction. There are low lung volumes with atelectasis at the lung bases. There is a left retrocardiac opacity and left-sided pleural effusion. No pneumothoraces are identified.


SubjectID: 16893042, StudyID: 59152953, Comparison: better

WET READ: ___ ___ ___ 10:31 AM Left basilar opacity may reflect atelectasis, however pneumonia or aspiration could also be considered in the appropriate clinical setting. Unremarkable positioning of the endotracheal tube.

WET READ VERSION #1 ___ ___ ___ 7:33 PM Left basilar opacity may reflect atelectasis, however pneumonia or aspiration could also be considered in the appropriate clinical setting. Unremarkable positioning of the endotracheal tube. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___ year old man with bacteremia s/p R hip fracture // please evaluate for evidence of pneumonia

TECHNIQUE: Portable

COMPARISON: ___

FINDINGS: The nasogastric tube has been removed. The ET tube is in good position. The left-sided asymmetric pulmonary edema has improved   Keywords: improve. Minimal left residual basal atelectasis. No pneumothorax. The cardiomediastinal silhouette is compared with the prior. There is barium seen within the stomach.

IMPRESSION: Interval improvement, of the left pulmonary edema and atelectasis   Keywords: improve. The ET tube remains in good position.


SubjectID: 16893042, StudyID: 54975145, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with respiratory failure s/p intubation with distended abdomen // please evaluate ETT and OGT placement please evaluate ETT and OGT placement

IMPRESSION: In comparison with the study of ___, the monitoring and support devices are unchanged. No evidence of acute pneumonia or vascular congestion. The abdomen has been excluded from the image, so that the degree of bowel dilatation cannot be assessed on this study.


SubjectID: 16893042, StudyID: 54487725, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with respiratory failure s/p intubation // interval change interval change

IMPRESSION: In comparison with the study of ___, the monitoring and support devices have been removed. The patient has taken a better inspiration. The cardiac silhouette is at the upper limits of normal in size or mildly enlarged. Some indistinctness of pulmonary vessels suggest elevated pulmonary venous pressure. No evidence of acute focal pneumonia or pleural effusion


SubjectID: 16893042, StudyID: 51560082, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man w/resp failure currently intubated with ET/OG tube // check ET/OG tube placement check ET/OG tube placement

IMPRESSION: The endotracheal tube remains in good position. Nasogastric tube extends to the mid body of the stomach, before coiling upon itself so that the tip lies close to the esophagogastric junction and pointing upwards. No evidence of acute pneumonia or vascular congestion. Multiple punctate opacifications are seen in the right mid to upper abdomen. However, these are not appreciated on a CT examination on the following day and could well be artifactual.


SubjectID: 16893042, StudyID: 50174139, Comparison: None

WET READ: ___ ___ ___ 10:39 AM The enteric feeding tube is coiled in the stomach, with the tip at the gastric fundus. The endotracheal tube ends 5.9 cm from the carina and should be advanced for more secure seating. Wet read was discussed with Dr. ___ by Dr. ___ ___ telephone at 20:07 on ___, approximately ___ min after discovery.

WET READ VERSION #1 ___ ___ ___ 8:09 PM The enteric feeding tube is coiled in the stomach, with the tip at the gastric fundus. The endotracheal tube ends 5.9 cm from the carina and should be advanced for more secure seating. Wet read was discussed with Dr. ___ by Dr. ___ ___ telephone at 20:07 on ___, approximately ___ min after discovery. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___ year old man currently intubated with OG tube // Please evaluate placement of OG tube; ETT

TECHNIQUE: Chest portable

COMPARISON: ___

FINDINGS: The enteric feeding tube is coiled in the stomach, with the tip at the gastric fundus. The endotracheal tube ends 5.9 cm from the carina. The lungs are clear. Cardiomediastinal silhouette is not enlarged. No pneumothorax an check a trace left-sided effusion is suspected.

IMPRESSION: No acute interval change.


SubjectID: 16893042, StudyID: 58927403, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man pulled dobhoff // placement placement

COMPARISON: Comparison to ___ at 16:16

FINDINGS: Portable semi-erect chest film ___ at 09:06 is submitted.

IMPRESSION: A feeding tube is seen coursing below the diaphragm with the tip projecting over the stomach. A right internal jugular central line is unchanged in position. Overall cardiac and mediastinal contours are unchanged. Lungs appear well inflated without evidence of focal airspace consolidation, pleural effusions or pneumothorax. No pulmonary edema.


SubjectID: 16893042, StudyID: 57542211, Comparison: None

FINAL REPORT

INDICATION: ___M with hypoxia, CHF history // Eval for volume status

TECHNIQUE: Single portable view of the chest.

COMPARISON: ___.

FINDINGS: There are bibasilar hazy opacities compatible with layering effusions. Engorged central pulmonary vasculature is again seen. The cardiomediastinal silhouette is unchanged. Prior support lines and tubes have since been removed. No acute osseous abnormalities

IMPRESSION: Bilateral layering pleural effusions with mild pulmonary edema.


SubjectID: 16893042, StudyID: 56343673, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with worsening resp status and ?aspiration PNA // ET tube placement

TECHNIQUE: Semi-upright portable chest radiograph.

COMPARISON: CTA chest dated ___.

FINDINGS: The ETT terminates 5.5 cm above the carina. The tip of the NG tube is not visualized, however the side hole appears to be above the diaphragm. The vascular congestion appears to have worsened bilaterally in comparison to the prior chest radiograph   Keywords: worse. Large unchanged pleural effusions. Stable enlargement of the cardiac silhouette. The mediastinal and hilar contours are stable. No pneumothorax is seen. There are no acute osseous abnormalities.

IMPRESSION: 1. NG tube with side hole above the diaphragm, which should be advanced at least 5 cm. 2. ET tube in appropriate positioning. 3. Worsening vascular congestion with large unchanged pleural effusions   Keywords: worse.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 3:50 PM, 10 minutes after discovery of the findings.


SubjectID: 16893042, StudyID: 56898402, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with respitaory failre and NG tube confirmation // ___ year old man with respitaory failre and NG tube confirmation

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the patient has received a nasogastric tube. The course of the tube is unremarkable, the tip of the tube is not visible, but the side-hole is positioned at the level of the gastroesophageal junction. No complications, notably no pneumothorax. Otherwise unchanged radiograph   Keywords: unchanged radiograph.


SubjectID: 16893042, StudyID: 56480114, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with UGIB now intubated for EGD // ? ET tube placement

TECHNIQUE: Chest PA

COMPARISON: ___

FINDINGS: The endotracheal tube is in good position m from the carina. The left-sided PICC line is in similar position in the mid SVC. The lung volumes remain low with bibasal atelectasis. No pneumothorax. Small bilateral effusions layering effusions persist.

IMPRESSION: The endotracheal tube is approximately 5 cm from the carina. Small layering effusions persist.


SubjectID: 16893042, StudyID: 53257225, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with sacral decubitus ulcer, GNR bacteremia, hypernatremia, now with rigors, new O2 requirement. // aspiration pneumonitis vs PNA

COMPARISON: Radiographs from ___

IMPRESSION: Cardiomediastinal silhouette is within normal limits. Mild subsegmental atelectasis is seen at the lung bases. There are no focal consolidations, pleural effusion, or pulmonary edema. There are no pneumothoraces.


SubjectID: 16901707, StudyID: 56365418, Comparison: None

WET READ: ___ ___ ___ 10:49 AM Mildly displaced fractures of the left seventh and eighth ribs. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Status post fall with pain.

COMPARISONS: ___.

TECHNIQUE: Chest, portable AP upright.

FINDINGS: A left-sided dialysis catheter is in place, again terminating in the upper right atrium. The patient is also status post coronary artery bypass graft surgery. The heart is again mild-to-moderately enlarged. The cardiac, mediastinal and hilar contours appear not significantly changed. There is no evidence for pleural effusion or pneumothorax. Streaky opacity in the left mid lung suggests minor atelectasis or scarring, probably located within the lingula. There are new slightly displaced left posterolateral seventh and eighth rib fractures that appear acute.

IMPRESSION: Rib fractures.


SubjectID: 16901707, StudyID: 51045017, Comparison: None

FINAL REPORT

INDICATION: Left rib fractures, 7 through 9, evaluate for pneumothorax or hemothorax.

COMPARISON: Chest radiographs from ___.

FINDINGS: PA and lateral views of the chest. Sternotomy wires and mediastinal clips are seen. A left double-lumen catheter is seen ending in the right atrium. Mild-to-moderate cardiomegaly is unchanged. Mediastinal and hilar contours are normal. Bibasilar opacities represent atelectasis; however, pneumonia cannot be excluded. Small left pleural effusion. The upper lung zones are clear. Left rib fractures are unchanged. No pneumothorax.

IMPRESSION: 1. Bibasilar opacities likely represent atelectasis; however, pneumonia cannot be ruled out. 2. Small left pleural effusion. 3. No pneumothorax.


SubjectID: 16901707, StudyID: 54982619, Comparison: same

FINAL REPORT

INDICATION: Fall and rib fracture, now fever, evaluate for acute cardiopulmonary process.

COMPARISON: Chest radiographs on ___.

FINDINGS: Left hemodialysis catheter ends in the right atrium. Mediastinal clips and sternotomy wires are in appropriate position. Mild-to-moderate cardiomegaly is unchanged. Mild pulmonary vascular congestion is unchanged   Keywords: unchanged. Mild left basilar atelectasis with likely tiny left pleural effusion. Right lung is clear. No evidence of pneumonia.

IMPRESSION: No evidence of pneumonia.


SubjectID: 16901707, StudyID: 53465111, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Hypoxia, questionable pneumonia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is a minimal increase in blunting of the posterior aspect of the costophrenic sinus, potentially suggesting a minimal pleural effusion. In unchanged manner, there is both retrocardiac and right basal atelectasis. Moderate cardiomegaly without signs of fluid overload. Unchanged alignment of sternal wires after CABG. The hemodialysis catheter is in unchanged position. No evidence of pneumonia or other acute lung disease.


SubjectID: 16901707, StudyID: 50295947, Comparison: None

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Fever and hemodialysis.

COMPARISONS: ___.

TECHNIQUE: Chest, PA and lateral.

FINDINGS: There is a left-sided hemodialysis catheter which appears unchanged. The patient is status post coronary artery bypass graft surgery. The heart is at the upper limits of normal size. The mediastinal and hilar contours appear unchanged. The aorta is diffusely calcified. Mild hyperinflation is present. There is no definite pleural effusion or pneumothorax. The lungs appear clear. The bones are probably demineralized to some degree with similar mild degenerative changes along the mid thoracic spine.

IMPRESSION: No evidence of acute disease.


SubjectID: 16911520, StudyID: 59689953, Comparison: None

FINAL REPORT

INDICATION: Severe AS and cirrhosis, preoperative evaluation prior to valve replacement.

COMPARISON: ___. PA AND LATERAL CHEST RADIOGRAPHS: The cardiomediastinal and hilar contours are stable, with heart in the upper limits of normal. The lung volumes are low, without consolidation or pulmonary edema. Pulmonary vascular congestion has improved. Small right and a moderate left pleural effusions remain unchanged.

IMPRESSION: Bilateral pleural effusions and bibasilar atelectasis.


SubjectID: 16911520, StudyID: 54165840, Comparison: None

FINAL REPORT

INDICATION: Shortness of breath.

COMPARISON: Chest radiograph on ___.

FINDINGS: PA and lateral views of the chest. There are small to moderate sized bilateral pleural effusions, new from prior study. There is mild pulmonary vascular congestion. There is bibasilar atelectasis. No focal consolidation. There is moderate cardiomegaly. No pneumothorax. Scarring at the apices.

IMPRESSION: Small to moderate bilateral pleural effusions and pulmonary vascular congestion. Moderate cardiomegaly.


SubjectID: 16911520, StudyID: 58780141, Comparison: None

FINAL REPORT

HISTORY: ___-year-old male status post trach and PEG. Rule out pneumothorax.

COMPARISON: Multiple prior exams, most recently of ___.

FINDINGS: Single frontal view of the chest was obtained. Large subdiaphragmatic lucency appears to outline the diaphragm and the liver, and may represent a large pneumoperitoneum or a markedly distended viscous such as stomach or transverse colon. Endotracheal tube has been replaced with a tracheostomy tube. Right internal jugular central catheter terminates in the distal SVC. Sternotomy wires are intact. Moderate to large right and moderate left pleural effusions are slightly enlarged since prior with similar bibasilar opacities. Cardiomediastinal contours are stable with mild cardiomegaly.

IMPRESSION: 1. Large subdiaphragmatic lucency may represent pneumoperitoneum related to recently placed PEG or a markedly distended viscous. Dedicated abdominal radiograph could differentiate between these entities. 2. Status post tracheostomy placement. No pneumothorax. 3. Slight interval enlargement of moderate-to-large right and moderate left pleural effusions. Findings were communicated via phone call by Dr. ___ to ___, NP, on ___ at ___ PM, 5 minutes after discovery of the findings.


SubjectID: 16911520, StudyID: 58681148, Comparison: better

FINAL REPORT

HISTORY: Respiratory arrest, to assess for consolidation and pneumothorax.

FINDINGS: In comparison with the study of ___, there is no evidence of pneumothorax. The diffuse bilateral pulmonary opacifications may be slightly improved on the left   Keywords: improve. Again, they most likely reflect layering pleural effusions with vascular congestion and bibasilar atelectasis. The possibility of supervening pneumonia would be difficult to exclude given the extensive pulmonary changes.


SubjectID: 16911520, StudyID: 57278212, Comparison: same

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___ radiograph.

FINDINGS: Small biapical pneumothoraces have decreased in size since the prior radiograph. Otherwise, no relevant short interval change since the recent study   Keywords: no relevant short interval change.


SubjectID: 16911520, StudyID: 54328830, Comparison: None

FINAL REPORT

INDICATION: Status post CABG, evaluate for left-sided infiltrate.

COMPARISON: Chest radiographs on ___, and ___.

FINDINGS: Unchanged moderate bilateral pleural effusions and severe left lower lobe atelectasis. Previously seen possible left upper lobe opacity is no longer seen and likely due to overlying tubing on prior study. No pneumothorax. The mediastinal and hilar contours are stable. ET tube ends 5.6 cm from the carina, unchanged. Enteric tube ends off the imaged portion. Right internal jugular sheath ends just above the origin of the SVC, unchanged.

IMPRESSION: No significant change in bilateral pleural effusions and left lower lobe atelectasis. Previously seen possible left upper lobe opacity is no longer seen and likely due to overlying tubing on prior study.


SubjectID: 16911520, StudyID: 52216822, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Status post coronary artery bypass graft surgery.

COMPARISONS: Prior day.

TECHNIQUE: Chest, portable AP upright.

FINDINGS: The patient has been extubated. The patient is status post coronary artery bypass graft surgery. A right internal jugular central venous catheter terminates at the cavoatrial junction. The cardiac, mediastinal and hilar contours are stable. There is a moderate to large pleural effusion on the right, possibly increased in size, although a confounding factor is different positioning, so it is difficult to be certain as to whether there has been any real change. There is probably a small pleural effusion on the left. More conspicuous is retrocardiac opacification obscuring the left hemidiaphragm, a typical appearance for atelectasis although not specific.

IMPRESSION: Moderate right-sided pleural effusion, increasing retrocardiac opacification, not specific but most commonly due to atelectasis.


SubjectID: 16911520, StudyID: 52071457, Comparison: same

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph of earlier the same date.

FINDINGS: Small bilateral pneumothoraces are less apparent on the current study, possibly due to positional differences of the patient given the recency of the prior exam. Interval intubation with tip of endotracheal tube terminating approximately 6 cm above the carina. New nasogastric tube terminates within the stomach. Persistent cardiomegaly, accompanied by mild interstitial edema and moderate bilateral effusions with adjacent bilateral lower lobe areas of atelectasis and/or consolidation   Keywords: persistent.


SubjectID: 16911520, StudyID: 52035313, Comparison: None

WET READ: ___ ___ ___ 8:14 PM Interval exchange of a right IJ line with catheter tip now terminating in the low SVC. Otherwise, unchanged position of lines and tubes and stable appearance of chest without pneumothorax. ______________________________________________________________________________

FINAL REPORT

HISTORY: CABG with new line, to assess for position.

FINDINGS: In comparison with the earlier study of this date, there has been placement of a right IJ catheter that extends to the mid to lower portion of the SVC. Otherwise, the monitoring and support devices remain in place and there is no evidence of change in the appearance of the heart and lungs. No pneumothorax.


SubjectID: 16911520, StudyID: 56630582, Comparison: None

WET READ: ___ ___ ___ 5:40 PM Persistent bilateral pneumothorax, unchanged in size from 4 hours earlier. Unchanged bilateral small pleural effusions and bibasilar atelectasis.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph of earlier the same date.

FINDINGS: Bilateral small to moderate apicolateral pneumothoraces are unchanged since the recent study. Moderate layering pleural effusions are also similar, with adjacent atelectasis in both lower lobes.


SubjectID: 16911520, StudyID: 53330587, Comparison: -1.0

FINAL REPORT

INDICATION: Intubated, evaluate tube placement.

COMPARISON: Chest radiograph on ___.

FINDINGS: AP portable view of the chest. Endotracheal tube ends 4.4 cm from the carina in appropriate position. Right internal jugular catheter ends in the low SVC. Enteric tube ends off the imaged portion of the chest. Sternotomy wires are unchanged. Cardiomegaly is unchanged. Mediastinal and hilar contours are unchanged. No pneumothorax. Moderate right and small to moderate left pleural effusions are likely unchanged. Bibasilar opacities are unchanged   Keywords: unchanged   Keywords: unchanged. Slight increase in mild pulmonary edema   Keywords: increase   Keywords: increase.

IMPRESSION: Moderate right and small to moderate left pleural effusions are likely unchanged. Bibasilar opacities are unchanged. Slight increase in mild pulmonary edema.


SubjectID: 16921793, StudyID: 59886743, Comparison: 1.0

FINAL REPORT

HISTORY: Right pulmonary edema and possible pneumonia.

COMPARISON: ___.

FINDINGS: ET tube and NG tube are unchanged. There has been interval decrease in the pleural effusions with a small residual right-sided pleural effusion. There continues to be pulmonary vascular redistribution and alveolar infiltrate   Keywords: continue. Compared to the study from the prior day, there is improved aeration on the left and continued alveolar infiltrates on the right   Keywords: improve. Heart size continues to be moderately enlarged.

IMPRESSION: Slight improvement in pulmonary edema   Keywords: improve.


SubjectID: 16921793, StudyID: 56850226, Comparison: same

FINAL REPORT

INDICATION: Respiratory distress and cardiac decompensation. Post-intubation radiograph.

COMPARISONS: 5, ___.

FINDINGS: AP chest radiograph. The patient has been intubated in the interim. ET tube terminates 2.3 cm above the carina. There are moderate bilateral pleural effusions and pulmonary vascular engorgement with interstitial edema, not significantly changed from radiograph from approximately one hour prior   Keywords: not significantly changed. Moderate cardiomegaly is again noted. There is no pneumothorax. NG tube tip and side hole are below the diaphragm.


SubjectID: 16921793, StudyID: 55249793, Comparison: worse

FINAL REPORT

INDICATION: Dyspnea.

COMPARISON: ___.

FINDINGS: AP chest radiograph. There is a large pleural effusion on the right and probably a small one on the left as well. Moderate cardiomegaly is similar to prior radiographs. However, pulmonary vascular engorgement and interstitial edema are worsened from ___   Keywords: worse. There is no pneumothorax. The right proximal femur has a "pagetoid" appearance to it.


SubjectID: 16921793, StudyID: 59793436, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female with shortness of breath and productive cough. STUDY: PA and lateral chest radiograph.

COMPARISON: ___.

FINDINGS: The heart size is enlarged, but similar to prior study. Mediastinal and hilar contours are within normal limits. The lungs are clear. There is no pleural effusion or pneumothorax. Incidental note is made of calcified atherosclerotic disease along the coronary arteries. Sclerotic endplate changes are compatible with a history of renal osteodystrophy. Wedge deformity of the mid thoracic again seen.

IMPRESSION: Cardiomegaly, but no evidence of pneumonia. Renal osteodystrophy.


SubjectID: 16921793, StudyID: 58319142, Comparison: same

FINAL REPORT

HISTORY: Lung crackles after dialysis, to assess for pneumonia.

FINDINGS: In comparison with study of ___, there is little change in the substantial enlargement of the cardiac silhouette with some evidence of pulmonary vascular congestion   Keywords: little change. The relative ___ raises the possibility of either cardiomyopathy or pericardial effusion.


SubjectID: 16921793, StudyID: 59624820, Comparison: None

FINAL REPORT

HISTORY: Pulmonary hypertension and edema related to MI.

FINDINGS: In comparison with the study of ___, the monitoring and support devices remain in place. Again there is substantial enlargement of the cardiac silhouette with elevation of pulmonary venous pressure. In the appropriate clinical setting, more focal areas of opacification such as at the right base could represent developing consolidation.


SubjectID: 16921793, StudyID: 58112587, Comparison: worse

FINAL REPORT

HISTORY: ___-year-old woman with end-stage renal disease in the setting of acute coronary syndrome; rule out worsening fluid overload and infiltrate.

TECHNIQUE: Portable frontal chest radiograph was obtained with the patient in a semi erect position.

COMPARISON: Chest radiographs from ___ and ___. And ___.

FINDINGS: Mild increase in pulmonary vascular parenchymal changes noted on the right   Keywords: increase. Unchanged appearance of cardiomegaly and mediastinal contours. The right internal jugular central venous line still terminates within the upper ___ of the right atrium. ET tube is unchanged in appropriate position. Gastric tube traverses past the diaphragm outside the scope of the radiograph.

IMPRESSION: Mild increase in pulmonary vascular changes noted on the right   Keywords: increase. No new focal infiltrate seen.


SubjectID: 16921793, StudyID: 54497945, Comparison: better

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___ radiograph.

FINDINGS: Indwelling support and monitoring devices are unchanged in position, and cardiomegaly and pulmonary vascular congestion are present, although pulmonary edema has decreased in extent with a mild residual edema remaining as well as a layering right pleural effusion   Keywords: decrease.


SubjectID: 16921793, StudyID: 53870005, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: Chest AP portable single view.

INDICATION: ___-year-old female patient with pulmonary hypertension and end-stage renal disease. Intubated, evaluate for interval change.

FINDINGS: AP single view of the chest has been obtained with patient in supine position. Analysis is performed in direct comparison with the next preceding similar study of ___. The patient remains intubated, the ETT in unchanged position. Same holds for the previously described right internal jugular approach central venous line still terminating overlying the upper third of the right atrium. No pneumothorax has developed, and the previously described pulmonary vascular parenchymal changes appear unaltered. Unchanged appearance of cardiomegaly, vascular findings and configuration are consistent with thw clinical diagnosis of pulmonary vascular hypertension.


SubjectID: 16921793, StudyID: 59600107, Comparison: None

WET READ: ___ ___ ___ 8:20 PM Marked cardiomegaly is unchanged. Mild pulmonary vascular congestion is seen without definite pulmonary edema.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

REASON FOR

EXAMINATION: Cough and history of asthma, dialysis. PA and lateral upright chest radiographs were reviewed in comparison to ___ obtained at 2:22 p.m.

FINDINGS: Cardiomegaly is unchanged. Mediastinal silhouette is stable. Pulmonary arteries are enlarged as before. Hyperinflation is better appreciated on the lateral view as well as extensive coronary calcifications. Overall no substantial change since the prior study has been demonstrated.


SubjectID: 16921793, StudyID: 55796701, Comparison: 0.0

FINAL REPORT

CHEST, TWO VIEWS, ___.

HISTORY: ___-year-old female with dyspnea.

FINDINGS: Frontal and lateral views of the chest were compared to previous exam from ___. Since prior, there has been no significant interval change   Keywords: no significant interval change. Increased interstitial markings again suggestive of mild interstitial edema   Keywords: increase. There is no confluent consolidation. No large effusions. There is blunting of the right posterior costophrenic angle suggestive of possible trace effusion. Cardiac silhouette is significantly enlarged, similar to prior. Coronary artery calcifications are again noted. There is diffuse osteopenia limiting evaluation of osseous structures.

IMPRESSION: Cardiomegaly and mild interstitial pulmonary edema, not significantly changed from yesterday's exam   Keywords: not significantly changed.


SubjectID: 16921793, StudyID: 51627042, Comparison: None

FINAL REPORT

INDICATION: History of end-stage renal disease, due for dialysis today, now with orthopnea, here to evaluate for pulmonary edema.

COMPARISON: Chest radiograph dated ___.

TECHNIQUE: PA and lateral radiographs of the chest.

FINDINGS: The cardiac silhouette is severely enlarged but stable. Extensive coronary calcifications are best appreciated on the lateral radiograph. The mediastinal contours are prominent due to an unfolded and tortuous thoracic aorta. Calcification at the aortic knob is noted. The trachea is slightly deviated to the right by the aortic knob. The pulmonary vasculature is congested with minimal interstitial pulmonary edema. No significant pleural effusion or pneumothorax is detected. There is no focal consolidation concerning for pneumonia. Note is again made of exaggerated thoracic kyphosis with multiple wedge compression deformities at the mid thoracic vertebral bodies.

IMPRESSION: 1. Pulmonary vascular congestion and minimal interstitial pulmonary edema. 2. Stable severe cardiomegaly.


SubjectID: 16935843, StudyID: 55968244, Comparison: better

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___ radiograph.

FINDINGS: Previously reported biapical pneumothoraces have nearly resolved. Asymmetrical pattern of pulmonary edema has substantially improved and currently affects the right lung to a greater degree than the left   Keywords: improve. Moderate right and small left pleural effusions are present with adjacent atelectasis, the latter slightly worse on the right, but markedly improved on the left since the prior study.


SubjectID: 16935843, StudyID: 53180026, Comparison: same

FINAL REPORT

PORTABLE CHEST OF ___.

COMPARISON: ___ radiograph.

FINDINGS: Small biapical pneumothoraces are present. The left apical pneumothorax is in retrospect similar to prior study allowing for positional differences, and the right apical pneumothorax is apparently new, but could have been obscured by supine positioning on the previous study. Status post removal of various indwelling support and monitoring devices with residual right internal jugular central venous catheter sheath remaining in place. Slight interval increase in size of the heart, with persistent pulmonary vascular congestion   Keywords: persistent. Change in distribution of combined alveolar and interstitial edema pattern, which is probably of overall similar severity   Keywords: similar. Coexisting atelectasis is likely present in the lung bases, as well as bilateral pleural effusions, small to moderate in size.


SubjectID: 16943681, StudyID: 58980599, Comparison: better

WET READ: ___ ___ 7:03 PM Compared to the earlier study, the lungs seem slightly better aerated, although with persistent perihilar opacities, likely due to developing multifocal pneumonia as described earlier. Pulmonary edema is mild. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with acute SOB desat to ___% // r/o aspiration r/o aspiration

IMPRESSION: Widespread heterogeneous pulmonary opacification has improved since earlier in the day, largely due to better lung volumes   Keywords: improve. Whether this is widespread pneumonia or asymmetric edema is radiographically indeterminate, although I expect both are present. There is also been consistent fullness to the lower pole of the right hilus, possibly due to adenopathy. Heart size is top-normal. Mitral annulus calcification is very heavy, which can contribute to acute mitral regurgitation. Pleural effusions are presumed, but not large. No pneumothorax.


SubjectID: 16943681, StudyID: 57909649, Comparison: same

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___ year old woman with chronic aspiration, likely pna or pulm edema on ap CXR // pneumonia

TECHNIQUE: Chest AP and lateral

COMPARISON: ___

FINDINGS: Worsening right perihilar opacities may reflect a developing multifocal pneumonia. Multiple lucencies in the right perihilar region may reflect cavitary lesions.Mild bilateral pulmonary edema is again noted   Keywords: again. Small bilateral pleural effusions may be present. The cardiac and mediastinal silhouettes are unchanged.

IMPRESSION: Persistently worsening right perihilar opacities likely reflect a developing multifocal pneumonia with possible cavitations. Further evaluation with chest CT is recommended. Pulmonary edema is unchanged   Keywords: unchanged. Small bilateral pleural effusions may be present.

RECOMMENDATION(S): Chest CT

NOTIFICATION: The findings were discussed with ___, M.D. by ___ ___, M.D. on the telephone on ___ at 1:20 PM, 20 minutes after discovery of the findings.


SubjectID: 16949700, StudyID: 58763439, Comparison: 1.0

FINAL REPORT

INDICATION: ___M with intubation // eval for tube, line placement

TECHNIQUE: Frontal chest radiographs were obtained with the patient in the supine position.

COMPARISON: Radiograph from ___ at 10:20 AM, ___ at 07:___.

FINDINGS: There has been interval placement of a endotracheal tube which terminates approximately 7.4 cm above the carina, with distal tip of the tube at the inferior edge of the medial clavicular heads. There has also been interval placement of a nasogastric tube which appears to terminate below the level of the diaphragm and outside the view of this radiograph. Of note, the inferior edge of this film probably lies in the region of the GE junction. Otherwise, no gross interval change is detected compared with the chest radiograph performed 30 minutes earlier. Again seen is cardiomegaly, with pulmonary edema   Keywords: again. There has probably been slight improvement in the appearance of the right upper lobe. Possible slight improvement in the degree of interstitial edema in the left upper lobe   Keywords: improve. Left-sided pacemaker device again noted, with 2 leads in appropriate position.

IMPRESSION: Interval placement of endotracheal tube and nasogastric tube, detailed above. Possible slight interval improvement in pulmonary edema findings, but the overall appearance is quite similar   Keywords: improve.


SubjectID: 16949700, StudyID: 58701949, Comparison: worse

FINAL REPORT

INDICATION: ___M with cardiogenic shock // eval for interval change from ___ x-ray

TECHNIQUE: Frontal chest radiographs were obtained with the patient in the upright position.

COMPARISON: Chest radiograph from ___ from ___ at 07:43,.

FINDINGS: The cardiac silhouette continues to be enlarged, but without gross change. Again noted is a left-sided pacemaker type device with appropriate position of leads over the right atrium and right ventricle. There is moderate pulmonary edema, possibly slightly worse compared to the chest radiograph from 2 hours earlier   Keywords: worse. No gross effusions identified on this AP film. No pneumothoraces detected.

IMPRESSION: Cardiomegaly with moderate pulmonary edema.


SubjectID: 16949700, StudyID: 53549548, Comparison: None

FINAL REPORT

HISTORY: Known CAD, ischemic cardiomyopathy, now status post PEA arrest. Rule out worsening pulmonary edema. CHEST, SINGLE AP PORTABLE SUPINE VIEW. None of the available views include the lung bases. Allowing for this, an ET tube is present, tip approximately 7.1 cm above the carina. An NG tube is present, tip extending along the length of the visible mediastinum. A right IJ central line is present, tip over distal SVC. A left-sided dual-lead pacemaker is present, lead tips over right atrium and right ventricle. Scattered mediastinal clips are present. There is cardiomegaly, similar, possibly slightly improved compared with ___ at 18:56 p.m. There is increased retrocardiac density, consistent with left lower lobe collapse and/or consolidation. There is upper zone redistribution and mild diffuse vascular blurring, with crowding of vessels in the right cardiophrenic region, quite similar to the prior film. Assessment for small effusions is limited, but no gross effusion is detected.

IMPRESSION: 1. Limited assessment of lung bases. 2. Upper zone redistribution and evidence for interstitial edema. 3. Left lower lobe collapse and/or consolidation and probable element of consolidation at the right base medially. 4. Cardiomegaly, possibly slightly improved. 5. Otherwise, appearance is similar to one day earlier. Possibility of early alveolar edema cannot be excluded.


SubjectID: 16952127, StudyID: 58300753, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF and aortic stenosis s/p TAVR, on IABP // Interval changes Interval changes

IMPRESSION: Comparison to ___. Improvement in severity of the pre-existing pulmonary edema   Keywords: improve. Moderate cardiomegaly persists. Stable monitoring and support devices, the pre-existing minimal pleural effusions have slightly increased in extent.


SubjectID: 16952127, StudyID: 57525148, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with respiratory distress // Interval changes Interval changes

COMPARISON: ___

IMPRESSION: Moderate cardiomegaly is unchanged. There is unchanged appearance of extensive parenchymal opacities, most likely concerning for interstitial pulmonary edema with potentially slight progression as compared this radiograph but different progression as compared to ___   Keywords: progression. Small bilateral pleural effusion is present.


SubjectID: 16952127, StudyID: 55541673, Comparison: None

WET READ: ___ ___ ___ 10:11 PM 1. ET tube in appropriate position. Enteric feeding tube tip not seen. 2. Worsening moderate to severe pulmonary and interstitial edema with small bilateral pleural effusions ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF and severe AS // post-TAVR, please evaluate ET tube position post-TAVR, please evaluate ET tube position

IMPRESSION: Comparison to ___, 07:49. Severe pulmonary edema. The patient is now intubated. The tip of the endotracheal tube projects 4.5 cm above the carina. A Swan-Ganz catheter is in correct position. The tip of the intra-aortic balloon pump projects 5 cm be low the upper most portions of the aortic arch, the device could be advanced by approximately 3-4 cm. No pneumothorax. Mild cardiomegaly. Mild bilateral pleural effusions.


SubjectID: 16952127, StudyID: 53216186, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with feeding tube // feeding tube placement? feeding tube placement?

IMPRESSION: In comparison with the study of ___, there is been placement of the nasogastric tube that extends to the upper stomach. However, the side port is above the cavoatrial junction, and the tube should be pushed forward at least 5-10 cm for more optimal positioning. The IABP has been repositioned so that the tip is approximately 4.4 cm top of the transverse arch of the aorta. It could be pushed forward another 2 cm for more optimal positioning. Diffuse bilateral pulmonary opacifications, in conjunction with enlargement of the cardiac silhouette, produces a pattern consistent with pulmonary edema. In the appropriate clinical setting, the possibility of superimposed pneumonia could be considered.


SubjectID: 16952127, StudyID: 50482020, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with respiratory failure, intubated // Interval changes

TECHNIQUE: Portable chest

COMPARISON: ___.

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change.


SubjectID: 16952127, StudyID: 58287899, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with dyspnea, hypoxia, aortic stenosis

TECHNIQUE: Portable supine AP view of the chest

COMPARISON: ___ at 05:18

FINDINGS: Moderate enlargement of the cardiac silhouette is re- demonstrated. The mediastinal contour is unchanged with atherosclerotic calcifications noted at the aortic knob. Moderate to severe pulmonary edema appears minimally worse compared to the previous study with continued small bilateral pleural effusions   Keywords: worse. More focal opacities at the lung bases may reflect areas of atelectasis. No pneumothorax is present. There are no acute osseous abnormalities.

IMPRESSION: Slight interval worsening of moderate to severe pulmonary edema and continued small bilateral pleural effusions   Keywords: worse.


SubjectID: 16952127, StudyID: 56071110, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with severe AS, CHF, respiratory failure s/ OGT placement // ?OGT placement ?OGT placement

IMPRESSION: Severe infiltrative pulmonary abnormality has worsened, accompanied by at least moderate pleural effusions, most likely pulmonary edema. Heart is moderately enlarged. No pneumothorax. ET tube and transesophageal drainage tube in standard reflect placements. No pneumothorax.


SubjectID: 16952127, StudyID: 54141787, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF and severe AS, p/w chest pain concerning for ACS, intubated for hypoxemia // please evaluate ET tube, please evaluate for changes please evaluate ET tube, please evaluate for changes

IMPRESSION: Compared to the only prior chest radiograph, ___:52. Lung volumes are appreciably lower exaggerating the worsening if any of the already moderately severe pulmonary edema. Moderate pleural effusions are likely. Cardiomegaly is moderate. No pneumothorax. ET tube in standard placement. Nasogastric drainage tube ends


SubjectID: 16952127, StudyID: 52861747, Comparison: better

FINAL REPORT

INDICATION: ___ year old man with NSTEMI, heart failure exacerbation, and pleural effusions // interval change

COMPARISON: The comparison is made with prior studies including ___.

IMPRESSION: Endotracheal tube tip is 2 cm above the carina. Nasogastric tube tip is in the stomach. There has been significant improvement in the pulmonary edema   Keywords: improve. There is some patchy atelectasis in the left lung base. There is stable small pleural effusions bilaterally. There is no pneumothorax.


SubjectID: 16952127, StudyID: 52706758, Comparison: worse

WET READ: ___ ___ 3:55 PM Moderate to severe pulmonary edema is unchanged or mildly worsened. Mild cardiomegaly is stable. There has been interval placement of an endotracheal tube which ends in the mid thoracic trachea.

WET READ VERSION #1 ___ ___ 8:25 PM Moderate to severe pulmonary edema is unchanged or mildly worsened. Mild cardiomegaly is stable. There has been interval placement of an endotracheal tube which ends in the mid thoracic trachea. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___ year old man with CHF and severe AS, intubated prior to cath. Please evaluate ET tube place

TECHNIQUE: Portable AP chest radiograph

COMPARISON: Chest radiographs from ___, ___, ___.

FINDINGS: ET tube terminates approximately 4 cm from the carina. Compared to chest radiograph from ___ at 09:53, there is mild increase in bilateral pleural effusion. There is left perihilar opacity that is slightly more confluent today compared to prior, possibly from atelectasis and worsening edema   Keywords: worse. The moderate to severe pulmonary edema is possibly worsening   Keywords: worse. The right upper lobe is clear. Cardiomegaly is likely unchanged. The aortic knob calcification is unchanged.

IMPRESSION: 1. New ETT in standard position. 2. Moderate to severe pulmonary edema, worsening   Keywords: worse. 3. Mild increase in bilateral pleural effusion.


SubjectID: 16952127, StudyID: 50736344, Comparison: None

WET READ: ___ ___ 7:00 AM Moderate central pulmonary vascular congestion with associated moderate to severe interstitial pulmonary edema. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___M with chf dyspnea, evaluate for pulmonary edema or pneumonia.

TECHNIQUE: Single portable semi-upright AP view radiograph of the chest.

COMPARISON: Multiple prior chest radiographs dating back to ___.

FINDINGS: Moderate central pulmonary vascular congestion is associated with moderate to severe interstitial pulmonary edema, predominantly in the bilateral lung bases. Small bilateral pleural effusions are likely. There is no pneumothorax or definite focal consolidation. The cardiomediastinal contour, including mild cardiomegaly, is unchanged. The osseous structures and upper abdomen are unremarkable.

IMPRESSION: Moderate central pulmonary vascular congestion with associated moderate to severe interstitial pulmonary edema.


SubjectID: 16952127, StudyID: 54801255, Comparison: worse

FINAL REPORT

INDICATION: ___ year old man with CAD, AS, respiratory failure // ?acute change

COMPARISON: The comparison is made with prior studies including ___.

IMPRESSION: Since the prior exam, there is increasing upper zone redistribution and blurring of vascular detail consistent with pulmonary edema   Keywords: increasing. There is no pneumothorax. The cardiac silhouette is enlarged and has a somewhat globular configuration. If there is clinical concern for pericardial effusion, then cardiac ultrasound should be considered.


SubjectID: 16952127, StudyID: 52246499, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with severe AS and CHF // please evaluate for any changes

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Moderate cardiomegaly is a stable. Bilateral effusions have increased on the left. Moderate pulmonary edema has minimally improved   Keywords: improve. Bibasilar atelectasis larger on the left side have increased. There is no evident pneumothorax.


SubjectID: 16952127, StudyID: 56859896, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with hypoxic respiratory distress with worsening hypoxia // ?acute change

COMPARISON: The comparison is made with prior studies including ___.

IMPRESSION: The endotracheal tube and nasogastric tubes have been removed. There is cardiomegaly, upper zone redistribution and blurring of vascular detail suggesting CHF. There is probable superimposed atelectasis in the left lung base. There is no pneumothorax.


SubjectID: 16952127, StudyID: 55848565, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with respiratory failure // Interval changes

COMPARISON: The comparison is made with prior studies including ___

IMPRESSION: There is stable patchy density in both lower lobes. There are probable effusions bilaterally. There is no pneumothorax or CHF.. The endotracheal tube tip is 5 cm above the carina. Nasogastric tube tip is in the stomach.


SubjectID: 16952127, StudyID: 55991601, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with respiratory failure, intubated // Interval changes

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: A femoral line is seen to cross midline and no into the left upper chest, presumably in to the left pulmonary artery. It would have to be pulled back 5 cm to be in the pulmonary outflow tract. Otherwise the appearance of the lungs and tubes are unchanged

IMPRESSION: Femoral Swan-Ganz catheter out slightly far on the left


SubjectID: 16959552, StudyID: 55442441, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF // CHF? CHF?

IMPRESSION: In comparison with the study of ___, the right PICC line has been pulled back into the axillary region. Continued enlargement of the cardiac silhouette with probable worsening pulmonary edema   Keywords: worse. Volume loss in the left lower lung is again seen.


SubjectID: 16962402, StudyID: 55761202, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Dropping hematocrit.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the Swan-Ganz catheter has been removed. The patient has also been extubated and the nasogastric tube has been removed. A right chest tube as well as a mediastinal drain and a venous introduction sheath are in situ. After extubation, the lung volumes have decreased, with newly appeared bilateral areas of atelectasis at the lung bases. A coexisting small left pleural effusion cannot be excluded. Borderline size of the cardiac silhouette without evidence of overt pulmonary edema. No evidence of pneumothorax.


SubjectID: 16962402, StudyID: 50399528, Comparison: None

WET READ: ___ ___ ___:___ PM No pneumothorax after chest tube removal. Small left pleural effusion and retrocardiac opacity, likely atelectasis, unchanged. ___ ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluation for pneumothorax, chest tube removal.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the chest tube and the right internal jugular vein catheter has been removed. Minimal left pleural effusion. Moderate retrocardiac atelectasis. Otherwise, the radiograph is unchanged, no evidence of acute changes.


SubjectID: 16990734, StudyID: 59693543, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF // Volume status, pulmonary edema, infiltrates, interval change

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Cardiomegaly is stable. There is mild vascular congestion. Bibasilar atelectasis are more conspicuous than before. There is no pneumothorax or enlarging effusions No other interval change from prior study.


SubjectID: 16990734, StudyID: 50873251, Comparison: None

WET READ: ___ ___ 5:25 AM No pneumonia. ______________________________________________________________________________

FINAL REPORT

INDICATION: History: ___F with elev lactate and WBC // eval foe pneumonia

TECHNIQUE: Chest PA and lateral

COMPARISON: Prior chest radiographs dated ___ through ___, and CT chest dated ___.

FINDINGS: Right apical pleural parenchymal scarring is stable. More irregular subpleural nodulation in the right upper lung also appears unchanged from ___. A calcified density in the right upper lung corresponds to calcification of the costal cartilage. The cardiac silhouette is unchanged. Mitral annular calcifications are dense.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 16990734, StudyID: 50824926, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF and COPD p/w acute SOB // e/o pulmonary edema

TECHNIQUE: Portable AP chest radiograph.

COMPARISON: Chest radiograph ___

FINDINGS: Even allowing for the projection, there is mild cardiomegaly. There is persistent left lower lobe atelectasis. Increased opacity at the right lung base is more conspicuous than on the prior study. Given the lack of associated volume loss, appearances are suspicious for superimposed infection. There is persistent prominence of the bilateral hila with mild pulmonary vascular congestion. No pneumothorax seen.

IMPRESSION: Background changes of atelectasis and pulmonary vascular congestion. Increased opacity at the right lung base suspicious for superimposed infection.


SubjectID: 16990734, StudyID: 53776058, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with fevers, hypoxia, on vanc // pneumonia vs pulm edema

TECHNIQUE: Portable AP chest radiograph.

COMPARISON: Chest radiograph ___

FINDINGS: There has been interval improvement in aeration of the right lung base with residual linear atelectasis. Lung volumes are grossly unchanged. There is persistent moderate cardiomegaly. No pleural effusion or consolidation seen. A dense opacity at the right upper lobe is likely a calcified granuloma. Calcifications in the left upper abdomen are consistent with splenic granulomas.

IMPRESSION: Interval improvement of the right lower lobe airspace opacity.


SubjectID: 16995942, StudyID: 59727302, Comparison: worse

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___F with chest pain, bradycardia, SOB // chest pain, bradycardia

TECHNIQUE: Chest AP and lateral

COMPARISON: Chest radiograph dated ___.

FINDINGS: As compared to the prior examination dated ___ there is increased and now moderate-severe cardiomegaly with increasing central pulmonary vascular congestion and mild interstitial edema. Probable trace bilateral pleural effusions.

IMPRESSION: Increasing, moderate-severe cardiomegaly and mild interstitial pulmonary edema   Keywords: increasing.


SubjectID: 16995942, StudyID: 57183942, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with dyspnea // Evidence of new intrapulmonary process Evidence of new intrapulmonary process

IMPRESSION: Comparison to ___. No relevant change   Keywords: no relevant change. Massive cardiomegaly, status post valvular replacement. Sternotomy wires in unchanged position. Non recent fibrotic changes at the right lung base, with blunting of the costophrenic sinus. No overt pulmonary edema. Moderate elongation of the descending aorta. No interval appearance of focal parenchymal opacities potentially suggesting pneumonia.


SubjectID: 16995942, StudyID: 51392124, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with heart failure exacerbation, currently tachypnic hypertensive // eval for flash pulm edema eval for flash pulm edema

COMPARISON: Prior chest radiographs since ___, most recently ___ and ___, at 04:32.

IMPRESSION: Lung volumes are slightly lower, exaggerating what is probably stable mild pulmonary edema   Keywords: stable. Cardiomegaly is severe and chronic. Small pleural effusions are unchanged. No pneumothorax.


SubjectID: 17012909, StudyID: 56380627, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with sob, prior effusion, hypoxia // eval effusion

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, there is substantial increase in extent of a pre-existing right pleural effusion. The effusion now occupies approximately ___% of the right hemithorax, causing extensive atelectasis at the right lung bases. On the left, the elevation of the hemidiaphragm, that pre existed, has also increased. The precise size the cardiac silhouette can no longer be determined. Increases in diameter of the perihilar vessels suggest the presence of mild pulmonary edema.


SubjectID: 17012909, StudyID: 54844646, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___F with pmhx of DM, HTN, HLD, h/o breast cancer, dysphagia of unclear etiology despite GI workup, recent pleural effusion with atypical cells although no definitive dx who presents with dyspnea for one week. // Is there any evidence of pneumothorax after thoracentesis?

TECHNIQUE: Portable frontal view of the chest.

COMPARISON: ___

FINDINGS: Patient has undergone right-sided thoracentesis now with small right-sided pleural effusion and small left pleural effusion with adjacent compressive atelectasis. Increased density along the right lung may represent expansion edema. There is no pneumothorax. Heart size is difficult to assess. Calcifications are seen in the aortic knob.

IMPRESSION: Decrease in right-sided pleural effusion after thoracentesis, now small. Small left-sided pleural effusion and probable expansion edema in the right lung.


SubjectID: 17023312, StudyID: 59174463, Comparison: None

FINAL REPORT

HISTORY: ET tube placement.

FINDINGS: In comparison with the study of ___, there has been placement of an endotracheal tube with its tip approximately 2.9 cm above the carina. Nasogastric tube is now in place with the tip at least in the upper body of the stomach where it crosses the lower margin of the image. The patient has taken a slightly better inspiration. There is continued cardiomegaly with elevation of pulmonary venous pressure.


SubjectID: 17023312, StudyID: 54269980, Comparison: None

FINAL REPORT

HISTORY: COPD with hypoxia.

FINDINGS: No previous images. There are low lung volumes, which accentuate the enlargement of the cardiac silhouette. There is moderate pulmonary vascular congestion. No definite acute pneumonia.


SubjectID: 17023312, StudyID: 50234626, Comparison: None

FINAL REPORT

HISTORY: COPD and CHF.

FINDINGS: No previous images are available, so that comparison cannot be made with previous studies. There is enlargement of the cardiac silhouette with indistinctness of engorged pulmonary vessels consistent with pulmonary vascular congestion. Some hazy opacification at the bases could reflect layering effusion, though it could also be a manifestation of the size of the patient and resulting scattered radiation. Right IJ catheter tip extends to lower portion of the SVC.


SubjectID: 17023312, StudyID: 57532258, Comparison: same

FINAL REPORT

INDICATION: History of chest tube removal, please evaluate.

COMPARISON: Multiple chest radiographs dating back to ___.

TECHNIQUE: Single AP portable exam of the chest.

FINDINGS: The ET tube terminates approximately 28 mm above the carina. The remainder of the lines and tubes are in appropriate position. There has been interval removal of a right-sided chest tube compared to the prior exam. No definite pneumothorax is identified. There has been interval increase in consolidation at the left lung base which could be secondary to atelectasis; however, an acute infectious process cannot be excluded. There is a stable moderate right and small left-sided pleural effusions. Again seen is pulmonary vascular engorgement with stable mild bilateral pulmonary edema   Keywords: stable, again.

IMPRESSION: 1. Status post removal of the right-sided chest tube without evidence of pneumothorax. 2. Interval worsening of left basilar consolidation which could be secondary to atelectasis, however an infectious process cannot be excluded. 3. Stable moderate right and small left pleural effusions.


SubjectID: 17023312, StudyID: 56670985, Comparison: same

FINAL REPORT

HISTORY: Right thoracotomy, to assess for effusion.

FINDINGS: In comparison with the study of ___, the monitoring and support devices remain in place. There is again enlargement of the cardiac silhouette with pulmonary edema and layering effusions, more prominent on the right   Keywords: again. In the appropriate clinical setting, it would be impossible to exclude supervening pneumonia given the diffuse pulmonary changes.


SubjectID: 17023312, StudyID: 56412089, Comparison: better

FINAL REPORT

HISTORY: Post-surgical.

FINDINGS: In comparison with the study of ___, the endotracheal and nasogastric tubes have been removed. There are somewhat lower lung volumes. Little definite change in the appearance of the bilateral pleural effusions with bibasilar atelectasis. The degree of pulmonary vascular congestion has improved   Keywords: improve.


SubjectID: 17023312, StudyID: 54439637, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post right thoracotomy, evaluation for pleural effusion.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The monitoring and support devices, including the right chest tubes, are constant. The position of the endotracheal tube and the nasogastric tube are also constant. The lung volumes remain low, with areas of atelectasis at the lung bases and signs of mild fluid overload. Mild areas of moderate atelectasis bilaterally.


SubjectID: 17023312, StudyID: 57244256, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with COPD and hypercarbia/ hypoxia on BIPAP // interval change

COMPARISON: Chest radiograph ___

FINDINGS: Single AP view of the chest provided. The prominence of the pulmonary vasculature is stable. Lung volumes are low. Bilateral, diffuse interstitial and some alveolar infiltrates are mildly worsened from ___   Keywords: worse. No pleural effusion or pneumothorax. Hilar contours are normal. Moderate cardiomegaly is unchanged. Multiple rib fractures and probable surgical rib changes are stable from ___.

IMPRESSION: Mild pulmonary edema is worsened from ___   Keywords: worse.


SubjectID: 17023312, StudyID: 55976256, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with AMS, hypoxia // eval for acute process

COMPARISON: ___.

FINDINGS: AP portable upright view of the chest. Lung volumes are low limiting assessment. Overlying EKG leads are present. Previously noted PICC line has been removed. There has been a prior left rib resection unchanged. The heart remains mildly enlarged. There is no definite evidence for pneumonia or overt CHF. Mild congestion is likely present. No large effusion or pneumothorax. Bony structures appear intact.

IMPRESSION: Stable cardiomegaly, mild congestion. Limited exam.


SubjectID: 17023312, StudyID: 52389258, Comparison: same

WET READ: ___ ___ 9:32 PM No significant change in extensive parenchymal opacities and as seen on the previous chest x-ray which may be due to pulmonary edema . There is a layering right pleural effusionas seen previously. Cardiomegaly is stable. Support devices are unchanged. ______________________________________________________________________________

FINAL REPORT

HISTORY: Thoracotomy, to assess for bleeding.

FINDINGS: In comparison with the earlier study of this date, the monitoring and support devices are unchanged. Diffuse bilateral parenchymal opacifications are again seen   Keywords: again. This most likely reflects pulmonary edema with layering effusions. In the appropriate clinical setting, supervening pneumonia would have to be considered.


SubjectID: 17023838, StudyID: 58733200, Comparison: None

FINAL REPORT

HISTORY: Hypotension.

TECHNIQUE: Single portable view of the chest.

COMPARISON: ___

FINDINGS: Right-sided PICC terminates at the cavoatrial junction. The patient is significantly rotated to the left. Cardiomegaly remains. Mild pulmonary edema. The right lung is clear. No signs of infection.

IMPRESSION: Mild pulmonary edema.


SubjectID: 17023838, StudyID: 52839777, Comparison: worse

FINAL REPORT

EXAM: Chest, single AP upright portable view. CLINICAL INFORMATION: CHF.

COMPARISON: ___.

FINDINGS: The left costophrenic angle is not included on the image. The right-sided PICC is seen, terminating at the low SVC/cavoatrial junction, stable. The patient is slightly rotated to the left less so than on the prior study. There is moderate pulmonary vascular congestion with possible small pleural effusions. Degree of edema appears slightly increased as compared to the prior study   Keywords: increase. Cardiac and mediastinal silhouettes are stable.


SubjectID: 17023838, StudyID: 54728977, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Pleural effusion.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the lung volumes have increased and the extent of the bilateral pleural effusions has substantially decreased. However, signs of effusion are still seen bilaterally, notably on the right. Both hilar structures are at the upper range of normal in diameter. There is a minimal increase in right upper mediastinal density, potentially caused by patient's rotation. No evidence of pneumothorax.


SubjectID: 17023838, StudyID: 50111769, Comparison: None

FINAL REPORT

INDICATION: Evaluation for interval change of pleural effusions in a patient with bilateral lower extremity ischemia.

COMPARISON: Chest radiographs of ___ and ___.

FINDINGS: PA and lateral views of the chest are reviewed and compared to the prior study. Low lung volumes persist. Moderate bilateral pleural effusions with underlying bibasilar atelectasis are unchanged. Cardiomegaly and a calcified mitral valve ring are unchanged.

IMPRESSION: 1. Unchanged moderate bilateral pleural effusions with underlying bilateral atelectasis. 2. Unchanged cardiomegaly.


SubjectID: 17025899, StudyID: 54234744, Comparison: None

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with effusion.

COMPARISON: Chest x-rays from ___ to ___.

FINDINGS: The patient just had sternotomy for CABG. Left chest tube has been removed and there is a new left apical pneumothorax measuring 7 mm. The right lung is unremarkable. Bibasilar atelectasis has improved. There is no pulmonary edema. Right jugular line ends at the cavoatrial junction. Cardiac contour is top normal.

CONCLUSION: The patient just had sternotomy for CABG. Left small apical pneumothorax is new after left chest tube removal. This was discussed with the medical team.


SubjectID: 17025899, StudyID: 51505569, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: Chest AP portable single view.

INDICATION: ___-year-old male patient with removal of mediastinal chest tubes and central line change over wire, evaluate for pneumothorax.

FINDINGS: AP single view of the chest has been obtained with patient in semi-upright position. Comparison is made with the next preceding similar study of ___. The patient is now extubated. The previously existing Swan-Ganz catheter has been removed. The sheath has been exchanged over a wire by a right internal jugular route line, the tip of which reaches some 4 cm below the level of the carina in the area of the expected right SVC/atrial junction. Whereas the right-sided chest tube has been removed, the left-sided tube remains in unchanged appropriate position. Heart size has increased slightly postoperatively, but no significant increase of pulmonary congestive pattern or new infiltrates is seen. The previously mentioned metallic structures of a mitral valve prosthesis remain in unchanged position.

IMPRESSION: No pneumothorax. Central venous line terminating close to atrial junction. Recommend withdrawal by 2 cm to avoid possible contact with cardiac structures.


SubjectID: 17047039, StudyID: 57233229, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman POD MVR CT removal // evaluate for PTX

TECHNIQUE: Portable chest

COMPARISON: ___.

FINDINGS: The ET tube, NG tube, Swan-Ganz catheter. Comma chest to this, mediastinal drains been removed. There is volume loss at both bases. There is a moderate right effusion that appears larger than on the prior study. There is dense retrocardiac opacity compatible volume loss/ infiltrate/effusion.

IMPRESSION: Fluid overload. The appearance on the right is much worse compared to prior.


SubjectID: 17047039, StudyID: 56387167, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST OF ___

COMPARISON: ___.

FINDINGS: Small left apical pneumothorax is unchanged. Cardiomediastinal contours are stable in the postoperative period. Atelectatic changes in the right middle and both lower lobes are again demonstrated, slightly worse in the left lower lobe in the interval. Moderate right and small left pleural effusions are unchanged when allowances are made for positional differences between the exams.


SubjectID: 17051420, StudyID: 58659623, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with worsening SOB since this AM // worsening edema? worsening edema?

IMPRESSION: Comparison to ___. Known unchanged mild pulmonary edema   Keywords: unchanged. Moderate cardiomegaly. No larger pleural effusions. The radiograph has not changed since today 10:01.


SubjectID: 17051420, StudyID: 55910335, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___M with chest pain // iniltrate or pneumothorax iniltrate or pneumothorax

IMPRESSION: Comparison to ___. On the current radiograph, mild pulmonary edema is present, with both vascular and an interstitial component. Moderate cardiomegaly. No larger pleural effusions. No pneumonia, no pneumothorax.


SubjectID: 17051420, StudyID: 58537428, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with COPD, CHF, p/w increased dyspnea and new leukocytosis // pulmonary edema vs infiltrate?

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Borderline size of the cardiac silhouette. Coronary calcifications. No pleural effusions. No pneumonia, no pulmonary edema. Minimal retrocardiac atelectasis.


SubjectID: 17051420, StudyID: 50391244, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiographs.

INDICATION: Cough.

COMPARISON: Radiographs from ___ and CT from ___.

TECHNIQUE: Chest, PA and lateral.

FINDINGS: New since the prior radiographs but also since the recent prior CT are opacities in the superior segment of the left lower lobe and also more vague but new right upper lobe opacity, all suggesting development of pneumonia. There is no pleural effusion or pneumothorax. Mild to moderate degenerative changes are similar along the thoracic spine.

IMPRESSION: New opacities suggesting pneumonia.


SubjectID: 17051420, StudyID: 57285554, Comparison: better

FINAL REPORT

INDICATION: ___-year-old man with chest pain and shortness of breath.

TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position.

COMPARISON: Radiograph from ___, ___, ___ and ___.

FINDINGS: The heart continues to be enlarged, and there is interval improvement in the interstitial edema from prior radiograph   Keywords: improve. No pleural effusions, focal consolidation or pneumothorax is seen.

IMPRESSION: Cardiomegaly with mild interval improvement in interstitial edema   Keywords: improve.


SubjectID: 17051420, StudyID: 50783845, Comparison: None

FINAL REPORT

INDICATION: ___ year old male with history of recent CPR, rib fractures, now presenting with chest pain, cough, hemoptysis.

TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position.

COMPARISON: Radiographs from ___ and ___.

FINDINGS: The heart continues to be markedly enlarged, and there is pulmonary vascular congestion with mild interstitial edema. No definite pleural effusions are seen. No displaced rib fractures are noted.

IMPRESSION: Marked cardiomegaly with mild interstitial edema.


SubjectID: 17051420, StudyID: 55613131, Comparison: None

WET READ: ___ ___ 8:00 PM No substantial change from prior. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF. // assess interval change

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Heart size and mediastinum are stable. There is no evidence of pulmonary edema. There is no appreciable pleural effusion or pneumothorax.


SubjectID: 17051420, StudyID: 52439330, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with COPD, CHF, thrombocytopenia with hemoptysis // interval change

COMPARISON: ___

IMPRESSION: No relevant change as compared to the previous image   Keywords: no relevant change. Mild cardiomegaly without pulmonary edema. No pneumonia, no pleural effusions. No pneumothorax.


SubjectID: 17051420, StudyID: 53308470, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___M with cough, sob, hx CHF

COMPARISON: ___

FINDINGS: PA and lateral views of the chest provided. Cardiomegaly is again noted with mild pulmonary interstitial edema re- demonstrated   Keywords: again. No significant progression. No large effusion or pneumothorax. No convincing evidence for pneumonia. Mediastinal contour stable. Bony structures are intact.

IMPRESSION: Mild interstitial edema, cardiomegaly.


SubjectID: 17051420, StudyID: 50704218, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___M with dyspnea. History of congestive heart failure off meds.

TECHNIQUE: Chest PA and lateral

COMPARISON: ___

FINDINGS: Cardiac silhouette size is moderately enlarged, similar compared to the prior study. Mediastinal contours are unchanged. Mild interstitial pulmonary edema is not substantially changed in the interval, and hilar contours are similar. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities.

IMPRESSION: Mild interstitial pulmonary edema, not changed in the interval.


SubjectID: 17051420, StudyID: 53239242, Comparison: None

FINAL REPORT

CHEST, TWO VIEWS, ___.

HISTORY: ___-year-old male with chest pain and shortness of breath.

COMPARISON: ___.

FINDINGS: Frontal and lateral views of the chest. The lungs are clear of consolidation, effusion or pulmonary vascular congestion. Cardiac silhouette is mild to moderately enlarged. No acute osseous abnormalities.

IMPRESSION: Cardiomegaly without acute cardiopulmonary process.


SubjectID: 17051420, StudyID: 52063857, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___ radiograph.

FINDINGS: Cardiac silhouette is mildly enlarged and accompanied by pulmonary vascular congestion. There is no overt pulmonary edema. Patchy opacity has developed at the lung bases which most likely represents atelectasis. Short-term followup radiographs may be helpful to exclude aspiration or an early focus of pneumonia.


SubjectID: 17056572, StudyID: 58887183, Comparison: None

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPH

INDICATION: Dyspnea.

TECHNIQUE: Chest, AP upright.

COMPARISON: None.

FINDINGS: Patient is status post coronary artery bypass graft surgery. The cardiac, mediastinal and hilar contours are unremarkable aside from a double contour appearance to the left cardiac border which may indicate the presence of a large left atrium. There is a small pleural effusion on the right and patchy opacification at the right lung base, probably atelectasis. Prominent indistinct pulmonary vasculature and mild interstitial abnormality are suggestive of mild pulmonary edema although without prior studies, it is difficult to assess for chronicity of interstitial changes in the lower lungs.

IMPRESSION: Findings suggest mild pulmonary edema. Small right-sided pleural effusion. Question regarding possibility of enlarged left atrium.


SubjectID: 17056572, StudyID: 53949529, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with AS, HTN, respiratory distress // r/o flash pulm edema

TECHNIQUE: Single AP portable radiograph of the chest

COMPARISON: ___

FINDINGS: Lines and Tubes: None. EKG leads overlie the anterior chest wall. Lungs: Moderately well inflated with unchanged bibasilar opacities   Keywords: unchanged. Unchanged prominence of lung vasculature diffusely. Pleura: Likely moderate right pleural effusion. No pneumothorax. Mediastinum: There is no cardiomegaly. Surgical clips project over the mediastinum. Sternal sutures in situ. Bony thorax: No significant interval change   Keywords: no significant interval change   Keywords: no significant interval change.

IMPRESSION: Moderate right pleural effusion with bibasilar atelectasis and mild pulmonary edema. No significant interval change.


SubjectID: 17056572, StudyID: 56115259, Comparison: same

WET READ: ___ ___ ___ 8:58 AM Stable mild pulmonary edema with small bilateral pleural effusion. No interval change in left mid lung opacity possibly representing asymmetric pulmonary edema or infection.

WET READ VERSION #1 ___ ___ ___ 1:15 AM Stable mild pulmonary edema with small bilateral pleural effusion. No interval change in left mid lung opacity possibly representing asymmetric pulmonary edema or infection. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with COPD in respiratory distress // Evaluate for pulmonary edema Evaluate for pulmonary edema

IMPRESSION: In comparison with the study of ___, there is stable or slightly improved elevation of pulmonary venous pressure. The hemidiaphragms are more sharply seen. This could be a manifestation of improved pleural effusion, or merely reflect a more upright position of the patient. Little change in the left mid zone opacity, which again could reflect a combination of dependent edema and atelectasis, though aspiration and infection should be considered in the appropriate clinical setting   Keywords: again, little change.


SubjectID: 17056572, StudyID: 54494735, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man s/p ppm // PTX, leads PTX, leads

IMPRESSION: In comparison with the study ___ ___, there is further improvement in pulmonary vascular status   Keywords: improve. Bilateral pleural effusions are again seen. Pacer device remains in place and there is no evidence of pneumothorax.


SubjectID: 17056572, StudyID: 55934688, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with copd, cad, as s/p tavr // s/p tavr with temp lead in place

TECHNIQUE: Chest PA and lateral

COMPARISON: Radiographs on ___ and ___.

FINDINGS: Patient has had median sternotomy and coronary bypass grafting. Sternal wires are intact and aligned. A new right internal jugular approach cardiac pacing wire projects over the right ventricle. No pneumothorax, mediastinal widening, or pleural effusion. Mild pulmonary vascular engorgement and mild interstitial edema are new   Keywords: new. The heart is larger, but not enlarged. No pneumothorax

IMPRESSION: No pneumothorax. Top-normal heart size, mild vascular engorgement and early interstitial edema are new   Keywords: new. New right transjugular temporary pacer lead in standard placement. No complications.


SubjectID: 17056572, StudyID: 51604134, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with AS s/p TAVR // s/p TAVR

IMPRESSION: As compared to ___ chest radiograph, the pulmonary edema has slightly worsened accompanied by increasing small right pleural effusion   Keywords: worse, increasing. Additionally, bibasilar opacities and a left juxta hilar opacity appear more confluent, possibly representing a combination of dependent edema and atelectasis but aspiration and infection should also be considered in the appropriate clinical setting.


SubjectID: 17069642, StudyID: 54228195, Comparison: None

FINAL REPORT

AP CHEST, 8:08 P.M., ___

HISTORY: New leukocytosis and hypoxia.

IMPRESSION: AP chest compared to ___: Subcutaneous emphysema in the upper right abdominal wall and lower chest is decreasing. Contour of the right lung base suggests at least a small right subpulmonic effusion or given the appropriate clinical circumstances a subphrenic collection. Lungs are clear. Heart is top normal size. No pneumothorax.


SubjectID: 17069642, StudyID: 54027609, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: Chest AP portable single view.

INDICATION: ___-year-old female patient with respiratory distress. Evaluate for possible postoperative aspiration.

FINDINGS: AP single view of the chest has been obtained with patient in sitting semi-upright position. Comparison is made with the next preceding PA and lateral chest examination of ___. On today's examination, the patient is moderately rotated towards the right which results in a somewhat different projection of the previously identified sternotomy wires and the cardiovascular and mediastinal silhouettes. Grossly, the findings are unchanged. The pulmonary vasculature is not congested. No signs of new acute parenchymal infiltrates are present, and the lateral pleural sinuses remain free from any fluid accumulation.

IMPRESSION: No gross interval change is identified on this portable single view examination in comparison with the previous PA and lateral chest examination of ___. Thus, there is evidence of previous bypass surgery with borderline heart size but no evidence of acute infiltrates or congestion. As before general findings consistent with COPD.


SubjectID: 17077306, StudyID: 52359836, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, evaluation for interval change.

COMPARISON: ___, 8:33 a.m.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Minimal atelectasis at the lung bases, appearing slightly more extensive on the right, given patient rotation. Calcified valvular annulus. Moderate cardiomegaly without overt pulmonary edema. No pleural effusions. No pneumothorax. Unchanged course of the pacemaker leads.


SubjectID: 17086932, StudyID: 57602887, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Study of earlier the same date.

FINDINGS: Small right apicolateral pneumothorax is similar in size to recent radiograph. Overall appearance of the chest is similar, except for slight worsening in bibasilar atelectasis.


SubjectID: 17086932, StudyID: 57198310, Comparison: better

FINAL REPORT

PORTABLE CHEST X-RAY, ___

COMPARISON: ___ radiograph.

FINDINGS: Small right apical pneumothorax has slightly decreased in size. Otherwise, little change in the appearance of the chest since the recent radiograph except for slight improvement in pulmonary edema and slight improved aeration in the left lung base   Keywords: improve.


SubjectID: 17086932, StudyID: 56998771, Comparison: worse

WET READ: ___ ___ ___ 6:23 PM No pneumothorax status post right chest tube removal. Interval development of right greater than left small pleural effusions. Similar appearing interstitial edema. ______________________________________________________________________________

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph one day earlier.

FINDINGS: Following removal of right chest tube, a small-to-moderate right apical pneumothorax has developed. This has subsequently been followed on separately dictated chest radiograph performed after this time. Endotracheal tube has been removed. Swan-Ganz catheter has been slightly withdrawn, now terminating in right ventricular outflow tract. Cardiomediastinal contours are stable except for resolution of pneumomediastinum. Mild-to-moderate pulmonary edema has slightly worsened, and note is also made of increased right pleural effusion with adjacent worsening atelectasis in the right mid and lower lung regions   Keywords: worse. Left basilar atelectasis has also slightly worsened and is accompanied by a small left pleural effusion.


SubjectID: 17086932, StudyID: 52806960, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST RADIOGRAPH OF ___

COMPARISON: ___ study.

FINDINGS: Interval decrease in size of right pneumothorax with very small residual pneumothorax remaining. Cardiomediastinal contours are stable in the postoperative period. Interval improvement in extent of bibasilar atelectasis. Bilateral small pleural effusions are also slightly smaller.


SubjectID: 17086932, StudyID: 56653931, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with sHF, afib, rheumatic heart disease // compare with prior

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Widespread opacities appear to be unchanged/minimally improved consistent with slight interval improvement of pulmonary edema   Keywords: improve. Bilateral pleural effusions are unchanged. Cardiomegaly and mediastinal silhouette is unchanged. There is no pneumothorax


SubjectID: 17086932, StudyID: 55807685, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: Followup

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, there is unchanged evidence of moderate pulmonary edema and bilateral pleural effusions are present   Keywords: unchanged. Moderate cardiomegaly with areas of atelectasis at the lung bases. No pneumothorax.


SubjectID: 17086932, StudyID: 52398124, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: Shortness of breath, assessment after diuresis.

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Heart size and mediastinum are stable. There is slight interval improvement in still present mild interstitial edema associated with bilateral pleural effusion and bibasal atelectasis   Keywords: improve.


SubjectID: 17096606, StudyID: 58293183, Comparison: same

FINAL REPORT

HISTORY: Intubation for respiratory distress.

FINDINGS: In comparison with study of ___, there is continued enlargement of the cardiac silhouette with pulmonary edema and bilateral pleural effusions with compressive atelectasis at the bases   Keywords: continue. Monitoring and support devices remain in place.


SubjectID: 17096606, StudyID: 56417780, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: Chest AP portable single view.

INDICATION: ___-year-old female patient, intubated, follow up tiny left apical pneumothorax. Evaluate for interval change of pneumothorax.

FINDINGS: AP single view of the chest has been obtained with patient in semi-upright position. Comparison is made with the next preceding portable chest examination obtained six and a half hours earlier during the same day. Status post sternotomy, marked cardiac enlargement and aortic valve replacement (metallic structures of porcine valve) unchanged. Pulmonary congestive pattern encountered earlier during the day has regressed slightly. Patient remains intubated, the ETT in unchanged position. Previously suspected small left apical pneumothorax cannot be identified with certainty now on portable film and a special high contrast copy. No new pulmonary abnormalities are seen.

IMPRESSION: No significant pneumothorax remaining. No new pulmonary abnormalities. Slight regression of pulmonary congestion.


SubjectID: 17096606, StudyID: 55492723, Comparison: None

FINAL REPORT

EXAM: Chest, single supine AP portable view. CLINICAL INFORMATION: Shortness of breath, intubated.

COMPARISON: None.

FINDINGS: Single supine AP portable view of the chest was obtained. Endotracheal tube terminates approximately 3.6 cm above the carina. A nasogastric tube is seen coursing below the level of the diaphragm, distal aspect not well seen/not included on the image. There are perihilar opacities concerning for pulmonary edema. Bilateral right greater than left pleural effusions are likely present with overlying atelectasis. No evidence of pneumothorax is seen. The cardiac silhouette is mildly enlarged. The mediastinum is unremarkable. The patient is status post median sternotomy and cardiac valve replacement.

IMPRESSION: 1. Endotracheal and nasogastric tubes appear in appropriate position. 2. Pulmonary edema with bilateral pleural effusions. Underlying infectious process is difficult to exclude.


SubjectID: 17096606, StudyID: 55472594, Comparison: None

FINAL REPORT

EXAM: Chest, single frontal view. CLINICAL INFORMATION: Hypoxia. Evaluate for tube placement.

COMPARISON: None.

FINDINGS: Single supine AP portable view of the chest was obtained. Endotracheal tube terminates approximately 3 cm above the level of the carina. Nasogastric tube is seen coursing below the level of the diaphragm, inferior aspect not included on the image. There are bilateral perihilar opacities, most likely represent pulmonary edema. There are bilateral pleural effusions with overlying atelectasis. Left base retrocardiac opacity may relate to effusion and atelectasis, though underlying consolidation is not excluded. Patient is status post median sternotomy and CABG. The cardiac silhouette is mildly enlarged.


SubjectID: 17096606, StudyID: 51979856, Comparison: better

FINAL REPORT

AP CHEST, 7:59 A.M. ON ___

HISTORY: ___-year-old woman with aortic stenosis and CHF. Now intubated.

IMPRESSION: AP chest compared to ___: Mild pulmonary edema has improved since ___, including the most recent chest radiograph at 9:01 p   Keywords: improve.m. There is greater opacification in the left suprahilar upper lobe than anywhere and while this may be asymmetric edema and should be monitored to exclude concurrent pneumonia, particularly aspiration. ET tube is in standard placement. Right internal jugular line ends close to the superior cavoatrial junction. Greater opacification at the lung bases is probably a combination of mild dependent edema, atelectasis and pleural effusions collected posteriorly, even though small. No pneumothorax. Moderate cardiomegaly has improved slightly since its worst on ___. There is a suggestion of a tiny left apical pneumothorax which led me to question if there had been an attempted line placement from the left side prior to the right. The resident physician caring for this patient and I discussed these findings by telephone 2 minutes after the recognition.


SubjectID: 17096606, StudyID: 58013592, Comparison: same

FINAL REPORT

HISTORY: Status post AVR with temp pacer placement.

COMPARISON: ___.

TECHNIQUE: Portable frontal chest radiograph.

FINDINGS: There has been no significant interval change compared to prior examination with redemonstration of right internal jugular temporary pacing lead terminating in expected location in the right ventricle   Keywords: no significant interval change. The patient is status post aortic valve replacement with median sternotomy wires in place. Mild vascular congestion is unchanged in severity without frank edema   Keywords: unchanged. There is no pneumothorax. There is no new focal consolidation.

IMPRESSION: No significant change compared to prior examination with appropriate positioning of right internal jugular temporary pacing lead and redemonstration of mild vascular congestion, without frank edema   Keywords: no significant change.


SubjectID: 17096606, StudyID: 56479998, Comparison: 1.0

FINAL ADDENDUM ADDENDUM This addendum complements the report from the radiograph of ___, 6:54 p.m. The device seen on the chest radiograph is an external pacemaker and not, as previously mentioned, a Swan-Ganz catheter. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: History of chronic heart failure, evaluation for fluid status.

COMPARISON: ___, 6:54 p.m.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. External pacemaker in constant position. The lung volumes have increased, the heart continues to be mildly enlarged, but the pulmonary edema has slightly decreased in severity   Keywords: decrease. No pleural effusions. No evidence of pneumonia.


SubjectID: 17096606, StudyID: 53515056, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: temporary pacemaker placing.

COMPARISON: ___, 8:17 a.m.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The tip of the external pacemaker wire is still positioned at the bases of the right ventricle. Course of the catheter is unchanged. Sternal wires after sternotomy and the valve itself are in unchanged position. Minimal fluid overload, but no overt pulmonary edema. Borderline size of the cardiac silhouette. No larger pleural effusions. No pneumonia.


SubjectID: 17096606, StudyID: 51768780, Comparison: None

WET READ: ___ ___ ___ 8:32 PM Decreased lung volumes but improved aeration of the right lung base from ___. Mild pulmonary vascular congestion without overt pulmonary edema or pleural effusion. Temporary right IJ pacemaker in place per clinician. Linear metallic density projecting over the right lung apex and soft tissues of the right supraclavicular region is likely external to the patient. D/w Dr. ___ ___ telephone at 8pm on ___. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has undergone valve replacement. The sternotomy wires are in unchanged position. The patient has a Swan-Ganz catheter in correct position. The radiograph shows moderate fluid overload and mild interstitial edema. The heart continues to be moderately enlarged. However, no pleural effusions or pneumothorax is seen. Mild overinflation of the stomach, potentially amenable to improvement by nasogastric tube placement.


SubjectID: 17114771, StudyID: 56443366, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with mechanical avr presents with decompensated heart failure // pulmonary edema pulmonary edema

IMPRESSION: In comparison with the study of ___, there again is substantial enlargement of the cardiac silhouette in a patient with aortic valve replacement. There is elevation of pulmonary venous pressure, though this appears slightly less than on the previous study. Hazy opacification at the right base most likely represents layering pleural fluid and compressive atelectasis. The right subclavian PICC line again extends to about the junction of the brachiocephalic vein and SVC.


SubjectID: 17114771, StudyID: 51663270, Comparison: None

WET READ: ___ ___ ___ 9:37 AM Since the exam at 11:20, the right PICC catheter tip appears to have been retracted, now projecting over the upper SVC. This could be advanced approximately 3-4 cm if the tip is desired in the region of the low SVC. Otherwise, no significant interval change. ___ d/w Dr. ___ on the telephone by ___ on ___ at 11pm, 5 min after discovery.

WET READ VERSION #1 ___ ___ 11:04 PM Since the exam at 11:20, the right PICC catheter tip appears to have been retracted, now projecting over the upper SVC. This could be advanced approximately 3-4 cm if the tip is desired in the region of the low SVC. Otherwise, no significant interval change. ___ d/w Dr. ___ on the telephone by ___ on ___ at 11pm, 5 min after discovery. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___ year old woman with tachypnea, chf exacerbation // any new infiltrate or effusion

COMPARISON: Radiographs from ___

IMPRESSION: The tip of the right PICC line has migrated more proximally and is now within the proximal SVC. There is unchanged cardiomegaly. Mediastinal wires are seen. There is prominence of the pulmonary interstitial markings and atelectasis at the lung bases. There are no pneumothoraces.


SubjectID: 17114771, StudyID: 54151997, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with cardiogenic vs septic shock // interval changes interval changes

IMPRESSION: In comparison with the study of ___, there are improved lung volumes. There is still substantial enlargement of the cardiac silhouette with relatively mild elevation of pulmonary venous pressure. Again there is an area of increased opacification above the elevated right hemidiaphragm. Although this could merely represent atelectatic changes or crowding of vessels, in the appropriate clinical setting superimposed pneumonia would have to be considered, especially in the absence of a lateral view.


SubjectID: 17114771, StudyID: 53787491, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with AI s/p mechanical AVR (___) on warfarin, sCHF (EF ___%), DM2, HTN, CKD (baseline Cr 1.2-1.4) and hidradenitis suppuritiva presented with cough, DOE, and ___ swelling, found to be in severe decompensated heart failure, now w/new tachyarrythmia and transferred to the CCU. // ?pneumonia ?volume overload ?pneumonia ?volume overload

IMPRESSION: In comparison with the study of ___, there is little overall change   Keywords: little overall change. Again there is substantial enlargement of the cardiac silhouette with mild to moderate pulmonary edema. The right PICC line again extends to the mid portion of the SVC. No evidence of acute focal pneumonia, though this would be difficult to unequivocally exclude in the absence of a lateral view.


SubjectID: 17116674, StudyID: 58757463, Comparison: worse

WET READ: ___ ___ 9:22 AM 1. Interval progression of mild to moderate interstitial edema. 2. Persistent patchy opacities at the lung bases bilaterally may be secondary to atelectasis however superimposed infectious process can't be excluded. 3. Interval increase in small pleural effusion.

WET READ VERSION #1 ___ ___ ___ 1:00 AM 1. Interval progression of mild to moderate interstitial edema. 2. Persistent patchy opacities at the lung bases bilaterally may be secondary to atelectasis however superimposed infectious process can't be excluded. 3. Interval increase in small pleural effusion. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___ year old woman with new onset fever // eval for PNA

FINDINGS: Since the recent radiograph of ___, moderate edema has worsened   Keywords: worse. Increasing confluent opacity in the lingula and left lower lobe could reflect atelectasis and dependent edema, but infection is an additional consideration in the appropriate clinical setting. Small bilateral pleural effusions have slightly increased in size appear


SubjectID: 17116674, StudyID: 58372881, Comparison: better

FINAL REPORT

INDICATION: ___ year old woman with fever, leukocytosis, and ? obscured heart border at left lung // eval for PNA

COMPARISON: ___ and ___

FINDINGS: Since a recent chest radiograph of earlier the same date, there has been improvement in the extent of pulmonary edema with residual moderate asymmetrical edema remaining   Keywords: improve. Left lower lobe and lingular opacities have slightly improved, and could be due to a combination of atelectasis and dependent edema, and less likely an infectious process   Keywords: improve. No other substantial interval change.


SubjectID: 17116674, StudyID: 50421459, Comparison: worse

WET READ: ___ ___ 9:58 PM Compared to the prior chest radiograph, there is continued retrocardiac opacity which may represent atelectasis or pneumonia, and the heterogeneous opacity of the right lung base has improved. -___ ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with STEMI s/p stent now with new fever. // r/o new infiltrate pna r/o new infiltrate pna

COMPARISON: Comparison to prior study dated ___ at 911

FINDINGS: Portable AP upright study dated ___ at 18 56 is submitted.

IMPRESSION: There is slight worsening of mild interstitial edema   Keywords: worse. Persistent patchy opacity at both bases may reflect atelectasis in the setting of small effusions, although superimposed infectious process cannot be excluded. No pneumothorax. Overall cardiac and mediastinal contours are stable.


SubjectID: 17116674, StudyID: 55962716, Comparison: same

WET READ: ___ ___ ___ 8:23 AM No substantial change from prior.

WET READ VERSION #1 ___ ___ 12:33 AM No substantial change from prior. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with cad s/p balloon of the rca with acute dyspnea // acute dyspnea after angiogram

COMPARISON: ___

IMPRESSION: As compared to the previous image, there is no relevant change   Keywords: no relevant change. Pulmonary edema of moderate severity. Likely minimal bilateral pleural effusions and areas of basilar atelectasis. Moderate cardiomegaly. In addition, the right upper lobe shows a relatively circumscribed parenchymal opacity with air bronchograms at might reflect pneumonia. No pneumothorax. The mediastinum appears normal.


SubjectID: 17116674, StudyID: 50753742, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with HoTN // PNA?

COMPARISON: ___

IMPRESSION: As compared to the previous image, the severity of the pre-existing and pre described pulmonary edema has increased   Keywords: increase. The patient is now in moderate pulmonary edema. In addition, there is a newly appeared right perihilar opacity, potentially reflecting developing pneumonia. No change in appearance of the pleural effusions. Repeat radiograph should be performed within 24 hr. Unchanged appearance of the cardiac silhouette.


SubjectID: 17116674, StudyID: 53503568, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with STEMI // evaluate for interval change

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the pre described signs of pulmonary edema have increased in extent and severity   Keywords: increase. The patient is now in moderate pulmonary edema, as manifested by bilateral parenchymal opacities at the lung bases and in the perihilar areas that are symmetrical in distribution. On the left, the presence of a small pleural effusion cannot be excluded. Moderate cardiomegaly. No pneumothorax. No pneumonia.


SubjectID: 17116674, StudyID: 52619079, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___F with dyspnea

TECHNIQUE: Chest PA and lateral

COMPARISON: ___

FINDINGS: Heart size is moderately enlarged but unchanged. The mediastinal and hilar contours are similar. There is mild pulmonary edema, though not substantially changed from the previous exam. Small bilateral pleural effusions are increased in size compared to the prior exam. Bibasilar airspace opacities may reflect atelectasis. No pneumothorax is identified. No acute osseous abnormality is present.

IMPRESSION: Mild pulmonary edema and small bilateral pleural effusions.


SubjectID: 17121948, StudyID: 58738848, Comparison: same

FINAL REPORT

EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Bilateral swollen legs, question edema.

COMPARISON: ___.

FINDINGS: Focal left upper lobe pulmonary nodule/ground ground-glass opacity with fiducial marker is similar in appearance compared to the prior study. The appearance of the lungs is stable. No large pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are stable, as are the hilar contours.

IMPRESSION: No significant interval change   Keywords: no significant interval change.


SubjectID: 17121948, StudyID: 53241550, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with concern for PE // needed before V/Q scan

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The clip in the left upper lobe parenchymal opacity, both solid an associated with some surrounding scarring, is unchanged. Unchanged moderate cardiomegaly with mild elongation of the descending aorta. No pulmonary edema. No pleural effusions. No pneumonia.


SubjectID: 17121948, StudyID: 56917165, Comparison: None

FINAL REPORT

HISTORY: Lower extremity edema.

COMPARISON: ___.

FINDINGS: Frontal and lateral views of the chest. Heart size and cardiomediastinal contours are normal. Left upper lobe lesion containing a fiducial marker appears similar to prior. There is slightly increased density of the left lower lobe which may represent aspiration or developing pneumonia. No pleural effusion or pneumothorax.

IMPRESSION: 1. Increased left lower lobe density, representing either aspiration or developing pneumonia. 2. Stable radiographic appearance of left upper lobe lesion. Final impression was communicated via phone call by Dr. ___ to Dr. ___ ___ on ___ at ___ AM.


SubjectID: 17121948, StudyID: 54855835, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST ___

COMPARISON: ___.

FINDINGS: Recently described focal left lower lobe opacity has rapidly improved. However, there is now a more diffuse reticular pattern present with mid and lower lung predominance, and accompanying bronchial wall thickening/peribronchial cuffing. Focal left upper lobe lung nodule with adjacent fiducial seed appears similar to the recent radiograph, and cardiomediastinal contours are stable as well. There are no pleural effusions or pneumothoraces.

IMPRESSION: 1. Rapid resolution of focal left lower lobe opacity favoring atelectasis or aspiration as the likely etiology. 2. Subtle bilateral mid and lower lung reticular opacities, for which the differential diagnosis includes evolving atypical pneumonia, interstitial edema, and drug reaction.


SubjectID: 17153292, StudyID: 54263217, Comparison: None

FINAL REPORT

INDICATION: Evaluate for fluid in a patient with dyspnea.

COMPARISON: Chest radiographs from ___, ___, ___, ___.

FINDINGS: A portable frontal chest radiograph demonstrates low lung volumes and a mildly enlarged heart. Diffuse bilateral opacities are consistent with severe pulmonary edema. No large pleural effusion is seen, though difficult to evaluate given overlying opacity. There is no pneumothorax. The visualized upper abdomen is unremarkable.

IMPRESSION: Severe pulmonary edema.


SubjectID: 17153292, StudyID: 52351873, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with Afib, CHF, now with hypoxia. // pulmonary edema, focal infiltrate?

TECHNIQUE: Single frontal view of the chest

COMPARISON: Prior radiographs performed on same day on ___ at 06:17

FINDINGS: Compared with prior radiographs performed on same day on ___ at 06:17, there has been interval improvement in severe bilateral pulmonary edema in the mid and upper lung zones, with persistent opacifications at the bilateral bases, and possible bilateral pleural effusions   Keywords: improve. There is no pneumothorax. Cardiomediastinal silhouette is similar to prior.

IMPRESSION: Interval improvement in severe bilateral pulmonary edema, particularly in the mid and upper lung zones   Keywords: improve.


SubjectID: 17156219, StudyID: 59953667, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with redo MVR // r/o effusion r/o effusion

IMPRESSION: In comparison with the study of ___, there is a residual right IJ sheath and left chest tube in place. The other monitoring and support devices of been removed. Continued substantial enlargement of the cardiac silhouette with pulmonary vascular congestion and bilateral pleural effusions with compressive atelectasis at the bases.


SubjectID: 17156219, StudyID: 58939819, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p MVR // eval for pneumothorax s/p chest tube removal eval for pneumothorax s/p chest tube removal

COMPARISON: Comparison to prior study dated ___ at 13 21

IMPRESSION: Interval removal of the left chest tube, mediastinal drains and right internal jugular introducer. Stable postoperative cardiac and mediastinal contours status post median sternotomy. Bilateral layering effusions with associated bibasilar airspace opacities most likely reflecting compressive atelectasis, although pneumonia cannot be excluded. No pneumothorax is appreciated. Right-sided dual lead pacer remains in place. Probable hiatal hernia.


SubjectID: 17156219, StudyID: 53384681, Comparison: -1.0

WET READ: ___ ___ ___ 8:45 PM New haziness at the right lung base may reflect a small layering effusion. No other significant change from the most recent prior study. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: Portable AP chest x-ray.

INDICATION: ___ year old woman s/p MVR // eval for hemothorax

TECHNIQUE: AP projection.

COMPARISON: Portable AP chest x-ray obtained ___ at 12:47.

FINDINGS: The ET tube is in stable position, terminating 6 cm above the carina. There is stable position of right chest pacer device with associated dual leads projecting in unchanged position approximately over the right atrium and right ventricle. Multiple median sternotomy wires and mediastinal surgical clips are again seen. Left chest tube is in stable position. Enteric tube again seen in stable position with tip projecting of left hemidiaphragm, consistent with known large hiatal hernia. There is a PA catheter are in stable position. There is leftward rotation on the current radiograph. The cardiomediastinal silhouette is unchanged. In comparison to prior radiograph, there is increased opacification at the right lung base and indistinctness of the right lateral CP angle, consistent with new small right layering pleural effusion   Keywords: increase. There is no left effusion. There is continued retrocardiac opacification obscuring the left hemidiaphragm, consistent with ongoing left lower lobe volume loss, possibly atelectasis. There is no evidence of pulmonary vascular congestion. There is no pneumothorax.

IMPRESSION: Stable lines and tubes. New small right layering pleural effusion, may represent small hemothorax. Otherwise no significant interval changes   Keywords: no significant interval change.


SubjectID: 17156219, StudyID: 53351033, Comparison: worse

FINAL REPORT

EXAMINATION: Portable AP chest x-ray.

INDICATION: ___ year old woman with as above // s/p redo sternotomy/MVR w/dropping HCT r/o effusion

TECHNIQUE: AP projection.

COMPARISON: Portable AP chest x-ray from earlier the same day, at 18:11.

FINDINGS: There is again seen ET tube which projects 4.7 cm above carina. Left chest tube is seen in stable position without evidence of pneumothorax. Other monitoring and support devices are in unchanged position in comparison to prior radiograph. The cardiomediastinal silhouettes are normal. The bilateral hila are normal. There is interval increase in pulmonary vascular prominence, as well as increasing bilateral hazy airspace opacities with a lower lobe predominance, signifying an increasing pulmonary vascular pressures and developing pulmonary edema   Keywords: increase, developing. There is a new left layering pleural effusion, and the right layering pleural effusion has worsened. There is no pneumothorax.

IMPRESSION: 1. Pulmonary vascular congestion and developing pulmonary edema   Keywords: developing. 2. New small left layering pleural effusion, and worsening of still small right layering pleural effusion. 2. Stable lines and tubes.


SubjectID: 17156219, StudyID: 59729545, Comparison: None

FINAL REPORT

HISTORY: AVR, follow up edema and right pneumothorax. CHEST, TWO VIEWS. There is probable background hyperinflation/COPD. There is moderate cardiomegaly, with sternotomy wires present. There is upper zone redistribution and mild diffuse vascular plethora, without other evidence of CHF. There are small bilateral effusions, with underlying collapse and/or consolidation. A right-sided pacemaker is present, lead tips over right atrium and right ventricle. Mild-to-moderate degenerative changes of the thoracic spine are noted. A small right pneumothorax is unchanged compared with ___ at 11:24 a.m. Compared with ___ at 11:24 a.m. and allowing for differences in positioning, I doubt significant interval change.

IMPRESSION: 1. COPD. 2. Cardiomegaly, status post sternotomy with pacemaker. 3. Upper zone redistribution and very slight vascular plethora, without overt CHF. 4. Bilateral small effusions with underlying collapse and/or consolidation. 5. Small right pneumothorax again seen, unchanged.


SubjectID: 17156219, StudyID: 50391935, Comparison: None

FINAL REPORT

AP CHEST, 11:24 A.M., ___

HISTORY: ___-year-old woman after an AVR. Question pneumothorax after chest tube removed.

IMPRESSION: AP chest compared to ___: Previous mild pulmonary edema has almost entirely cleared. Bibasilar atelectasis, moderate on the left, unchanged, moderate on the right, increased slightly, accompanied by new small right pleural effusion. Postoperative cardiomediastinal silhouette is unremarkable and unchanged. Small right pneumothorax is new. There is no pneumothorax on the left. Transvenous right atrial and right ventricular pacer leads in standard placement.


SubjectID: 17172702, StudyID: 59035463, Comparison: None

FINAL ADDENDUM ADDENDUM Left PICC has been replaced or repositioned, with tip now the directed at the level of the proximal superior vena cava, with the tip directed towards the lateral wall of this vessel. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hypoxemic respiratory failure // please assess for interval change

IMPRESSION: As compared to previous radiograph of 1 day earlier, widespread bilateral airspace opacities with relative sparing of the extreme lung periphery have progressed. Remainder of exam is unchanged.


SubjectID: 17172702, StudyID: 58795226, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hypoxemia // Assess for worsenign lung progression

TECHNIQUE: Portable AP chest radiograph.

COMPARISON: Chest radiograph ___

FINDINGS: There are persistent bilateral airspace opacities, similar in extent when compared to the prior study   Keywords: similar, persistent. A left-sided PICC is in-situ, the tip has now flipped up or heads and is likely in the right brachiocephalic vein. No pneumothorax seen.

NOTIFICATION: The findings were discussed with the ICU intern at 14:00 on ___ at the time of discovery.


SubjectID: 17172702, StudyID: 58463849, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with shortness of breath and hypoxemia // Assess for lung progression

TECHNIQUE: Portable AP chest radiograph.

COMPARISON: Serial chest radiographs most recent dated ___

FINDINGS: The left-sided PICC line now terminates in the left brachiocephalic vein. The bilateral diffuse airspace opacities have increased slightly in extent with more confluent opacity seen in the left mid and right mid lung   Keywords: increase. Assessment of the heart size is not possible as the left heart border is silhouetted. No pleural effusion seen. No pneumothorax seen.

IMPRESSION: Slight interval progression of the bilateral airspace opacities   Keywords: progression. The left-sided PICC terminates in the left brachiocephalic vein.


SubjectID: 17172702, StudyID: 55314066, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man pulmonary disease s/p right chest tube placement for pneumothorax // interval change of right chest tube and resolution of pneumothorax interval change of right chest tube and resolution of pneumo

IMPRESSION: In comparison with the study of ___, the right chest tube remains in place and there is no recurrent pneumothorax. Other monitoring and support devices are again seen. Diffuse bilateral pulmonary opacifications are essentially unchanged   Keywords: unchanged.


SubjectID: 17172702, StudyID: 53985693, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p chest tube // Chest tube placement Chest tube placement

IMPRESSION: In comparison with the earlier study of this date, there is little change in the appearance of the right chest tube and no evidence of pneumothorax. Diffuse bilateral pulmonary opacifications persist.


SubjectID: 17172702, StudyID: 52719943, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with sepsis // confirm OGT location confirm OGT location

IMPRESSION: In comparison with the earlier study of this date, there has been development of a substantial right pneumothorax. This has been observed by the clinical team, since a subsequent study shows a chest tube in place an the lung re-expanded. Nasogastric tube extends to the upper stomach, where it crosses the lower margin of the image.


SubjectID: 17172702, StudyID: 52705755, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with ___ year old man s/p chest tube // Interval change

TECHNIQUE: Portable

COMPARISON: ___

FINDINGS: The right IJ catheter, left PICC, right chest tube and nasogastric tube are in good position. There is a dual bronchial ETT, the right main stem portion is not visualized and the left mainstem bronchus is intubated. No residual right-sided pneumothorax. No significant pleural effusions. Diffuse airspace opacities have not significantly changed when compared to the prior   Keywords: not significantly changed   Keywords: not significantly changed. The heart is not significantly enlarged.

IMPRESSION: There is a dual bronchial ETT, the right main stem portion is not visualized and the left mainstem bronchus is intubated. No residual right-sided pneumothorax. Diffuse airspace opacities have not significantly changed when compared to the prior.


SubjectID: 17172702, StudyID: 51371704, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with intubated // eval for NG tube position

TECHNIQUE: Semi-upright portable chest radiograph.

COMPARISON: Chest radiograph dated ___ at 09:54 a.m..

FINDINGS: The ETT tube terminates 3 cm above the carina with neck flexion. There is a left PICC, which in comparison to the prior chest radiograph, appears to have changed in orientation and now projects more horizontally, likely in the azygos vein. The NG tube courses below the diaphragm, however the tip is not visualized on this image Stable appearance of bilateral diffuse airspace opacities   Keywords: stable. No pleural effusion or pneumothorax. There are no acute osseous abnormalities.

IMPRESSION: 1. Malpositioned left PICC, which is likely in the azygos vein. 2. Appropriately positioned ETT and NG tube. 3. Persistent unchanged bilateral diffuse airspace opacities   Keywords: unchanged, persistent.

NOTIFICATION: The covering resident was paged twice without response. Pertinent critical findings were posted by Dr. ___ on ___ at 17:09 to the Department of Radiology online critical communications system for direct communication to the referring provider.


SubjectID: 17172702, StudyID: 56050336, Comparison: worse

WET READ: ___ ___ 11:14 PM Interval increase in diffuse lung opacities right greater than left concerning for worsening pulmonary edema. Heart size also mildly increased in size. Left PICC ends in the mid SVC. No pneumothorax. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with COPD, CHF, newly diagnosed MZL variant. // Please assess for acute pulmonary process.

TECHNIQUE: Portable AP chest radiograph.

COMPARISON: Serial chest radiographs most recent dated ___

FINDINGS: There has been interval increase in the bilateral parenchymal opacities, with more confluent opacities in the right lung   Keywords: increase. Appearances are consistent with worsening pulmonary edema although superimposed infection cannot be excluded   Keywords: worse. No pleural effusion seen. The heart size remains mildly enlarged even allowing for the projection. No pneumothorax. A left-sided PICC line terminates in the proximal SVC.

IMPRESSION: Interval progression of the bilateral airspace opacities, right worse than left   Keywords: progression, worse. A left-sided PICC line terminates in the proximal SVC.


SubjectID: 17172702, StudyID: 58023547, Comparison: None

FINAL REPORT

HISTORY: Persistent shortness of breath.

TECHNIQUE: Frontal and lateral chest radiographs were obtained.

COMPARISON: Comparison is made to radiographs dated ___.

FINDINGS: The lung volumes are decreased, leading to crowding of the bronchovascular structures. There are increasingly prominant, patchy opacities in the right lower lobe, which may represent atlectasis versus pneumonia. Redemonstrated is moderate cardiomegaly with small bilateral pleural effusions. Mild peripheral emphysema with adjacent scaring is most prominant in the right upper lobe. Minimal left lower lobe atelectasis is noted. There is no pneumothorax or overt pulmonary edema. Mediastinal and hilar contours are stable.

IMPRESSION: 1. Increasing patchy opacities in the RLL which may represent atelectasis or developing pneumonia. Recommend short term imaging followup. 2. Stable moderate cardiomegaly with small bilateral pleural effusions.


SubjectID: 17172702, StudyID: 56965723, Comparison: None

FINAL REPORT

HISTORY: Shortness of breath and cough.

TECHNIQUE: Frontal and lateral chest radiographs were obtained.

COMPARISON: Comparison is made to radiograph dated ___.

FINDINGS: The lung volumes are once again noted to be decreased. The previously noted patchy opacities in the right lower lobe are now significantly less conspicuous. Moderate cardiomegaly with small bilateral pleural effusions is unchanged. Mild peripheral emphysema with adjacent scarring is again noted. There is no pneumothorax or overt pulmonary edema identified. Mediastinal and hilar contours are stable.


SubjectID: 17172702, StudyID: 50566799, Comparison: None

FINAL REPORT

INDICATION: History of worsening shortness of breath.

COMPARISON: Chest radiograph from ___.

FINDINGS: Single portable chest radiograph provided. Lung volumes are low. There is no focal consolidation, pleural effusion, or pneumothorax. There is no overt pulmonary edema. Cardiac silhouette remains enlarged.

IMPRESSION: Stable cardiomegaly. Otherwise, no acute process.


SubjectID: 17172702, StudyID: 56866591, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Increased shortness of breath, rule out pneumonia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Minimal atelectatic opacity in the retrocardiac lung region. No new parenchymal opacities   Keywords: new. The size of the cardiac silhouette remains enlarged. No pleural effusions. No overt pulmonary edema. Minimal fibrosis with associated pleural thickening at the level of the right upper lobe.


SubjectID: 17172702, StudyID: 55524993, Comparison: None

FINAL REPORT

HISTORY: Shortness of breath and chest pain.

FINDINGS: In comparison with the earlier study of this date, the patient has taken a better inspiration. Continued enlargement of the cardiac silhouette with some fullness of pulmonary vessels, consistent with elevated pulmonary venous pressure. Opacification at the left base most likely represents a combination of atelectasis and small effusion. However, in the appropriate clinical setting, supervening pneumonia would have to be considered.


SubjectID: 17172702, StudyID: 56737165, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with lymphoma hypoxemic respiratory failure s/p PTX s/p chest tube // e/o PNA, effusion, interval change e/o PNA, effusion, interval change

IMPRESSION: In comparison with the study of ___, the monitoring and support devices are unchanged. Continued enlargement the cardiac silhouette with substantial pulmonary vascular congestion   Keywords: continue. The right hemidiaphragm is more sharply seen, though this could merely be a manifestation of a more erect position of the patient rather than improvement in the the degree of pleural effusion. Retrocardiac opacification again is consistent with volume loss in the left lower lobe and pleural fluid.


SubjectID: 17172702, StudyID: 55916168, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with lymphoma and worsening resp fxn s/p chest tube for PTX // s/p chest tube

COMPARISON: ___

FINDINGS: The monitoring and support device are unchanged in standard position. No significant change in the pulmonary vascular congestion   Keywords: no significant change   Keywords: no significant change. There is also improved aeration of the left lower lobe. The cardiac silhouette remains enlarged. No pneumothorax post chest tube removal.

IMPRESSION: No pneumothorax post chest tube removal. No significant change in the pulmonary vascular congestion.


SubjectID: 17172702, StudyID: 50489463, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with lymphoma hypoxemic respiratory failure s/p PTX s/p chest tube // Resolution of PTX, infiltrates, edema, interval change

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. All monitoring and support devices, including the right chest tube are in constant position. Constant appearance of the lung parenchyma and of the cardiac silhouette. . Small retrocardiac atelectasis.


SubjectID: 17172702, StudyID: 56556248, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with B-cell lymphoproliferative disorder and COPD/emphysema and prior h/o MRSA+fungal PNA, here with SOB. // Interval change in pleural effusion Interval change in pleural effusion

IMPRESSION: In comparison with the study of ___, the hazy opacification at the bases is less prominent, especially on the left. This could reflect decreasing pleural effusion, though it also could be a manifestation of a more erect position of the patient. There is still enlargement of the cardiac silhouette with pulmonary vascular congestion   Keywords: still.


SubjectID: 17172702, StudyID: 51711984, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with b cell lymphoma, CHF, AFIB, COPD, OSA. Admitted with dyspnea. Triggered for tachypnea // Eval etiology of acute on chronic dyspnea. ? fluid Eval etiology of acute on chronic dyspnea. ? fluid

IMPRESSION: In comparison with the study of ___, the cardiac silhouette remains mildly enlarged with evidence of pulmonary vascular congestion   Keywords: remains. Continued layering bilateral effusions, more prominent on the right, associated with compressive basilar atelectasis.


SubjectID: 17172702, StudyID: 56018686, Comparison: same

WET READ: ___ ___ ___ 8:32 AM A left PICC is unchanged in position, terminating at the cavoatrial junction. There is no focal consolidation, pleural effusion, or pneumothorax. Mildly increased interstitial markings are similar appearance compared to chest radiograph from 2 days prior. No significantly increased pulmonary edema.

WET READ VERSION #1 ___ ___ ___ 10:05 PM A left PICC is unchanged in position, terminating at the cavoatrial junction. There is no focal consolidation, pleural effusion, or pneumothorax. Mildly increased interstitial markings are similar appearance compared to chest radiograph from 2 days prior. No significantly increased pulmonary edema. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with splenic marginal zone lymphoma, CHF, COPD receiving rituxan treatment and now with dyspnea. // Evidence of pulmonary edema Evidence of pulmonary edema

IMPRESSION: In comparison with the study of ___, there is little overall change   Keywords: little overall change. Cardiac silhouette remains at the upper limits of normal in size and there is mild indistinctness of pulmonary vessels consistent with some elevated pulmonary venous pressure. Central catheter is unchanged and there is no evidence of acute pneumonia.


SubjectID: 17172702, StudyID: 54289227, Comparison: None

WET READ: ___ ___ ___ 8:21 AM Frontal chest radiograph shows a left PICC terminating at the cavoatrial junction. The cardiac silhouette is stable in size. There are prominent interstitial markings which may reflect mild interstitial edema, similar to slightly worse from prior exam.

WET READ VERSION #1 ___ ___ ___ 5:37 PM Frontal chest radiograph shows a left PICC terminating at the cavoatrial junction. The cardiac silhouette is stable in size. There are prominent interstitial markings which may reflect mild interstitial edema, similar to slightly worse from prior exam. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with h/o IDDM, HTN, COPD, sys/dia CHF (___%), CKD, afib on warfarin now presenting for SOB/fatigue and lymphocytosis, newly dxd splenic marginal zone lymphoma with persistent O2 requirement // eval for pulm edema/interval change

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, a position of the left PICC line at the cavoatrial junction is unchanged. Mild cardiomegaly. Unchanged minimal areas of atelectasis at the right lung base and the retro cardiac lung regions. No other lung parenchymal changes are visualized. Known changes at the level of the right shoulder, documented on the previous shoulder x-ray from ___


SubjectID: 17172702, StudyID: 55703418, Comparison: None

FINAL REPORT

HISTORY: Chronic dyspnea.

FINDINGS: In comparison with study of ___, the increased apparent prominence of the cardiac silhouette most likely reflects differences in obliquity of the patient. There is again some poor definition of pulmonary vessels, raising the possibility of some elevated pulmonary venous pressure. No definite acute pneumonia.


SubjectID: 17172702, StudyID: 52653603, Comparison: same

FINAL REPORT

HISTORY: Shortness of breath.

COMPARISON: ___.

FINDINGS: Compared to the prior study there is no significant change   Keywords: no significant change.


SubjectID: 17172702, StudyID: 55066893, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with severe dyspnea // ? acute cardiopulm process

COMPARISON: ___

FINDINGS: AP portable upright view of the chest. Port-A-Cath resides over right chest wall with catheter tip extending into the SVC. Pulmonary edema is increased from prior, now severe   Keywords: increase. Small bilateral pleural effusions are likely present. Scarring is seen in the upper lungs. Hilar congestion is notable. Cardiomegaly is unchanged.

IMPRESSION: Cardiomegaly, severe pulmonary edema and small bilateral pleural effusions.


SubjectID: 17172702, StudyID: 51112976, Comparison: worse

WET READ: ___ ___ ___ 9:18 AM No pneumothorax. Port-A-Cath catheter tip terminates in the proximal right atrium. C/w chest radiograph from 8 hours prior - cardiomegaly - severe pulmonary edema, not significantly changed since recent examination - likely bilateral pleural effusions - no definite new consolidation.

WET READ VERSION #1 ___ ___ ___ 6:44 PM C/w chest radiograph from 8 hours prior - cardiomegaly - severe pulmonary edema, not significantly changed since recent examination - likely bilateral pleural effusions - no definite new consolidation. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with lymphoma h/o possible aspergillus PNA now with encephalopathy // eval pulm edema, pna eval pulm edema, pna

COMPARISON: ___ obtained at 10:38

IMPRESSION: Cardiomediastinal silhouette appears to be similar to previous but there is progression of the left upper lobe and perihilar opacities concerning for progression of pulmonary edema   Keywords: progression. Bilateral pleural effusions and bibasal consolidations are unchanged.


SubjectID: 17172702, StudyID: 53697234, Comparison: worse

WET READ: ___ ___ ___ 9:32 AM Diffuse airspace opacities have increased compared to prior, particularly in the right lung. Finding may represent worsening pneumonia and/or superimposed pulmonary edema.

WET READ VERSION #1 ___ ___ ___ 3:29 AM Diffuse airspace opacities have increased compared to prior, particularly in the right lung. Finding may represent worsening pneumonia and/or superimposed pulmonary edema. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF with EF ___%, afib on coumadin, and newly diagnosed lymphoma with increasing dyspnea, hypoxia // eval pulm edema, PNA, effusion

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the bilateral parenchymal opacities have slightly increased in extent and severity   Keywords: increase. Low lung volumes and moderate cardiomegaly persists. No pleural effusions. Unchanged course of the left PICC line.


SubjectID: 17172702, StudyID: 50002557, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with heme malignancy, COPD, CHF. acute resp decompensation // assess for increased Pulm edema, acute processes

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the known pre-existing diffuse nodular parenchymal opacities increase in extent and severity   Keywords: increase. In the right lung, these opacities that tends to confluate, thereby forming larger areas of changes with air bronchograms. The mediastinum could have slightly increased in diameter, suggesting either fluid overload or increasing adenopathy   Keywords: increase. No pleural effusions.


SubjectID: 17172702, StudyID: 52962970, Comparison: same

FINAL REPORT

HISTORY: Left effusion versus pulmonary edema.

FINDINGS: In comparison with study of ___, there is continued enlargement of the cardiac silhouette with evidence of pulmonary vascular congestion and moderate left effusion. Volume loss is seen in the lower lobe on the left.

IMPRESSION: Little change   Keywords: little change.


SubjectID: 17172702, StudyID: 51602203, Comparison: None

FINAL REPORT

INDICATION: Evaluation for pneumothorax in a patient status post left-sided thoracentesis.

COMPARISON: Multiple chest radiographs, the most recent ___.

FINDINGS: Portable AP upright view of the chest was reviewed and compared to the prior study. Blunting of the left lateral costophrenic sulcus has improved status post thoracentesis and elevated left hemidiaphragmatic contour could represent an elevated hemidiaphragm or a subpulmonic effusion. The lungs are clear without evidence of vascular congestion or pneumothorax. Unchanged mild cardiomegaly. Right impaced humeral head fracture is better characterized on dedicated shoulder radiograph from ___.

IMPRESSION: 1. Decreased left-sided pleural effusion status post thoracentesis with no pneumothorax. 2. Elevated left hemidiaphragmatic contour could represent a subpulmonic effusion or true hemidiaphragmatic elevation. Left lateral decubitus radiograph could differentiate between these entities.


SubjectID: 17175688, StudyID: 56830544, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___M with dyspnea

TECHNIQUE: Chest PA and lateral

COMPARISON: ___ chest radiograph and ___ chest CTA

FINDINGS: Mild to moderate enlargement of the cardiac silhouette is unchanged. The mediastinal and hilar contours appear similar, with prominence of the right hilum re- demonstrated. No pulmonary edema is present. Streaky opacity in the right lung base may reflect atelectasis. No pleural effusion, pneumothorax, or focal consolidation is demonstrated. No acute osseous abnormality is detected.

IMPRESSION: Streaky opacity in the right lung base, likely atelectasis. No pulmonary edema.


SubjectID: 17175688, StudyID: 53620418, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___M with SOB. Evaluate for pulmonary edema.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph from ___ and CT chest ___.

FINDINGS: Mild to moderate cardiomegaly is unchanged. Prominence of the right hilum is re- demonstrated, and there is evidence of mild pulmonary vascular congestion. Trace pleural fluid is seen tracking along the fissural planes. Streaky opacity in the right lung base is likely atelectasis. No pleural effusion, pneumothorax, or focal consolidation.

IMPRESSION: Mild pulmonary vascular congestion. Stable cardiomegaly. Trace pleural fluid.


SubjectID: 17205507, StudyID: 55258442, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: Prostate cancer. Question developing pneumonia.

IMPRESSION: In comparison to prior radiograph of 1 day earlier, there has not been a relevant change in the appearance of the chest.


SubjectID: 17205507, StudyID: 54342075, Comparison: worse

WET READ: ___ ___ ___ 6:52 AM Opacity in the mid left lung appears more prominent compared to the prior exam, and may be secondary to worsening infection. Diffuse osseous sclerotic lesions, compatible with metastatic prostate cancer.

WET READ VERSION #1 ___ ___ ___ 2:27 AM Opacity in the mid left lung appears more prominent compared to the prior exam, and may be secondary to worsening infection. Diffuse osseous sclerotic lesions, compatible with metastatic prostate cancer. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: STAT - POST-CODE, concern for perf, VFib/PEA arrest now with ROCS // STAT - POST-CODE

IMPRESSION: In comparison ___ chest radiograph, the cardiac silhouette has increased in size and accompanied by pulmonary vascular congestion   Keywords: increase. Interval placement of endotracheal tube and nasogastric tube in standard position. Worsening opacities in the left mid and lower lung are present as well as an apparently new moderate left pleural effusion. Widespread skeletal metastases are again demonstrated.


SubjectID: 17205507, StudyID: 50880347, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with recent cardiac arrest s/p extubation. // interval changes

COMPARISON: Radiographs from ___

IMPRESSION: Endotracheal tube and feeding tube have been removed. There is a residual right-sided central venous line with the distal lead tip in the cavoatrial junction. Heart size is enlarged. There is a persistent left retrocardiac opacity with likely pleural effusion. There also a wedge-shaped opacity within the left suprahilar region, stable. Opacity at the right base is also seen. Overall findings are stable.


SubjectID: 17206933, StudyID: 57571408, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with altered mental status and history of CHF with concern for pneumonia. Evaluate for interval change.

EXAMINATION: Single frontal chest radiograph.

COMPARISONS: ___ and ___.

FINDINGS: Since ___, there has been continued progressive consolidation involving the left lung with asymmetric opacification distributed throughout the right hemithorax most compatible with multifocal pneumonia. There are superimposed areas of bibasilar atelectasis. There are no pleural effusions or pneumothorax. The cardiomediastinal and hilar contours are stable, with the heart borderline enlarged. There is tortuosity and atherosclerotic calcification within the thoracic aorta.

IMPRESSION: Increased asymmetric opacification involving the left lung compatible with worsening multifocal pneumonia.


SubjectID: 17206933, StudyID: 57141526, Comparison: None

WET READ: ___ ___ ___ 7:57 PM Bilateral diffuse lung opacification with bilateral effusion is likely due to CHF, much less likely multifocal PNA.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

INDICATION: ___-year-old man with mental status changes, assess for pneumonia or CHF.

FINDINGS: Frontal radiograhs shows diffuse bilateral lung opacities, most pronounced in the left upper lobe in the perihilar region likely due to CHF, less likely multifocal PNA. Postdiuresis films should be obtained. Left retrocardiac opacity likely represents atelectasis.


SubjectID: 17244693, StudyID: 57799958, Comparison: same

FINAL REPORT

INDICATION: ___M with PPM // lead placement

TECHNIQUE: Chest PA and lateral

COMPARISON: ___

FINDINGS: In comparison is a study of 1 day prior, single lead ICD lead is unchanged in position. Cardiomediastinal silhouette including mild cardiomegaly is stable. Lung volumes are slightly increased. Pulmonary vascular congestion and a small right pleural effusion with a loculated component appear similar. The sternotomy wires and mediastinal clips are noted.

IMPRESSION: 1. Stable positioning of single lead ICD. 2. Stable pulmonary vascular congestion and small right pleural effusion with a loculated component   Keywords: stable.


SubjectID: 17244693, StudyID: 57478148, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man s/p single chamber ICD. // Assess lead placement and r/o PTx. Assess lead placement and r/o PTx.

IMPRESSION: In comparison with the study of ___, there is an placement of a single lead ICD that extends to the apex of the right ventricle. No evidence of post -procedure pneumothorax.


SubjectID: 17256683, StudyID: 59411180, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Acute respiratory failure, endotracheal tube placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient is still intubated. The course of the nasogastric tube is unchanged. Moderate cardiomegaly, mild fluid overload. For technical reasons, the lung apices appear denser on today's examination than previously. No larger pleural effusions. Interposition of colon between the liver and the chest wall.


SubjectID: 17256683, StudyID: 55446585, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluation for endotracheal tube position.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has received a new endotracheal tube. The tip of the tube projects approximately 4 cm above the carina. The course of the nasogastric tube is normal in the upper two-thirds of the esophagus, but in lower anatomical regions, the tube cannot be reliably visualized. Multiple healing rib fractures are better appreciated on the torso CT examination from ___.


SubjectID: 17256683, StudyID: 53689437, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Acute dyspnea, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the parenchymal opacities, additionally documented on a CT examination from ___, at 4:43 p.m., has not substantially changed. Also unchanged is a small left pleural effusion confined to an area of atelectasis. Unchanged size of the cardiac silhouette. Unchanged right internal jugular vein catheter.


SubjectID: 17256683, StudyID: 53409836, Comparison: worse

FINAL REPORT

INDICATION: Respiratory failure, status post intubation. Evaluate endotracheal tube.

COMPARISONS: Chest radiograph from ___. CT of the chest from ___.

TECHNIQUE: A single AP semi-upright view of the chest was obtained.

FINDINGS: An endotracheal tube is in satisfactory position, 4.8 cm from the carina. An enteric tube is present with the tip in the stomach. A right internal jugular central venous catheter is present with the tip in the mid SVC. Again, there are bilateral parenchymal opacities, predominantly at the bases, which are in keeping with an infectious process. Additionally, there are worsening interstitial opacities, suggesting worsening edema   Keywords: worse. A small left pleural effusion appears grossly stable. A small right pleural effusion has likely slightly increased in size. There is no pneumothorax. The cardiomediastinal silhouette is normal.

IMPRESSION: 1. Worsening interstitial opacities, suggesting interval worsening of mild-to-moderate pulmonary edema   Keywords: worse. 2. Grossly stable parenchymal opacities, likely infectious. 3. Stable small left pleural effusion. Increased small right pleural effusion.


SubjectID: 17256683, StudyID: 52950001, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPH

INDICATION: Dyspnea, CHF // Eval for volume status.

TECHNIQUE: Portable AP chest radiographs.

COMPARISON: Prior chest radiograph from ___ and chest CT from ___.

FINDINGS: The heart is enlarged. There is persistent retrocardiac opacity and left lower lobe opacification, which could reflect a combination of pleural fluid and atelectasis. There is also mild pulmonary edema which is worsened since prior exam   Keywords: worse. There is a vague nodularity lateral to the left hila for which repeat examination is recommended once edema clears. No pneumothorax or focal consolidation identified.

IMPRESSION: 1. Mild pulmonary edema. Persistent retrocardiac and recurrent left lower lobe opacity, which could reflect a combination of fluid and atelectasis. 2. Vague nodularity lateral to the left hila for which repeat examination is recommended once edema clears.

NOTIFICATION: Final report discussed with Dr. ___ by ___ via telephone on ___ at 9:05 AM.


SubjectID: 17256683, StudyID: 50930971, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF presenting with SOB in the setting of cough and fevers // ?interval change, ?pna/pulm edema ?interval change, ?pna/pulm edema

IMPRESSION: In comparison with the study of ___, there is again substantial enlargement of the cardiac silhouette with pulmonary edema. Retrocardiac opacification is consistent with volume loss in the left lower lobe and probable fusion.


SubjectID: 17274271, StudyID: 54089928, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with sepsis - new R IJ // eval for line placement

COMPARISON: Prior exam from earlier today.

FINDINGS: AP portable upright view of the chest. Interval placement of a right IJ central venous catheter is seen with its tip in the mid SVC region. No pneumothorax. Otherwise unchanged.

IMPRESSION: Appropriately positioned right IJ central venous catheter.


SubjectID: 17274271, StudyID: 51291941, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___M with cough, dyspnea, hypoxia, wheeze // eval for pna

COMPARISON: ___.

FINDINGS: PA and lateral views of the chest provided. Fusion hardware is partially noted in the lower C-spine. Minimal opacity is seen projecting over the right lower lung on the frontal view which could represent a very early pneumonia or atelectasis. No large effusion or pneumothorax. Cardiomediastinal silhouette is stable. Bony structures are intact.

IMPRESSION: Possible early pneumonia versus atelectasis at the right lung base.


SubjectID: 17274271, StudyID: 52974877, Comparison: same

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old man with dobhoff // check placement after pulling stylette

TECHNIQUE: Portable chest radiograph

COMPARISON: Chest x-ray ___ at 11:54

FINDINGS: Since the prior radiograph performed earlier on the same date, the Dobbhoff tube has been advanced and now terminates in the antrum of stomach. No other relevant changes from the earlier study   Keywords: no other relevant change.

IMPRESSION: Dobbhoff tube terminates in the stomach antrum.


SubjectID: 17274271, StudyID: 52194772, Comparison: None

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old man currently NPO, now requiring Dobhoff placement // ?Dobhoff placement

TECHNIQUE: Portable chest radiograph

COMPARISON: Chest x-ray ___

FINDINGS: Initial images show the Dobbhoff tube to be coiled within the pharynx but subsequent images show repositioning with the tip terminating in the stomach. There are worsening bibasilar opacities, most notable on the left, and aspiration or pneumonia should be considered in the appropriate clinical setting. There is no pneumothorax. Cardiomediastinal silhouette is unremarkable.

IMPRESSION: 1. Dobhoff tube terminates in the stomach. 2. Worsening bibasilar opacities, particularly on the left, and aspiration or pneumonia should be considered in the appropriate clinical setting.


SubjectID: 17274271, StudyID: 51964051, Comparison: None

WET READ: ___ ___ 8:21 AM Dobbhoff tube appears coiled within the oral cavity and is removed on subsequent images. This finding was confirmed with the team. Right lung base opacity persists and is concerning for pneumonia. Discussed with ___ NP by ___ via telephone on ___ at 00:19.

WET READ VERSION #1 ___ ___ ___ 12:20 AM Dobbhoff tube appears coiled within the oral cavity and is removed on subsequent images. This finding was confirmed with the team. Right lung base opacity persists and is concerning for pneumonia. Discussed with ___ NP by NSR via telephone on ___ at 00:19. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with dobhoff placement // ? Placement of dobhoff tube ? Placement of dobhoff tube

IMPRESSION: In comparison with the earlier study of this date, the Dobbhoff appears to be coiled within the oral cavity and pharynx. Bibasilar opacifications could reflect atelectasis, but in the appropriate clinical setting are worrisome for pneumonia.


SubjectID: 17274271, StudyID: 50315941, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with renal cell carcinoma s/p ACDF. // dopoff placement dopoff placement

IMPRESSION: In comparison with the study of ___, the endotracheal tube has been removed. On the final image, the uptake tip of the Dobbhoff tube is just distal to the esophagogastric junction. If possible, the tube could be pushed in further. There is continued opacification at the right base, worrisome for pneumonia. Atelectatic changes is seen at the left base.


SubjectID: 17274271, StudyID: 50526960, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with tumor // ETT evaluation, and OG evaluation ETT evaluation, and OG evaluation

IMPRESSION: In comparison with the study of ___, there has been placement of an endotracheal tube, with its tip approximately 6.5 cm above the carina. No orogastric tube is seen, raising the possibility that it is coiled within the back of the throat. There is increased opacification at the right base, worrisome for developing pneumonia. Probable retrocardiac atelectatic changes with blunting of the left costophrenic angle.

NOTIFICATION: The possible misplaced orogastric tube and right lower lung pneumonia were conveyed to Dr. ___, who is covering for Dr. ___


SubjectID: 17279403, StudyID: 53055784, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M s/p chemoradiation for NHL (w h/o pericardial window) now with nonischemic cardiomyopathy and LBBB s/p epicardial lead placement // s/p L thoracotomy and subxiphoid window w/ epicardial leads placed. chest tube placed. r/o PTX s/p L thoracotomy and subxiphoid window w/ epicardial leads placed. chest tube placed. r/o PTX

COMPARISON: Prior chest radiographs since ___ most recently ___.

IMPRESSION: No pulmonary edema. Small left pleural effusion if any. No pneumothorax. Moderate to severe enlargement of the cardiac silhouette is probably exaggerated by AP positioning and low lung volumes. Left pleural drainage catheter in place. Epicardial pacer leads project over the left upper heart border and the diaphragmatic surface.


SubjectID: 17279403, StudyID: 51038650, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/pepicardial lead placement // eval for pneumothoraces s/p chest tube removal eval for pneumothoraces s/p chest tube removal

IMPRESSION: As compared to ___, the left chest tube has been removed. There is no evidence of pneumothorax on the left. The epicardial lead is in unchanged position. No pulmonary edema. No pneumonia. Unchanged left retrocardiac atelectasis.


SubjectID: 17288685, StudyID: 59149955, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with Stage V CKD not yet on HD but with matured AVF, CHF, DM2, and HTN who presents with hypoxemic respiratory failure secondary to volume overload in the setting of hypertensive emergency and CKD V. // interval assessment

TECHNIQUE: Portable chest

COMPARISON: ___

IMPRESSION: The endotracheal tube and NG tube have been removed. The heart is severely enlarged and there is mild pulmonary vascular redistribution and small bilateral pleural effusions. There patchy areas of alveolar infiltrate. The overall impression is that of worsened CHF   Keywords: worse


SubjectID: 17288685, StudyID: 55955576, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with recent intubation - please evaluate position of ETT and OGT thank yyou // ___ year old woman with recent intubation - please evaluate position of ETT and OGT thank you

TECHNIQUE: Portable chest

COMPARISON: ___

IMPRESSION: the ET tube is 5 cm above the carina. The NG tube is in the stomach. IVC filter is visualized in the abdomen. There are small bilateral effusions right greater than left that have increased compared to the prior exam. The heart is severely enlarged. There is pulmonary vascular redistribution compatible fluid overload, which is increased compared to the prior study   Keywords: increase.


SubjectID: 17288685, StudyID: 55310441, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with increasing hypoxia // Evaluate for pulmonary edema

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Cardiomegaly is substantial. Mediastinum is unremarkable. Vascular congestion is noted but improved since the prior study   Keywords: improve. Atelectasis at the left mid lung is unchanged. Hiatal hernia is most likely present


SubjectID: 17288685, StudyID: 54002972, Comparison: 0.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF and CKD with resp failure // interval change

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Cardiomegaly is severe, unchanged. Mediastinal silhouette is stable. There is interval substantial improvement in pulmonary edema   Keywords: improve. Bibasal opacities which are remaining might potentially represent be CT a of pulmonary edema but infectious process is a possibility   Keywords: remain.


SubjectID: 17288685, StudyID: 51744664, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with ESRD now with respiratory failure // interval change

TECHNIQUE: Portable chest

COMPARISON: ___ at 13 15

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change.


SubjectID: 17288685, StudyID: 51697944, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiograph.

INDICATION: ___F with hypoxia dyspnea, evaluate for acute process.

TECHNIQUE: Portable chest radiograph.

COMPARISON: None available.

FINDINGS: No prior studies are available for comparison. The heart is severely enlarged. There are diffuse airspace opacities most pronounced in the lower lobes. There are small to moderate bilateral pleural effusions. There is no pneumothorax. No acute osseous abnormality is seen.

IMPRESSION: Cardiomegaly diffuse primarily lower lobe airspace opacities and bilateral pleural effusions findings favor pulmonary edema with differentials including multifocal infection.


SubjectID: 17290566, StudyID: 54371197, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: CABG, evaluation for pneumothorax after chest tube removal.

COMPARISON: ___.

FINDINGS: The patient is intubated. A Swan-Ganz catheter is in correct position. Nasogastric tube follows expected course. Previously placed aortic balloon pump has been removed in the interval. The patient has a left and a right chest tube. The lung volumes are low, a pre-existing left upper lobe opacity is resolving. However, there are unchanged signs of mild fluid overload and relatively extensive retrocardiac atelectasis   Keywords: unchanged. No newly appeared focal parenchymal opacities   Keywords: new. No evidence of pneumothorax.


SubjectID: 17290566, StudyID: 51674405, Comparison: None

WET READ: ___ ___ ___ 7:19 PM NG, ET, Right IJ sheath, CABG wires in appropriate position. No pneumothorax. A ___ ___ ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post CABG, evaluation for pneumothorax.

FINDINGS: As compared to the previous radiograph, both the left and the right chest tube have been removed. Also removed is the Swan-Ganz catheter, while the other monitoring and support devices remain in place. There is no evidence of pneumothorax. Minimal fluid overload with mildly enlarged cardiac silhouette and retrocardiac atelectasis. No larger pleural effusions.


SubjectID: 17290566, StudyID: 53606924, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST ON ___

HISTORY: CABG, rule out infiltrate.

IMPRESSION: PA and lateral chest compared to ___: Previous abnormality in the left upper hemithorax has cleared. It was probably a pleural loculation. Only a small left pleural effusion remains. Consolidation at the left lung base accompanied by downward displacement of the hilus is an indication of atelectasis. Atelectasis at the right lung base is less severe, though both have worsened since ___. There is no longer vascular congestion. Moderate cardiomegaly persists. No pneumothorax.


SubjectID: 17290566, StudyID: 50716013, Comparison: worse

WET READ: ___ ___ 10:02 PM The sternum cannot be assessed on a single frontal radiograph. Midline sternotomy wires are intact. A lateral view can identify displaced fractures. CT would also be useful, if clinically indicated. Low lung volumes accentuate pulmonary vasculature. Small left effusion is stable since yesterday. RIJ central line has been removed. ______________________________________________________________________________

FINAL REPORT

AP CHEST, 7:22 P.M. ON ___

HISTORY: Status post CABG. Sternal drainage after a fall, evaluate the sternum.

IMPRESSION: AP chest compared to ___ through ___. Frontal chest radiograph on ___ presented for review on ___ at 10:45 a.m. Mild pulmonary edema has worsened slightly   Keywords: worse. Hazy opacification projecting to the left of the left hilus is probably a pleural fluid collection, either fissural anterior or posterior. Post-operative caliber of large cardiomediastinal silhouette is stable. There is no pneumothorax or appreciable right pleural effusion. Sternal wires are intact and the alignment has not changed since ___.


SubjectID: 17290566, StudyID: 52912567, Comparison: None

FINAL REPORT

INDICATION: Left effusion, to assess for interval change.

TECHNIQUE: AP semi-upright portable radiograph of the chest.

COMPARISON: Chest radiograph ___.

FINDINGS: Right internal jugular catheter terminates at the superior cavoatrial junction. Right costophrenic sulcus is excluded from the image. Lungs are low in volume. Aside from atelectasis at the right lung base, the right lung is well aerated. The left lung is slightly better aerated than on the prior study with minimal decrease in left pleural effusion though some of it appears to be collected in a nondependent location, perhaps within the major fissure. Mild cardiomegaly is noted and slightly decreased from the prior study. Median sternotomy wires as before.

IMPRESSION: Overall likely unchanged to minimally decreased left pleural effusion, with a portion collecting in a non-dependent fashion, perhaps within the major fissure.


SubjectID: 17290566, StudyID: 52301647, Comparison: None

FINAL REPORT

HISTORY: ___-year-old male, status post CABG. STUDY: Supine portable AP chest radiograph.

COMPARISON: ___ at 9:10 a.m.

FINDINGS: The intra-aortic balloon pump has been advanced such as the tip projects over the upper portion of the aortic arch, approximately 8 mm from the top of the arch; retraction may be considered by about 2 cm. Otherwise, the lines and tubes are similar in appearance. The degree of cardiomediastinal widening is unchanged from 20 minutes prior. If developing mediastinal hematoma is if concern, short-interval followup may be considered. Additionally, the left upper lobe opacity may represent aspiration or hemorrhage - followup as clinically indicated.


SubjectID: 17290566, StudyID: 50259191, Comparison: worse

FINAL REPORT

INDICATION: Patient with chest pain and crackles on exam.

COMPARISONS: Chest radiograph ___ ___.

FINDINGS: Portable frontal view of the chest demonstrates low lung volumes. Moderate pulmonary edema is new since prior exam   Keywords: new. Mild-to-moderate cardiomegaly also appears progressed from prior study. The left costophrenic angle is obscured, suggestive of small pleural effusion. No large right pleural effusion is seen. Hilar and mediastinal silhouettes are unremarkable. There is no pneumothorax.

IMPRESSION: Moderate pulmonary edema, cardiomegaly and small left pleural effusion.


SubjectID: 17302284, StudyID: 57055805, Comparison: None

WET READ: ___ ___ ___ 9:58 AM 1. Probable early consolidation in the right lower lobe. Subsegmental atelectasis is possible but less likely. 2. Moderate right pleural effusion and small left pleural effusion are new. 3. No pulmonary vascular congestion or pulmonary edema. 4. Likely unchanged moderate cardiomegaly. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___M with dyspnea, evaluate for CHF.

TECHNIQUE: PA and lateral view radiographs of the chest.

COMPARISON: Prior chest radiographs from ___ through ___.

FINDINGS: A small left pleural effusion and a moderate right pleural effusion are new from the prior study. An opacity at the right lung base more likely represents early consolidation and atelectasis. There is no pneumothorax, pulmonary vascular congestion, or pulmonary edema. A dual-chamber pacemaker and its leads project in expected location. Sternotomy ___ and mediastinal clips are noted. Moderate cardiomegaly is somewhat obscured by effusion but appears generally stable.

IMPRESSION: 1. Probable consolidation in the right lower lobe. Subsegmental atelectasis is possible but less likely. 2. Moderate right pleural effusion and small left pleural effusion are new. 3. No pulmonary vascular congestion or pulmonary edema. 4. Likely unchanged moderate cardiomegaly.


SubjectID: 17302284, StudyID: 51744668, Comparison: same

WET READ: ___ ___ ___ 4:13 PM No significant interval change. Right base opacity could be due to consolidation from pneumonia, atelectasis felt less likely, particularly given that the mediastinum is shifted slightly to the contralateral side. Underlying neoplastic process is not excluded either. Recommend followup to resolution. Consider nonemergent chest CT to further assess. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: History: ___M with CHF exacerbation. Prior CXR with ?consolidation // please eval s/p diuresis

TECHNIQUE: Chest: Frontal and Lateral

COMPARISON: ___ at 08:25

FINDINGS: Left-sided AICD is stable in position. The appearance of the lungs is without significant interval change   Keywords: without significant interval change. There are bilateral, right greater than left, pleural effusions with overlying atelectasis. Opacity at the right lung base raises concern for overlying pneumonia, underlying pulmonary mass is not excluded on this study.

IMPRESSION: No significant interval change in the appearance of the lungs   Keywords: no significant interval change. Moderate right pleural effusion with overlying atelectasis. Right base opacity is concerning for consolidation possibly due to infection, underlying neoplastic process is not excluded either. Recommend followup to resolution. Consider nonemergent chest CT to further assess. Stable cardiomediastinal silhouette.


SubjectID: 17302319, StudyID: 59409507, Comparison: same

WET READ: ___ ___ ___ 7:55 PM Bilateral thoracostomy tubes unchanged in position. Neighboring opacities most likely reflect atelectasis or mild edema. Stable cardiomegaly. No pneumothorax detected. Trace bilateral pleural effusions are unchanged. ______________________________________________________________________________

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old man status post cardiac surgery with air leaks.

FINDINGS: Cardiac silhouette is enlarged. There are again seen bilateral chest tubes which are stable in position. No pneumothoraces are seen. There is a right-sided PICC line whose distal lead tip is in the proximal SVC. Overall, these findings are unchanged. There remains a mild-to-moderate pulmonary edema and small bilateral pleural effusions   Keywords: remains.


SubjectID: 17302319, StudyID: 57334682, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old male status post cardiac surgery with air leaks and bilateral Pleur-evac. Evaluate for pneumothorax.

FINDINGS: Comparison is made to the prior study from ___. The right-sided PICC line tip is at the level of the proximal right atrium. There are bilateral chest tubes. These are unchanged in position. No pneumothoraces are seen on either side. The cardiac size is enlarged but stable. There is a trace pulmonary edema. Bilateral pleural effusions are again present and stable in size.


SubjectID: 17302319, StudyID: 55698659, Comparison: None

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: Evaluate for pneumothorax following chest tube to water seal.

FINDINGS: Comparison is made to prior study from ___. There is again seen a chest tube at the right base. There is no significant pneumothorax on either side. There is again seen increased density at the right base at the site of the chest tube. There is minimal prominence of the pulmonary interstitial markings and small bilateral pleural effusions.


SubjectID: 17302319, StudyID: 52929845, Comparison: None

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old man with persistent air leaks. Chest tubes have been clamped. Evaluate for pneumothoraces.

FINDINGS: Comparison is made to prior study from ___. There are bilateral chest tubes. The chest tube on the left side has migrated more proximally and is now projecting over GE junction. On the right side, there is a small apical pneumothorax. A tiny apical pneumothorax in the left side is also identified. The heart size is enlarged but stable. There are some areas of consolidation at lung bases with the consolidation on the right side having improved.


SubjectID: 17302319, StudyID: 51209163, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old man with removal of left-sided chest tube. Evaluate for pneumothorax.

FINDINGS: There is a right-sided pneumothorax which is stable to slightly larger than on the prior study. The left apical pneumothorax is no longer seen. There is a right-sided PICC line whose distal lead tip is in the proximal SVC. Cardiac silhouette is enlarged. There is persistent small bilateral pleural effusions. There is consolidation in the lower lungs bilaterally which are stable.


SubjectID: 17302319, StudyID: 56492974, Comparison: worse

FINAL REPORT

AP CHEST ___

HISTORY: ___-year-old man with endocarditis, evaluate pulmonary edema.

IMPRESSION: AP chest compared to ___ through ___. Severe pulmonary edema has worsened again since ___, more pronounced than it was at its maximum, ___, accompanied by small bilateral pleural effusion, left greater than right   Keywords: worse. Dr. ___ was paged at 10:03 a.m., one minute after the findings were recognized, and we discussed them by telephone one minute after that.


SubjectID: 17302319, StudyID: 54721204, Comparison: better

FINAL REPORT

INDICATION: ___-year-old male with endocarditis, endotracheal tube placement.

COMPARISON: ___. CHEST, AP UPRIGHT: A new endotracheal tube terminates 6 cm above the carina. A nasogastric tube courses through the stomach and inferiorly beyond the film. Moderate left and small right layering pleural effusions are unchanged. Moderate cardiomegaly and central venous congestion persist. There has been slight improvement in moderate interstitial and airspace pulmonary opacities. Persistent retrocardiac opacity could represent atelectasis or consolidation.

IMPRESSION: 1. Endotracheal and nasogastric tubes in standard position. 2. Slight improvement in moderate pulmonary edema   Keywords: improve. 3. Left lower lobe atelectasis or consolidation.


SubjectID: 17302319, StudyID: 56752036, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man status post cardiac surgery.

COMPARISON: ___ to ___.

FINDINGS: Bibasilar effusions and atelectasis are similar to yesterday's exam. No new consolidation, effusion, pneumothorax is present. A right apical pneumothorax is tiny and unchanged.

IMPRESSION: Unchanged appearance of moderate bibasilar effusions, atelectasis and tiny right apical pneumothorax.


SubjectID: 17302319, StudyID: 51044620, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man with right-sided pneumothorax, to assess interval change.

COMPARISON: Chest radiograph, ___. PORTABLE AP CHEST RADIOGRAPH: Small right apical pneumothorax and a small right pleural effusion, are stable since ___. Right-sided chest tube is unchanged in position terminating in the right basal pleural space. Heterogeneous areas of consolidation in both lungs, predominantly seen in the lower lobes, have not significantly changed and likely represent asymmetric pulmonary edema, less likely infection. The cardiomediastinal and hilar contours are stable. Small left pleural effusion and moderate left basal atelectasis are unchanged. A right upper extremity PICC terminates at the level of the upper SVC.

IMPRESSION: 1. Small right apical pneumothorax, stable since ___. 2. Bilateral pulmonary consolidations, predominant in the lower lobes, likely represent asymmetric pulmonary edema, less likely infection.


SubjectID: 17302319, StudyID: 53133317, Comparison: worse

FINAL REPORT

AP CHEST, 9:56 A.M., ___

HISTORY: Endocarditis. Any change in pulmonary edema.

IMPRESSION: AP chest compared to ___: Moderately severe pulmonary edema, which worsened from ___ to ___, has redistributed, now more dependent, but also improved slightly over the past day   Keywords: worse. Small bilateral pleural effusions are new or newly apparent. Moderate cardiomegaly has improved slightly. Given the distribution of edema, concurrent pneumonia cannot be excluded, but does not need to be invoked to explain the sequence of changes.


SubjectID: 17302319, StudyID: 55825394, Comparison: worse

FINAL REPORT

AP CHEST, 3:27 A.M. ON ___

HISTORY: ___-year-old man with dyspnea and orthopnea. Evaluate for interval change after diuresis.

IMPRESSION: AP chest compared to ___: What was previously moderately severe interstitial pulmonary edema has progressed to severe pulmonary edema with a perihilar distribution   Keywords: progressed. Moderate cardiomegaly may be slightly larger and small bilateral pleural effusions are larger as well. No pneumothorax.


SubjectID: 17302319, StudyID: 50698766, Comparison: None

FINAL REPORT

INDICATION: Shortness of breath.

COMPARISON: None. PA AND LATERAL VIEWS OF THE CHEST: The cardiac silhouette size is moderately enlarged. The mediastinal contours are within normal limits. There is mild pulmonary edema with perihilar haziness, vascular indistinctness, and ___ B lines. Small bilateral pleural effusions are noted. There is no focal consolidation or pneumothorax. No acute osseous abnormality is present.

IMPRESSION: Mild congestive heart failure with mild pulmonary edema and small bilateral pleural effusions.


SubjectID: 17303323, StudyID: 59296708, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p BiV ICD upgrade // PTX, leads

IMPRESSION: Since the prior radiograph of ___, a biventricular pacing lead has been placed, with no visible pneumothorax. Pre-existing ICD pacing leads in right atrium and right ventricle appear unchanged. Stable cardiomegaly accompanied by pulmonary vascular congestion   Keywords: stable.


SubjectID: 17303323, StudyID: 57434514, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man s/p BiV ICD upgrade // lead, ptx

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, a pre-existing signs of pulmonary edema have completely resolved   Keywords: resolve. No evidence of pneumothorax of the lead placement. Low lung volumes. Moderate cardiomegaly. The sternal wires show unchanged alignment.


SubjectID: 17303323, StudyID: 56598866, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF (LVEF ___%) and empyema now s/p chest tube placement // Please assess for interval change

COMPARISON: Chest x-ray from ___ at 21:04

FINDINGS: There are low inspiratory volumes, significantly lower than on the most recent prior chest radiograph. Allowing for this, the cardiomediastinal silhouette is probably similar in size. The left-sided pacemaker type device and right IJ lines are similar in configuration. Right-sided pleural drain is again noted, also similar in configuration. The previously seen right effusion is smaller. Curvilinear lucency at the right lung base raises the question of a small pneumothorax at the right lung base versus ___ artifact. Some confluent opacity at the right lung base is compatible with residual collapse and/___ consolidation. The area of opacity questioned along the upper right chest wall on the most recent prior film is no longer visualized, likely represent artifact. As before, the left lung base is obscured obscured by the generator device. There is probably some subsegmental atelectasis at the right base, slightly more pronounced on the prior study. Mild vascular plethora is present, likely accentuated by low inspiratory volumes.

IMPRESSION: Considerable improvement in right pleural effusion. New linear lucency at the right lung base could reflect either a small pneumothorax ___ ___ artifact. Residual collapse and/___ pneumonic consolidation at the right base is present. Low inspiratory volumes. Atelectasis at the left base probably slightly increased. Mild vascular plethora, likely accentuated by low lung volumes.


SubjectID: 17303323, StudyID: 54884056, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF and empyema now s/p chest tube removal. // Please assess for change in effusion s/p chest tube removal

IMPRESSION: Since the prior radiograph of 1 day earlier, a right-sided pleural catheter has been removed, with no definite pneumothorax. Appearance of the chest is otherwise similar to the recent study except for slight improved aeration at the right lung base.


SubjectID: 17303323, StudyID: 53722246, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with chf and complicated effusion s/p chest tube // assess ptx

COMPARISON: Chest x-ray from ___ at 601 a.m.

FINDINGS: Transvenous atrial biventricular pacer defibrillator leads with left pectoral generator are unchanged. Right IJ central line with tip over the upper right atrium is unchanged. Right-sided chest tube is new. No pneumothorax is detected. The patient is status post sternotomy, with a large cardiomediastinal silhouette, similar to the prior film. Again seen is opacification at the right base which likely represents a combination of a right effusion and underlying collapse and/or consolidation. The right pleural effusion may be very slightly smaller. Faint blurring in the upper zones bilaterally likely reflects CHF, also similar to the prior study   Keywords: similar. Equivocal area of more confluent density in the upper right lung laterally, though I suspect that this is artifact due to overlying iatrogenic device. There is atelectasis in the retro cardio region, similar prior. No gross left effusion.

IMPRESSION: Interval placement of right chest tube. Opacification at the right base a is overall similar, with possible slight decrease in the size of the right pleural effusion. No pneumothorax detected. Probable CHF and left base atelectasis. Ill-defined confluent opacity in the right upper chest laterally most likely represents artifact due to overlying materials. Attention to this area on followup films is requested.


SubjectID: 17303323, StudyID: 54853673, Comparison: same

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___-year-old with a right IJ CVL. Evaluate placement of CVL, ? PTX.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph dated ___, earlier on the same day at 15:02.

FINDINGS: Interval placement of a right internal jugular-approach central venous catheter noted with tip projecting over the expected region of the right atrium. No pneumothorax. Otherwise no change   Keywords: no change.

IMPRESSION: Appropriately positioned right IJ cv catheter. No pneumothorax.


SubjectID: 17303323, StudyID: 54048431, Comparison: same

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___-year-old man presenting with shortness of breath. Evaluate pneumonia.

TECHNIQUE: Single portable AP upright radiograph view of the chest.

COMPARISON: Chest radiograph and CTA chest dated ___.

FINDINGS: Lung volumes have decreased since the prior exam. Central bronchovascular congestion persists despite low volumes   Keywords: persists. Opacity in the right lower lobe persists. No large pleural effusion or pneumothorax. Cardiomegaly is moderate. Prominence of the pulmonary artery is are better assessed on the prior CT. Left cardiac pacer defibrillator is unchanged. Median sternotomy wires and mediastinal are also unchanged.

IMPRESSION: 1. Persistent right lower lobe opacity, thought to be pneumonia on CT. Recommend follow-up imaging 6 weeks after treatment to ensure resolution and exclude underlying lesion. 2. Lower lung volumes.

RECOMMENDATION(S): Follow-up imaging 6 weeks after treatment to ensure complete resolution of right lower lobe opacity exclude underlying lesion.


SubjectID: 17310670, StudyID: 51066855, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with effusion // effusiion f/u

COMPARISON: ___.

IMPRESSION: Decrease in extent of the bilateral pleural effusions. The effusions are mild to moderate at the current stage. Subsequent areas of atelectasis are seen. There located at both lung bases. Normal size of the cardiac silhouette. Unchanged course of the pacemaker leads.


SubjectID: 17310670, StudyID: 52835342, Comparison: None

FINAL REPORT

INDICATION: Chest pain.

COMPARISON: ___.

FINDINGS: Frontal and lateral views of the chest demonstrate moderate-to-large bilateral pleural effusions. Heart is moderately enlarged. There is moderste pulmonary edema. No pneumothorax. Hilar and mediastinal silhouettes are unremarkable.

IMPRESSION: Moderate-to-large bilateral pleural effusions, moderate cardiomegaly and pulmonary edema.


SubjectID: 17310670, StudyID: 50554040, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Decompensated heart failure, evaluation for pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the signs of pulmonary edema are present in unchanged manner and the pleural effusion on the right has mildly increased in extent   Keywords: unchanged. The effusion on the left has not substantially changed. Also unchanged are bilateral areas of atelectasis at the lung bases. Mild cardiomegaly remains present. Unchanged course and position of the left pectoral pacemaker.


SubjectID: 17315623, StudyID: 58321169, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hypoxia and LLL opacficiation/effusion // please eval left lung infiltrate/effusion

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, there is unchanged complete opacification of the left hemi thorax. The left heart contour is not visible. The right heart contour is unchanged and normal. Unchanged evidence of likely atelectatic opacities at the right lung base. The right lateral aspect of the costophrenic sinus are not visualized on the image.


SubjectID: 17315623, StudyID: 56650904, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with left lung white out // evaluate for interval change

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, largest portion of the left hemi thorax is still completely opacified. However, a small area of the ventilated lung parenchyma at the level of the left apex has newly appeared. The right heart border and the right lung continue to be overall unremarkable. However, there is an oval opacity in the mid right lung that could represent a small intrafissural pleural effusion. No right-sided pneumonia. No right pulmonary edema.


SubjectID: 17315623, StudyID: 52477741, Comparison: worse

FINAL REPORT

INDICATION: COPD and known left lower lobe consolidation, acutely dyspneic. Evaluate for new infiltrative process.

COMPARISON: ___.

FINDINGS: There is a new near complete opacification of the left hemithorax with a small amount of aerated lung in the left upper lung. There is no significant shift of the mediastinum, likely reflecting combination of effusion and collapse. A small right pleural effusion is unchanged. Mild pulmonary edema is new   Keywords: new. Difficult to assess the heart size due to overlying effusion.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 10:46 AM, 2 minutes after discovery of the findings.


SubjectID: 17315623, StudyID: 51954992, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with mucous plug s/p bronch with mucous extraction // evaluate for interval change

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the ventilation of the left lung has substantially improved. However, the inferior part of the hemi thorax is still atelectatic and the cardiac silhouette is enlarged. There is no evidence of a pleural drain on the left. On the right, the lung has increased in transparency, likely reflecting improved ventilation. The pre-existing oval opacity is no longer seen


SubjectID: 17329106, StudyID: 58931161, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF and new fever // New infiltrate c/w pneumonia/aspiration? New infiltrate c/w pneumonia/aspiration?

COMPARISON: Comparison to ___ at 15:17

FINDINGS: Portable AP upright chest radiograph ___ at 08:20 is submitted.

IMPRESSION: There are increasing patchy areas of consolidation at both bases, right greater than left, which would be concerning for pneumonia or aspiration, less likely atelectasis, given the clinical setting of new fever. No pulmonary edema. Due to marked patient rotation, cardiac and mediastinal contours cannot be adequately assessed. No pneumothorax.


SubjectID: 17329106, StudyID: 54217211, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with shortness of breath. // evaluate for change in pulmonary edema or consolidation evaluate for change in pulmonary edema or consolidation

COMPARISON: Comparison to ___ at 20:52

FINDINGS: Portable upright chest radiograph ___ at 15:17 is submitted.

IMPRESSION: There is improving aeration in both lungs suggestive of resolving pulmonary edema   Keywords: resolving. Residual patchy opacity is seen at both bases which may reflect atelectasis or subsegmental atelectasis, less likely pneumonia. Overall cardiac and mediastinal contours are stable given differences in patient rotation. No pneumothorax.


SubjectID: 17329106, StudyID: 56479762, Comparison: better

FINAL REPORT

EXAMINATION: Chest radiograph.

INDICATION: ___-year-old woman with shortness of breath

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph ___.

FINDINGS: Mild cardiomegaly is unchanged. There is no pleural effusion or pneumothorax. There is bibasilar atelectasis. There is mild interstitial edema, improved from ___   Keywords: improve. There is no focal lung consolidation. There is calcification of the anterior longitudinal ligament of the thoracic spine consistent with DISH.

IMPRESSION: No definite focal consolidation. Mild interstitial edema improved from ___   Keywords: improve.


SubjectID: 17329106, StudyID: 56340344, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with hx of COPD/asthma, CHF, p/w with worsening SOB and found to be lethargic and altered this AM. // please evaluate for pulm edema versus evolving consolidation. priors available.

COMPARISON: Radiographs from ___

IMPRESSION: Heart size is upper limits of normal. There is minimal atelectasis at the lung bases. No focal consolidation or significant pulmonary edema is seen. There are no pneumothoraces.


SubjectID: 17329106, StudyID: 56267354, Comparison: None

FINAL REPORT

INDICATION: ___F with dyspnea // Acute process

TECHNIQUE: AP and lateral views of the chest.

COMPARISON: ___.

FINDINGS: Based on limited exam due to rotation, portable technique and patient body habitus, there is no definite focal consolidation. There are small bilateral pleural effusions, larger on the right. There is mild pulmonary edema. Cardiomediastinal silhouette is grossly unchanged.

IMPRESSION: Mild pulmonary edema and small bilateral effusions.


SubjectID: 17329106, StudyID: 53205885, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with chest pain and tachycardia.

COMPARISON: ___. CHEST, AP UPRIGHT: Patient position is not specified. The patient is rotated rightward, if the patient is also supine, that would explain enlargement of the right hilus. Mild volume loss in the right lung and possible asymmetry in the extent of peripheral vascularity need to be verified with carefully positioned radiographs to see if imaging possible pulmonary embolus is indicated. Cardiomediastinal and hilar contours are otherwise normal. There is no evidence of pleural effusion or pneumothorax.

IMPRESSION: Need repeat radiographs to evaluate indirect signs of acute pulmonary embolus. Dr ___ was paged at 9:00AM.


SubjectID: 17336284, StudyID: 55433341, Comparison: same

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: Asthma, CHF. Dedicated AP and lateral views for evaluation of opacities.

TECHNIQUE: Chest PA and lateral

COMPARISON: ___ 03:05

FINDINGS: As compared to the examination from ___ min prior, there has been no relevant change   Keywords: no relevant change. Lateral view demonstrates no correlate to the opacities seen on frontal view and these almost certainly represent perihilar opacities of edema. While lateral view confirms no definite evidence of pneumonia, subtle infection cannot be excluded in the context of CHF in the appropriate clinical circumstance.

IMPRESSION: See above.


SubjectID: 17336284, StudyID: 55404670, Comparison: worse

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: Acute nocturnal dyspnea. History of asthma and CHF.

TECHNIQUE: Single portable frontal view of the chest.

COMPARISON: ___

FINDINGS: Moderate cardiomegaly and left anterior chest wall ICD and leads are unchanged. Mild unfolding of the thoracic aorta is unchanged. There is increase in the degree of pulmonary edema with blunting of the costophrenic angles consistent with in small bilateral pleural effusions   Keywords: increase. Opacification at the right base could represent an early atelectasis, though in the appropriate clinical setting superimposed pneumonia would have to be considered.

IMPRESSION: Increasing size of the cardiac silhouette with increased elevation of pulmonary venous pressure. Right basilar opacification could reflect developing pneumonia in the appropriate clinical setting.


SubjectID: 17339765, StudyID: 59134576, Comparison: None

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old man with hypoxia and fever. Evaluate for interval changes.

FINDINGS: Comparison is made to prior study from ___. Cardiac silhouette is enlarged. There are again seen bilateral pleural effusions, which have decreased in size since the prior study. There is also improved aeration at the lung bases since the prior study. There remains some atelectasis. No pneumothoraces are seen.


SubjectID: 17339765, StudyID: 50332306, Comparison: None

FINAL REPORT

INDICATION: Patient with hypoxia. Assess for fever.

COMPARISONS: Chest radiograph of ___.

FINDINGS: Semi-upright portable view of the chest demonstrated right PIC catheter projecting over mid SVC. Low lung volumes. Moderate-to-large bilateral pleural effusions have significantly increased in size since prior exam. Cardiac contour is obscured by overlying opacities, which is likely enlarged. Azygous vein appears prominent. There is pulmonary edema. Bibasilar consolidations are new since prior exam. Thickening of right minor fissure is again noted. There is no pneumothorax.

IMPRESSION: In comparison to ___ exam, there is significant progression of moderate-to-large bilateral pleural effusions, cardiomegaly and pulmonary edema. Bibasilar consolidations may represent atelectasis, however superimposed infection cannot be excluded.


SubjectID: 17339765, StudyID: 58186486, Comparison: None

FINAL REPORT

INDICATION: Leukemia, history of pleural effusion and new hypoxia, question infiltrate or effusion.

COMPARISON: Chest radiograph on ___.

FINDINGS: PA and lateral views of the chest. Left PICC line ends in low SVC. The large left pleural effusion is unchanged. There is slightly more blunting of the right costophrenic angle representing a minimal right pleural effusion. There is no opacity concerning for pneumonia. There is no pneumothorax.

IMPRESSION: Stable large left pleural effusion. Minimal right pleural effusion. No opacity concerning for pneumonia. These findings were discussed with Dr. ___ at 5:30pm on ___ by telephone.


SubjectID: 17339765, StudyID: 50580129, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST, ___

HISTORY: ___-year-old man with left pleural effusion following thoracentesis.

IMPRESSION: PA and lateral chest compared to ___: Only small volume of left pleural effusion remains. There is no pneumothorax. Small right pleural effusion is stable. Last time the heart shadow was visible unencumbered bypleural effusion was ___. The relative enlargement of that shadow is stable. Lobulation of the margin of the cardiac silhouette may be a reflection of previously demonstrated pericardial effusion. Pulmonary vascular congestion in the lungs is mild. Right lower lobe opacification has been present since at least ___ and is presumably atelectasis. Left PIC catheter ends in the region of the superior cavoatrial junction. No pneumothorax.


SubjectID: 17339765, StudyID: 57860874, Comparison: None

FINAL REPORT

PORTABLE CHEST, 4:28 A.M., ___.

HISTORY: ___-year-old man with sepsis and fever, question interval change.

IMPRESSION: AP chest compared to ___ through ___: Moderate-to-large right pleural effusion has both increased and changed in distribution since ___, with a growing right fissural component and a likely paramediastinal component simulating widening of the mediastinum in the right paratracheal region, rather than mediastinal hematoma which would tend to displace the trachea and/or the right internal jugular line. If there is clinical concern about mediastinal hematoma, CT scanning would be definitive, although an attempted right decubitus chest radiograph carefully positioned might show migration of the paramediastinal pleural fluid collection that we see on these conventional chest radiographs. Moderate cardiomegaly unchanged. Left pleural effusion is small if any. Left lower lobe atelectasis is longstanding. No pulmonary edema or pneumonia. Dr. ___ was paged.


SubjectID: 17339765, StudyID: 57655037, Comparison: None

FINAL REPORT

HISTORY: Febrile neutropenia with history of pleural effusion.

FINDINGS: In comparison with study of ___, there are lower lung volumes. Extensive bilateral pleural effusions persist with compressive basilar atelectasis and engorgement of pulmonary vessels consistent with elevated pulmonary venous pressure. Central catheter remains in position.


SubjectID: 17339765, StudyID: 57213651, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST ON ___

HISTORY: Bilateral pleural effusions. Fever. Thoracentesis yesterday.

IMPRESSION: PA and lateral chest compared to ___ at 10:58 p.m.: Small-to-moderate bilateral pleural effusions are unchanged following thoracentesis. Region of dense consolidation in the right mid lung is clearing, presumably post-reexpansion edema. There is also better aeration of the previously densely consolidated left lower lobe. Whether there is a small region of pneumonia in the abnormal lower lungs is radiographically indeterminate, but if present it is not worsening nor is there any pneumonia in the upper lungs. Moderate cardiomegaly appears improved, but just because of differences in from AP to PA projection. Right PIC line ends in the upper right atrium. No pneumothorax.


SubjectID: 17339765, StudyID: 51687405, Comparison: None

FINAL REPORT

AP CHEST, 10:58 P.M. ___

HISTORY: Bilateral pleural effusions and severe cough after right thoracentesis.

IMPRESSION: AP chest compared to ___ and ___: Small right pleural effusion is dramatically smaller than it was on ___, but there is a new large area of consolidation in the right mid lung, which could be either in the middle or lower lobe. I suspect this is a complication of thoracentesis, either localized reexpansion edema or hemorrhage, but since there was substantial atelectasis prior to thoracentesis, I do not know if this is necessarily a new finding or newly apparent consolidation that was present earlier in previously collapsed lung. Moderate left pleural effusion and left lower lobe consolidation, presumably atelectasis has worsened. There is no longer edema in the upper lungs, but severe enlargement of the cardiac silhouette persists. A right PIC line can be traced as far as the low SVC, but the tip is indistinct.


SubjectID: 17339765, StudyID: 56889680, Comparison: None

FINAL REPORT

PORTABLE UPRIGHT CHEST, ___

COMPARISON: Chest radiograph, ___.

FINDINGS: Comparison to prior studies is somewhat limited due to apparent semi-upright rather than fully upright positioning. Apparent increase in size of moderate-to-large right and moderate left pleural effusions could in part be related to the positional differences. Worsening bibasilar lung opacities are probably due to atelectasis in the setting of pleural effusions, but underlying infectious process is also possible in the appropriate clinical setting. Diffuse haziness in the upper abdomen is suggestive of ascites.


SubjectID: 17339765, StudyID: 51634376, Comparison: same

FINAL REPORT

PORTABLE CHEST RADIOGRAPH, ___

COMPARISON: Radiograph of earlier the same date.

FINDINGS: Following right thoracentesis, right pleural effusion has decreased in size, with residual small-to-moderate effusion remaining. Associated improvement in degree of right basilar atelectasis. Otherwise, no relevant changes since recent study performed several hours earlier   Keywords: no relevant change.


SubjectID: 17339765, StudyID: 51031683, Comparison: None

FINAL REPORT

HISTORY: ___-year-old male with acute shortness of breath.

COMPARISON: Chest radiograph from ___ and PA and lateral chest radiograph from ___. PORTABLE FRONTAL CHEST RADIOGRAPH: There are increased opacities in the lung bases, left greater than right. Findings likely reflect recurrence of bilateral pleural effusions. Underlying consolidation may be due to atelectasis, though aspiration or pneumonia, particularly in the left lung base, cannot be excluded. Mild vascular congestion is evident, however, there is no overt pulmonary edema. Detailed evaluation of the hilum and cardiac contours is limited due to basilar opacities, but there is marked cardiomegaly. There is no pneumothorax. A right PICC line terminates in the mid SVC.

IMPRESSION: Recurrence of bilateral pleural effusions, moderate on the left and small on the right. Probable associated underlying bibasilar atelectasis, though pneumonia or aspiration, particularly within the left base, cannot be entirely excluded. Vascular congestion present.


SubjectID: 17339765, StudyID: 54882948, Comparison: worse

WET READ: ___ ___ ___ 9:51 PM No apparent pneumothorax s/p right thoracentesis. Improved aeration of right lung base with decreased fluid. Increasing left basilar opacity - probable moderate effusion and atelectasis. Mild fluid tracking in the fissures. Right PICC in low SVC. ___ d/w ___ at 9:50 pm on ___ by telephone. ___ p_________________________________________________________________________________

FINAL REPORT

AP CHEST, 8:17 P.M., ___

HISTORY: Possible pneumothorax after thoracentesis.

IMPRESSION: AP chest compared to ___: Right pleural effusion has effectively resolved. Small-to-moderate left pleural effusion is larger. No pneumothorax. Moderate enlargement of the cardiac silhouette has progressed, and there may be mild left perihilar edema   Keywords: progressed. No pneumothorax. Right PIC line ends close to the anticipated location of the ___ cavoatrial junction.


SubjectID: 17339765, StudyID: 51780766, Comparison: None

FINAL REPORT

HISTORY: Recurrent bilateral effusions.

FINDINGS: In comparison with study of ___, there is an increase in prominence of the right pleural effusion with a stable effusion on the left. Bibasilar compressive atelectasis with several dense streaks of atelectasis bilaterally. The upper lung zones are clear. It is difficult to unequivocally exclude supervening pneumonia in the basilar regions. PICC line tip is within the lower portion of the SVC.


SubjectID: 17339765, StudyID: 54242010, Comparison: same

FINAL REPORT

INDICATION: ___-year-old woman with history of right pleural effusion, status post drainage with chest tube removal on ___ and E. coli sepsis, increased labored breathing, assess for fluid collection or loculation.

COMPARISONS: Portable AP chest radiograph from ___, CT chest, abdomen and pelvis from ___, and multiple other prior radiographs.

FINDINGS: Since the prior radiograph, there has been no significant change   Keywords: no significant change. There is a right pleural effusion with loculation near the upper lung zone which is not changed from the prior CT exam on ___. Linear opacities at the right base are likely atelectasis. Opacification of the left base is unchanged, and right IJ central line is stable in position   Keywords: unchanged.

IMPRESSION: No significant change since prior study   Keywords: no significant change. Persistent large right pleural effusion with loculation as seen on prior CT exam.


SubjectID: 17340686, StudyID: 57032496, Comparison: same

FINAL REPORT

EXAM: Chest, single AP semi-upright portable view. CLINICAL INFORMATION: ___-year-old female with history of shortness of breath on dialysis, question fluid overload.

COMPARISON: ___.

FINDINGS: Single AP semi-erect portable view of the chest was obtained. Moderate-to-severe pulmonary edema is again seen   Keywords: again. Difficult to exclude underlying pleural effusions. The cardiac and mediastinal silhouettes are stable. There has been interval placement of a large-bore left-sided catheter, distal tip not optimally seen, but likely terminates in the cavoatrial junction/right atrium.


SubjectID: 17340686, StudyID: 54716590, Comparison: same

FINAL REPORT

HISTORY: CHF and renal failure, on hemodialysis.

FINDINGS: In comparison with the study of ___, there is little overall change   Keywords: little overall change. Continued enlargement of the cardiac silhouette with moderate-to-severe pulmonary edema. Opacification at the left base may reflect effusion and atelectasis. Hemodialysis catheter again extends to probably the upper portion of the right atrium.


SubjectID: 17340686, StudyID: 56162656, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with COPD and ESRD on HD here with pneumonia and respiratory failure s/p intubation // ET placement

TECHNIQUE: Portable chest

COMPARISON: ___ at ___

FINDINGS: The ET tube is 2.6 cm above the Carina. The right lower lung opacity is again visualized. The heart is moderately enlarged. There is pulmonary vascular redistribution with ill-defined vascularity compatible fluid overload. An underlying infectious infiltrate cannot be excluded. NG tube tip is off the film, at least in the stomach. Severe degenerative changes of the right humeral head are again seen.

IMPRESSION: ET tube 2.6 cm above the Carina.


SubjectID: 17340686, StudyID: 54614605, Comparison: same

CLINICAL INFORMATION & QUESTIONS TO BE ANSWERED: ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with new subclavian line // eval for subclavian

TECHNIQUE: Portable chest

COMPARISON: ___ at 0 400

FINDINGS: There is a new left subclavian line with tip at the cavoatrial junction. Lung volumes are low. The right lower lobe opacities unchanged. There continues to be cardiomegaly, pulmonary vascular redistribution, ill-defined vascularity, and retrocardiac opacity compatible with CHF   Keywords: continue. The NG tube and large bore right IJ line are unchanged. The ET tube is 2 cm above the Carina. There is no pneumothorax.

IMPRESSION: New left central line. No pneumothorax.


SubjectID: 17340686, StudyID: 53739758, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with ESRD on HD here with respiratory failure s/p multiple attempts at LIJ and left subclavian // ? pneumothorax

TECHNIQUE: Portable chest

COMPARISON: ___.

FINDINGS: Compared to the prior study there is interval increase in the cardiomegaly and pulmonary vascular redistribution. There are patchy areas of alveolar infiltrate bilaterally compatible with fluid overload. The ET tube is 5.7 cm above the carinal. Large bore catheter tip is in the right atrium. NG tube is unchanged. No pneumothorax

IMPRESSION: Fluid overload. An underlying infectious infiltrate can't be excluded.


SubjectID: 17340686, StudyID: 55921730, Comparison: worse

FINAL REPORT

PORTABLE CHEST OF ___

COMPARISON: Radiograph of two days earlier.

FINDINGS: Support and monitoring devices are in standard position. Cardiomegaly is accompanied by pulmonary vascular congestion and worsening edema   Keywords: worse. Increasing confluent opacity in the right perihilar and infrahilar regions may reflect asymmetrical edema or developing pneumonia   Keywords: developing. Known right middle lobe mass is partially obscured by this process. Moderate layering right pleural effusion and small left pleural effusion are also demonstrated.


SubjectID: 17340686, StudyID: 55232811, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Hemodialysis, evaluation for pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the endotracheal tube, the nasogastric tube, and the left internal jugular vein catheter are unchanged. The right hemodialysis catheter has been removed. The signs of moderate to massive fluid overload, combined to a rounded opacity at the right lung base, are unchanged in extent and severity. No larger pleural effusions. No new parenchymal opacities   Keywords: new.


SubjectID: 17340686, StudyID: 53247313, Comparison: worse

FINAL REPORT

AP CHEST 10:15 P.M. ON ___

HISTORY: Suspect left lower lobe pneumonia.

IMPRESSION: AP chest compared to ___: Lung volumes are lower exaggerating what is at least worsened moderate pulmonary edema   Keywords: worse. More focal areas of opacification in the lateral left mid lung and infrahilar right lung could be atelectasis and edema but pneumonia is of serious concern. The moderately enlarged cardiac silhouette and dilated pulmonary arteries are larger today, and there is more mediastinal vascular engorgement. Dual channel right supraclavicular central venous line ends in the upper right atrium as before. There is no appreciable pleural effusion and no pneumothorax.


SubjectID: 17340686, StudyID: 51544976, Comparison: better

FINAL REPORT

INDICATION: History of multiple medical problems with cough and possible pneumonia.

COMPARISON: Chest radiograph ___. Chest radiograph ___. Chest ___ ___.

FINDINGS: An opacity in the right infrahilar region on the PA image and overlying the spine on the lateral image is consistent with pneumonia. The previously seen opacity on the left has improved suggesting it was likely due to edema   Keywords: improve. A pulmonary edema is improved from the prior radiograph, although a small amount of edema remains   Keywords: improve. The cardiac silhouette is stably enlarged. There is no pleural effusion or pneumothorax. A right internal jugular double-lumen hemodialysis catheter ends in the atrium.

IMPRESSION: 1. Right infrahilar opacity is most likely pneumonia. 2. Improving pulmonary edema   Keywords: improving.


SubjectID: 17361324, StudyID: 58006236, Comparison: worse

FINAL REPORT

PORTABLE CHEST ___, ___

COMPARISON: Radiograph of earlier the same date.

FINDINGS: ICD with left ventricular pacing lead remains in place. Persistent cardiomegaly but worsening pulmonary vascular congestion accompanied by interstitial edema   Keywords: worse. More confluent lower lobe opacities have also worsened in the interval, and could be due to developing pneumonia in the appropriate clinical setting. These findings appear to be superimposed on chronic basilar fibrotic lung disease, and note is made of extensive calcified granulomas in the upper lobes, as well as an incompletely characterized asymmetrical opacity in the right apex, more fully characterized with recommendations for followup on the prior radiograph of earlier the same date.


SubjectID: 17361324, StudyID: 53392758, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph of one day earlier.

FINDINGS: Allowing for differences in technique and projection, there has not been a relevant short interval change since the recent study performed one day earlier.


SubjectID: 17373950, StudyID: 55895331, Comparison: worse

FINAL REPORT

INDICATION: History: ___M with dyspnea // CHF?

TECHNIQUE: Portable supine AP chest

COMPARISON: Outside radiographs of the chest ___ and ___. Also chest radiograph ___.

FINDINGS: Mild pulmonary edema has developed since earlier in the day Moderate to severe cardiomegaly is stable   Keywords: develop. Small to moderate bilateral layering pleural effusion has increased. There is no pneumothorax. The aortic arch is calcified.

IMPRESSION: 1. New mild pulmonary edema, increased small to moderate bilateral pleural effusion   Keywords: new, increase. . 2. Moderate cardiomegaly is unchanged.


SubjectID: 17373950, StudyID: 54478275, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with shock of unclear etiology, cardiogenic vs septic // eval for volume overload vs pneumonia eval for volume overload vs pneumonia

IMPRESSION: In comparison with the study of ___, there is continued enlargement of the cardiac silhouette and with mild to moderate pulmonary edema. Retrocardiac opacification is consistent with volume loss in the left lower lobe and there probably are small bilateral pleural effusions.


SubjectID: 17374256, StudyID: 56383918, Comparison: same

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old man with end-stage renal disease and possible malignant effusions with respiratory distress. Evaluate fluid status.

FINDINGS: Comparison is made to previous study from ___. There are pleural effusions, left side worse than right. The effusions have decreased in size since the previous study. There is increased density at the left hilar region which may be due to tumor or persistent pulmonary interstitial edema which appears stable   Keywords: persistent, stable. There is a left-sided pacemaker with lead tips in the right atrium and right ventricle. Degenerative changes of the right glenohumeral joint are seen. There is some widening of the AC joint, which may be postoperative. There is a left IJ central venous line with the distal lead tip in the mid SVC.

IMPRESSION: 1. Improvement in the bilateral pleural effusions since the prior study. 2. Persistent pulmonary edema with prominence of the opacities at the left hilar region   Keywords: persistent.


SubjectID: 17374256, StudyID: 54655896, Comparison: None

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old man with CHF and on hemodialysis, now with orthopnea and pulmonary edema. Evaluate for pleural effusion.

FINDINGS: Comparison is made to prior study from ___. There is cardiomegaly which is stable. There is left-sided pacemaker which is unchanged. There are disconnected leads inferiorly which are unchanged. There are pleural effusions, left greater than right. There is a persistent left retrocardiac opacity. There is some atelectasis at the right base. Overall, the findings are relatively stable allowing for differences in technique and positioning. There is moderate pulmonary edema.


SubjectID: 17393825, StudyID: 58090469, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with dyspnea and increased O2 requirement // Please eval for pulm volume overload

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Moderate cardiomegaly. No pulmonary edema. No pneumonia, no pleural effusions.


SubjectID: 17393825, StudyID: 54280430, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with resp distress // Eval for pulmonary edema, PNA

TECHNIQUE: Single portable view of the chest.

COMPARISON: Chest x-ray from ___.

FINDINGS: Lungs are hyperinflated. There is no focal consolidation or large effusion. Moderate cardiomegaly is again noted. Atherosclerotic calcifications seen at the aortic arch. Surgical clips identified in the upper abdomen. No acute osseous abnormalities identified.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 17396346, StudyID: 57382119, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with dCHF p/w SOB, hypoxic // e/o worsening pulm edema e/o worsening pulm edema

IMPRESSION: No relevant change as compared to ___   Keywords: no relevant change. Moderate cardiomegaly, mild to moderate pulmonary edema. Small bilateral pleural effusions. Subsequent areas of basilar atelectasis. No evidence of pneumonia.


SubjectID: 17396346, StudyID: 51828119, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with CHF and ? aspiration // eval pulm edema and aspiration

FINDINGS: As compared to ___, improved inspiration and less of a lordotic view. Mild interstitial pulmonary edema with moderate severe cardiomegaly. Small to moderate bilateral pleural effusions with stable bibasal opacities. No pneumothorax. Surgical clips in the left axilla.

IMPRESSION: No significant interval change in mild interstitial edema and moderate bilateral effusions   Keywords: no significant interval change.


SubjectID: 17396346, StudyID: 56890017, Comparison: None

FINAL REPORT

INDICATION: Hypoxia.

COMPARISON: Multiple prior studies including chest radiograph from ___.

FINDINGS: Bilateral hazy opacities, in particular overlying the lower lobes, are noted, suggestive of moderate pulmonary edema. The cardiomediastinal silhouette appears enlarged. There are also small bilateral pleural effusions. Bibasilar opacities, which is more pronounced in the retrocardiac region, likely reflect compressive atelectasis. Post-surgical changes are noted in the left axilla. There is no pneumothorax. No acute fractures are identified.

IMPRESSION: Moderate congestive heart failure with small bilateral pleural effusions. Bibasilar opacities likely reflect atelectatic change, but an infectious process cannot be excluded.


SubjectID: 17396346, StudyID: 56062302, Comparison: None

FINAL REPORT

HISTORY: Pneumonia, to assess for change.

FINDINGS: In comparison with the study of ___, there is again substantial enlargement of the cardiac silhouette with pulmonary vascular congestion that appears to be less prominent, especially on the right. The right costophrenic angle is sharply seen. Mild atelectatic changes are seen at both bases. No definite pneumonia is appreciated, though this could be obscured by the cardiomegaly and vascular congestion.


SubjectID: 17396346, StudyID: 54910466, Comparison: 1.0

FINAL REPORT

AP CHEST 8:00 A.M. ON ___

HISTORY: ___-year-old woman with pneumonia, question interval change.

IMPRESSION: AP chest compared to ___: Moderate to severe cardiomegaly and mediastinal vascular engorgement are chronic, unchanged acutely   Keywords: unchanged. Mild pulmonary edema is stable   Keywords: stable. Small pleural effusions are presumed, but unchanged. There is no pneumothorax. Whether there is concurrent pneumonia is radiographically indeterminate and should be reevaluated after improvement in edema   Keywords: improve.


SubjectID: 17396346, StudyID: 55010316, Comparison: None

FINAL REPORT

HISTORY: Hypoxia with volume overload.

FINDINGS: In comparison with the study of ___, there is continued enlargement of the cardiac silhouette with bilateral pleural effusions and atelectatic changes at the bases. The streaks of atelectasis at the right base are more prominent. On the left, hemidiaphragm cannot be seen, again consistent with substantial volume loss in the left lower lobe. Lower lung volumes may be worsening the overall appearance.


SubjectID: 17399295, StudyID: 54305038, Comparison: -1.0

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Shortness of breath, questionable flash pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is unchanged evidence of minimal atelectasis at the right lung bases. The pleural effusions that pre-existed have not substantially increased as compared to the previous examination. However, the lateral film shows more fluid in interstitial spaces, suggesting an increase in severity of pre-existing fluid overload   Keywords: increase. Unchanged appearance of the pre-described calcifications   Keywords: unchanged appearance. Unchanged size of the cardiac silhouette.


SubjectID: 17399295, StudyID: 50286142, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Hodgkin's lymphoma, atypical chest pain, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is unchanged evidence of minimal atelectasis at the right lung bases. In addition, a right pleural effusion is bigger than on the previous image, and has a relatively substantial apical lateral component. Calcifications are still seen projecting over the anterior mediastinum on the lateral film and over the aortopulmonary window on the frontal film. A pacemaker device has been inserted in the anterior chest wall. Given the underlying disorder, CT is recommended to clarify cause for the increasing pleural effusion and pleural thickening on the left. The finding was posted on the radiology dashboard at the time of discovery and dictation of the report, 11:39 a.m., on ___.


SubjectID: 17400716, StudyID: 59431214, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with ESRD on HD, CAD, here with fevers, now in resp distress // flash pulmonary edema? flash pulmonary edema?

IMPRESSION: In comparison with the study of ___, there is worsening diffuse bilateral pulmonary opacification, consistent with the clinical diagnosis of flash pulmonary edema   Keywords: worse.


SubjectID: 17400716, StudyID: 58234794, Comparison: None

FINAL REPORT

INDICATION: ___F with fever, tachypnea // eval for PNA

TECHNIQUE: AP and lateral views the chest.

COMPARISON: Chest x-ray from ___.

FINDINGS: There are now indistinct pulmonary vascular markings throughout the lungs with enlarged central pulmonary vasculature. Cardiac silhouette is enlarged but not significantly changed. Probable small bilateral pleural effusions are noted. Atherosclerotic calcifications noted in the aorta. No acute osseous abnormalities identified.

IMPRESSION: Mild pulmonary edema and small pleural effusions.


SubjectID: 17400716, StudyID: 58661057, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___F with cough, L>R crackles // eval for pna

TECHNIQUE: Chest AP and Lateral

COMPARISON: ___

FINDINGS: There is a moderate amount of pulmonary edema. Cardiomegaly is again present. Bilateral pleural effusions left greater than right. No focal opacities concerning for pneumonia. No pneumothorax.

IMPRESSION: Cardiomegaly and moderate pulmonary edema. Bilateral pleural effusions left greater than right.


SubjectID: 17400716, StudyID: 51030751, Comparison: better

WET READ: ___ ___ ___ 9:51 AM Persistent cardiomegaly, with slightly increased pulmonary edema compared to chest radiograph from ___. Bilateral pleural effusions are also slightly increased, left greater than right.

WET READ VERSION #1 ___ ___ ___ 9:54 PM Persistent cardiomegaly, with slightly increased pulmonary edema compared to chest radiograph from ___. Bilateral pleural effusions are also slightly increased, left greater than right. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with dCHF, ESRD with acute tachypnea and dyspnea // assess interval change assess interval change

COMPARISON: Comparison to prior study dated ___ at 20:34

FINDINGS: AP portable upright chest film ___ at 18 51 is submitted.

IMPRESSION: There is persistent but improving mild interstitial edema   Keywords: improving. More focal opacity in the retrocardiac region is seen with an associated effusion most likely reflecting partial lower lobe atelectasis, although pneumonia or aspiration should also be considered. A smaller right effusion is also present. No pneumothorax. Overall cardiac and mediastinal contours are stable.


SubjectID: 17400716, StudyID: 58240990, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with fevers

TECHNIQUE: Portable AP view of the chest

COMPARISON: ___

FINDINGS: Moderate cardiomegaly is re- demonstrated. The aorta is diffusely calcified. There is persistent moderate pulmonary edema, not substantially changed from the previous exam   Keywords: persistent. Left basilar opacity may reflect atelectasis. Small bilateral pleural effusions are re- demonstrated. No pneumothorax is seen.

IMPRESSION: Congestive heart failure with moderate pulmonary edema and trace bilateral pleural effusions, not substantially changed in the interval. Left basilar atelectasis.


SubjectID: 17400716, StudyID: 57962474, Comparison: better

WET READ: ___ ___ ___ 9:33 PM Interval improvement in pulmonary edema, which is now mild to moderate. Trace bilateral pleural effusions, similar to prior exam.--___ ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman here with fever, acute resp distress during HD // acute intrathoracic process?

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Since the prior study there has been interval improvement in pulmonary edema which is currently moderate   Keywords: improve. Small bilateral effusions are noted, unchanged. Cardiomediastinal silhouette is stable. Substantial degenerative changes in the right shoulder are partially imaged.


SubjectID: 17400716, StudyID: 57321775, Comparison: -1.0

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: History of chronic heart failure, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is unchanged evidence of relatively severe pulmonary edema   Keywords: unchanged. The severity of the edema is comparable to ___. In addition to the edema, areas of increased lung density seen at the right lung bases   Keywords: increase. Here, pneumonia could be present. Moderate cardiomegaly. No pleural effusions. No pneumothorax. At the time of observation and dictation, 8:58 a.m., on ___, the referring physician ___. ___ was paged for notification.


SubjectID: 17400716, StudyID: 51862323, Comparison: worse

WET READ: ___ ___ ___ 7:46 PM no significant change in degree of pulmonary edema. bibasliar air space opacities are largely unchanges, likely superimposed infection. mild cardiomegaly and trace BL pleural effusions ___ ___ ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Right lower lobe pneumonia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is increasing evidence of moderate pulmonary edema   Keywords: increasing. Opacity at the right lung base is minimally decreased in extent and severity. Moderate cardiomegaly that is unchanged. Lateral radiograph shows minimal dorsal pleural effusions.


SubjectID: 17400716, StudyID: 57299843, Comparison: worse

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: Tachycardia. Assess for cardiopulmonary process.

COMPARISON: Chest radiograph ___, ___, ___.

FINDINGS: Frontal and lateral chest radiograph demonstrates mildly hypoinflated lungs with bilateral heterogeneous interstitial opacities suggestive of edema. Opacities in the posterior costophrenic angles suggestive of small bilateral effusions. No pneumothorax. Persistent moderate cardiomegaly is seen. Coronary artery stents are identified. Mediastinal contour and hila are otherwise unremarkable. Calcification of the aortic arch is stable. Limited assessment upper abdomen is within normal limits.

IMPRESSION: Mild pulmonary edema with moderate cardiomegaly and new small bilateral effusions   Keywords: new.


SubjectID: 17400716, StudyID: 53138124, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with ESRD now with new onset SOB. // Is there pulmonary edema? Is there pulmonary edema?

IMPRESSION: In comparison with the study of ___, the patient has taken a better inspiration. There is still prominence of the cardiac silhouette with pulmonary edema   Keywords: still. Opacification of the left spaces consistent with volume loss in the lower lobes and small pleural effusion.


SubjectID: 17400716, StudyID: 57131612, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with dyspnea, cough, fever

TECHNIQUE: Portable upright AP view of the chest

COMPARISON: ___ at 14:16

FINDINGS: Heart size remains mildly enlarged. The aorta demonstrates diffuse atherosclerotic calcifications. The mediastinal contours are unchanged. There is continued mild pulmonary edema, slightly improved in the interval with perihilar haziness and vascular indistinctness   Keywords: improve. Small bilateral pleural effusions are not substantially changed in the interval. No pneumothorax is identified. No acute osseous abnormalities are visualized.

IMPRESSION: Mild improvement in mild pulmonary edema with small bilateral pleural effusions   Keywords: improve.


SubjectID: 17400716, StudyID: 52396788, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT))

INDICATION: ___ year old woman with esrd s/p failed dcd, chf, cad 3v dz, presented with pulm edema vs pna. Evaluate for pneumonia after removing fluid via hemodialysis.

COMPARISON: Chest radiograph dated ___.

FINDINGS: Probable small amount of basilar atelectasis at the left lung base. Otherwise, the lungs are well-expanded and clear. Mild pulmonary vascular congestion but pulmonary edema, improved from the prior exam   Keywords: improve. No new specific focal consolidation to suggest pneumonia. No pneumothorax. Stable moderate cardiomegaly. Stable mildly tortuous or dilated descending aorta. Mediastinal contours and hila are unchanged.

IMPRESSION: 1. No focal consolidation to suggest pneumonia. 2. Mild pulmonary vascular congestion.


SubjectID: 17400716, StudyID: 56757337, Comparison: better

FINAL REPORT

INDICATION: Evaluate for interval change in a patient with an NSTEMI, ESRD on hemodialysis.

COMPARISON: Chest radiographs from ___, ___, ___.

FINDINGS: A portable frontal chest radiograph again demonstrates moderate cardiomegaly and well-aerated lungs. Mild pulmonary edema is persistent, but improved   Keywords: improve. A trace left pleural effusion is unchanged. No focal consolidation or pneumothorax is present. An incompletely imaged right upper extremity graft is unchanged. The visualized upper abdomen is unremarkable.

IMPRESSION: Persistent but improved mild pulmonary edema   Keywords: improve. Unchanged trace left pleural effusion.


SubjectID: 17400716, StudyID: 55180068, Comparison: None

WET READ: ___ ___ ___ 11:06 PM 1. Moderate to severe pulmonary edema with moderate cardiomegaly and small left pleural effusion. 2. Heterogeneous left mid lung opacity likely represents asymmetric pulmonary edema however differential includes pneumonia in the appropriate clinical setting.

WET READ VERSION #1 ___ ___ ___ 10:13 PM 1. Moderate pulmonary edema with moderate cardiomegaly and small left pleural effusion. 2. Heterogeneous left mid lung opacity likely represents asymmetric pulmonary edema however differential includes pneumonia in the appropriate clinical setting. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: Chest radiograph.

INDICATION: ___F with dyspnea. Assess for pneumonia.

TECHNIQUE: Single portable frontal chest radiograph

COMPARISON: Chest radiograph ___, ___, ___.

FINDINGS: The lungs are moderately well inflated. Bilateral perihilar interstitial opacities with moderate cardiomegaly and small left pleural effusion is noted. Heterogeneous opacity in the left mid lung is present. No right pleural effusion. No pneumothorax. Mediastinal contour and hila are otherwise unremarkable. Calcified aortic arch is present. Severe degenerative disease of the right shoulder is noted. There is a new stent projecting over the left upper hemi thorax at the level of the clavicle, likely related to hemodialysis.

IMPRESSION: 1. Moderate to severe pulmonary edema with moderate cardiomegaly and small left pleural effusion. 2. Heterogeneous left mid lung opacity likely represents asymmetric pulmonary edema however differential includes pneumonia in the appropriate clinical setting.


SubjectID: 17400716, StudyID: 52327524, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with chest pain, ST depressions on EKG, pulm edema on initial cxr, fevers, ?PNA // edema? edema?

IMPRESSION: Comparison with the study of ___, there again is enlargement of the cardiac silhouette with some improvement in the degree of pulmonary edema   Keywords: improve. Atelectatic changes and possible small effusion at the left base. No evidence of focal consolidation.


SubjectID: 17400716, StudyID: 55098120, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with PMH signficant for dCHF, ESRD ___ diabetic nephropathy s/p DCD renal transplant ___ who presented with presumed heart failure with preserved EF, attempting diuresis on the cardiology floor however becomin oliguric. // please assess for interval change post ultra filtration please assess for interval change post ultra filtration

IMPRESSION: In comparison with the study of ___, there is an placement of a right IJ Swan-Ganz catheter with its tip in the right pulmonary artery at the outer aspect of the mediastinum. The cardiac silhouette is at the upper limits of normal in size and there appears to be some improvement in pulmonary vascular congestion   Keywords: improve. The left hemidiaphragm is not well seen, suggestive of small pleural effusion and associated basilar atelectasis.


SubjectID: 17401630, StudyID: 59148054, Comparison: None

FINAL REPORT

INDICATION: Shortness of breath. Evaluate for pneumonia.

COMPARISON: Chest radiographs ___, ___ and ___.

TECHNIQUE: Upright PA and lateral radiographs of the chest.

FINDINGS: Again, there is elevation and tenting of the left hemidiaphragm suggesting persistent atelectasis. There is new lace-like interstitial abnormality in the right upper lung and new opacities in the right middle lobe and perihilar region. Mild cardiomegaly is unchanged. The mediastinal and hilar contours are normal. There is no large pleural effusion or pneumothorax.

IMPRESSION: New opacities predominantly in the right middle lobe and right perihilar region concerning for multifocal pneumonia; hemorrhage or drug reaction is less likely. Updated results were telephoned to ___ by ___ at 8:05 am, ___, 10 minutes after discovery.


SubjectID: 17401630, StudyID: 59010552, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with rapidly worsening hypoxia. // Please assess for etiology.

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the pre-existing parenchymal opacities have minimally decreased in extent and severity   Keywords: decrease. However, the overall severity is still high and distribution of the changes is very diffuse. Most likely is a combination of multifocal pneumonia and pulmonary edema. Moderate cardiomegaly. No larger pleural effusions. No pneumothorax.


SubjectID: 17401630, StudyID: 55348890, Comparison: same

FINAL REPORT

INDICATION: Dyspnea status post intubation.

COMPARISON: ___.

FINDINGS: Portable frontal radiograph of the chest demonstrates ET tube ending 4 cm above the carina. There are persistent severe diffuse parenchymal opacities which could reflect a combination of multifocal pneumonia and pulmonary edema   Keywords: persistent. Moderate cardiomegaly persists. No large pleural effusion or pneumothorax.


SubjectID: 17401630, StudyID: 55657535, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hypoxemia, intubated // eval for interval change, tube placement

COMPARISON: ___.

IMPRESSION: As compared to the previous image, the endotracheal tube is in unchanged position. The pre described severe bilateral parenchymal opacities are unchanged in extent and severity, but there slightly increased radiodensity is caused by a lesser inspiratory volume   Keywords: unchanged. No new parenchymal opacities   Keywords: new. Moderate cardiomegaly persists.


SubjectID: 17401630, StudyID: 52980478, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with respiratory failure // inubation

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, there is no change in appearance of the massive bilateral parenchymal opacities in the lung parenchyma and a moderate to severe cardiomegaly. The patient has been intubated. The course of the endotracheal tube is unremarkable. The tip projects 4 cm above the carinal. There is no evidence of complications, notably no pneumothorax


SubjectID: 17405329, StudyID: 59622235, Comparison: worse

WET READ: ___ ___ ___ 8:22 PM New ET tube ends 4.8 cm above the level of the carina. Asymmetric right lung greater than left heterogeneous opacities have slightly increased on the right and are not significantly changed on the left, possibly related to asymmetric pulmonary edema versus an atypical infectious process.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post intubation, endotracheal tube placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has been intubated. The tip of the endotracheal tube projects 4.6 cm above the carina. The course of the nasogastric tube is changed, with the tip now projecting over the prepyloric region. The venous introduction sheath on the left is constant. Minimally increasing signs of pulmonary edema on the right   Keywords: increasing. Otherwise, the radiograph is unchanged. There is no evidence of complications, notably no pneumothorax.


SubjectID: 17405329, StudyID: 58340956, Comparison: -1.0

FINAL REPORT

PORTABLE CHEST OF ___

COMPARISON: ___ radiograph.

FINDINGS: Following removal of right-sided chest tube, there is no visible pneumothorax. Stable postoperative widening of cardiomediastinal contours. Improved pulmonary edema which has nearly resolved   Keywords: improve, resolve. Residual asymmetrical airspace opacity in right upper lobe has slightly worsened, however, and could reflect asymmetrical edema or a superimposed process such as aspiration   Keywords: worse. Bibasilar atelectasis and small left pleural effusion are unchanged.


SubjectID: 17405329, StudyID: 57224646, Comparison: None

FINAL REPORT

HISTORY: Cardiac surgery.

FINDINGS: In comparison with study of ___, the monitoring and support devices are essentially unchanged. Diffuse bilateral pulmonary opacifications persist, consistent with substantial elevation of pulmonary venous pressure and bibasilar atelectasis. The left hemidiaphragm is slightly better seen than on the previous study.


SubjectID: 17405329, StudyID: 56527163, Comparison: None

FINAL REPORT

PORTABLE CHEST X-RAY OF ___

COMPARISON: Chest x-ray of earlier the same date.

FINDINGS: New feeding tube terminates within the distal stomach. Exam is otherwise unchanged since the previous study performed several hours earlier.


SubjectID: 17405329, StudyID: 59428920, Comparison: None

FINAL REPORT

CLINICAL

HISTORY: Status post aortic valve replacement, evaluate for effusion. CHEST

COMPARISON FILM: ___. The size of the right effusion has increased since the prior chest x-ray and it now extends towards the apex. A left effusion is not identified.

IMPRESSION: Increasing size of right effusion.


SubjectID: 17405329, StudyID: 57819784, Comparison: None

FINAL REPORT

CLINICAL

HISTORY: Status post aortic valve replacement, now with vomiting, evaluate for aspiration. CHEST Increased densities are now noted in the right lung in all areas. This could be due to aspiration but equally could be to failure pattern mostly affecting the right lung.

IMPRESSION: Diffuse opacification right lung, possibly due to pneumonia or possibly asymmetric failure.


SubjectID: 17405329, StudyID: 57747789, Comparison: None

FINAL REPORT

HISTORY: Status post cardiac surgery with right-sided pleural effusion.

COMPARISON: ___.

FINDINGS: Portable semi-erect film of chest demonstrate a large right-sided pleural effusionm, increasing in size from prior studies. There is also vascular engorgement and pulmonary edema without underlying focal consolidation concerning for pneumonia. Tracheostomy tube is in correct position. Median sternotomy wires are unchanged in position. The G-tube balloon is partially visualized in the upper abdomen.

IMPRESSION: 1. Large right-sided pleural effusion, increasing in size. 2. Pulmonary edema.


SubjectID: 17405329, StudyID: 52690953, Comparison: None

FINAL REPORT

PORTABLE AP CHEST FILM ___ AT ___ CLINICAL

INDICATION: ___-year-old intubated, evaluate positions of lines and tubes. Comparison is made to patient's prior study of ___ at ___. Portable supine chest film ___ at ___ is submitted.

IMPRESSION: 1. Endotracheal tube has its tip approximately 5 cm above the carina. Left internal jugular Swan-Ganz catheter continues to have its tip in the pulmonary outflow tract. A nasogastric tube is seen coursing below the diaphragm with the tip not identified. Bilateral chest tubes and mediastinal drains remain in place. Status post median sternotomy with overall stable post-operative cardiac and mediastinal contours given patient's rotation. Interval reduction in lung volumes with diffuse airspace process most likely representing pulmonary edema given the interval change from ___. Infectious process or ARDS would be less likely. No large effusions. No obvious pneumothorax, although the sensitivity to detect a pneumothorax would be diminished given supine technique.


SubjectID: 17405329, StudyID: 56967927, Comparison: same

FINAL REPORT

INDICATION: Status post right thoracentesis, here to evaluate for pneumothorax and evidence for lung reexpansion.

COMPARISON: Chest radiograph dated ___.

TECHNIQUE: Portable supine frontal radiograph of the chest.

FINDINGS: The right PICC tip now appears to terminate in the right atrium and should be retracted 3 cm to place in the low SVC. A tracheostomy tube is unchanged in position. Multiple mediastinal wires are aligned and intact. A tricuspid valve ring is noted. In comparison to the most recent prior study, there has been interval right thoracentesis with significant decrease in size of right pleural effusion, now with small residual pleural fluid in the right lung base. The right lung is well aerated. No pneumothorax is detected. The left lung base demonstrates persistent opacification, likely a combination of pleural fluid and underlying atelectasis. Mild residual atelectasis is present in the right lung base. There is persistent mild pulmonary edema   Keywords: persistent. The cardiomediastinal silhouette is stably prominent.

IMPRESSION: 1. Right PICC tip in right atrium should be retracted 3 cm to place in the low SVC. 2. Significantly improved aeration at the right lung and decreased amount of pleural fluid, status post right thoracentesis. No pneumothorax. 3. Persistent left basilar opacification, likely a combination of pleural fluid and underlying atelectasis or consolidation. 4. Unchanged mild pulmonary edema   Keywords: unchanged.


SubjectID: 17405329, StudyID: 54788815, Comparison: None

FINAL REPORT

INDICATION: Post-trach with new onset respiratory changes.

COMPARISON: Radiograph available from ___. FRONTAL CHEST RADIOGRAPH: The patient is post-tracheostomy tube placement and right-sided PICC terminating at the cavoatrial junction. A left subclavian central line has been removed. Multiple intact sternal wires denote prior median sternotomy. Diffuse bilateral opacities with some sparing of the left upper zone are minimally changed since ___, compatible with moderate-to-severe pulmonary edema. Bilateral pleural effusions are unchanged. The heart is moderately enlarged.

IMPRESSION: Minimally unchanged appearance of widespread bilateral pulmonary opacities with sparing of the left upper zone. PICC now terminates at the caval-atrial junction.


SubjectID: 17405329, StudyID: 55378016, Comparison: worse

WET READ: ___ ___ ___ 7:05 PM No evidence of right pneumothorax. LLL atelectasis and possible effusion. Mild pulmonary edema increased. Unchanged L PICC. RUL consolidative nodular opacity as on prior CT.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post thoracocentesis, evaluation for pneumothorax.

COMPARISON: ___, 4:17 p.m.

FINDINGS: As compared to the previous radiograph, an upright portable radiograph is performed. There is no evidence of pneumothorax. The patient is after right thoracocentesis. The evidence of mild fluid overload and the increased opacity at the right lung apex is constant   Keywords: increase. Minimal left pleural effusion with atelectasis. Unchanged left PICC line, unchanged appearance of the cardiac silhouette.


SubjectID: 17405329, StudyID: 51825249, Comparison: better

FINAL REPORT

INDICATION: Pleural effusion, status post thoracentesis on the right. Assess for pneumothorax.

COMPARISON: Chest radiograph from ___.

FINDINGS: A left PICC ends in the low SVC, as before. There is redemonstration of midline sternotomy wires. There is evidence of a "deep sulcus sign" on the right with hyperlucency outlining the lateral aspect of the right hemidiaphragm, new compared to the prior study from ___, concerning for a right pneumothorax. There has been a marked improvement in the degree of pulmonary edema seen on the prior study from ___, now with only residual vascular congestion   Keywords: improve. Mild enlargement of the cardiac silhouette is not significantly changed. A small left pleural effusion is not excluded.

IMPRESSION: 1. Findings suspicious for a right pneumothorax. Further evaluation could be performed with a well-positioned upright radiograph. 2. Marked improvement in previously seen pulmonary edema with only residual pulmonary vascular congestion on the present study   Keywords: improve. 3. Possible small left pleural effusion. Pertinent findings were discussed with Dr. ___ by Dr. ___ at 5:34 p.m. via telephone on the day of the study.


SubjectID: 17405329, StudyID: 53464564, Comparison: None

FINAL REPORT

HISTORY: Thoracentesis.

FINDINGS: In comparison with the earlier study of this date, there has been a right thoracentesis with drainage of a substantial amount of fluid from the right hemithorax. No convincing evidence of pneumothorax. The appearance of the heart and lungs is otherwise essentially unchanged.


SubjectID: 17405329, StudyID: 50008257, Comparison: worse

FINAL REPORT

CLINICAL

HISTORY: ___-year-old woman with MVR and TVR, now with fevers. Question pneumonia.

COMPARISON: Multiple prior studies, most recently ___.

FINDINGS: A tracheostomy tube is in correct position. Patient is post-median sternotomy and MVR. Left subclavian terminates at the cavoatrial junction. There has been a marked increase in the right-sided opacities as well as the left-sided opacities consistent with pulmonary edema given the timeframe and general distribution   Keywords: increase. Underlying pneumonia could be a possibility, so continued follow up is recommended.


SubjectID: 17409226, StudyID: 59705774, Comparison: better

FINAL REPORT

INDICATION: ___ year old woman with CHF // e/o pulm edema

FINDINGS: As compared to a radiograph from 1 day prior, interval improvement in the interstitial pulmonary edema   Keywords: improve. The nasogastric and endotracheal tube have been removed. No pneumothorax. No significant pleural effusions. Moderate hiatal hernia and vascular stent within the ascending aorta are stable.

IMPRESSION: Interval improvement of the pulmonary interstitial edema   Keywords: improve.


SubjectID: 17409226, StudyID: 53715600, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF // e/o pulm edema e/o pulm edema

IMPRESSION: As compared to the previous image, the external pacemaker was removed. The patient now carries a right internal jugular vein catheter in correct position. Moderate hiatal hernia. Unchanged borderline size of the cardiac silhouette with mild left basilar atelectasis. No new focal parenchymal opacities   Keywords: new. No pulmonary edema.


SubjectID: 17409226, StudyID: 50150300, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with severe AS s/p TAVR // ?interval change

TECHNIQUE: AP chest

COMPARISON: Chest radiograph ___

FINDINGS: No significant interval change since ___   Keywords: no significant interval change. Right jugular catheter ending in the mid SVC. No evidence pneumothorax. Moderate hiatal hernia. Unchanged mild cardiomegaly. Left basilar atelectasis is unchanged. No pleural effusion. No consolidation.

IMPRESSION: No significant change since ___   Keywords: no significant change


SubjectID: 17409226, StudyID: 57371101, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with s/p PICC to midline adjustment // midline placement

COMPARISON: Chest radiograph ___ at 17:17, CTA chest ___

FINDINGS: Left PICC tip is in the left axillary vein. Right edema is slightly improved since prior   Keywords: improve. There is likely a trace left effusion. There is no focal consolidation or pneumothorax. The cardiomediastinal silhouette is similar to prior. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. Prosthetic aortic valves are again seen. Hiatal hernia is again seen.

IMPRESSION: Left PICC tip is in the left axillary vein.


SubjectID: 17409226, StudyID: 57042975, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with pneumonia and new respiratory distress // new infiltrate? lobar collapse? new infiltrate? lobar collapse?

IMPRESSION: In comparison with the study ___ ___, the cardiac silhouette is more prominent and there is indistinctness of engorged pulmonary vessels, consistent with mild to moderate pulmonary edema. Previously described hiatal hernia is again seen. Although there is no convincing area of acute pneumonia on this single frontal view, given the extensive pulmonary changes it would be very difficult to unequivocally exclude superimposed pneumonia, especially in the absence of a lateral view.


SubjectID: 17409226, StudyID: 56285132, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hypoxia and respiratory distress with diminished breath sounds on left // Evaluate for lung collapse, mucus plugging, PTX Evaluate for lung collapse, mucus plugging, PTX

IMPRESSION: In comparison with the study of earlier in this date, the cardiomediastinal silhouette is stable. Mild elevation of pulmonary venous pressure is seen. The medial aspect of the left hemidiaphragm is not sharply seen, consistent with volume loss in the left lower lobe similar to the previous study. The left costophrenic angle remains clear. There is no evidence of pneumothorax.


SubjectID: 17409226, StudyID: 54702204, Comparison: same

FINAL REPORT

EXAMINATION: DX CHEST PORTABLE PICC LINE PLACEMENT

INDICATION: ___ year old woman with Left PICC ___ ___ // Reposition of Left PICC ___ ___

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: In comparison to the study from earlier on the same day, the left subclavian PICC extends into the left internal jugular vein with tip out of view as seen on prior. No pneumothorax. A large hiatal hernia is noted. Aortic valve repair is again noted. No significant changes compared to prior study   Keywords: no significant change.

IMPRESSION: Left PICC enters the left internal jugular with tip out of view. No pneumothorax.


SubjectID: 17409226, StudyID: 52039665, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with acute agitation and respiratory distress, concern for possible aspiration // Eval for aspiration Eval for aspiration

IMPRESSION: Comparison to ___. The aortic valve replacements are in situ. The extent of the known hiatal hernia has decreased. Normal size of the heart. No focal parenchymal opacities suspicious for pneumonia.


SubjectID: 17433873, StudyID: 59097538, Comparison: better

FINAL REPORT

AP CHEST 7:44 A.M., ___

HISTORY: ___-year-old woman with an MI complicated by tamponade, now after thoracentesis.

IMPRESSION: AP chest compared to ___: Size of the cardiomediastinal silhouette has not changed appreciably, but previous mediastinal vascular engorgement has resolved   Keywords: resolve. Moderate bilateral pleural effusion is larger. There is no pulmonary edema and no pneumothorax. Right jugular line ends in the region of the superior cavoatrial junction.


SubjectID: 17433873, StudyID: 51439922, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman with hypoxia and pericardial effusion.

FINDINGS: Comparison is made to the previous study from ___ at 7:13 a.m. The catheter projecting over the left heart border has been removed. There is prominence of the pulmonary arteries. The heart size is enlarged but stable. There is moderate pulmonary edema and a left retrocardiac opacity with bilateral pleural effusions. No pneumothoraces are seen.


SubjectID: 17433873, StudyID: 57453496, Comparison: None

FINAL REPORT

STUDY: AP chest ___. CLINICAL INFORMATION: ___-year-old woman with recent LAD stent, now with intense chest and shoulder pain. Evaluate for evidence for widened mediastinum.

FINDINGS: Comparison is made to previous study from ___. Catheter device seen projecting over the left heart border. There is mild cardiomegaly. There is prominence of the pulmonary arteries bilaterally. There are small bilateral pleural effusions and a left retrocardiac opacity. There are no pneumothoraces. There is mild prominence of the pulmonary interstitial markings.


SubjectID: 17433873, StudyID: 52539990, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with chest pain.

COMPARISON: ___. CHEST, AP UPRIGHT: The lungs are clear. Heart size is normal. Aorta is slightly tortuous and unfolded. No significant pleural effusions or pneumothorax.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 17433873, StudyID: 51285827, Comparison: None

FINAL REPORT

INDICATION: Shortness of breath.

COMPARISON: Chest radiograph, ___.

TECHNIQUE: Upright AP view of the chest.

FINDINGS: Right internal jugular central venous catheter has been removed. Since the prior exam, the bilateral pleural effusions have increased in size compared to the prior study, appearing moderate to large in degree. There is worsening opacification within the lung bases which could reflect compressive atelectasis though aspiration or infection cannot be excluded. Mild pulmonary edema is also present. There is no pneumothorax. Aortic arch calcifications are present. Heart size is difficult to assess given the presence of bilateral pleural effusions, but likely mildly enlarged.

IMPRESSION: Increased bilateral pleural effusions which are moderate to large in extent with worsening bibasilar airspace opacification, which could reflect compressive atelectasis though infection or aspiration is not excluded. Mild pulmonary edema.


SubjectID: 17439137, StudyID: 58064217, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___-year-old male with CHF, shortness of breath and hemoptysis; evaluate for pneumonia.

TECHNIQUE: PA and lateral radiographs of the chest from ___.

COMPARISON: ___ and ___.

FINDINGS: The patient is status post median sternotomy. Moderate cardiomegaly is unchanged. There has been no significant interval change in bilateral interstitial and airspace opacities. There is no pneumothorax. Right shoulder degenerative changes have progressed since ___.

IMPRESSION: Unchanged bilateral interstitial and airspace opacities which may be due to edema versus infection   Keywords: unchanged. Stable moderate cardiomegaly.


SubjectID: 17439137, StudyID: 53612203, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF, pulmonary edema // Eval for improvement Eval for improvement

IMPRESSION: In comparison with the study of ___, there again is diffuse prominence of interstitial and airspace opacities bilaterally consistent with some combination of pulmonary edema and superimposed infection   Keywords: again. Otherwise little change   Keywords: little change.


SubjectID: 17439137, StudyID: 52009601, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with pulm fibrosis from amiodarone toxicity and sCHF EF ___% presents with R multilobar pna/hypoxia // interval change, evaluate spared regions to determine cystic/necrotizing foci vs. spared lung tissue interval change, evaluate spared regions to determine cystic

COMPARISON: Comparison to ___ at 05:35

FINDINGS: PA and lateral views of the chest ___ at 12:24 are submitted.

IMPRESSION: Given differences in technique between studies, there is likely no significant interval change in appearance of the right lung where there are more confluent areas of consolidation containing areas of lucency in the right upper and mid lung periphery. No new area of consolidation is appreciated. The heart remains stably enlarged. The patient is status post median sternotomy. A small right pleural effusion is present.


SubjectID: 17439137, StudyID: 50420769, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pneumonia // eval for evolution of consolidation/possible cavitation eval for evolution of consolidation/possible cavitation

IMPRESSION: In comparison with the study of ___, there again is opacification involving much of the right hemithorax, consistent with the clinical diagnosis of widespread pneumonia. Again, areas of lucency with in the consolidation could merely reflect spared lung, though cavitation from necrotizing pneumonia could be considered. A lateral view might be helpful if the condition of the patient permits.


SubjectID: 17451560, StudyID: 59646928, Comparison: better

FINAL REPORT

INDICATION: ___F with CHFpEF, hypertension, paroxysmal atrial fibrillation on rate control and warfarin, s/p pacemaker placement for SSS ___, who presents with dyspnea and chest pain // evolution from prior; ?pna versus CHF exacerbation

TECHNIQUE: Portable

FINDINGS: As compared to chest radiograph from 1 day prior, mild pulmonary congestion and edema has improved   Keywords: improve. Right lower lobe opacities also improved, was likely engorged vessels   Keywords: improve. No pleural effusions. Moderate cardiomegaly improved. No pneumothorax.

IMPRESSION: Improved pulmonary edema and cardiomegaly   Keywords: improve.


SubjectID: 17451560, StudyID: 53739324, Comparison: None

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: History: ___F with dyspnea // eval PNA, CHF

TECHNIQUE: Chest: Frontal and Lateral

COMPARISON: ___

FINDINGS: Dual lead left-sided pacemaker is stable in position. There are low lung volumes. There are several patchy opacities involving the right mid to lower lung worrisome for pneumonia. There is also a background of mild interstitial edema. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable.

IMPRESSION: Right mid to lower lung patchy opacities worrisome for pneumonia on a background of mild interstitial edema. No pleural effusion.


SubjectID: 17451560, StudyID: 57760244, Comparison: better

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Study of earlier the same date.

FINDINGS: Widespread, heterogeneous pulmonary opacities have substantially improved, most likely representing pulmonary edema given rapid response following diuresis   Keywords: improve. Residual opacities are more pronounced at the bases than in the remainder of the lungs, and affect the right lower lobe to a greater degree than the left. Continued radiographic followup would be helpful to exclude co-existing pneumonia, particularly in the right lung. Small pleural effusions are also demonstrated.


SubjectID: 17451560, StudyID: 52509954, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Hypoxia, pulmonary edema, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The lung volumes are slightly increased, potentially reflecting improved inspiratory effort. Borderline size of the cardiac silhouette and tortuosity of the thoracic aorta. Likely presence of pleural calcifications. Minimal bilateral fibrotic changes at the lung bases and at the level of the right lung apex. No overt pulmonary edema. No larger pleural effusions.


SubjectID: 17451560, StudyID: 56472465, Comparison: None

FINAL REPORT

PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Evaluation pre-VQ scan. There is mild-to-moderate cardiomegaly. The lungs are clear. There is no pleural effusion or pneumothorax. There are mild degenerative changes in the thoracic spine. There is an old rib fracture in the sixth left rib.

IMPRESSION: No evidence of acute cardiopulmonary abnormalities.


SubjectID: 17451560, StudyID: 53865532, Comparison: None

FINAL REPORT

INDICATION: Dyspnea and bilateral leg edema. Evaluate for fluid overload. Comparison CXR ___, ___, CT ___.

FINDINGS: Frontal and lateral views of the chest were obtained. The lungs are well expanded without focal consolidation, pleural effusion, or pneumothorax. Pulmonary vasculature is normal without pulmonary edema. Heart size is normal. Mediastinal silhouette and hilar contours are normal aside from unchanged mild aortic tortuosity. A healed left rib fracture is seen. There is no free air under the diaphragm. Degenerative changes are seen in the thoracic spine.

IMPRESSION: No acute intrathoracic process.


SubjectID: 17453847, StudyID: 59988548, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF and cough w/ WBC ___ // r/o consolidation

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Moderate cardiomegaly is stable. Pacer leads are in standard position. Right PICC tip is in the upper SVC. There is no pneumothorax. New small bilateral effusions are unchanged. . Bibasilar atelectasis have minimally increased. There is no evidence of pulmonary edema.


SubjectID: 17453847, StudyID: 58895867, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with HF and IABP // IABP IABP

IMPRESSION: Comparison with the study ___ ___, there are slightly lower lung volumes but no evidence of acute pneumonia or vascular congestion. Streak of atelectasis is seen at the right base. The IABP tip has migrated downward, so that it now is about 4.7 cm below the transverse arch of the aorta, for optimal positioning 8 could be pushed forward about 2 - 2.5 cm.


SubjectID: 17453847, StudyID: 55462780, Comparison: better

WET READ: ___ ___ ___ 8:30 AM Study of ___, there has been placement of Persistent mild cardiomegaly. Support lines and tubes in appropriate position.

WET READ VERSION #1 ___ ___ 12:46 AM Persistent mild cardiomegaly. Support lines and tubes in appropriate position. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with HF now s/p balloon pump. // assess placement of balloon pump assess placement of balloon pump

IMPRESSION: In comparison with the study of ___, there has been placement of an IABP that appears well situated with the tip approximately 2 cm below the transverse arch of the aorta. Right IJ Swan-Ganz catheter is in place with its tip in the right pulmonary artery. Continued enlargement of the cardiac silhouette with little if any vascular congestion and better lung volumes   Keywords: better.


SubjectID: 17453847, StudyID: 51195859, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cardiogenic shock on dobutamine // Interval change? Interval change?

IMPRESSION: In comparison with the study ___ ___, the monitoring and support devices are unchanged, though the IABP has been removed. Again there is prominence of the cardiac silhouette without definite vascular congestion. No evidence of pneumonia.


SubjectID: 17453847, StudyID: 57625321, Comparison: None

FINAL REPORT

INDICATION: ___ year old man s/p CS lead via L subclavian // rule out pneumothorax

TECHNIQUE: Portable chest x-ray.

COMPARISON: Chest radiographs dated ___ through ___.

FINDINGS: Portable semi-upright radiograph of the chest demonstrates low lung volumes, which results in bronchovascular crowding. The cardiomediastinal and hilar contours are unchanged. The heart remains enlarged. There is no pneumothorax, pleural effusion, or consolidation. The right upper extremity PICC ends in the SVC. Four cardiac pacemaker leads are present.

IMPRESSION: No pneumothorax.


SubjectID: 17453847, StudyID: 55080717, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man s/p CS lead via L subclavian // confirm lead placement

COMPARISON: ___.

IMPRESSION: Unchanged appearance of the left pectoral pacemaker and the pacemaker leads. Constant correct position of the right PICC line. No pneumothorax. Moderate cardiomegaly with signs of mild fluid overload but no overt pulmonary edema. Seen on the lateral radiograph only are small bilateral dorsal pleural effusions.


SubjectID: 17453847, StudyID: 52271128, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with acute-on-chronic systolic CHF // any evidence of pneumonia? any evidence of pneumonia?

IMPRESSION: In comparison with the study of ___, there again are low lung volumes that accentuate the enlargement of the cardiac silhouette. The pulmonary vessels are more indistinct and engorged, consistent with mild to moderate pulmonary vascular congestion. No definite acute focal pneumonia.


SubjectID: 17453847, StudyID: 50061256, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with chf on home pressors eval home pucc // Eval home pucc eval pulm edema Eval home pucc eval pulm edema

IMPRESSION: In comparison with study of ___, there are lower lung volumes with continued prominence of the cardiac silhouette without appreciable pulmonary vascular congestion. Triple -lead pacer device is unchanged. Right subclavian PICC line extends to the mid to lower portion of the SVC.


SubjectID: 17462585, StudyID: 59903612, Comparison: None

WET READ: ___ ___ ___ 8:16 PM Diffuse bilateral interstitial infiltrates, likely from pulmonary edema. A component of infection is difficult to exclude, but follow-up after diuresis can be obtained. No pleural effusion or pneumothorax. Stable cardiomegaly.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

EXAM: Chest, single AP portable view. CLINICAL INFORMATION: Acute onset chest pain, shortness of breath.

COMPARISON: ___.

FINDINGS: There are diffuse bilateral opacities and haziness and indistinctness of the hila, most likely due to moderate-to-severe pulmonary edema. The cardiac silhouette is top normal to mildly enlarged. The aorta is tortuous. No large pleural effusions are seen. There is no pneumothorax.

IMPRESSION: Bilateral perihilar opacities, most likely due to pulmonary edema; however, component of infection is difficult to exclude in the appropriate clinical setting. Followup after diuresis can be obtained for further evaluation.


SubjectID: 17462585, StudyID: 56722816, Comparison: 1.0

FINAL REPORT

EXAM: Chest, single AP frontal view. CLINICAL INFORMATION: Shortness of breath and hypoxia with history of pulmonary edema.

COMPARISON: ___ at 16:59.

FINDINGS: Moderate pulmonary edema appears slightly improved as compared to the prior study   Keywords: improve. Haziness and indistinctness of the pulmonary vasculature persists   Keywords: persists. In the interval since the prior study, there is increase in bibasilar atelectasis. No large pleural effusion is seen. The cardiac and mediastinal silhouettes are stable.

IMPRESSION: Moderate pulmonary edema, improved since the prior study   Keywords: improve. Bibasilar atelectasis.


SubjectID: 17462585, StudyID: 55659757, Comparison: same

WET READ: ___ ___ 7:52 PM No significant interval change. Persistent pulmonary edema and bibasilar opacities. No definite pleural effusions, though small ones would be difficult to exclude.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

HISTORY: Worsening lung function.

FINDINGS: In comparison with the earlier study of this date, the patient has taken a somewhat better inspiration. There is again enlargement of the cardiac silhouette with pulmonary edema and bibasilar opacifications consistent with atelectasis and possible small pleural effusions   Keywords: again.


SubjectID: 17477304, StudyID: 59585119, Comparison: worse

FINAL REPORT

INDICATION: History: ___M with new L IJ // central line placement

TECHNIQUE: Portable chest x-ray.

COMPARISON: Multiple prior radiographs of the chest dated ___ through ___.

FINDINGS: Portable semi-upright radiograph of the chest demonstrates slight interval increase in the degree of pulmonary edema, which is moderate   Keywords: increase. There are persistent bibasilar opacities come which may represent a combination of pleural fluid and compressive atelectasis. The patient is status post interval placement of a left-sided internal jugular central venous line, which ends in the upper SVC. No pneumothorax. The cardiomediastinal and hilar contours are unchanged. Increased sclerosis of the visualized osseous structures likely relates to end-stage renal disease.

IMPRESSION: 1. Left-sided internal jugular central venous line ends in the upper SVC. 2. Slight interval worsening of pulmonary edema   Keywords: worse. 3. Bilateral pleural effusions with adjacent atelectasis.


SubjectID: 17477304, StudyID: 56042816, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with Dyspnea // evidence of effusion of breathing

TECHNIQUE: Portable upright AP view of the chest

COMPARISON: ___

FINDINGS: Pulmonary edema which is now moderate in extent has increased when compared to the previous exam   Keywords: increase. The heart size appears mildly enlarged. Small pleural effusions appear slightly increased compared to the prior exam. There is no pneumothorax. Patchy opacities in the lung bases likely reflect compressive atelectasis. Deformity of the distal right clavicle likely reflects a remote fracture. Mediastinal contour is unchanged.

IMPRESSION: Worsening moderate pulmonary edema with increased size of small bilateral pleural effusions and bibasilar airspace opacities likely reflective of atelectasis   Keywords: worse, increase.


SubjectID: 17477304, StudyID: 56492407, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: History of aspiration and cough, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient is rotated. A goiter seems to cause widening of the right aspects of the mediastinum and moderate deviation of the trachea to the left. At the right lung base, a subtle parenchymal opacity has newly appeared. The location of this opacity would be consistent with pneumonia following aspiration. At the time of dictation and observation, 10:56 a.m., on ___, the referring physician, ___. ___, covered by Dr. ___, was paged for notification.


SubjectID: 17477304, StudyID: 56372248, Comparison: None

WET READ: ___ ___ ___:___ PM The RLL opacity has cleared considerably with only a single band of linear atelectasis remaining. - ___ ___ ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic aspiration, three days of cough, assessment of right lower lobe for aspiration pneumonia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has taken a substantially deeper breath in. The lung parenchyma is now well expanded. The pre-existing parenchymal opacity at the bases of the right lung is no longer visible. Currently, the lung parenchyma shows normal structure and transparency. There is no evidence of pneumonia. Normal size of the cardiac silhouette. Moderate tortuosity of the thoracic aorta. Unchanged dense right upper mediastinum with deviation of the trachea, potentially caused by a retrosternal goiter.


SubjectID: 17477304, StudyID: 54493263, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man with tachycardia, fever, poor historian, sepsis workup.

COMPARISON: ___.

FINDINGS: A single portable AP semi-upright view of the chest was obtained. Heart is normal size and cardiomediastinal silhouette is stable. Low volume lungs limit assessment for vascular congestion. There is no focal consolidation, pleural effusion or pneumothorax. A vascular stent is noted in the left arm.

IMPRESSION: No evidence of pneumonia.


SubjectID: 17477304, StudyID: 52657692, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man with urosepsis, central line placement.

COMPARISON: ___.

FINDINGS: A single portable AP semi-upright view of the chest is obtained. There is interval placement of a right internal jugular central venous catheter with tip near the confluence of the internal jugular and right subclavian veins. Although the trachea appears narrower than before, a prior CT torso from ___ showed displacement of the right innominate vein from the trachea; therefore, the increased distance between the right IJ line and the trachea need not be due to a hematoma. Lungs are clear. No effusion or pneumothorax.

IMPRESSION: Interval placement of a right internal jugular line with tip at the confluence of the IJ and subclavian veins.


SubjectID: 17477304, StudyID: 51594703, Comparison: None

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with end-stage renal disease, hemodialysis, desaturation, line placement. Last hemodialysis ___, concern for pulmonary edema.

COMPARISON: ___.

FINDINGS: Trachea is slightly more displaced to the right partly caused by the tilted position of the patient and left lower lung atelectasis. Left subclavian dialysis catheter has been removed. Tracheal coronal diameter is narrowed as shown on previous CT. There is no pulmonary edema. There is no pleural effusion or pneumothorax. There is dense opacity projecting in the left upper quadrant of the abdomen measuring 18 mm, possibly in the bowel.

CONCLUSION: 1. There is no pulmonary edema. 2. The trachea is slightly more displaced to the right, probably due to the position of the patient and volume loss. However, considering the fact that the dialysis catheter has been recently removed, mediastinal hematoma has to be considered but is less likely. A followup chest x-ray has been suggested to the medical team.


SubjectID: 17477304, StudyID: 50602088, Comparison: None

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: End-stage renal disease, pulmonary edema?

COMPARISON: ___.

FINDINGS: There is no pulmonary edema. Trachea is still slightly displaced towards the right with right lower lung atelectasis. The mediastinum has not enlarged. Cardiac contour is normal. There is no pneumothorax or pleural effusion.

CONCLUSION: 1. There is no pulmonary edema. 2. The exam is unchanged with right lower lung atelectasis and slight displacement of trachea towards the right. This has been discussed directly with the medical team who is not worried for mediastinal bleeding after removal of central catheter.


SubjectID: 17477807, StudyID: 55803555, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: ___. CLINICAL

HISTORY: Shortness of breath, assess pneumonia or CHF.

FINDINGS: PA and lateral views of the chest are obtained. The heart is moderately enlarged with a left ventricular configuration. Interstitial pulmonary edema is noted. There is no pleural effusion or pneumothorax. No focal consolidation to suggest pneumonia. Mediastinal contour appears normal. The bony structures are intact.

IMPRESSION: Cardiomegaly, interstitial edema.


SubjectID: 17477807, StudyID: 50665229, Comparison: same

FINAL REPORT

INDICATION: ___-year-old male with diastolic heart failure, stage IV CKD, presents with dyspnea and pulmonary edema.

COMPARISON: PA and lateral chest radiographs, ___.

TECHNIQUE: PA and lateral chest radiographs.

FINDINGS: Minimal amount of pulmonary edema is again seen and unchanged as compared to prior study   Keywords: again, unchanged. The heart is mildly enlarged with stable left ventricular configuration likely representing systemic hypertension. There is no pleural effusion or pneumothorax. There is no focal consolidation suggestive of pneumonia. Mediastinal contours are within normal limits. The pleural surfaces are unremarkable. Kyphosis and multilevel moderate degenerative changes of the thoracic spine are noted.

IMPRESSION: Stable minimal pulmonary edema   Keywords: stable.


SubjectID: 17481338, StudyID: 55689162, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with HCAP // ___ year old man with HCAP

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Right internal jugular line tip is at the level of lower SVC. Cardiomediastinal silhouette is unchanged including cardiomegaly and prominent pulmonary arteries. Lungs are demonstrating low volumes. There is interstitial changes in the left mid and lower lung that might represent asymmetric pulmonary edema versus infectious process. Small bilateral pleural effusion are most likely present. There is no evidence of pneumothorax.


SubjectID: 17481338, StudyID: 51209885, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ w/ CHF and possible PNA. // interval change, edema, effusions, PNA? interval change, edema, effusions, PNA?

COMPARISON: Comparison to ___ at 13:14

FINDINGS: Portable upright chest film ___ at 04:10 is submitted

IMPRESSION: The patient is markedly rotated limiting evaluation of the cardiac and mediastinal contours. However, given this limitation, the right hilar region is prominent raising concern for either prominent pulmonary arteries versus lymphadenopathy. The pulmonary edema has improved   Keywords: improve. Right hemidiaphragm is now elevated and there are streaky opacities at the right base likely reflecting atelectasis. No pneumothorax.


SubjectID: 17481338, StudyID: 51085861, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with new fever to 102.9, unclear source. H/o CHF, here for CHF exacerbation // ?PNA ?PNA

COMPARISON: Comparison to ___ at 14:47

FINDINGS: Portable semi-erect chest film ___ at 13:15 is submitted.

IMPRESSION: Interval appearance of moderate perihilar and interstitial edema. Interval appearance of a left pleural effusion. Overall cardiac and mediastinal contours cannot be adequately assessed due to marked patient rotation. Given the congestive heart failure, it is difficult to exclude superimposed infection, and therefore, followup imaging would be prudent. No pneumothorax is appreciated.


SubjectID: 17490145, StudyID: 56596590, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHFrEF and difficult to assess volume status, wish to assess for pulmonary edema // ? pulmonary edema

IMPRESSION: As compared to ___ radiograph, cardiomegaly is stable. Considering accentuation of bronchovascular structures by low lung volumes, there is no definite evidence of congestive heart failure. Focal left basilar atelectasis and adjacent pleural effusion or pleural thickening are unchanged with associated mild elevation of left hemidiaphragm.


SubjectID: 17490145, StudyID: 50490408, Comparison: None

WET READ: ___ ___ ___ 8:08 AM As compared to radiograph from a few hours prior, cardiomegaly is stable. Lung volumes have mildly increased. Focal left basilar opacity a and adjacent pleural effusion or pleural thickening, not significantly changed. Median sternotomy wires are present. The right lung is grossly clear.

WET READ VERSION #1 ___ ___ 7:40 PM As compared to radiograph from a few hours prior, cardiomegaly is stable. Lung volumes have mildly increased. Focal left basilar opacity a and adjacent pleural effusion or pleural thickening, not significantly changed. Median sternotomy wires are present. The right lung is grossly clear. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with fever, tachypnea, tachycardia // eval for PNA v. pulmonary edema

IMPRESSION: As compared to ___ radiograph at an earlier time, there has been little change in the appearance of the chest except for worsening left basilar atelectasis with persistent adjacent small left pleural effusion.


SubjectID: 17513800, StudyID: 58805230, Comparison: better

WET READ: ___ ___ 4:51 PM 1. Interval improvement in now mild pulmonary edema   Keywords: improve. Previously described right upper lobe opacity has cleared, and likely represented asymmetric pulmonary edema. 2. Unchanged small bilateral pleural effusions. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: PA and lateral chest x-ray.

INDICATION: A ___-year-old man with pulmonary edema, prior same-day chest x-ray suggestive of.

TECHNIQUE: PA and lateral projections, upright positioning.

COMPARISON: Same-day chest x-ray obtained at 06:01.

FINDINGS: In comparison to prior radiograph from same day, there has been interval improvement in centrally predominant engorgement of the pulmonary vasculature along with diffuse interstitial prominence, reflecting improvement in now mild pulmonary edema status post diuresis. The previously described focal opacity within the right upper lobe has cleared, and is no longer apparent, and likely represented asymmetric pulmonary edema. There is stable moderate cardiomegaly. There is no focal lung consolidation. There are unchanged bilateral small pleural effusions. There is no pneumothorax.

IMPRESSION: 1. Interval improvement in now mild pulmonary edema. Previously described right upper lobe opacity has cleared, and likely represented asymmetric pulmonary edema. 2. Unchanged small bilateral pleural effusions.


SubjectID: 17513800, StudyID: 52812616, Comparison: None

FINAL REPORT

INDICATION: Shortness of breath. Evaluate for heart failure.

TECHNIQUE: Frontal and lateral views the chest.

COMPARISON: Chest radiograph ___.

FINDINGS: There are diffuse interstitial opacities with engorgement of the central vasculature, compatible with mild to moderate pulmonary edema. Small bilateral pleural effusions are best appreciated on the lateral view. A more focal opacity in the right upper lobe is likely asymmetric edema. The heart is mildly enlarged. No pneumothorax or focal airspace consolidation worrisome for pneumonia.

IMPRESSION: 1. Mild to moderate pulmonary edema with mild cardiomegaly and small bilateral pleural effusions. 2. Focal opacity in the right upper lobe is likely asymmetric edema, however, followup radiographs after diuresis are recommended to exclude an secondary process such as infection and less likely neoplasm. The findings were discussed by Dr. ___ with Dr. ___ ___ telephone on ___ at 7:51 AM, 5 minutes after discovery of the findings.


SubjectID: 17516073, StudyID: 54352715, Comparison: None

FINAL REPORT

INDICATION: Gentleman with BiV PPM implant. Evaluate lead positions.

COMPARISON: Chest radiograph, ___.

FINDINGS: Three transvenous pacemaker leads terminate in the right atrium, right ventricle, and left ventricle. Median sternotomy wires appear intact. Small bilateral pleural effusions, left greater than right, are grossly unchanged. Left lower lobe atelectasis is similarly unchanged. Mild cardiomegaly is unchanged. The mediastinal silhouette and hilar contours appear normal. There is no pneumothorax.

IMPRESSION: 1. Biventricular pacemaker leads terminate in appropiate position. 2. Small bilateral pleural effusions, left greater than right, are unchanged. Mild left lower lobe atelectasis is also unchanged.


SubjectID: 17517983, StudyID: 59724416, Comparison: worse

FINAL REPORT

EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Chest pain.

COMPARISON: ___.

FINDINGS: There is increase in bilateral perihilar patchy opacities, which could be due to pulmonary edema; however, in the appropriate clinical setting, multifocal infection could be present   Keywords: increase. No large pleural effusion is seen, but trace pleural effusions are difficult to exclude. There is no pneumothorax. The cardiac silhouette is top normal. Mediastinal contours are unremarkable.

IMPRESSION: Increase in patchy perihilar opacities could be due to worsening pulmonary edema versus multifocal infection depending on the clinical scenario   Keywords: worse, increase.


SubjectID: 17517983, StudyID: 58330211, Comparison: 1.0

FINAL REPORT

CHEST, TWO VIEWS: ___

HISTORY: ___-year-old female with chest pain and prior fluid overload. Evaluate volume status.

COMPARISON: ___.

FINDINGS: Frontal and lateral views of the chest. As on prior, there are small-to-moderate effusions, not significantly changed. Degree of cardiomegaly is unchanged with possible underlying effusion not excluded. Prominence of interstitial markings is again seen but slightly improved compared to prior exam   Keywords: improve. No acute osseous abnormality is identified.

IMPRESSION: Persistent volume overload with mild-to-moderate bilateral effusions   Keywords: persistent. Slightly less prominent interstitial edema when compared to prior. Unchanged degree of enlargement of the cardiac silhouette potentially combination of cardiomegaly and pericardial effusion.


SubjectID: 17517983, StudyID: 57823321, Comparison: 0.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with ESRD on HD, p/w volume overload // R/o worsening pulmonary edema

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, there is an improvement in the severity of the pre-existing pulmonary edema   Keywords: improve. However, signs of edema are still clearly seen   Keywords: still. No pleural effusions. Moderate cardiomegaly. No pneumothorax.


SubjectID: 17517983, StudyID: 57174710, Comparison: worse

WET READ: ___ ___ ___ 5:54 PM Severe pulmonary edema, intervally progressed with cardiomegaly unchanged   Keywords: progressed. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with tachypnea, low o2 sats, dilaysis dependent, DKA // r/o infiltrate, effusion

COMPARISON: Prior exam from ___.

FINDINGS: AP portable upright view of the chest. There is severe pulmonary edema, progressed from prior exam   Keywords: progressed. The heart remains mildly enlarged. No large effusion or pneumothorax is seen. Bony structures are intact.

IMPRESSION: Severe pulmonary edema, intervally progressed with cardiomegaly unchanged.


SubjectID: 17517983, StudyID: 57134809, Comparison: None

FINAL REPORT

INDICATION: Leukocytosis, DKA, chills.

COMPARISON: Chest radiograph ___, ___.

FINDINGS: The cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. There is a small well defined rectangular opacity lateral to the EKG lead overlying the left upper chest wall, which is likely associated with the EKG lead. There is no other focal consolidation concerning for pneumonia. Pulmonary vasculature is within normal limits.

IMPRESSION: Small well demarcated focal opacity adjacent to an EKG lead along the left upper chest wall which is likely associated with the lead. However, a small focus of pneumonia cannot be excluded. Removal of the lead and repeat chest radiograph is recommended to document resolution of this opacity. Dr. ___ ___ this recommendation with the clinical team via telephone on ___ around 5 pm.


SubjectID: 17517983, StudyID: 53725963, Comparison: same

FINAL REPORT

HISTORY: DKA. Opacity in the left chest on prior study was obscured by EKG lead. Repeat evaluation with removal of EKG leads.

COMPARISON: ___.

TECHNIQUE: Portable frontal chest radiograph, single view.

FINDINGS: In comparison with prior examination, there has been removal of the EKG leads and the associated ellipsoid density in the left upper chest does not persist and was associated with the lead itself. There is otherwise no change compared to prior evaluation   Keywords: no change. Cardiomediastinal silhouette and hilar contours are stable. Lungs are clear. There is no pleural effusion or pneumothorax.

IMPRESSION: Normal chest radiograph. Previously noted density was part of an EKG lead.


SubjectID: 17517983, StudyID: 57072116, Comparison: worse

FINAL REPORT

INDICATION: History: ___F with hypoglycemia // ? pna

TECHNIQUE: Single portable upright AP image of the chest.

COMPARISON: Comparison is made with chest radiographs from ___ and ___.

FINDINGS: The lungs are well expanded. There are increased interstitial markings as on prior exam and vascular indistinctness, consistent with increased mild pulmonary edema, most prominent in the lung bases, right greater than left   Keywords: increase. Trace bilateral pleural effusions are likely present. No pneumothorax is seen. Cardiomegaly is again noted.

IMPRESSION: Increased mild pulmonary edema, most prominent lung bases, right greater than left   Keywords: increase.


SubjectID: 17517983, StudyID: 52490734, Comparison: worse

FINAL ADDENDUM ADDENDUM Discussed with Dr. ___ ___ the phone by Dr. ___ at 11:50 a.m. on ___ ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with diabetes, CKD on dialysis with acute hypoxemia. // pulmonary edema, infection?

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Since the prior study there has been interval development of interstitial pulmonary edema, mild to moderate   Keywords: development. Cardiomegaly is substantial. No interval increase in pleural effusion or development of pneumothorax demonstrated


SubjectID: 17532555, StudyID: 56423432, Comparison: worse

FINAL REPORT

HISTORY: Bilateral lower extremity edema.

TECHNIQUE: PA and lateral views of the chest.

COMPARISON: ___.

FINDINGS: There has been interval enlargement of the cardiac silhouette size which is now moderate to severely enlarged. The configuration of the cardiac silhouette is somewhat globular, and a pericardial effusion is not excluded. Aortic calcifications are again demonstrated. The mediastinal contours are unchanged. There is perihilar haziness and vascular indistinctness which is more pronounced compared to the prior study compatible with mild pulmonary edema. More focal patchy opacity within the right lung base is noted and an underlying infectious process in this region is not completely excluded. The lungs are hyperinflated with relative lucency of the lung apices compatible with emphysema. No definite pleural effusion is noted. There is no pneumothorax. Clips are noted in the right upper quadrant the abdomen compatible with prior cholecystectomy.

IMPRESSION: Worsening congestive heart failure, mild to moderate in extent   Keywords: worse. Globular configuration of the cardiac silhouette raises the possibility of underlying pericardial effusion. More focal opacity in the right lung base likely is related to the patient's pulmonary edema, though underlying infection is not excluded.


SubjectID: 17532555, StudyID: 55495753, Comparison: None

FINAL REPORT

HISTORY: CHF.

FINDINGS: In comparison with study of ___, there is continued enlargement of the cardiac silhouette with evidence of pulmonary vascular congestion. Again, the globular configuration of the heart raises the possibility of underlying pericardial effusion. A more focal opacification at the right base is not appreciated at this time.


SubjectID: 17572294, StudyID: 56989383, Comparison: better

WET READ: ___ ___ ___ 11:38 PM Interval placement of a right chest catheter, with a persistent but decreased moderate right pleural effusion. The left pleural effusion is unchanged. There is associated atelectasis bilaterally. No pneumothorax is identified. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pleural effusion s/p chest tube // eval for ptx

TECHNIQUE: Portable AP radiograph of the chest.

COMPARISON: ___.

FINDINGS: Sternotomy wires are intact and aligned. Mild pulmonary edema with moderate bilateral pleural effusions have slightly decreased on the right following chest tube drainage   Keywords: decrease. There is no pneumothorax. The heart and mediastinum cannot be accurately assessed on this projection.

IMPRESSION: Interval decrease in size of moderate right pleural effusion following catheter drainage. Stable moderate left pleural effusion. No pneumothorax.


SubjectID: 17572294, StudyID: 54660289, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with hypoxia and effusions // eval for worsening effusion

TECHNIQUE: CHEST (PA AND LAT)

COMPARISON: ___

IMPRESSION: Bilateral pleural effusions are demonstrated, moderate on the left and small on the right. Right pigtail catheter appears to be discontinued. Upper lungs are essentially clear. Cardiomediastinal silhouette is unchanged.


SubjectID: 17572294, StudyID: 51447907, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pleural effusion // eval for interval change

IMPRESSION: As compared to ___ radiograph, a large right pleural effusion has increased in size and a moderate left pleural effusion is slightly smaller. Remainder of the exam is not appreciably changed.


SubjectID: 17595401, StudyID: 59607085, Comparison: same

FINAL REPORT

INDICATION: Evaluate for interval change in a patient with CHF exacerbation and possible pneumonia.

COMPARISON: Chest radiographs from ___, ___, ___, ___.

FINDINGS: A portable frontal chest radiograph again demonstrates thoracic spinal hardware and sternal wires. Lung volumes are low with increased prominence of the cardiac silhouette and bronchovascular crowding. Even allowing for this, there is cardiomegaly. Mild to moderate pulmonary edema is unchanged, as is retrocardiac opacity   Keywords: unchanged. Increased opacity in the right lower lung is new. Small bilateral pleural effusions are unchanged. There is no pneumothorax.

IMPRESSION: 1. Unchanged retrocardiac opacity and new increased opacity in the right lower lung, which is concerning for pneumonia. 2. Unchanged mild to moderate pulmonary edema   Keywords: unchanged.


SubjectID: 17595401, StudyID: 51600879, Comparison: worse

WET READ: ___ ___ ___ 5:38 AM 1. Mild increase in left lower lobe opacity is worrisome for pneumonia, although differential includes asymmetric pulmonary edema and atelectasis. Clinical correlation is recommended. 2. Interval increase in moderate pulmonary edema with small bilateral, left greater than right, pleural effusions   Keywords: increase. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: History of shortness of breath, hypoxia and congestive heart failure. Assess congestive heart failure versus acute process.

COMPARISON: Chest radiograph ___, ___, ___, ___, ___, ___.

FINDINGS: Single portable semi-upright chest radiographdemonstrates intact median sternotomy wires. Lung volumes are low with crowding of vasculature. There is moderate pulmonary edema with cephalization of vasculature. Mild increase in left base opacity is noted. Small bilateral, left greater than right, pleural effusions have slightly increased in size since previous examination. No pneumothorax. Mild cardiomegaly is likely accentuated due to low lung volumes and patient positioning. Mediastinal contour and hila are otherwise unremarkable. Limited assessment of the upper abdomen is within normal limits. Posterior fusion device of thoracic spine is again seen.

IMPRESSION: 1. Mild increase in left lower lobe opacity is worrisome for pneumonia, although differential includes asymmetric pulmonary edema and atelectasis. Clinical correlation is recommended. 2. Interval increase in moderate pulmonary edema with small bilateral, left greater than right, pleural effusions.


SubjectID: 17595401, StudyID: 58950858, Comparison: None

FINAL REPORT

PORTABLE CHEST OF ___

COMPARISON: ___ radiograph.

FINDINGS: Moderate-sized partially loculated left pleural effusion has increased in size and is accompanied by worsening left retrocardiac opacity, which may be due to atelectasis or infectious pneumonia. Small left apical pneumothorax is present and was also demonstrated on recent CT of one day earlier. Right lung is clear except for minor atelectasis at the right lung base.


SubjectID: 17595401, StudyID: 55367224, Comparison: None

WET READ: ___ ___ ___ 10:15 PM interval improvement in left pleural effusion, now small, with adjacent atelectasis. underlying infection cannot be excluded. an edge is noted in the left lung but with lung markings extending beyond it, likely a skin fold rather than a pneumothorax. Convenional PA and lateral radiographs may be helpful for further evaluation if clinically indicated. -___ d/w ___ ___ at 10:13pm on ___.

WET READ VERSION #1

WET READ VERSION #___ ___ ___ 10:08 PM interval improvement in left pleural effusion, now small, with adjacent atelectasis. underlying infection cannot be excluded. no pneumothorax. ______________________________________________________________________________

FINAL REPORT

HISTORY: CABG.

FINDINGS: In comparison with the study of ___, there has been substantial improvement in the left pleural effusion. Continued enlargement of the cardiac silhouette with indistinct pulmonary vessels consistent with elevated pulmonary venous pressure. Some retrocardiac atelectatic change is again seen. In the appropriate clinical setting, lower lung consolidation cannot be excluded in the absence of a lateral view.


SubjectID: 17595401, StudyID: 58143219, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with ?PNA // f/u CXR for pneumonia vs atelectasis. Please evaluate for edema

TECHNIQUE: Portable AP radiograph of the chest.

COMPARISON: Plain chest radiograph dated ___. Correlation made to thoracic spine CT dated ___.

FINDINGS: Lung volumes are low. Chronic small bilateral pleural effusions have increased. Despite vascular crowding, mild pulmonary edema likely persists   Keywords: persists. The left lower lobe airspace opacity has increased, and is worrisome for pneumonia or atelectasis. The heart and mediastinum are magnified by the projection. Sternotomy wires and spinal fixation hardware are again noted.

IMPRESSION: Increased left lower lobe opacity may be due to atelectasis or pneumonia. Increased small bilateral pleural effusions. Stable mild pulmonary edema   Keywords: stable.


SubjectID: 17595401, StudyID: 57704297, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF, now hypoxia and crackles // Please eval for edema

COMPARISON: ___.

IMPRESSION: Low lung volumes persist. Unchanged sternal wires and vertebral fixation devices. Moderate cardiomegaly. Small bilateral pleural effusions and mild pulmonary edema are unchanged   Keywords: unchanged.


SubjectID: 17596566, StudyID: 58943109, Comparison: better

FINAL REPORT

PORTABLE CHEST ___ Compared to previous radiograph of one day earlier.

FINDINGS: Patient is status post recent median sternotomy and coronary artery bypass surgery. Support and monitoring devices are in standard position. Cardiomediastinal contours are stable in the post-operative period. Mild edema has slightly improved since the previous study, and patchy bibasilar areas of atelectasis are demonstrated   Keywords: improve. No definite pneumothorax.


SubjectID: 17596566, StudyID: 54800217, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post CABG, evaluation for pneumothorax.

COMPARISON: ___, 7:35 a.m.

FINDINGS: As compared to the previous radiograph, the Swan-Ganz catheter and the bilateral chest tubes and mediastinal drains have been removed. There is no evidence of pneumothorax or larger pleural effusions. Two hyperlucent lines projecting over the right hemithorax were visible on the previous radiograph and correspond to skin folds. The patient remains intubated. The position of the right venous introduction sheath, the left subclavian line, the endotracheal tube and the nasogastric tube are constant. Constant alignment of the sternal wires.


SubjectID: 17596566, StudyID: 54413509, Comparison: None

FINAL REPORT

HISTORY: Status post CABG, evaluate for effusion. CHEST, SINGLE AP PORTABLE VIEW OBTAINED SUPINE.

COMPARISON: Chest x-ray from ___ at 19:43 p.m. An ET tube is present, tip approximately 6.0 cm above the carina. Apparent NG tube -- tip is partially obscured but it appears to extend beneath diaphragm, off the film. Bilateral chest tubes present. Probable mediastinal drain. A right Swan-Ganz catheter tip overlies the main pulmonary artery. Sternotomy wires present. Compared to the prior film, the cardiomediastinal silhouette and mild vascular plethora with bibasilar atelectasis is unchanged. No gross effusion is seen on either side. No convincing pneumothorax is identified on this supine film. Slight curvilinear lucency along the lateral left hemidiaphragm likely represents ___ artifact, but attention to this area on followup films to assess for subtle left base pneumothorax is requested.

IMPRESSION: 1. Lines and tubes as described. 2. Cardiomediastinal silhouette and lung findings are grossly unchanged. 3. No convincing evidence of pneumothorax identified. However, attention to the left lateral lung base on followup films to assess for subtle left base pneumothorax is requested.


SubjectID: 17596566, StudyID: 52378418, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post CABG, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the monitoring and support devices, including the endotracheal tube, the bilateral chest tubes and the Swan-Ganz catheter are in unchanged position. Mild centralized pulmonary edema. Normal post-operative appearance of the cardiac silhouette. No larger pleural effusions. No pneumothorax. Several linear lucencies on the right caused by skin folds.


SubjectID: 17596566, StudyID: 57391996, Comparison: None

FINAL REPORT

HISTORY: Shortness of breath.

FINDINGS: In comparison with study of ___, even allowing for the AP portable technique, there is enlargement of the cardiac silhouette with pulmonary vascular congestion and bilateral pleural effusions with compressive atelectasis at the bases.


SubjectID: 17596566, StudyID: 57110040, Comparison: better

WET READ: ___ ___ 8:28 PM Interval retraction of intraaortic balloon pump with radioopaque tip now projecting at the level of the proximal descending thoracic aorta. No other major interval change detected.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

INDICATION: History of intra-aortic balloon pump. Please evaluate for location.

COMPARISONS: Chest radiograph from ___ performed earlier in the day.

FINDINGS: The ET tube terminates approximately 5.6 cm above the carina. There has been interval retraction of the intra-aortic balloon pump with the radiopaque marker now projecting over the proximal descending aorta. Swan-Ganz catheter continues to terminate in the right main pulmonary artery and should be pulled back if desired location is in the main pulmonary outflow tract. Small bilateral pleural effusions are persistent; however, there has been interval improvement of the diffuse mild pulmonary edema   Keywords: improve. Mild bibasilar atelectasis is persistent. Enteric tube extends below the diaphragm with the tip out of view of this film. There is no evidence of pneumothorax. The visualized osseous structures are unremarkable.

IMPRESSION: Interval retraction of intra-aortic balloon pump which now terminates in the proximal descending aorta. Interval improvement of mild pulmonary edema   Keywords: improve.


SubjectID: 17596566, StudyID: 56450342, Comparison: None

FINAL REPORT

INDICATION: History of coronary artery disease status post V-fib arrest and intubated, now with intra-aortic balloon pump. Please evaluate for interval change.

COMPARISONS: Chest radiographs dated back to ___, most recently from ___.

TECHNIQUE: Portable supine radiograph of the chest.

FINDINGS: The ET tube terminates approximately 6.8 cm above the carina. A Swan-Ganz catheter is positioned with the tip in the right main pulmonary artery, overall unchanged in position compared to the prior exam. Enteric tube traverses below the diaphragm with the tip out of view of this film. Layering right-sided effusion has improved compared to the prior exam. Linear radiopaque structure seen projecting over the proximal descending thoracic aorta is in the expected location and demarcates the intra-aortic balloon pump marker. Mild bibasilar atelectasis is persistent.

IMPRESSION: 1. Overall, lines and tubes appear to be in appropriate position except for a right Swan-Ganz catheter, which appears to be in the right main pulmonary artery. 2. Appropriate position of the IABP. These findings were discussed with Dr. ___ by Dr. ___ by phone at 9 a.m. on the day of the exam.


SubjectID: 17596566, StudyID: 54207420, Comparison: None

FINAL REPORT

INDICATION: Intubation. Evaluate endotracheal tube placement.

TECHNIQUE: Single portable semi-erect chest.

COMPARISON: ___ (approximately 4 hours previously).

FINDINGS: It is noted that the right side of the chest wall has been excluded from this image. The physician at the patient's bedside did not desire an additional image to cover this portion of the anatomy. The patient has had interval intubation, with the tip of the endotracheal tube approximately 2 cm above the carina. The right can't left-sided pleural effusion seen previously are slightly more layering given the semi erect imaging technique. There is persistent retrocardiac dense opacity, as well as some increased opacity at the right lung base. The left basilar opacity likely represents a combination of consolidation and atelectasis, while the right-sided changes are more likely to be have a dominant component of atelectasis. No overt osseous abnormalities. Numerous cardiac monitoring leads are present.

IMPRESSION: Interval intubation. The tip of the endotracheal tube is 2 cm above the carinal.


SubjectID: 17596566, StudyID: 52974278, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with increasing oxygen requirement // interval changes

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the lung volumes have decreased and the pleural effusions have bilaterally mildly increased. Mild pulmonary edema persists   Keywords: persists. Moderate cardiomegaly. No pneumothorax.


SubjectID: 17596566, StudyID: 51572499, Comparison: worse

FINAL REPORT

INDICATION: Status post CABG with new Dobbhoff placement. Evaluate for positioning.

COMPARISON: ___.

FINDINGS: The newly placed Dobbhoff is seen below the diaphragm and curling in the stomach. There has been interval removal of a right internal jugular central venous line and the left subclavian line tip terminates at the cavoatrial junction. Interstitial opacities are increased consistent with worse pulmonary edema   Keywords: worse, increase. The heart size, hilar and mediastinal contours are stable. A small left pleural effusion is new and no pneumothorax is seen.

IMPRESSION: Tip of the Dobbhoff tube is in the stomach. Worse pulmonary edema and new left pleural effusion   Keywords: worse, new.


SubjectID: 17598360, StudyID: 57967835, Comparison: same

FINAL REPORT

HISTORY: Thoracentesis, to assess for pneumothorax.

FINDINGS: In comparison with the study of ___, there is again significant pulmonary edema   Keywords: again. Some decrease in the pleural effusion on the right following thoracentesis, with no evidence of pneumothorax. The right IJ catheter appears to have been removed.


SubjectID: 17598360, StudyID: 51766093, Comparison: worse

FINAL REPORT

HISTORY: Pneumonia, respiratory failure, and CHF, now with concern for aspiration.

COMPARISON: Multiple prior chest radiographs, most recently of ___.

FINDINGS: Frontal views of the chest. Swan-Ganz catheter remains deployed in the descending pulmonary artery. Endotracheal tube terminates 4.9 cm above the carina. Left IJ central venous catheter terminates at the thoracic inlet. Sternotomy wires are intact. Slight interval worsening of moderate pulmonary edema   Keywords: worse. Moderate left pleural effusion is enlarged and small right pleural effusion is stable. No pneumothorax or new consolidation. Heart size and mediastinal contours are stable.

IMPRESSION: 1. Moderate pulmonary edema with enlarging moderate left and small right pleural effusions. 2. Stable lines and tubes.


SubjectID: 17598360, StudyID: 53017262, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic respiratory failure, pneumonia, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the tracheostomy tube as well as the left persistent superior vena cava are unchanged in position. Unchanged appearance of the lung parenchyma, with the extensive bilateral parenchymal opacities that have not substantially changed since the previous examination.


SubjectID: 17598360, StudyID: 54168076, Comparison: better

FINAL REPORT

HISTORY: ___-year-old man with pulmonary hypertension, ARDS, and new orogastric tube placement. Evaluate for position of orogastric tube.

COMPARISON: Multiple prior radiographs of the chest dated ___ through ___.

FINDINGS: Portable semi-upright radiograph of the chest demonstrates bilateral parenchymal opacities consistent with pulmonary edema, which is slightly improved from the prior study   Keywords: improve. Cardiomediastinal and hilar contours are unchanged. There is no pneumothorax or consolidation. The endotracheal tube tip is obscured by overlying sternotomy wires. A left-sided internal jugular line ends in the persistent left SVC. A nasogastric tube courses into the stomach and out of the field of view.

IMPRESSION: Nasogastric tube courses into the stomach and out of the field of view.


SubjectID: 17598360, StudyID: 52236467, Comparison: worse

FINAL REPORT

HISTORY: ___-year-old man with fevers. Evaluate for pneumonia.

COMPARISON: Multiple prior radiographs of the chest dated ___ through ___.

FINDINGS: Portable semi-upright radiograph of the chest demonstrates persistent diffuse bilateral parenchymal opacities, which is worsened over the interval   Keywords: worse. Cardiomediastinal and hilar contours are unchanged. The endotracheal tube ends 4.9 cm from the carina. Nasogastric tube courses into the stomach.

IMPRESSION: Interval increase in diffuse bilateral parenchymal opacities consistent with worsening pulmonary edema   Keywords: increase, worse. Pneumonia cannot be excluded.


SubjectID: 17598360, StudyID: 52116602, Comparison: same

FINAL REPORT

HISTORY: ___-year-old man with pulmonary hypertension, ARDS, with new orogastric tube placement. Evaluate for position of orogastric tube.

COMPARISON: Multiple prior radiographs of the chest dated ___ through ___.

FINDINGS: Portable semi-upright radiograph of the chest demonstrates persistent diffuse bilateral parenchymal opacities consistent with pulmonary edema, which is stable as compared to the prior study   Keywords: persistent, stable. The cardiomediastinal and hilar contours are unchanged. The endotracheal tube ends 4.1 cm from the carina. A left-sided internal jugular central venous line ends at the persistent left SVC. An orogastric feeding tube courses into the stomach and out of the field of view.

IMPRESSION: Orogastric tube courses into the stomach and out of the field of view.


SubjectID: 17600369, StudyID: 57260862, Comparison: same

FINAL REPORT

HISTORY: Chest tube removal, to assess for pneumothorax.

FINDINGS: In comparison with the study of ___, the chest tube has been removed and there is no evidence of pneumothorax. Right Swan-Ganz catheter has been pulled back and there is a right IJ sheath is in place. Endotracheal tube and nasogastric tube remain in position. Bibasilar opacification persists   Keywords: persists. The position of the heart with respect to the midline suggests some substantial volume loss in the left lower lobe.


SubjectID: 17600369, StudyID: 56168578, Comparison: None

FINAL REPORT

HISTORY: Right lower lobe abnormality.

FINDINGS: In comparison with the study of ___, the monitoring and support devices are essentially unchanged without evidence of pneumothorax. Bibasilar opacifications persist. On the right this most likely represents partial collapse of the lower lobe with pleural fluid. Effusion with compressive atelectasis is also seen in the retrocardiac region at the left base.


SubjectID: 17600369, StudyID: 50163880, Comparison: None

FINAL REPORT

HISTORY: Right effusion.

FINDINGS: In comparison with the earlier study of this date, the monitoring and support devices are essentially unchanged. There is again opacification at the left base consistent with volume loss in the left lower lobe and pleural effusion. Opacification at the left base also is consistent with pleural effusion with mild compressive atelectasis. No evidence of pneumothorax.


SubjectID: 17600369, StudyID: 56648490, Comparison: None

FINAL REPORT

INDICATION: Recent ascending aortic arch repair, now with chest and back pain, please evaluate for widened mediastinum or infiltrate.

COMPARISON: Comparison is made to chest radiograph performed ___.

FINDINGS: Stable cardiomediastinal appearance. Dense retrocardiac opacification likely represents a combination of a stable moderate left pleural effusion and atelectasis. Trace right pleural effusion noted. Linear density within the right middle lung consistent with atelectasis. No pneumothorax evident. Sternotomy sutures are midline and intact.

IMPRESSION: Dense retrocardiac opacification, likely combination of a moderate left pleural effusion and atelectasis. Stable small right pleural effusion.


SubjectID: 17600369, StudyID: 55703689, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female status post ascending aortic replacement. Evaluate effusions.

COMPARISONS: Multiple prior chest radiographs, most recently of ___.

FINDINGS: Semi-erect frontal view of the chest was obtained. A small right pleural effusion and a moderate-sized left pleural effusion are similar to ___, allowing for difference in patient position. Adjacent atelectasis is also similar to prior. No pneumothorax is present. The cardiomediastinal contour is stable in appearance. A calcified aortopulmonary node is again seen.

IMPRESSION: Moderate left and small right pleural effusions with adjacent atelectasis, similar to ___.


SubjectID: 17600369, StudyID: 52919572, Comparison: None

FINAL REPORT

CHEST ON ___

HISTORY: Status post replacement of ascending aorta, post-op day 8, check infiltrate. REFERENCE EXAM: ___.

FINDINGS: There are moderate bilateral pleural effusions, left greater than right that have increased in the interval. The right IJ line has been removed.

IMPRESSION: Worsened bilateral pleural effusions.


SubjectID: 17608002, StudyID: 59761757, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with pulmonary htn, ? PVOD, chf, cad, copd p/w dyspnea requiring bipap // ? effusions, edema, ptx ? effusions, edema, ptx

COMPARISON: ___

IMPRESSION: Right central venous line tip terminates at the level of mid to lower SVC. There is interval development of left basal consolidation not seen on the previous study, concerning for massive aspiration or rapidly developing infectious process. The re- is no evidence of pulmonary edema. No appreciable increase in pleural effusions demonstrated.


SubjectID: 17608002, StudyID: 59134689, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with pulmonary htn, ? PVOD, chf, cad, copd p/w dyspnea requiring bipap // interval change interval change

IMPRESSION: Comparison to ___. Newly introduced Swan-___ catheter. The catheter is showing a normal course. The tip projects over the outflow tract of the right ventricle. Unchanged bilateral pleural effusions. Unchanged mild pulmonary edema and moderate cardiomegaly   Keywords: unchanged. No pneumothorax.


SubjectID: 17608002, StudyID: 54148285, Comparison: None

FINAL REPORT

INDICATION: ___F with dyspnea // acute process

TECHNIQUE: Single portable view of the chest.

COMPARISON: ___.

FINDINGS: Right-sided central venous catheter again seen with tip at the RA SVC junction. Moderate cardiomegaly is again noted. The lungs are clear without focal consolidation or large pleural effusion. Enlarged hila bilaterally is compatible patient's known pulmonary hypertension. No acute osseous abnormalities.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 17608002, StudyID: 54732690, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with COPD, PVOD, on remodulin. // interval change

TECHNIQUE: Portable chest

COMPARISON: ___.

FINDINGS: There has been interval removal of the Swan-Ganz catheter with placement of a right IJ Cordis. . Otherwise, Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change.


SubjectID: 17608002, StudyID: 56199824, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with pulmonary hypertension, acute decompensated HF // pulm edema

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph ___

FINDINGS: Since ___, no significant change   Keywords: no significant change   Keywords: no significant change. Prominent right hilar region is unchanged. Moderate cardiomegaly. Mild pulmonary central vascular congestion. No pleural effusions. No pneumothorax. Mediastinal borders are normal.

IMPRESSION: Since ___, no significant change. Persistent moderate cardiomegaly and right hilar prominence. No signs of pulmonary edema.


SubjectID: 17608002, StudyID: 55992207, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with PAH s/p RHC with swan in place. Eval location of PAC // location of PAC

IMPRESSION: Since the prior radiograph of 1 day earlier, a Swan-Ganz catheter is been placed with tip terminating in the interlobar right pulmonary artery. No visible pneumothorax. Allowing for lower lung volumes on the current study, there is otherwise no relevant change since recent radiograph   Keywords: no relevant change.


SubjectID: 17608002, StudyID: 52989376, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with pulmonary hypertension // ? edema ?infection

TECHNIQUE: Portable AP chest radiograph.

COMPARISON: Chest radiograph ___.

FINDINGS: Lung volumes are unchanged compared to the prior study. The cardiomediastinal contour is also unchanged with moderate cardiomegaly. The right hilum appears enlarged, likely reflecting pulmonary arterial hypertension. The central pulmonary vasculature is also prominent. No frank pulmonary edema however. No new airspace opacity seen. No definite pleural effusion or pneumothorax.

IMPRESSION: No significant interval change when compared to the prior study   Keywords: no significant interval change.


SubjectID: 17608002, StudyID: 50279950, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with PAH with hypoxia

TECHNIQUE: Portable AP view of the chest was obtained.

COMPARISON: PA and lateral views of the chest dated ___.

FINDINGS: The cardiac silhouette is stably enlarged. Right hilar enlargement is compatible with right pulmonary artery enlargement suggesting pulmonary hypertension. The central pulmonary vasculature is prominent, also unchanged since prior examination. The lungs are clear. There is no definite pleural effusion or pneumothorax.

IMPRESSION: No acute intrathoracic process.


SubjectID: 17618022, StudyID: 56678521, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man s/p PPM upgrade // ptx, leads ptx, leads

IMPRESSION: As compared to the previous radiograph, pacemaker leads are unchanged. The tips project over the right atrium and right ventricle, respectively. The alignment of the sternal wires and the clips of the CABG are constant. Normal size of the cardiac silhouette. No pneumothorax. Elongation of the descending aorta. No pleural effusions. No pulmonary edema.


SubjectID: 17618022, StudyID: 52071902, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p PPM upgrade // PTX, leads

IMPRESSION: Compared to ___, a an additional pacing lead has been placed for biventricular pacing. Standard lateral chest radiograph would be helpful to confirm appropriate positioning when the patient's condition permits. There is no evidence of pneumothorax. No other relevant changes compared to recent study   Keywords: no other relevant change.


SubjectID: 17635650, StudyID: 55599049, Comparison: same

FINAL REPORT

INDICATION: Upper gastrointestinal bleed, history of diastolic disease. Evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The monitoring and support devices are in constant position, except for the nasogastric tube that has been removed in the interval. Unchanged moderate cardiomegaly with mild fluid overload, bilateral areas of basal atelectasis, and a small left pleural effusion   Keywords: unchanged. No interval appearance of other parenchymal opacities.


SubjectID: 17635650, StudyID: 53139939, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post intubation, evaluation for nasogastric tube placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has been intubated. The tip of the endotracheal tube projects 4 cm above the carina. The patient has also received a nasogastric tube, the course of the tube is unremarkable, the tip of the tube projects over the distal parts of the stomach. Known sternotomy wires after valvular repair. Unchanged moderate cardiomegaly with signs of mild fluid overload   Keywords: unchanged. No larger pleural effusions. No pneumonia, mild retrocardiac atelectasis.


SubjectID: 17641105, StudyID: 55790625, Comparison: None

FINAL REPORT

INDICATION: Found down. Rule out fracture or bleeding.

COMPARISON: Chest radiograph ___ and ___.

FINDINGS: Frontal and lateral views of the chest. There is a vague opacity seen over the left mid lung, best appreciated on the frontal view. No pleural effusion or pneumothorax. The heart is mildly enlarged and unchanged. The mediastinal and hilar structures are unremarkable. An acute-appearing nondisplaced rib fracture is seen in the posterior left seventh rib.

IMPRESSION: 1. Nondisplaced left seventh rib fracture. 2. Vague opacity in the left mid lung may reflect contusion or aspiration. These findings were discussed with Dr. ___ by Dr. ___ at 11 p.m. on ___ by telephone.


SubjectID: 17641105, StudyID: 52580237, Comparison: None

FINAL REPORT

HISTORY: Fall with left seventh rib fracture.

FINDINGS: In comparison with the study of ___, there are lower lung volumes. There may be mild enlargement of the cardiac silhouette. Some indistinctness of pulmonary vessels could reflect some elevated pulmonary venous pressure, though this may merely be a manifestation of low lung volumes.


SubjectID: 17644567, StudyID: 52574272, Comparison: worse

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with shortness of breath/flash pulmonary edema.

COMPARISON: ___ at 11:17 a.m.

FINDINGS: Moderate-to-severe pulmonary edema has slightly worsened   Keywords: worse. Bibasilar atelectasis with small pleural effusion is unchanged in this patient with moderate cardiomegaly. There is no pneumothorax.

CONCLUSION: Worsening of moderate-to-severe pulmonary edema   Keywords: worse.


SubjectID: 17644567, StudyID: 50784167, Comparison: worse

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with critical aortic stenosis, congestive heart failure, shortness of breath, rule out pulmonary edema.

COMPARISON: ___ at 1:00 a.m.

FINDINGS: Moderate-to-severe pulmonary edema has slightly worsened   Keywords: worse. There is also more layering pleural effusion, especially on the right side in this patient with moderate cardiomegaly. There is no pneumothorax.

CONCLUSION: Worsening of moderate-to-severe pulmonary edema and layering pleural effusion   Keywords: worse.


SubjectID: 17652927, StudyID: 53569352, Comparison: None

FINAL REPORT

INDICATION: Right PICC line in place for home milrinone but withdrew approximately 5 cm. Evaluate location.

COMPARISON: ___.

FINDINGS: The right PICC has withdrawn and now terminates in the right subclavian vein. Mild cardiomegaly is unchanged. The lung fields are clear. There is no pneumothorax or pleural effusion.

IMPRESSION: Right PICC now terminates in the right subclavian vein.


SubjectID: 17652927, StudyID: 51677653, Comparison: 1.0

FINAL REPORT

INDICATION: ___-year-old patient in severe CHF.

TECHNIQUE: Frontal and lateral radiographs of the chest were obtained.

FINDINGS: There is moderate cardiomegaly, mild vascular congestion, but no pulmonary edema,, increased since ___   Keywords: increase. An ICD pacemaker lead ends in the right ventricle. The right PICC line ends at the cavoatrial junction.

IMPRESSION: Moderate cardiomegaly, mild vascular congestion, but no pulmonary edema, progressed since ___   Keywords: progressed.


SubjectID: 17653729, StudyID: 59430679, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with pneumonia, pleural effusion s/p lasix. // interval changes

IMPRESSION: As compared to ___ radiograph, pulmonary vascular congestion has improved   Keywords: improve. Improving asymmetrical left perihilar and basilar opacities may reflect improving asymmetrical edema with or without coexisting infection   Keywords: improving. Right pleural effusion has apparently resolved, and a small to moderate left pleural effusion has not appreciably changed.


SubjectID: 17653729, StudyID: 52309094, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with new hypotension. c. diff infection. // new infection new infection

IMPRESSION: In comparison with the study of ___, of the monitoring and support devices remain in place. Hazy opacification at the bases is consistent with layering effusions and atelectatic changes. There may be mild residual elevation of pulmonary venous pressure.


SubjectID: 17653729, StudyID: 51939364, Comparison: same

FINAL REPORT

INDICATION: Pulmonary edema and effusions.

COMPARISON: Chest radiograph from ___.

TECHNIQUE: Frontal chest radiograph.

IMPRESSION: A right IJ central venous catheter terminates at the cavoatrial junction. The endotr portable acheal tube terminates 5.0 cm above the carina. The heart size is normal. Central pulmonary vascular congestion, mild interstitial edema, and moderate bilateral pleural effusions are unchanged since ___   Keywords: unchanged. Mild cardiomegaly is stable. There is no pneumothorax.


SubjectID: 17653729, StudyID: 59416391, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with respiratory failure and recent emesis and massive aspiration // Evidence of worsening pneumonia, effusions? Evidence of worsening pneumonia, effusions?

IMPRESSION: In comparison with the study of ___, there is little interval change   Keywords: little interval change. Bibasilar opacifications are again consistent with pleural effusion and atelectasis, although in the appropriate clinical setting it would be difficult to exclude superimposed pneumonia. Continued elevation of pulmonary venous pressure. Monitoring and support devices remain in place.


SubjectID: 17653729, StudyID: 58529931, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with new resp distress. // etiology distress

IMPRESSION: Since the prior radiograph of 1 day earlier, the patient has apparently been extubated. Apparent narrowing of the proximal trachea could potentially represent edema in the post intubation state but is suboptimally evaluated due to patient rotation and portable radiographic technique. Cardiomediastinal contours are stable. Previously reported bibasilar opacities have improved on the left and worsened on the right   Keywords: worse. The latter could reflect atelectasis or a developing infectious pneumonia. Small pleural effusions persist, left greater than right.


SubjectID: 17653729, StudyID: 58320020, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: New respiratory distress and Re intubated. Assess endotracheal tube positioning.

COMPARISON: Chest radiograph ___.

FINDINGS: Single portable semi-erect frontal chest radiograph demonstrates endotracheal tube in appropriate position, 5 cm above the level of the carina. A right subclavian CVL tip is in the lower SVC. The lungs are well inflated. A persistent right lower lobe opacity is present. Stable small left pleural effusion. No right pleural effusion. No pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. Limited assessment upper abdomen is within normal limits.

IMPRESSION: 1. Endotracheal tube in appropriate position. Additional support line as described above. 2. Persistent right lower lobe opacity is worrisome for pneumonia, or aspiration pneumonia. 3. Stable small left pleural effusion.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 2:52 PM, 5 minutes after discovery of the findings.


SubjectID: 17653729, StudyID: 50214212, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with recent asp, new leukocytosis // r/o worsening PNA

TECHNIQUE: Single frontal view of the chest

COMPARISON: Fibroid ___

IMPRESSION: Cardiac size is top-normal. Bibasilar opacities have increased consistent with increasing atelectasis and small effusions. On the right could represent pneumonia. Moderate mild to moderate pulmonary edema has worsened   Keywords: worse. ET tube is in standard position. Right subclavian catheter tip is in the lower SVC.


SubjectID: 17653729, StudyID: 59120271, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with large volume emesis around NG tube // Aspiration?

COMPARISON: ___

IMPRESSION: New complete opacification of right hemithorax with ipsilateral shift of mediastinum is consistent with complete right lung collapse, likely due to mucous plugging of the right main bronchus. Exam otherwise appears similar to recent study except for improved aeration of the left lung base and apparent resolution of the pneumoperitoneum.

NOTIFICATION: Dr. ___ was successfully paged to discuss these findings at 08:50 on ___ at time of discovery


SubjectID: 17653729, StudyID: 56758333, Comparison: None

WET READ: ___ ___ ___ 9:07 AM There has been mild interval improvement in aeration of the right lung compared to the prior exam performed at 06:00 the same date. Small bilateral pleural effusions are persistent. There has been slight interval increase in the left basilar atelectasis. Mild pulmonary edema.

WET READ VERSION #1 ___ ___ ___ 10:10 PM There has been mild interval improvement in aeration of the right lung compared to the prior exam performed at 06:00 the same date. Small bilateral pleural effusions are persistent. There has been slight interval increase in the left basilar atelectasis. Mild pulmonary edema. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___ year old woman with complete right lung collapse, now s/p post bronch // right lung post bronch

TECHNIQUE: Single view at ___ 6:03 PM

COMPARISON: ___ at 06:01

FINDINGS: There has been reduction in the right pleural effusion. There is some increased translucency in the right base but bibasilar parenchymal disease remains. There is probably a small left pleural effusion. The heart is not enlarged. The osseous structures are normal for age. Right-sided PICC line and nasogastric tube seen. Monitor leads overlie the chest.

IMPRESSION: Improvement in the right pleural effusion and right basilar atelectasis. Bibasilar pleural and parenchymal disease persists


SubjectID: 17653729, StudyID: 55238660, Comparison: None

FINAL REPORT

INDICATION: Status post bronchoscopy for mucus plugging of the right mainstem bronchus, now with stable respiratory status. Evaluate right lung atelectasis.

COMPARISON: Chest radiographs ___ and ___, chest CT ___.

TECHNIQUE: Semi-upright bedside frontal chest radiograph.

FINDINGS: A right PICC courses into the upper SVC. An enteric tube terminates in the stomach. There has been further reduction in the volume of bilateral pleural effusions, now small. Increased opacity at the right lung base is likely in part atelectasis, but early consolidation cannot be excluded. There is no pneumothorax or focal airspace consolidation worrisome for pneumonia. No pulmonary edema. Cardiac silhouette is normal size. Mediastinal contours are unchanged.

IMPRESSION: Decreasing bilateral pleural effusions, now small. Continued density in the right base partially improved


SubjectID: 17653729, StudyID: 54113973, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with R lung collapse on prior x-ray, please eval for interval change, likely needs bronch, please perform at 6AM on ___ as pt may need procedure early // ?interval change, please perform at 6AM on ___ as pt may need procedure early

COMPARISON: ___

IMPRESSION: As compared to the previous image, the total opacification of the right hemithorax has improved. There are apical and medial parts of the right lung that are again ventilated. These areas, however, show mild opacities, likely reflecting re-expansion pulmonary edema. The patient has received a nasogastric tube that shows a normal course. The right PICC line is in unchanged position. Unchanged normal appearance of the left lung and of the left heart border.


SubjectID: 17653729, StudyID: 58883020, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with intubation and volume overload // Assess for improvement Assess for improvement

IMPRESSION: In comparison with the study of ___, the monitoring and support devices remain in place. Cardiac silhouette is within normal limits. Hazy opacification at the bases is again seen, consistent with layering effusion and atelectatic changes. The apparent improvement could merely reflect a more erect position of the patient.


SubjectID: 17653729, StudyID: 50104919, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with pulmonary edema, intubated. // interval changes interval changes

IMPRESSION: In comparison with the study of ___, the ___ support devices as essentially unchanged. Hazy opacification at the bases with poor definition of the hemidiaphragms is again consistent with layering pleural effusions and basilar atelectasis. Again there is mild elevation of pulmonary venous pressure.


SubjectID: 17653729, StudyID: 58763887, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hyoxia, leukocytosis // pls eval for interval change, concern for PNA

COMPARISON: ___

IMPRESSION: No relevant change as compared to the previous examination   Keywords: no relevant change. Left retrocardiac atelectasis, left small pleural effusion. Borderline size of the cardiac silhouette. No new focal parenchymal opacity indicative of pneumonia. Normal and unchanged position of the right-sided central venous access line.


SubjectID: 17653729, StudyID: 56316950, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with respiratory failure received 1L IVF. // assess volume status

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the monitoring and support devices are in unchanged correct position. The lung volumes have minimally decreased. A pre-existing left pleural effusion has minimally increased, with an increasing retrocardiac and left basilar atelectasis. Taking into account decreased lung volumes, there is no substantial change in appearance of the right lung. No overt pulmonary edema.


SubjectID: 17653729, StudyID: 55251484, Comparison: None

FINAL REPORT

INDICATION: ___F with recent trach decannulation, concern for aspiration, tachypnea/hypoxia // eval pna

TECHNIQUE: Single portable view of the chest.

COMPARISON: ___.

FINDINGS: Left basilar opacity silhouetting the hemidiaphragm is most suggestive of a layering effusion as on prior. Elsewhere, the lungs are clear. The cardiomediastinal silhouette is within normal limits for technique. Atherosclerotic calcifications are noted. Previously seen left central venous catheter is no longer visualized. Tracheostomy tube is also no longer seen.

IMPRESSION: Persistent left-sided pleural effusion without superimposed acute cardiopulmonary process.


SubjectID: 17653729, StudyID: 54629067, Comparison: None

FINAL REPORT

EXAMINATION: PA and lateral chest x-ray.

INDICATION: A ___-year-old woman with a recently placed right subclavian central line, please evaluate central line.

TECHNIQUE: Portable upright AP chest radiograph.

COMPARISON: Same day chest radiograph from 13:20.

FINDINGS: The cardiomediastinal silhouette is unchanged. There has been interval placement of a right chest central line whose distal tip projects over the lower SVC. The bilateral hila are normal. The left basilar opacity obscuring the left hemidiaphragm is unchanged, consistent with a layering left pleural effusion as seen on prior exams. There are no new focal lung consolidations. There is no evidence of pulmonary vascular congestion. There is no pneumothorax.

IMPRESSION: Interval placement of right chest central line with distal tip projecting over the low SVC. Otherwise, unchanged chest radiograph.


SubjectID: 17653729, StudyID: 51463563, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with respiratory failure // Evidence of improving pulmonary effusion/edema

COMPARISON: Chest radiograph ___

FINDINGS: Single AP view of the chest provided. Central venous line ends at low SVC unchanged from ___. An ET tube ends 4.5 cm above the carina. The lungs are well-inflated. Diffuse, bilateral alveolar consolidations worse at the lung bases are worse in. Bilateral moderate pleural effusions are mildly worsened. There is no pneumothorax. The hilar contours are normal.

IMPRESSION: 1. Diffuse, bilateral consolidations worse at the lung bases, and bilateral moderate pleural effusions likely represent new pulmonary edema or pneumonia since ___   Keywords: new. 2. Central venous line ends at the low SVC and an ET tube ends 4.5 cm above the carina, unchanged from ___. 3. Mild cardiomegaly is worsened from 1 day prior.


SubjectID: 17653729, StudyID: 58447567, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with right lung collapse now s/p intubation // please evaluate for interval change

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___.

IMPRESSION: ET tube tip is 5 cm above the carinal. Right internal jugular line tip is at the level of lower SVC. Right PICC line tip is at the level of mid SVC. There is interval progression or pulmonary edema, currently severe associated with bilateral pleural effusions   Keywords: progression. No evidence of lung collapse is currently seen.


SubjectID: 17653729, StudyID: 57496579, Comparison: 1.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman intubated, vol overload, prior mucus plugging, now w decreased R BS, decreased vol on PS // please eval fr interval changes

TECHNIQUE: Single frontal view of the chest

COMPARISON: Study performed 7 hours earlier

FINDINGS: Right lower lobe opacity has improved. Mild to moderate pulmonary edema has minimally improved   Keywords: improve. Bilateral effusions are unchanged allowing the difference in positioning of the patient. There are no other interval changes   Keywords: no other interval change

IMPRESSION: Improved right lower lobe opacity.


SubjectID: 17653729, StudyID: 55271538, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with s/p R lung collapse, weaning to extubate. // Please evaluate for interval change

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Right PICC tip is in themid SVC. Cardiac size is minimally enlarged. There is no pneumothorax. ET tube is in standard position. NG tube tip is out of view below the diaphragm. Moderate pulmonary edema and bilateral effusions larger on the left associated with adjacent atelectasis are unchanged


SubjectID: 17653729, StudyID: 53718442, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with respf failure // interval change interval change

IMPRESSION: In comparison with the study of ___, the monitor and support devices are unchanged. Again there is enlargement of the cardiac silhouette with pulmonary vascular congestion and bibasilar layering effusions with volume loss in the lower lungs. In the appropriate clinical setting, superimposed pneumonia would have to be considered.


SubjectID: 17653729, StudyID: 56587707, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with prior R lung opacification s/p bronch // please eval for interval changes

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the patient has undergone bronchoscopy. The ventilation of the partially collapsed right lung has not substantially changed. The patient is rotated. Normal appearance of the left hemi thorax and of the monitoring and support devices.


SubjectID: 17653729, StudyID: 55570756, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with R lung opacification, resp distress, now s/p therapeutic bronchoscopy // please eval for interval changes

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, there is a decrease in collapse of the right lung. Approximately ___% of the right hemithorax are now or ventilated. Unchanged course of the right PICC line and the nasogastric tube. Unremarkable appearance of the left lung.


SubjectID: 17653729, StudyID: 55395544, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman previously bronched for R main stem mucus plug, now with increasing rhonchi // Atelectasis

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, there is, as previously, as subtotal opacification of the right hemi thorax, likely due to a recurrent mucous plug in the right main bronchus. Signs of atelectasis with mediastinal deviation of seen. The appearance of the left lung and of the monitoring and support devices is unchanged. At the time of dictation and observation, 10:07, on the ___, the referring physician ___. ___ was paged for notification.


SubjectID: 17653729, StudyID: 51975869, Comparison: same

FINAL REPORT

HISTORY: Intubated, question interval change. CHEST, SINGLE AP PORTABLE VIEW.

COMPARISON: Chest x-ray from ___ at 5:22 a.m. An ET tube is present, the tip lies approximately 5.6 cm above the carina. An NG tube is present, tip extending beneath diaphragm overlying the fundus. Sideport lies in the region of the GE junction, possibly immediately distal to it. The right IJ central line is present, tip over distal SVC. A right subclavian central line is present, the tip is obscured, but is probably unchanged, overlying the mid SVC. No pneumothorax is detected. Compared with the earlier film, CHF with interstitial edema remains present. Hazy opacity at the lung bases is consistent with layering effusions, larger on the right, and underlying collapse and/or consolidation. Enlarged cardiomediastinal silhouette is also again noted.

IMPRESSION: CHF, bilateral effusions, underlying collapse and/or consolidation, similar to the prior film   Keywords: similar.


SubjectID: 17653729, StudyID: 58240924, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman, intubated // Eval for volume status

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Large bilateral effusions with adjacent atelectasis and moderate pulmonary edema are unchanged   Keywords: unchanged. Cardiomediastinal contours are stable. Lines and tubes are in unchanged standard position. There is no pneumothorax


SubjectID: 17653729, StudyID: 51600573, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman intubated // Eval for pleural effusions

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Mild to moderate cardiomegaly and widening mediastinum are stable. moderate to large right pleural effusion is more conspicuous than before, due to change in position of the patient. There is no pneumothorax. There are no enlarging left effusions. Mild to moderate pulmonary edema is stable   Keywords: stable. Lines and tubes are in unchanged standard position


SubjectID: 17653729, StudyID: 58193940, Comparison: better

FINAL REPORT

HISTORY: New atrial fibrillation with rapid ventricular rate, congestive heart failure.

TECHNIQUE: Upright AP view of the chest.

COMPARISON: ___ at 17:26.

FINDINGS: Moderate enlargement of cardiac silhouette persists. The mediastinal and hilar contours are unchanged. Previous pattern of mild pulmonary vascular congestion has somewhat improved   Keywords: improve. No focal consolidation, pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities.

IMPRESSION: Mild pulmonary vascular congestion, slightly improved in the interval   Keywords: improve.


SubjectID: 17653729, StudyID: 51184699, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Sepsis, AFib, possible pneumonia, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The patient is slightly rotated to the left, causing increased radiodensity of the left lower hemithorax. Moderate cardiomegaly and signs of mild fluid overload persist. No larger pleural effusions. No pneumonia.


SubjectID: 17653729, StudyID: 50106356, Comparison: None

FINAL REPORT

HISTORY: Altered mental status.

TECHNIQUE: Upright AP and lateral views of the chest.

COMPARISON: Chest radiograph ___.

FINDINGS: Heart size remains moderately enlarged. The aorta is mildly tortuous and diffusely calcified. Mediastinal and hilar contours are unchanged. There is mild pulmonary vascular congestion. No focal consolidation, pleural effusion or pneumothorax is identified. Mild multilevel degenerative changes are visualized in the thoracic spine.

IMPRESSION: Mild pulmonary vascular congestion.


SubjectID: 17653729, StudyID: 57459197, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F h/o asthma/COPD, Afib, CVA with residual left sided weakness, PAD s/p left AKA in ___, seizure disorder and recurrent C. Diff w/ recent sigmoid perforation s/p exlap, repair of sigmoid perforation and small bowel resection now with respiratory distress and right lung collapse now s/p intubation with persistent pulmonary edema, cholecystitis: // interval changes?

TECHNIQUE: Portable chest

COMPARISON: ___.

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change.


SubjectID: 17653729, StudyID: 55371696, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with left chest tube, now removed // Eval for Pneumothorax

TECHNIQUE: Portable chest

COMPARISON: 831 AT ___

FINDINGS: The left-sided pigtail catheter is been removed. There is no pneumothorax. The endotracheal tube and right-sided PICC line with tip in SVC are unchanged. There is pulmonary vascular redistribution

IMPRESSION: No pneumothorax


SubjectID: 17653729, StudyID: 50806957, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with seizures, respiratory failure, known b/l effusions. // please evaluate for interval change

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change.


SubjectID: 17653729, StudyID: 56901951, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman intubated with right effusion // Eval for interval change

COMPARISON: ___

IMPRESSION: No relevant change as compared to the previous examination   Keywords: no relevant change. The extent of the known right pleural effusion is constant. Moderate cardiomegaly with minimal fluid overload but without overt pulmonary edema persists   Keywords: persists. The monitoring and support devices are in unchanged normal position.


SubjectID: 17653729, StudyID: 51810671, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with respiratory failure, thick secretions // Please evaluate for interval change

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the right internal jugular vein catheter was removed. The nasogastric tube was also removed and a left pigtail catheter was inserted into the pleural space. The right pleural effusion is unchanged. No left a right pneumothorax. Moderate cardiomegaly persists. Unchanged signs of mild pulmonary edema   Keywords: unchanged.


SubjectID: 17653729, StudyID: 56643086, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with new left subclavian line

TECHNIQUE: Portable upright AP view of the chest

COMPARISON: ___ at 13:20

FINDINGS: A left subclavian central venous catheter terminates in the upper SVC. No pneumothorax is present. Tracheostomy tube is in unchanged position. Cardiac and mediastinal contours are grossly unchanged allowing for differences in technique and patient rotation. Re- demonstrated is a layering left pleural effusion with left basilar opacity, possibly atelectasis. Right lung remains clear. No pulmonary edema is identified. Vascular calcifications are noted projecting over the left apex.

IMPRESSION: Left subclavian central venous catheter tip in the upper SVC. No pneumothorax.


SubjectID: 17653729, StudyID: 55568659, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with chronic vent with fevers x 3 days // eval pna, picc placemnet

COMPARISON: ___.

FINDINGS: AP portable supine view of the chest. Tracheostomy tube projects over the superior mediastinum. There is a layering small left pleural effusion. Right lung is clear. No overt signs of edema or pneumonia. Cardiomediastinal silhouette is normal. No supine evidence for pneumothorax. Bony structures appear intact.

IMPRESSION: Small layering left pleural effusion.


SubjectID: 17653729, StudyID: 56425625, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with respiratory failure, refractory seizures, afib, CVA. // Please evaluate for interval change.

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: ET tube tip is 4 cm above the carinal. Right internal jugular line tip is at the level of lower SVC. NG tube tip is not seen potentially in the stomach below the inferior margin of the field of view. Cardiomediastinal silhouette is unchanged including mild cardiomegaly. Right pleural effusion is still present, moderate. The pigtail catheter on the left if partially imaged. Mild vascular engorgement is unchanged   Keywords: unchanged.


SubjectID: 17669276, StudyID: 53637827, Comparison: same

FINAL REPORT

INDICATION: History of duodenal ulcer bleed, question interval change.

COMPARISON: Chest radiographs from ___.

FINDINGS: Right internal jugular central line terminates in the mid SVC. Endotracheal tube is appropriately positioned 4.2 cm above the carina. A left PICC terminates in the lower SVC. Again seen are moderate pleural effusions, similar to the previous exam. A vertical line in the right hemithorax represents a skinfold. There is no pneumothorax or focal consolidation. Mild pulmonary edema is stable   Keywords: stable. Cardiomegaly is unchanged.

IMPRESSION: No significant interval change since the prior exam   Keywords: no significant interval change.


SubjectID: 17675880, StudyID: 53342826, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Pacemaker, evaluation for pulmonary edema or pneumonia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has developed moderate pulmonary edema   Keywords: develop. The size of the cardiac silhouette continues to be enlarged. The presence of small pleural effusions cannot be excluded. The course and position of the pacemaker leads are constant. At the time of observation and dictation, 11:44 a.m., on ___, the referring physician, ___. ___, was paged for notification. The findings were subsequently discussed over the telephone.


SubjectID: 17675880, StudyID: 52679513, Comparison: 0.0

FINAL REPORT

HISTORY: Productive cough and shortness of breath.

COMPARISON: Multiple prior chest radiographs, most recently of ___.

FINDINGS: Frontal and lateral views of the chest were obtained. Leads of a left chest wall pacer terminate in the right atrium and right ventricle. Moderate cardiomegaly is similar to prior and mediastinal contours are stable. Rounded calcification at the base of the heart is consistent with a known left ventricular aneurysm. Bibasilar opacities are consistent with atelectasis. Increased pulmonary vascular markings are consistent with mild congestion   Keywords: increase. Small right subpulmonic effusion is unchanged. No pneumothorax.

IMPRESSION: 1. Findings suggesting mild pulmonary vascular congestion with unchanged small right subpulmonic effusion   Keywords: unchanged. 2. Bibasilar atelectasis. 3. Moderate cardiomegaly with unchanged left ventricular aneurysm.


SubjectID: 17682234, StudyID: 59650024, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Acute hypoxia, questionable fluid overload.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is unchanged evidence of moderate severe pulmonary edema   Keywords: unchanged. In addition, the extent of the known and pre-described pleural effusions has increased. The size of the cardiac silhouette is constant. No pneumothorax. No new parenchymal opacities suggesting pneumonia.


SubjectID: 17682234, StudyID: 58273382, Comparison: 0.0

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Flash pulmonary edema, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the signs indicative of pulmonary edema have decreased in extent and severity   Keywords: decrease. However, signs of mild-to-moderate pulmonary edema are still present   Keywords: still. The extent of the bilateral pleural effusions is unchanged. Moderate cardiomegaly without parenchymal opacities suggesting pneumonia, but areas of bibasal atelectasis are still clearly visible.


SubjectID: 17682234, StudyID: 58798304, Comparison: worse

FINAL REPORT

PORTABLE CHEST

COMPARISON: Radiographs of ___ and ___.

FINDINGS: Allowing for patient rotation, cardiomediastinal contours are stable in appearance. Pulmonary vascular congestion has worsened and is accompanied by interstitial edema as well as an area of asymmetrical increasing airspace opacity in the right infrahilar region   Keywords: increasing, worse. The latter could reflect asymmetrical edema or a developing area of pneumonia   Keywords: developing. Left retrocardiac atelectasis has slightly worsened, and moderate right and small left pleural effusions are not appreciably changed.


SubjectID: 17682234, StudyID: 54665233, Comparison: same

FINAL REPORT

HISTORY: Shortness of breath.

FINDINGS: In comparison with study of ___, there is continued enlargement of the cardiac silhouette with pulmonary edema and moderate right and small left pleural effusions   Keywords: continue. Infrahilar opacification on the right, again most likely represents vascular congestion, though in the appropriate clinical setting, supervening pneumonia would have to be considered   Keywords: again.


SubjectID: 17699811, StudyID: 58409074, Comparison: None

FINAL REPORT

PORTABLE CHEST: ___

HISTORY: ___-year-old female with AFib, pulmonary edema.

FINDINGS: Single portable view of the chest is compared to previous exam from ___. Lower lung volumes are seen on the current exam. There are bibasilar opacities which partially silhouette the hemidiaphragms bilaterally raising possibilty of effusions and indistinct pulmonary vascular markings. Cardiac silhouette is enlarged but stable in configuration. Atherosclerotic calcifications noted at the arch. Osseous and soft tissue structures are unchanged.

IMPRESSION: Lower lung volumes. However, given this limitation, there are still findings suggestive of failure with effusions and interstitial edema.


SubjectID: 17699811, StudyID: 53639292, Comparison: None

FINAL REPORT

CHEST, TWO VIEWS: ___

HISTORY: ___-year-old female with worsening shortness of breath.

FINDINGS: Frontal and lateral views of the chest are compared to portable exam from earlier the same day and two-view chest from ___. Lower lung volumes are seen when compared to previous exam from ___. Blunting of the costophrenic angles is compatible with small effusions. Increased interstitial markings are seen, similar in appearance when compared to prior. Cardiac silhouette is enlarged but stable. Osseous structures again notable for hypertrophic changes in the spine. Triple-lead pacer device is again seen.

IMPRESSION: Increased interstitial markings and small pleural effusions, suggestive of congestive failure.


SubjectID: 17711415, StudyID: 52601158, Comparison: better

FINAL REPORT

PORTABLE CHEST, ___.

COMPARISON: ___ study.

FINDINGS: Cardiomediastinal contours are stable. Pulmonary vascular congestion is accompanied by improvement in extent of interstitial edema   Keywords: improve. Small-to-moderate right pleural effusion has apparently slightly decreased in size, and a small left pleural effusion is similar. Left retrocardiac atelectasis has worsened, however.


SubjectID: 17711415, StudyID: 51827879, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with new hypoxia // ?PNA vs pulmonary edema ?PNA vs pulmonary edema

IMPRESSION: In comparison with the study of ___, there is again enlargement of the cardiac silhouette with pulmonary vascular congestion and bilateral pleural effusions with compressive atelectasis at the base   Keywords: again. There has been the development of an area of the opacification and just above the right hemidiaphragm. It is unclear whether this represents a dense streak of atelectasis. A region of developing pneumonia, or possibly merely an artifact. A repeat study without obliquity of the patient is recommended.

NOTIFICATION: Dr. ___.


SubjectID: 17718978, StudyID: 54431023, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with new dual-chamber ICD.

COMPARISON: PA and lateral chest radiograph ___.

TECHNIQUE: Portable upright AP radiograph of the chest.

FINDINGS: New lead can be seen originating from left pectoral pacing device, coursing medially and then inferiorly to the level of the right atrium at which point it can no longer be seen. There are low lung volumes bilaterally with associated bronchovascular crowding with no evidence of pulmonary edema. No pleural effusion, focal consolidation or pneumothorax. Pleural surfaces are unremarkable. The cardiomediastinal silhouette is stably enlarged.

IMPRESSION: New ICD lead incompletely imaged. No pneumothorax. Recommend conventional PA and lateral radiographs for further evaluation.


SubjectID: 17720924, StudyID: 59083566, Comparison: None

FINAL REPORT

AP CHEST, 5:10 A.M. ON ___

HISTORY: ___-year-old man with COPD and hospital-acquired pneumonia.

IMPRESSION: AP chest compared to ___: The patient would not cooperate for standard positioning. Lateral aspect of the left hemithorax is excluded from the examination. Mild peribronchial opacification at the base of the right lung could be due to recent aspiration. Abnormality is more severe at the left lung base, more concerning for pneumonia. Pleural effusion on the right is minimal. Left cannot be assessed because the sulcus is excluded from the examination but there is no large left pleural effusion. Right PIC line ends close to the superior cavoatrial junction. Heart is not enlarged. No pneumothorax along the imaged pleural surfaces.


SubjectID: 17720924, StudyID: 58728926, Comparison: None

WET READ: ___ ___ ___ 11:21 AM Bibasilar opacification consistent with pneumonia in the right clinical setting.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

INDICATION: Shortness of breath and fever.

COMPARISON: Chest radiographs from ___ and ___. PORTABLE UPRIGHT RADIOGRAPH OF THE CHEST: There are ill-defined opacity at the bilateral lung bases which was not present on the prior examination. The remainder of the lungs are clear. The hilar and cardiomediastinal contours are normal. There is no large pleural effusion or pneumothorax. The pulmonary vascular markings appear normal. A right PICC line terminates at the cavoatrial junction and incidental note is made of several old right rib fractures.

IMPRESSION: Bilateral lung base opacity concerning for pneumonia.


SubjectID: 17725106, StudyID: 59490438, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Shortness of breath, chronic heart failure, exacerbation, evaluation for pleural effusions.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient shows unchanged signs of moderate pulmonary edema and a small right pleural effusion   Keywords: unchanged. Areas of atelectasis are also seen. The size of the cardiac silhouette remains enlarged. The left costophrenic sinus is unremarkable. No evidence of interval appearance of parenchymal opacities suggesting pneumonia.


SubjectID: 17725106, StudyID: 58933808, Comparison: same

FINAL REPORT

HISTORY: Hypoxia with pulmonary edema.

FINDINGS: In comparison with the study of ___, there is little interval change   Keywords: little interval change. Continued enlargement of the cardiac silhouette with some pulmonary vascular congestion. Blunting of the costophrenic angles persists with some atelectatic changes at the bases. In the appropriate clinical setting, supervening pneumonia would be difficult to exclude.


SubjectID: 17725106, StudyID: 58153032, Comparison: same

FINAL REPORT

HISTORY: ___-year-old with CHF exacerbation, interval change status post diuresis.

TECHNIQUE: Portable AP frontal chest radiograph was obtained.

COMPARISON: Chest radiograph from ___.

FINDINGS: Continued bilateral pleural effusions are seen. The right pleural effusion has layered which are likely secondary to patient position. There is continued enlargement of the cardiac silhouette with unchanged pulmonary vascular congestion   Keywords: unchanged.

IMPRESSION: Unchanged bilateral pleural effusions, cardiomegaly and pulmonary congestion   Keywords: unchanged.


SubjectID: 17725106, StudyID: 54867658, Comparison: same

FINAL REPORT

INDICATION: History of CHF exacerbation, who is now improved. Please evaluate for interval change in pulmonary edema.

COMPARISON: Multiple chest radiographs dated back to ___.

TECHNIQUE: Single portable exam of the chest.

FINDINGS: Again seen moderate cardiomegaly. There is a small right pleural effusion. Note is again made of bilateral pulmonary vascular engorgement with mild interstitial edema   Keywords: again. Stable small right pleural effusion. Again seen is bibasilar atelectasis. The left costophrenic sulcus is unremarkable.

IMPRESSION: Overall stable mild bilateral pulmonary edema   Keywords: stable.


SubjectID: 17729489, StudyID: 52337547, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with fevers // Evaluate for developing pneumonia

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the lung volumes have decreased, causing minimal atelectasis at both lung bases. However, there is no evidence of new focal parenchymal opacities suggesting pneumonia. Moderate cardiomegaly. No pulmonary edema.


SubjectID: 17729489, StudyID: 51938047, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___M with fever unknown origin// eval for pna

COMPARISON: ___.

FINDINGS: PA and lateral views of the chest provided. The lungs are clear. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen.

IMPRESSION: No convincing evidence for pneumonia.


SubjectID: 17736320, StudyID: 52575191, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with heart failure, CHF, DVT, ? underlying fibrosi vs infiltrate seen on previous CXR // please evaluate interval change in edema, and question of underlying fibrosis / infiltrate

EXAMINATION: CHEST (PORTABLE AP)

TECHNIQUE: Portable Chest radiograph, frontal view

COMPARISON: Chest radiograph ___

FINDINGS: There is diffuse reticular interstitial changes suspicious of underlying interstitial lung disease. Superimposed pulmonary edema is unchanged since ___   Keywords: unchanged. Considering the extensive underlying pulmonary disease, it is difficult exclude pneumonia. Cardiomediastinal silhouette is unchanged.

IMPRESSION: 1. Diffuse reticular interstitial changes suspicious of underlying interstitial lung disease. If clinically indicated, further evaluation with CT is recommended. 2. Pulmonary edema is unchanged   Keywords: unchanged. Pneumonia is difficult to exclude given the underlying pulmonary disease.


SubjectID: 17736320, StudyID: 50762469, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with pulmonary edema and heart failure. Please evaluate for pulmonary edema and cardiomegaly.

TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position.

COMPARISON: None available.

FINDINGS: There are low lung volumes, and the heart is moderately enlarged. Vascular congestion is accompanied by bilateral reticular opacities in the mid and lower lungs as well as superimposed heterogenous consolidatin in the right mid and lower lung.

IMPRESSION: 1. Cardiomegaly with pulmonary vascular congestion. 2. Right mid and lower lung heterogeneous consolidation may represent pneumonia or asymmetrical edema, likely superimposed upon chronic underlying fibrotic lung disease. Recommend short term follow up PA and lateral chest radiograph following diuresis. HRCT may be helpful for more complete characterization of the interstitium.


SubjectID: 17741310, StudyID: 57008664, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male post-pericardiocentesis with dyspnea.

COMPARISON: ___. CHEST, AP: Endotracheal and nasogastric tubes have been removed. Changes of median sternotomy, with continued leftward displacement of the fourth inferiomost sternal wire. There is continued moderate-to-severe enlargement of the cardiac silhouette. Pulmonary aeration is slightly improved, with residual left lower lobe atelectasis. Stable central venous congestion and interstitial pulmonary edema. Small bilateral pleural effusions are unchanged.

IMPRESSION: 1. ETT and NGT removal. 2. Moderate-to-severe cardiomegaly and pulmonary edema. 3. Slightly improved pulmonary aeration.


SubjectID: 17741310, StudyID: 52131401, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post intubation, evaluation of ETT placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The patient has received an endotracheal tube, the tip projects 3 cm above the carina. The patient has also received a nasogastric tube, the tip of the tube is not visible on the current image. The course of the tube is unremarkable. There is no evidence of complications, notably no pneumothorax. The left-sided PICC line is unchanged. Unchanged cardiomegaly. Extensive basal atelectasis. The presence of a small left pleural effusion cannot be excluded. The signs indicative of mild fluid overload are constant.


SubjectID: 17741310, StudyID: 56626298, Comparison: same

FINAL REPORT

CHEST ON ___

HISTORY: High chest tube drainage and sternal incision drainage. Check wires.

FINDINGS: Lung volumes are low with bilateral volume loss/infiltrate. Left-sided PICC line is again seen. The right IJ Cordis has been removed. There continues to be vascular plethora of pulmonary vascular redistribution and some patchy areas of alveolar infiltrate compatible fluid overload and infectious process in the lower lobes cannot be excluded   Keywords: continue. Left-sided chest tube is again seen. Sternal wires appear intact.


SubjectID: 17741310, StudyID: 51547906, Comparison: None

FINAL REPORT

CHEST ON ___

HISTORY: Status post chest tube pull, question pneumothorax.

FINDINGS: The left lower chest tube has been removed. The left upper chest tube is still in place. There is a small left apical pneumothorax, similar in size compared to the study from the prior day. Mild pulmonary vascular redistribution and volume loss in both lower lobes. Sternal wires are again visualized.


SubjectID: 17741310, StudyID: 55166972, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior study from ___. CLINICAL

HISTORY: Short of breath.

FINDINGS: AP upright chest radiograph is obtained. Midline sternotomy wires are noted. A PICC line again noted entering the left arm with tip residing in the region of the superior vena cava. The previously noted left apical pneumothorax is not clearly visualized and may have resolved in the interval. There is marked cardiomegaly with mild interstitial edema. Retrocardiac opacity is noted which could in part reflect an underpenetrated technique, though the possibility of effusion and consolidation is difficult to exclude. Bony structures appear grossly intact.

IMPRESSION: Marked cardiomegaly with retrocardiac opacity which could in part reflect an underpenetrated technique, though consolidation and effusion cannot be excluded on the basis of this exam. Interval resolution of left apical pneumothorax. Mild interstitial edema noted. Consider dedicated PA and lateral views to further assess.


SubjectID: 17767787, StudyID: 57698526, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with basal ganglia bleed // atelectasis, desaturation

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Cardiac size is top-normal. New opacities in the lower lobes right greater than left could be atelectasis but superimposed infection cannot be excluded in the appropriate clinical setting. There is no pneumothorax. If any there are small bilateral effusions. There is mild vascular congestion.


SubjectID: 17767787, StudyID: 50866138, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with basal ganglia hemorrhage, previously wet CXR // Please eval interval change Please eval interval change

IMPRESSION: In comparison with the study of ___, the cardiac size remains at the upper limits of normal. Bibasilar opacifications again suggests layering effusions with compressive atelectasis. However, in the appropriate clinical setting, superimposed pneumonia would have to be considered. There is mild indistinctness of pulmonary vessels, suggesting some elevation of pulmonary venous pressure.


SubjectID: 17775167, StudyID: 52433925, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with COPD. Evaluate for pneumonia.

COMPARISON: ___. PA AND LATERAL CHEST: In comparison to prior study, ill-defined opacities are again seen projecting over the right upper lobe and left upper lobe laterally. The lung bases remain clear. The lungs are hyperexpanded, with flattening of the hemidiaphragms suggesting underlying COPD. There is no effusion. There is no pneumothorax. Hilar and cardiomediastinal contours are normal. There is no pulmonary vascular congestion or edema. Degenerative changes are seen in the thoracic spine.

IMPRESSION: Little change in ill-defined bilateral upper lobe opacities compared to one day prior. The chronicity of these remains indeterminate. Early pneumonia could be considered in the proper clinical setting, though this could represent chronic scarring. Comparison with more remote imaging is recommended. Hyperinflation compatible with known COPD.


SubjectID: 17775167, StudyID: 51600455, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST, ___ AT ___ HOURS

HISTORY: Shortness of breath with wheezes and crackles.

COMPARISON: None.

FINDINGS: The lungs are hyperexpanded consistent with underlying obstructive lung disease. There is predominantly streaky linear opacity laterally in the left upper lung likely in the posterior segment of the left upper lobe when corroborated with the lateral view. Ill-defined opacities are seen in the right suprahilar region as well. No superimposed edema is noted. The mediastinum is unremarkable. The cardiac silhouette is within normal limits for size. No effusion or pneumothorax is noted. The visualized osseous structures are unremarkable.

IMPRESSION: Ill-defined densities laterally in both upper lungs. No comparisons to assess for chronicity of these findings. If acute they could represent early multifocal pneumonia. Conceivably however these could represent scarring which can be confirmed with prior radiographs.


SubjectID: 17783442, StudyID: 54769893, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with leukocytosis to ___ // ?pneumonia?

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: None

IMPRESSION: Right internal jugular line terminates in the right atrium and should be pulled back at least 3 cm to secure it position at the cavoatrial junction or above. Heart size is enlarged. Mediastinal contours are stable. There is left retrocardiac opacity, that potentially might represent a combination of atelectasis and pleural effusion although infectious process is at definitive possibility. Right upper lobe opacity is noted, faint but might represent developing infection as well. Small amount of left pleural effusion and even smaller amount of right pleural effusion is present. There is no pulmonary edema.


SubjectID: 17783442, StudyID: 53311284, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with chf worsening sob // ?falsh pulmonary edema

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the patient has developed mild to moderate pulmonary edema, manifested by an increase in vascular diameters and an increase in bronchial interstitium   Keywords: increase, develop. No larger pleural effusions. Borderline size of the cardiac silhouette.


SubjectID: 17784248, StudyID: 58918481, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post thoracocentesis, followup.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has undergone thoracocentesis. A substantial part of the pre-existing left pleural effusion has been drained. A minimal amount of effusion remains, visible at the level of the costophrenic sinus. Potentially post-effusion, pleural thickening on the left. Elevation of the left hemidiaphragm, fibrotic changes at the lung parenchyma after radiation and the clips in the left axillary region are constant in appearance.


SubjectID: 17784248, StudyID: 58356772, Comparison: None

FINAL REPORT

HISTORY: Breast cancer and left pleural effusion status post chest tube. Evaluate for interval change.

COMPARISON: ___.

FINDINGS: Frontal and lateral radiographs of the chest when compared to the prior study demonstrates increased lung volumes with hyperinflation, flattening of the diaphragms, and increased AP diameter, consistent with emphysematous change. Moderate left pleural effusion is relatively unchanged. The cardiac and mediastinal contours are normal. Surgical clips are again noted in the left axilla, likely from breast surgery. Left apicolateral lung fibrosis is seen, likely post-radiation changes. Calcified aortic knob is again seen.

IMPRESSION: Interval increase in lung volumes with minimal change in moderate left pleural effusion.


SubjectID: 17784248, StudyID: 56437890, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with dyspnea.

TECHNIQUE: PA and lateral chest radiographs were obtained.

COMPARISON: Chest radiograph from ___.

FINDINGS: Left apical pleural and parenchymal fibrosis with associated volume loss is consistent with radiation fibrosis in the setting of previous left mastectomy. There is no focal consolidation, pleural effusion or pneumothorax. The heart is mildly enlarged, and mediastinal and hilar contours are normal. Surgical clips projecting over the left axilla and right upper abdominal quadrant are again noted. Scoliosis is noted.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 17784248, StudyID: 54932140, Comparison: None

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___F with new picc line placement // eval picc line placement ___.5cm

TECHNIQUE: Portable AP upright view of the chest

COMPARISON: Chest radiograph ___ 4:39 AM

FINDINGS: There has been interval placement of a PICC which terminates at the level of the low SVC. There is no pneumothorax. Cardiomediastinal silhouette is unremarkable. Heart size may be exaggerated on this AP radiograph. Left apical scarring likely secondary to radiation are again seen. Surgical clips projecting over the left axilla and right upper lobe are again noted. Patient is status post left mastectomy.

IMPRESSION: Interval placement of a PICC tip terminates at the low SVC without pneumothorax.


SubjectID: 17784248, StudyID: 54682102, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Breast cancer, pleural effusion, rule out pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient now shows a 5-6 mm left apical pneumothorax. The left basal air inclusion has decreased in extent. No evidence of tension. Unchanged position of the left pleural catheter. The opacities in the right lung have minimally decreased in severity.


SubjectID: 17784248, StudyID: 50255148, Comparison: None

FINAL REPORT

HISTORY: Breast cancer and radiation with nonproductive cough.

COMPARISON: None.

FINDINGS: 2 views were obtained of the chest. Moderate-sized left pleural effusion may be loculated and is located anteriorly with accompanying opacification of the left lung base which may reflect compressive atelectasis though a component of infectious pathology cannot be excluded. Left apical pleural thickening and surrounding interstitial abnormality is of uncertain acuity given absence of prior studies though in the setting of prior breast cancer, this could reflect post radiation changes. Mild right basilar opacity is also of uncertain significance and could reflect atelectasis or infectious process. The heart and mediastinum are unremarkable though slightly shifted to the right. No pneumothorax.

IMPRESSION: Possibly loculated left pleural effusion with bibasilar opacities which could reflect atelectasis or infection. Left apical pleural and parenchymal changes are of uncertain acuity and may relate to prior radiation therapy.


SubjectID: 17798591, StudyID: 59583490, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF, intubated // assess volume status assess volume status

IMPRESSION: In comparison with study ___ ___, the endotracheal tube has been removed. Continued relatively low lung volumes with enlargement of the cardiac silhouette and pulmonary vascular congestion. Blunting of the left costophrenic angle again suggests pleural effusion with possible basilar atelectatic changes.


SubjectID: 17798591, StudyID: 56592236, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___F with HFpEF, AFib, CKD, p/w abdominal pain and fever; infectious work-up

COMPARISON: Prior study from ___

FINDINGS: PA and lateral views of the chest provided. Lungs are clear. No focal consolidation concerning for pneumonia. No large effusion or pneumothorax. There is probable mild hilar congestion without frank edema. Cardiomediastinal silhouette is unchanged. A retrocardiac opacity represents known hiatal hernia. DISH related changes of the T-spine noted. No acute bony injury.

IMPRESSION: Probable mild hilar congestion without frank edema. Hiatal hernia.


SubjectID: 17798591, StudyID: 54551983, Comparison: same

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___F AF (Coumadin), CHF p/w 3 days abd pain, nausea, fever today to ___ s/p ex lap, ___'s // ETT position

TECHNIQUE: Portable AP chest

COMPARISON: ___ PA and lateral chest radiographs

FINDINGS: Compared 1 day prior, there has been interval intubation. The endotracheal tube terminates 4.1 cm above the carina. Given the course of radiopaque tubing projecting over the upper left lung, this is likely external to the patient. Mild pulmonary vascular congestion is present. No pulmonary edema. No large pleural effusion or pneumothorax.

IMPRESSION: Interval intubation with an endotracheal tube terminating 4.1 cm above the carina. Otherwise, no significant change   Keywords: no significant change.


SubjectID: 17799305, StudyID: 56455216, Comparison: worse

FINAL REPORT

REASON FOR

EXAMINATION: Dyspnea, evaluation of the patient after ERCP. Portable AP radiograph of the chest was reviewed in comparison to ___. There is mild interstitial pulmonary edema, grossly unchanged since the prior study. Left retrocardiac opacity appears to be unchanged, but there is interval progression of right basal opacity. Small bilateral pleural effusion is present. No pneumothorax is seen.

IMPRESSION: Slight interval progression of left retrocardiac consolidation and interstitial pulmonary edema   Keywords: progression.


SubjectID: 17799305, StudyID: 56229100, Comparison: None

WET READ: ___ ___ 9:01 PM Pt is rotated. There is mild widening of the mediastinum with medialization of the aortic calcifications. No comparisons are available to assess for change. If there is concern for aortic pathology, this could represent intramural hematoma or dissection. Alternatively, it could be due to the rotation. Consider follow up with a PA/lateral. If concern for aortic pathology, could get a CTA. There is probable cardiomegaly, although again difficult to determine due to rotation. No definite retrocardiac opacity, but small effusion or early left basilar pneumonia cannot be fully excluded. Again, a lateral view would be helpful. ______________________________________________________________________________

FINAL REPORT

HISTORY: Infiltrate, effusion, cough. CHEST, SINGLE AP PORTABLE VIEW. No previous chest x-rays on PACS record for comparison. Rotated positioning. Allowing for this, there is probable cardiomegaly, together with prominence of the superior mediastinum. The aortic calcifications may be medialized. There is increased retrocardiac density, consistent with left lower lobe collapse and/or consolidation. Doubt CHF. Atelectasis at right base and possible minimal pleural fluid in the right costophrenic angle. ? tiny calcified granuloma right upper zone.

IMPRESSION: 1. Prominence of the cardiomediastinal silhouette and possible distortion of the aortic calcifications. While this may be accentuated by rotation, it raises the question of aortic pathology/hematoma. If clinically indicated, PA and lateral chest radiographs or, alternatively, a CTA could help for further assessment. Please see wet reading provided by radiology resident, Dr. ___, on the evening of ___. 2. Patchy retrocardiac opacity suggesting left lower lobe collapse and/or consolidation. This, too, could be more definitively assessed on a PA and lateral CXR or on a CT scan.


SubjectID: 17799996, StudyID: 59830518, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: CLL, chest tube placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is unchanged evidence of a right pleural pigtail catheter, a right subclavian line, an endotracheal tube and a nasogastric tube. No additional chest tube is visualized. The lung volumes are unchanged, with bilateral pleural effusions, some of which appear intrafissural and loculated. Moderate cardiomegaly with mild fluid overload. No evidence of pneumonia.


SubjectID: 17799996, StudyID: 59442270, Comparison: better

FINAL REPORT

HISTORY: Bacteremia with intubation.

FINDINGS: In comparison with the study of ___, the monitoring and support devices are in unchanged position. Right pigtail catheter remains in place and the degree of loculated effusion is essentially unchanged. The left effusion may be slightly reduced with continued atelectatic changes at the left base. The degree of pulmonary vascular congestion is decreasing   Keywords: decreasing.


SubjectID: 17799996, StudyID: 53744283, Comparison: None

FINAL REPORT

CLINICAL

HISTORY: CLL, hypoxic respiratory distress from pneumosepsis complicated by empyema. CHEST: The positions of the endotracheal tube, nasogastric tube, and pigtail catheter are unchanged. Increased opacities are seen in the right lung indicating fluid in the greater and lesser fissures. Left effusion is also present. Increased retrocardiac density is again noted, consistent with atelectasis, though pneumonia is not excluded in this region. Upper zone redistribution is still present.

IMPRESSION: Increasing pleural fluid, particularly in the right greater and lesser fissures.


SubjectID: 17799996, StudyID: 51498968, Comparison: None

FINAL REPORT

PORTABLE CHEST OF ___

COMPARISON: ___ radiograph.

FINDINGS: Indwelling support and monitoring devices are unchanged in position. Right pigtail pleural catheter remains in place, with persistent moderate to large loculated right pleural effusion with a dominant loculated component within the right major fissure, unchanged. Moderate partially loculated left pleural effusion has improved, along with an adjacent area of atelectasis at the left lung base. Heterogeneous opacities in the right lower lung have also slightly improved and may reflect a combination of pneumonic consolidation and interstitial edema.


SubjectID: 17799996, StudyID: 51228600, Comparison: better

FINAL REPORT

HISTORY: ___-year-old female with a history of relapsed chronic lymphocytic leukemia, now admitted with septic shock. STUDY: Portable AP upright chest radiograph.

COMPARISON: ___.

FINDINGS/

IMPRESSION: The endotracheal tube tip seats 4 cm above the carina. The endogastric tube courses inferiorly out of the field of view. The right-sided subclavian line tip terminates in the low SVC. The right-sided pleural pigtail catheter projects over the left lower chest. The heart size and mediastinal contours are within normal limits. The lung volumes are low with retrocardiac atelectasis. Blunting of the left costophrenic angle suggests small pleural effusion there. An ovoid density projecting over the right mid lung field likely reflects pleural fluid trapped within the major fissure, with mildly increasing right pleural effusion. Overall, the lungs demonstrate gradually improving edema   Keywords: improving.


SubjectID: 17799996, StudyID: 59567517, Comparison: worse

WET READ: ___ ___ 7:06 PM stable positioning of monitoring devices. interval placement of the pigtail ___ which projects over left lung base. subtle lucencies in the left lung base may represent trace pneumothorax. left pleural effusion has significantly improved now small. right pleural effusion is unchanged. ___ ___

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

PORTABLE AP CHEST FILM ___ AT ___ CLINICAL

INDICATION: ___-year-old with right chest tube, assess for pneumothorax. Comparison made to prior study of ___ at 452. A portable semi-erect chest film ___ at ___ is submitted.

IMPRESSION: 1. Endotracheal tube has its tip at the thoracic inlet. The nasogastric tube is seen coursing below the diaphragm with the tip not identified. Left internal jugular central line has its tip in the mid to distal SVC, unchanged. There has been interval placement of a left basilar chest tube with improvement in aeration of the left lung and some loculated air along the lateral and medial basilar aspects of the lower lobe likely representing loculated pneumothorax. Small right pleural effusion remains. There is increasing indistinctness of the pulmonary vascularity which likely represents an element of superimposed mild pulmonary and interstitial edema   Keywords: increasing. Overall, cardiac and mediastinal contours are stable.


SubjectID: 17799996, StudyID: 58854579, Comparison: None

FINAL REPORT

PORTABLE AP CHEST FILM, ___ AT 13:28 CLINICAL

INDICATION: ___-year-old with right pleural effusion status post chest tube, assess pneumothorax. Comparison is made to the patient's prior study dated ___ at 4:03. Portable semi-erect chest film, ___ at 13:28 is submitted.

IMPRESSION: 1. Internal jugular central line, endotracheal tube, nasogastric tube, basilar chest tube are unchanged. There has been interval placement of a right basilar pigtail catheter into the right pleural space, with interval decrease in size of a small right effusion. No right-sided pneumothorax is appreciated. There continues to be air loculated medially and laterally at the left lung base. There is streaky patchy opacity at the left base as well, likely reflecting residual atelectasis. Overall, the pulmonary vasculature appears somewhat less well defined, raising concern for superimposed interstitial edema. Clinical correlation is advised. Overall, cardiac and mediastinal contours are likely stable.


SubjectID: 17799996, StudyID: 57561715, Comparison: None

FINAL REPORT

INDICATION: Assessment for congestive heart failure and reassessment of pleural effusions in a patient with shortness of breath and a history of refractory CLL.

COMPARISON: Multiple chest radiographs, the most recent of ___.

FINDINGS: PA and lateral views of the chest were reviewed and compared to the prior studies. A left subclavian line ends in the low superior vena cava. Small right and moderate left pleural effusions have minimally increased since ___. Otherwise, the lungs are clear without focal consolidation, pulmonary edema or vascular congestion. There is no pneumothorax. The cardiac and mediastinal contours are normal.

IMPRESSION: Small right and moderate left pleural effusions have minimally increased since ___. Findings were telephoned to ___, NP by Dr. ___ at 1:29 p.m., five minutes after the discovery.


SubjectID: 17799996, StudyID: 57061963, Comparison: 0.0

FINAL REPORT

PORTABLE CHEST, ___ AT 4:03 CLINICAL

INDICATION: ___-year-old, assess endotracheal tube placement. Comparison to ___ at 17:36. A portable upright chest from ___ at 4 a.m. is submitted.

IMPRESSION: 1. Endotracheal tube, nasogastric tube, left internal jugular central line and left basilar chest tube remains unchanged in position. 2. Interval improvement in the mild pulmonary and interstitial edema   Keywords: improve. There is persistent streaky opacities within the re-expanded left lung, suggestive of atelectasis or re-expansion pulmonary edema   Keywords: persistent. There continues to be a loculated pneumothorax medially and laterally at the left base, not significantly changed. Overall, cardiac and mediastinal contours are likely stable given patient rotation. Stable small right pleural effusion.


SubjectID: 17799996, StudyID: 56631599, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Mitral valve replacement. Evaluation of the endotracheal tube position.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the monitoring and support devices are in constant position. The left PICC line has been pulled out in the interval. Increasing amounts of pleural effusions bilaterally, more evident on the left than on the right. Extensive areas of basal atelectasis. Borderline size of the cardiac silhouette.


SubjectID: 17799996, StudyID: 55198012, Comparison: better

FINAL REPORT

PORTABLE CHEST RADIOGRAPH ___

COMPARISON: Chest x-ray ___.

FINDINGS: Pigtail pleural catheter remains in place in the lower left hemithorax with decrease in adjacent pleural fluid, but overall moderate pleural effusion persists with loculated component in the left mid and upper hemithorax. No visible pneumothorax on this semi-upright radiograph. Left lower lobe opacities have improved compared the to previous radiograph with residual patchy and linear opacities remaining   Keywords: improve. On the right, pigtail pleural catheter remains in place at the right lung base, with no visible right pneumothorax, and no substantial pleural effusion. Minimal linear atelectasis persists at the right base. Indwelling support and monitoring devices remain in standard position, and cardiac silhouette is upper limits of normal in size.


SubjectID: 17799996, StudyID: 57666851, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Loculated effusion, evaluation for chest tube position.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is now a right-sided deep sulcus sign, strongly suggesting a right pneumothorax. There is atelectasis at the right lung base. The position of the bilateral chest tubes is constant. The other monitoring and support devices are also constant. Unchanged small atelectasis at the left lung bases and left pleural effusion.


SubjectID: 17799996, StudyID: 54799674, Comparison: None

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient intubated, empyema, interval change.

COMPARISON: ___ to ___.

FINDINGS: Right-sided pigtail still projects at the lung base. There is no visible pneumothorax. Moderate loculation inside the right major and minor fissure is unchanged. Left small pleural effusion with adjacent atelectasis is stable. ET tube ends 3.1 cm above the carina. NG tube is in the stomach. Mediastinal and cardiac contours are normal.

CONCLUSION: 1. Stable moderate right loculated fissural effusion and small left pleural effusion. 2. Tube and lines are in adequate position.


SubjectID: 17799996, StudyID: 51313980, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Loculated effusion, status post washout, evaluation for chest tubes.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the right pigtail catheter has been removed and two new right chest tubes have been inserted. The other monitoring and support devices are constant. There is a loss in volume of the right lung, but no pneumothorax is clearly visible. Air collection at the site of tube insertion. Small left pleural effusion with areas of atelectasis. Unchanged appearance of the cardiac silhouette. The nasogastric tube is currently coiled in the stomach, with the tip pointing back towards the gastroesophageal junction.


SubjectID: 17799996, StudyID: 59099638, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Refractory CLL, intubation, sedation, orogastric tube placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the orogastric tube has been advanced, as recommended. The tip of the tube now projects over the mid to distal parts of the stomach. The extensive pulmonary edema, combined to bilateral pleural effusions, is unchanged in extent and severity   Keywords: unchanged. Unchanged appearance of the cardiac silhouette. The other monitoring and support devices, including a left PICC line and an endotracheal tube are unchanged.


SubjectID: 17799996, StudyID: 58629900, Comparison: None

WET READ: ___ ___ ___ 8:01 PM Right subclavian central venous catheter in improved position with tip in the low SVC. Right basilar pleural pigtail catheter without significant pneumothorax. Improved aeration of the right lung base with persistent opacification of the left lung base from the most recent prior study. ______________________________________________________________________________

FINAL REPORT

HISTORY: Right-sided chest tube, to assess for pneumothorax.

FINDINGS: In comparison with study of ___, there has been placement of a pigtail catheter with its tip at the cardiophrenic angle. No evidence of pneumothorax. Substantial reduction in the amount of fluid in the right chest with concomitant expanded aeration. Retrocardiac and left basilar opacification persist, consistent with atelectasis and effusion. The right central catheter has been re-positioned with the tip in the low SVC. Endotracheal tube and nasogastric tube remain in good position.


SubjectID: 17799996, StudyID: 55300909, Comparison: None

FINAL REPORT

PORTABLE CHEST RADIOGRAPH, ___.

COMPARISON: ___ radiograph.

FINDINGS: Indwelling support and monitoring devices are in standard position, and cardiomediastinal contours are stable compared to the prior radiograph. Left pigtail pleural catheter remains in place in the left hemithorax with a persistent moderate-size partially-loculated left pleural effusion. Right-sided pigtail pleural catheter also remains in place, with a tiny right apical pneumothorax. Mild pulmonary vascular congestion is accompanied by interstitial edema. Additional multifocal patchy opacities in the lingula and both lung bases may reflect patchy atelectasis or developing infection.


SubjectID: 17799996, StudyID: 58655961, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: CLL, status post VATS, evaluation.

COMPARISON: ___.

FINDINGS: Compared to the previous radiograph, the extent of the left basal pleural thickening is minimally decreased. Also minimally decreased is the effusion on the right and the subsequent areas of atelectasis. There is no visible pneumothorax. The PICC line is unchanged. Moderate cardiomegaly. No pulmonary edema.


SubjectID: 17799996, StudyID: 57271779, Comparison: same

FINAL REPORT

INDICATION: ___-year-old female, status post left VATS, washout, and decortication for a left empyema, who presents for evaluation of pneumothorax, status post chest tube removal.

COMPARISONS: Chest radiographs from ___, ___, and ___.

TECHNIQUE: Single AP portable exam of the chest.

FINDINGS: There has been interval removal of a chest tube. The moderate bilateral pleural effusions are stable. There is a left-sided PIC line which appears to terminate in the lower SVC. The diffuse pulmonary edema is stable   Keywords: stable. The heart size is normal. The hilar and mediastinal contours are stable.

IMPRESSION: Interval removal of the left-sided chest tube. No pneumothorax.


SubjectID: 17799996, StudyID: 57058420, Comparison: None

FINAL REPORT

HISTORY: CLL with worsening respiratory status.

FINDINGS: In comparison with the earlier study of this date, there is increasing opacification at the left base consistent with some combination of pleural fluid, worsening volume loss, and supervening pneumonia. Monitoring and support devices are essentially unchanged. No definite rib fracture is appreciated, though appropriate oblique views could be obtained as a more sensitive diagnostic technique.


SubjectID: 17799996, StudyID: 51117961, Comparison: None

FINAL REPORT

HISTORY: VATS decortication. One left-sided chest tube removed. Evaluation for interval change.

COMPARISON: ___.

FINDINGS: Portable AP chest radiograph demonstrates 1 of 3 left-sided chest tubes has been removed. There is no pneumothorax. Moderate bilateral pleural effusions are not significantly changed. Right-sided PICC is in stable position in the low SVC. The cardiomediastinal silhouette is stable.

IMPRESSION: No pneumothorax.


SubjectID: 17799996, StudyID: 56451649, Comparison: same

FINAL REPORT

HISTORY: ___-year-old female with left empyema status post VATS decortication.

TECHNIQUE: Single frontal chest radiograph was obtained portably with the patient in an upright position.

COMPARISON: ___.

FINDINGS: There has been interval removal of the left internal jugular catheter. Right PICC and 3 left chest tubes appear similarly positioned. Right pleural effusion has decreased. Moderate left vascular congestion, edema, and atelectasis appear unchanged   Keywords: unchanged. Small left pleural effusion persists. No pneumothorax is detected, aside from a sliver of left pleural air. Heart and mediastinal contours appear unchanged.

IMPRESSION: Interval removal of left internal jugular catheter. Decreased right pleural effusion and stable appearance of the left hemithorax.


SubjectID: 17799996, StudyID: 55214499, Comparison: same

FINAL REPORT

AP CHEST, 4:08 A.M. ON ___

HISTORY: ___-year-old woman on mechanical ventilation. Assess ET tube placement.

IMPRESSION: AP chest compared to ___: Tip of the endotracheal tube is above the upper margin of the clavicles, no less than 47 mm from the carina. It should be advanced 15 mm for more secure seating. Left pleural effusion has effectively cleared and basal pneumothorax is minimal if any, with two left apical and a basal thoracostomy tube in place. Moderate-to-large right pleural effusion is probably increasing. Mild-to-moderate cardiomegaly is stable. Pulmonary edema is mild, and unchanged   Keywords: unchanged. Left internal jugular line ends in the mid-to-low SVC. No right pneumothorax.


SubjectID: 17799996, StudyID: 50136404, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Bilateral pigtail catheters, evaluation of questionable right apical pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has been extubated and the nasogastric tube has been removed. The bilateral pigtail catheters in the pleural space are unchanged. On the left, there is a deep sulcus sign, suggesting a moderate ventral left pneumothorax. No left apical pneumothorax is seen. On the right, there is no noticeable pneumothorax. Bilaterally, the scapula projects over the lung fields, thereby increasing the radiodensity. Moderate pulmonary edema. Retrocardiac atelectasis. Unchanged left internal jugular vein catheter. At the time of observation and dictation, 10:03 a.m., ___, the referring physician, ___. ___ was paged for notification.


SubjectID: 17805562, StudyID: 57591342, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with s/p mvr and cabg // s/p ct removal

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the bilateral chest tubes have been removed. The mediastinal drains are also removed. There is no convincing evidence for the presence of a pneumothorax. No larger pleural effusions. The Swan-Ganz catheter is in unchanged normal position. Moderate cardiomegaly persists. Unchanged alignment of sternal wires.


SubjectID: 17805562, StudyID: 51902909, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p mvr cabg-hct drop // assess for hemothorax

COMPARISON: ___

IMPRESSION: As compared to the previous image, the patient has been extubated and the nasogastric tube has been removed. The other monitoring and support devices remain in situ. No pneumothorax. Normal size of the cardiac silhouette with minimally improved retrocardiac ventilation. No larger pleural effusions. Unchanged alignment of sternal wires.


SubjectID: 17818329, StudyID: 56453878, Comparison: same

WET READ: ___ ___ ___ 10:46 AM Slightly increased right greater than left moderate pleural effusions and associated atelectasis from ___ with unchanged mild pulmonary vascular congestion   Keywords: unchanged. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: PORTABLE CHEST RADIOGRAPH

INDICATION: ___-year-old woman with dyspnea.

TECHNIQUE: Portable upright frontal radiograph of the chest.

COMPARISON: ___ and ___.

FINDINGS: A right pectoral pacemaker with dual leads is unchanged. The patient is status post CoreValve. Multiple vertebral kyphoplasty use are re- demonstrated. There is slightly increased opacification of both lung bases with moderate bilateral pleural effusions on the right greater than the left and associated atelectasis. There is mild pulmonary vascular congestion, which is unchanged   Keywords: unchanged. No pneumothorax is seen. The cardiac silhouette cannot be evaluated in the setting of bibasilar opacification. The mediastinal contours are unchanged. Multiple vertebroplasties are again noted.

IMPRESSION: Slightly increased right greater than left moderate pleural effusions and associated atelectasis from ___ with unchanged mild pulmonary vascular congestion.


SubjectID: 17818329, StudyID: 52597567, Comparison: worse

FINAL REPORT

EXAMINATION: Chest radiograph.

INDICATION: Worsening dyspnea.

COMPARISON: Earlier on the same day.

TECHNIQUE: Chest, portable AP upright.

FINDINGS: An endovascular aortic valve repair is noted in addition to a dual-lead pacemaker/ICD device. The heart is again enlarged. The cardiac, mediastinal and hilar contours appear similar. In addition to small to moderate bilateral pleural effusions, which are probably unchanged, there is increased prominence of pulmonary vasculature. This suggests mild but worsening pulmonary edema   Keywords: worse. Multiple vertebroplasty sites are again noted.

IMPRESSION: Mild but worsening pulmonary edema   Keywords: worse. Stable moderate pleural effusions.


SubjectID: 17818329, StudyID: 51971762, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with recent TAVR, AS, COPD, diastolic CHF p/w dyspnea s/p diuresis // Interval improvement in lung fields

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the lung volumes have slightly increased. However, there is evidence of mild pulmonary edema. A pre-existing left pleural effusion is constant. On the right, the pleural effusion has minimally decreased but the areas of right basilar atelectasis are unchanged. Moderate cardiomegaly. Right pectoral pacemaker.


SubjectID: 17818329, StudyID: 55564486, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with s/p TAVR, triggered for dyspnea and AF w/ RVR // interval changes interval changes

IMPRESSION: In comparison with the earlier study of this date, there is little change   Keywords: little change. Enlargement of the cardiac silhouette process along with pulmonary edema and bilateral pleural effusions with atelectatic changes at the bases. Monitoring and support devices are essentially unchanged.


SubjectID: 17818329, StudyID: 52053939, Comparison: same

FINAL REPORT

INDICATION: Sudden dyspnea.

COMPARISON: Chest radiograph from ___.

TECHNIQUE: Frontal chest radiograph.

FINDINGS: A right-sided cardiac pacemaker projecting leads into the right atrium and ventricle, right IJ catheter terminating at the cavoatrial junction, and the kyphoplasty cement are unchanged in configuration and positioning since the ___ examination. Mild cardiomegaly with central pulmonary vascular congestion and pulmonary edema is stable   Keywords: stable. A left retrocardiac opacity, likely reflecting atelectasis, is unchanged. Small bilateral pleural effusions are stable. There is no pneumothorax.

IMPRESSION: Unchanged mild central pulmonary vascular congestion and pulmonary edema since ___   Keywords: unchanged. Stable small bilateral pleural effusions.


SubjectID: 17824494, StudyID: 56711851, Comparison: None

FINAL REPORT

HISTORY: Bilateral lower extremity swelling, history of cancer and left upper extremity swelling.

TECHNIQUE: PA and lateral views of the chest.

COMPARISON: ___, ___.

FINDINGS: Heart size is moderately enlarged. Mediastinal contours unremarkable. Hyperinflation of the lungs is suggestive of underlying chronic obstructive pulmonary disease. Large left pleural effusion is noted with retrocardiac opacity likely reflective of atelectasis. Infection is not excluded. No pneumothorax is noted. Mild pulmonary vascular congestion may be present. The right lung is grossly clear. No acute osseous abnormalities seen. Multiple left axillary clips are demonstrated.

IMPRESSION: Large left pleural effusion with left basilar opacity likely reflective of atelectasis though infection is not excluded. Probable mild pulmonary vascular congestion.


SubjectID: 17824494, StudyID: 56612351, Comparison: same

WET READ: ___ ___ 7:02 PM interval placement of the left sided chest tube, which projects over left lung base. no sinificant change in large left pleural effusion and left lung base consolidation, likely atelectasis vs infection. worsening interstitial pulmonary edema. no appreciable pneumothorax. ___ ___

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Left chest tube, evaluation for pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has received a left chest tube. The tube is in correct position. The extent of the pre-existing left pleural effusion has substantially decreased. A small effusion at the level of the costophrenic sinus persists. Correct position of the left pigtail catheter. There is no evidence of pneumothorax. Otherwise, the radiograph is unchanged, with moderate cardiomegaly, mild fluid overload, and axillary left-sided clips   Keywords: unchanged.


SubjectID: 17824494, StudyID: 52795795, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Left pleural effusion, status post drainage.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is unchanged position of the left pigtail catheter. No pneumothorax. Decrease of the left pleural effusion. No other relevant changes   Keywords: no other relevant change. Constant cardiomegaly.


SubjectID: 17824494, StudyID: 51475918, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female patient with pleural effusions, status post thoracocentesis and now removal of pigtail. Study requested for evaluation of pneumothorax and interval change of effusion.

COMPARISON: Prior chest radiograph from ___ through ___.

TECHNIQUE: PA and lateral chest radiographs.

FINDINGS: Compared to prior radiograph from ___, there has been interval removal of the left pigtail catheter. There is no pneumothorax. The extent of the left pleural effusion has decreased. A small left sided effusion persists. There is retrocardiac atelectasis. The heart is enlarged. Surgical clips are seen within the left axilla.

IMPRESSION: Small left-sided pleural effusion with no evidence of pneumothorax.


SubjectID: 17838301, StudyID: 58936592, Comparison: worse

WET READ: ___ ___ 10:28 AM Findings suggesting mild pulmonary edema.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Lethargy. Question pneumonia. Patient also presents with shortness of breath.

COMPARISONS: ___.

TECHNIQUE: Chest, semi-upright AP portable.

FINDINGS: The heart is moderately enlarged. The mediastinal and hilar contours appear unchanged, allowing for differences in technique. A band-like opacity projecting over the left mid lung suggests minor atelectasis or scarring. More generally, there is mild increased opacification with indistinct pulmonary vascularity suggesting mild pulmonary vascular congestion without definite focal opacities   Keywords: increase. Calcified pleural plaques are suspected.

IMPRESSION: Findings consistent with mild pulmonary edema.


SubjectID: 17838301, StudyID: 55607397, Comparison: None

FINAL REPORT

AP CHEST, 4:45 A.M., ___

HISTORY: Improved respiratory failure.

IMPRESSION: AP chest compared to ___: Severe cardiomegaly and pulmonary vascular and hilar vascular engorgement are chronic, consistent with global heart failure and pulmonary hypertension. I do not think there is acute pulmonary edema, appreciable pleural effusion or evidence of pneumonia. Asbestos-related pleural calcifications noted.


SubjectID: 17838301, StudyID: 58449130, Comparison: None

FINAL REPORT

PORTABLE AP CHEST FROM ___ AT 5:32 CLINICAL

INDICATION: ___-year-old with AMS, concern for pneumonia. Comparison is made to the patient's previous study dated ___ at 18:26. Portable upright chest film ___ at 5:32 is submitted.

IMPRESSION: 1. The heart remains markedly enlarged which may reflect cardiomegaly, although a pericardial effusion should also be considered. There is prominence of the perihilar vasculature but no overt pulmonary edema on the current study. Calcified diaphragmatic plaques are seen suggestive of prior asbestos exposure. No focal airspace consolidation is seen to suggest pneumonia. No pneumothorax. No pleural effusions.


SubjectID: 17838301, StudyID: 57676222, Comparison: better

FINAL REPORT

EXAM: Chest, single AP upright portable view. CLINICAL INFORMATION: ___-year-old male with history of hypoxia.

COMPARISON: ___.

FINDINGS: Single AP upright portable view of the chest was obtained. The patient's overlying chin obscures the medial bilateral upper lobes. The cardiac silhouette remains enlarged. Prominence of the pulmonary arteries is partially imaged and again seen. Evidence of diaphragmatic/pleural plaques is seen bilaterally suggesting prior asbestos exposure.

IMPRESSION: The patient's chin overlies the bilateral medial upper lobes, obscuring the view. Given this, the cardiac silhouette is persistently enlarged. There is again prominence of the pulmonary arteries. Pulmonary vascular congestion appears improved   Keywords: improve.


SubjectID: 17838301, StudyID: 57255382, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Pulmonary edema, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the evidence of pulmonary edema, of moderate severity, is unchanged   Keywords: unchanged. The patient has been extubated and the nasogastric tube has been removed. Only the right internal jugular vein catheter persists. The ventilation at the left and right lung base is improved. There is unchanged evidence of scarring in the left mid lung and evidence of right basal pleural calcifications. No newly appeared focal parenchymal opacity suggesting pneumonia.


SubjectID: 17838301, StudyID: 56581318, Comparison: better

FINAL REPORT

PORTABLE CHEST OF ___

COMPARISON: Radiograph of earlier the same date.

FINDINGS: Endotracheal tube has been repositioned, now terminating about 5.2 cm above the carina. Heart remains enlarged. Rapid improvement in pulmonary edema, which is nearly resolved   Keywords: improve, resolve. More confluent opacity in right upper lobe is also improving, but difficult to fully assess due to patient rotation. Calcified pleural plaques are present, indicative of prior asbestos exposure.


SubjectID: 17838301, StudyID: 56219969, Comparison: better

FINAL REPORT

AP CHEST, 10:41 A.M. ___

HISTORY: Newly placed NG tube.

IMPRESSION: AP chest compared to ___ through ___ at 2:31 a.m.: New nasogastric tube ends in the upper stomach. Severe cardiomegaly and hilar and pulmonary vascular engorgement persists but mild interstitial edema is improving   Keywords: improving. Note is made of asbestos-related pleural calcifications, particularly along with diaphragmatic surfaces. Right jugular line ends low in the SVC. Pleural effusions are small if any. Lung apices excluded from this examination. The other pleural surfaces show no pleural air.


SubjectID: 17838301, StudyID: 50394941, Comparison: None

FINAL REPORT

INDICATION: ___-year-old, unresponsive man status post intubation, to assess tube position.

COMPARISON: Chest radiograph, ___

FINDINGS: The endotracheal tube ends approximately 2.5 cm above the carina. Moderate cardiomegaly, is unchanged since the prior study. Patchy consolidation of the right upper lobe along the mediastinal border is seen. Pleural effusions, if any, are small. Bilateral calcified pleural plaques are present. Moderate pulmonary edema is noted. The gastric tube courses through the stomach, and out of view.

IMPRESSION: 1. ET tube ends 2.5 cm above the carina, and could be withdrawn a few cm for optimal positioning. 2. Moderate pulmonary edema. Right upper lobe paramediastinal consolidation, which may represent acute infection or asymmetric edema.


SubjectID: 17843551, StudyID: 55026750, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with pacemaker implant, evaluate for pneumothorax and lead placement

COMPARISON: Chest radiograph from ___.

FINDINGS: PA and lateral views of the chest provided. Single pacemaker lead is seen terminating in the region of right ventricle. There is no pneumothorax. As compared to prior study, there is slight improvement in pulmonary edema   Keywords: improve. There is no pleural effusion. Cardiomegaly is stable. Aortic Corevalve is seen in appropriate position. Median sternotomy wires are intact.

IMPRESSION: No pneumothorax.


SubjectID: 17843551, StudyID: 53077716, Comparison: better

WET READ: ___ ___ ___ 8:06 AM Central vascular congestion/pulmonary edema, moderate cardiomegaly, and small bilateral pleural effusions are largely stable.

WET READ VERSION #1 ___ ___ ___ 7:33 PM Central vascular congestion/pulmonary edema, moderate cardiomegaly, and small bilateral pleural effusions are largely stable. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with recent TAVR and s/p PPM placement today now with run of VT. // please eval pacemaker lead placement.

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the Swan-Ganz catheter has been removed. The patient has received a left pectoral pacemaker. The previously placed external pacemaker was also removed. There is no evidence for the presence of a pneumothorax. The signs indicative of pulmonary edema have decreased in extent and severity   Keywords: decrease. Moderate cardiomegaly persists.


SubjectID: 17848200, StudyID: 59505535, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with cardiomyopathy s/p icd // lead placement and r/o pneumo

COMPARISON: ___.

IMPRESSION: No relevant change as compared to the previous image   Keywords: no relevant change. Unchanged single lead, with the tip projecting over the right ventricle. No pneumothorax. Mild cardiomegaly without pulmonary edema.


SubjectID: 17848200, StudyID: 52365440, Comparison: None

WET READ: ___ ___ ___ 8:08 AM Left pectoral pacemaker has a lead terminating in the right ventricle. No pneumothorax. Lungs are clear.

WET READ VERSION #1 ___ ___ ___ 1:29 AM Left pectoral pacemaker has a lead terminating in the right ventricle. No pneumothorax. Lungs are clear. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cardiomyopathy s/p icd // r/o pneumo and lead palcement

COMPARISON: ___.

IMPRESSION: Complete resolution of the pre-existing pulmonary edema. New left pectoral pacemaker. The single lead is in correct position, projecting over the right ventricle. No pneumothorax or other complications.


SubjectID: 17852330, StudyID: 59701930, Comparison: None

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: History: ___F with AMS // Eval for pna

TECHNIQUE: Chest: Frontal and Lateral

COMPARISON: ___

FINDINGS: Single lead left-sided AICD is seen with lead extending the expected position of the right ventricle. Lung volumes are low. There is mild to moderate pulmonary edema. Trace pleural effusions are seen. The cardiac silhouette is mildly enlarged. Aortic calcification is re- demonstrated.

IMPRESSION: Low lung volumes with mild to moderate pulmonary edema. Trace pleural effusions.


SubjectID: 17852330, StudyID: 55168528, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with altered mental status, sCHF, coughing and mild wheeze // any evidence of pneumonia?

IMPRESSION: In comparison to ___ chest radiograph, a patchy opacity in the right infrahilar region is new. In the setting of pulmonary vascular congestion and interstitial edema, it is uncertain whether this represents an asymmetrical focus of edema or secondary process such as aspiration or developing infectious pneumonia   Keywords: developing. Short-term followup radiographs may be helpful in this regard.


SubjectID: 17852330, StudyID: 58371010, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ ___-speaking with h/o MI in ___ s/p PCI of LAD, with ischemic cardiomyopathy with LVEF of 25%, s/p ICD, and severe mitral regurgitation presenting with altered mental status now on treatment for UTI and possible CAP with azithro and CTX. // please evaluate for interval change please evaluate for interval change

IMPRESSION: Heart size is enlarged. Mediastinum is stable. Patient continues to be in severe interstitial pulmonary edema associated with bilateral pleural effusions, which are at least moderate, left more than right   Keywords: continue. Pacemaker defibrillator terminates in the right ventricle.


SubjectID: 17852330, StudyID: 57691278, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with new wheeze and cough // ?aspiration ?aspiration

IMPRESSION: Pacemaker defibrillator lead terminates in the right ventricle. Heart size and mediastinum are unchanged including cardiomegaly but there is interval progression/worsening of pulmonary edema, currently severe   Keywords: worse, progression. Bibasal opacities might potentially also reflect aspiration although less likely and reassessment after diuresis is recommended.


SubjectID: 17854225, StudyID: 57324184, Comparison: 0.0

FINAL REPORT

INDICATION: ___-year-old female with shortness of breath and effusions. Evaluate for evidence of pneumonia.

COMPARISON: Chest radiograph performed at___ approximately one hour prior to this exam.

TECHNIQUE: Frontal upright and lateral chest radiograph.

FINDINGS: The lungs are well expanded. There is some vascular upper redistribution, and perihilar haziness as well as increased interstitial markings suggesting interstitial edema and vascular congestion   Keywords: increase. Bilateral pleural effusions, right worse than left are seen. Cardiac size cannot be properly assessed due to projection as well as obscuration of the cardiac margins by the pleural effusions and bibasilar atelectasis, but there is no evidence of cardiomegaly. There is no pneumothorax.

IMPRESSION: Findings compatible with acute interstitial pulmonary edema with associated bilateral pleural effusions slightly improved compared to recent radiograph performed at___ hospital   Keywords: improve.


SubjectID: 17872759, StudyID: 59402638, Comparison: same

FINAL REPORT

HISTORY: Pulmonary congestion and pneumonia.

FINDINGS: In comparison with the study of ___, there is continued enlargement of the cardiac silhouette with pulmonary vascular congestion   Keywords: continue. Small right and possibly left pleural effusions. The area of increased opacification focally at the right base is less prominent. Although this could represent pneumonia, the possibility of merely engorged vessels in an area where crowding of vessels is common should be considered.


SubjectID: 17872759, StudyID: 55228988, Comparison: worse

WET READ: ___ ___ ___ 12:50 AM Consolidation within the medial right lower lobe, concerning for pneumonia in the appropriate clinical setting, along with mild fluid overload. ______________________________________________________________________________

FINAL REPORT

HISTORY: Shortness of breath with dyspnea on exertion and orthopnea. Bilateral pedal edema. Evaluation for CHF.

COMPARISON: Comparison is made to radiograph of the chest from ___.

FINDINGS: PA and lateral views of the chest demonstrate an area of consolidation within the medial right lower lobe, which could represent an infectious process. There is increased interstitial prominence as well as haziness of the pulmonary vasculature, suggesting a component of fluid overload   Keywords: increase. Bilateral small pleural effusions are present. There is no pneumothorax.

IMPRESSION: Consolidation within the medial right lower lobe, concerning for pneumonia in the appropriate clinical setting, along with mild fluid overload.


SubjectID: 17890530, StudyID: 58503392, Comparison: None

WET READ: ___ ___ ___ 9:32 PM Stable severe cardiomegaly. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___F with SOB and chest pain // Eval for CHF

TECHNIQUE: Upright AP and lateral chest

COMPARISON: Chest radiographs ___ through ___

FINDINGS: Body habitus limits the evaluation. There is severe cardiomegaly as before. Mediastinal and hilar contours are stable. The lungs appear clear without evidence of pneumonia. There is no frank pulmonary edema. No pleural effusion or pneumothorax.

IMPRESSION: Stable severe cardiomegaly.


SubjectID: 17890530, StudyID: 54879617, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman on BiPAP with respiratory distress // please eval for pna please eval for pna

IMPRESSION: In comparison with the study ___ ___, there is again severe enlargement of the cardiac silhouette without appreciable vascular congestion. This discordance suggests underlying cardiomyopathy or pericardial effusion. No definite acute focal pneumonia.


SubjectID: 17890530, StudyID: 56593810, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF exacerbation // r/o coicurrent pna

COMPARISON: ___, 14:23

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Moderate cardiomegaly. Mild fluid overload but no overt pulmonary edema. No pleural effusions. No pneumonia. Unchanged retrocardiac atelectasis.


SubjectID: 17890530, StudyID: 55291849, Comparison: 0.0

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___-year-old female with a history of diastolic heart failure, underwent colonoscopy 3 weeks ago, now presenting with left-sided abdominal pain and shortness of breath.

TECHNIQUE: Portable chest radiograph

COMPARISON: Chest radiograph ___

FINDINGS: In comparison to the prior radiograph performed on ___, there has been significant interval improvement in previously noted pulmonary edema   Keywords: improve. There is still evidence of redistribution, suggestive of mild fluid overload   Keywords: still. No large pleural effusions. No pneumothorax. Severe cardiomegaly is stable. No acute osseous abnormalities identified. Evaluation for pneumoperitoneum is limited by this portable technique.

IMPRESSION: Stable severe cardiomegaly, with redistribution suggestive of mild fluid overload. No overt pulmonary edema.


SubjectID: 17890530, StudyID: 55658137, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with dCHF and HHS, fever, productive cough // Interval change

IMPRESSION: As compared to ___, cardiac silhouette remains markedly enlarged and is accompanied by pulmonary vascular congestion without evidence of overt pulmonary edema   Keywords: remains.


SubjectID: 17890530, StudyID: 55332315, Comparison: same

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPH

INDICATION: History: ___F with COPD, with cough, fevers, dyspnea // ? acute intrathoracic process ? acute intrathoracic process

TECHNIQUE: PA and lateral views of the chest.

COMPARISON: Prior chest radiograph from ___ and abdominal/pelvic CT from ___.

FINDINGS: There is moderate cardiomegaly, not significantly changed since prior examination. There is mild pulmonary vascular congestion. However there is no overt pulmonary edema. There is a focal area of linear atelectasis at the right lower lobe. No focal consolidation, pleural effusion or pneumothorax identified.

IMPRESSION: 1. No acute cardiopulmonary process. 2. Stable cardiomegaly with mild vascular congestion, but no overt pulmonary edema   Keywords: stable.


SubjectID: 17890530, StudyID: 50714653, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with dyspnea // Assess for effusions and pulmonary infiltrate

COMPARISON: ___.

IMPRESSION: As compared to the previous image, there is increasing severity of pulmonary edema   Keywords: increasing. The edema is now moderate. No larger pleural effusions. Substantial cardiomegaly persists.


SubjectID: 17890530, StudyID: 53958032, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with chf, worsening CP x5d // ?cpd

COMPARISON: Prior study performed earlier same day.

FINDINGS: AP portable upright view of the chest. Dialysis catheter again noted with its tip extending to the region of the cavoatrial junction. The heart is markedly enlarged and the hila are congested. There is likely mild pulmonary edema. No large effusion or pneumothorax is seen.

IMPRESSION: Cardiomegaly with congestion and mild edema.


SubjectID: 17890530, StudyID: 53933607, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (AP AND LAT)

INDICATION: ___F with c/o CP/SOB and cough // ? PNA

COMPARISON: ___

FINDINGS: AP upright and lateral views of the chest provided. Dialysis catheter again noted with its tip in the region of the right atrium. There is persistent cardiomegaly and hilar congestion with mild interstitial edema   Keywords: persistent. No large effusion or pneumothorax. No convincing evidence for pneumonia. Bony structures are intact.

IMPRESSION: Persistent cardiomegaly with hilar congestion and mild interstitial edema   Keywords: persistent.


SubjectID: 17894379, StudyID: 59807849, Comparison: None

FINAL REPORT

CHEST, TWO VIEWS: ___

HISTORY: ___-year-old male with history of AFib with recent episodes of rapid ventricular rate at dialysis.

COMPARISON: ___ and ___.

FINDINGS: Frontal and lateral views of the chest. The lungs are clear of focal consolidation, effusion, or vascular congestion. The cardiac silhouette is enlarged but stable. Enlargement of the thoracic aorta is unchanged. Median sternotomy wires and mediastinal clips are again seen.

IMPRESSION: Cardiomegaly without acute cardiopulmonary process.


SubjectID: 17894379, StudyID: 55885876, Comparison: None

FINAL REPORT

HISTORY: Chest tightness and dyspnea

COMPARISON: Chest radiograph from 1 day prior.

FINDINGS: 2 views of the chest show clear lungs with no focal consolidation. The cardiac silhouette is enlarged but stable. Tortuosity and enlargement of the thoracic aorta is unchanged. Mediastinal clips and intact median sternotomy wires are unchanged.

IMPRESSION: Stable cardiomegaly with no focal consolidation.


SubjectID: 17894379, StudyID: 56632584, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___M with shortness of breath and cough

TECHNIQUE: Chest PA and lateral

COMPARISON: ___

FINDINGS: The patient is status post median sternotomy and CABG. Moderate enlargement of the cardiac silhouette is re- demonstrated. The aorta is tortuous as seen previously. Mild pulmonary edema is not substantially changed in the interval. Previously noted small bilateral pleural effusions have nearly completely resolved. No pneumothorax is present. Patchy opacities in the retrocardiac region may reflect atelectasis. There is no acute osseous abnormality.

IMPRESSION: Mild pulmonary edema, as seen on the previous study, with near complete resolution of previously seen small bilateral pleural effusions.


SubjectID: 17894379, StudyID: 55460320, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF p/w productive cough // ?PNA and pulm edema

COMPARISON: ___.

IMPRESSION: No relevant change as compared to the previous image   Keywords: no relevant change. Mild fluid overload but no overt pulmonary edema. Moderate cardiomegaly, elongation of the descending aorta. Unchanged normal position of the sternal wires. No pleural effusions. No pneumonia.


SubjectID: 17902737, StudyID: 57192892, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with s/p CABG, leukocytosis // eval postop changes eval postop changes

COMPARISON: Chest radiographs since ___ most recently ___.

IMPRESSION: Moderate right pleural effusion is larger compared to ___, and the lateral view suggests a pneumonia may be present in the superior segment of the right lower lobe Stable enlargement of the postoperative cardiomediastinal silhouette. No pneumothorax. No pulmonary edema. .

NOTIFICATION: Dr. ___ reported the findings to ___ by telephone on ___ at 12:30 PM, 2 minutes after discovery of the findings.


SubjectID: 17902737, StudyID: 55987123, Comparison: None

WET READ: ___ ___ ___ 8:01 AM 1. Status post right chest tube removal. New apical pneumothoraces bilaterally, tiny on the right and small on the left. 2. Otherwise unchanged exam, with low lung volumes and bibasilar atelectasis. These findings were communicated via telephone by Dr. ___ to Dr. ___ at 23:50 on ___, approximately 20 minutes after discovery.

WET READ VERSION #1 ___ ___ ___ 11:51 PM 1. Status post right chest tube removal. New apical pneumothoraces bilaterally, tiny on the right and small on the left. 2. Otherwise unchanged exam, with low lung volumes and bibasilar atelectasis. These findings were communicated via telephone by Dr. ___ to Dr. ___ at 23:50 on ___, approximately 20 minutes after discovery. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with s/p cabg // s/p ct removal

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the right chest tube has been removed. There is a millimetric right apical pneumothorax. No evidence of tension. The left pneumothorax, with a left chest tube in place is constant. Low lung volumes. Moderate cardiomegaly without pulmonary edema.


SubjectID: 17902737, StudyID: 52512864, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with s/p CABG, status post right chest tube removal, evaluate for pneumothorax.

COMPARISON: Chest radiographs from ___.

FINDINGS: AP view of the chest provided. Left-sided chest tube has been removed. There is interval resolution of apical pneumothoraces. There are bilateral linear opacities at the prior chest tube sites, likely atelectatic changes or very subtle bleeding along tube tract. Lung volumes are low, which may contribute to the apparent increase in cardiac size.

IMPRESSION: Resolution of bi-apical pneumothoraces.


SubjectID: 17902737, StudyID: 51846393, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with s/p cabg // s/p ct removal s/p ct removal

COMPARISON: Chest radiographs since ___ most recently ___.

IMPRESSION: Previous mild postoperative pulmonary edema has resolved   Keywords: resolve. Following extubation Lung volumes are lower, and there is new moderate atelectasis at the right base. Pleural effusions are small if any. No pneumothorax. Bilateral pleural drains in place. Normal postoperative cardiomediastinal silhouette. .


SubjectID: 17908288, StudyID: 56145496, Comparison: None

WET READ: ___ ___ 11:12 AM Small bilateral pleural effusions. No pulmonary edema.

WET READ VERSION #1 ___ ___ 1:04 AM Small bilateral pleural effusions. No pulmonary edema. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___ year old woman with heart failure, dyspnea // pls eval for pulm edema

TECHNIQUE: Portable upright chest radiograph

COMPARISON: ___

FINDINGS: The lungs are essentially clear. Small bilateral pleural effusions are noted, smaller on the right compared to the prior radiograph from ___. Heart size is enlarged, as before. No evidence of pneumonia or pulmonary edema. No pneumothorax.

IMPRESSION: 1. Small bilateral pleural effusions, right greater than left. 2. No evidence of pulmonary edema or pneumonia.


SubjectID: 17908288, StudyID: 53271971, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with respiratory distress // pulmonary edema?

TECHNIQUE: Portable upright chest radiograph

COMPARISON: ___

FINDINGS: Since the radiograph from 3 hr prior, there is no relevant change   Keywords: no relevant change. No pulmonary edema or pneumonia. No pneumothorax. Left pleural effusion is slightly smaller. Right pleural effusion is unchanged. Moderate cardiomegaly is stable. This examination neither suggests nor excludes the possibility of pulmonary embolus.

IMPRESSION: Minimally smaller left pleural effusion, otherwise no change.


SubjectID: 17929966, StudyID: 58582407, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pulm edema post lasix ___ in Afib w RVR // evaluation of pulmonary edema

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, there is a marked improvement with a decrease in extent of pulmonary edema and of pleural effusions   Keywords: decrease, improve. Moderate cardiomegaly an low lung volumes persist.


SubjectID: 17929966, StudyID: 53734436, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with PVD, and new onset dyspnea // rule out infiltrates/aspiration

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, there is increasing severity of the pre-existing pulmonary edema, with increase in extent of bilateral pleural effusions   Keywords: increasing. In turn, this leads to increase of the basal atelectasis seen bilaterally. Low lung volumes and moderate cardiomegaly persist.


SubjectID: 17929966, StudyID: 57991947, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with shortness of breath

TECHNIQUE: Portable upright AP view of the chest

COMPARISON: ___

FINDINGS: Lung volumes are low. Heart size appears moderately enlarged, but is accentuated due to the presence of low lung volumes. The aorta is tortuous. There is mild pulmonary edema with small to moderate sized bilateral pleural effusions, not substantially changed from the prior exam. Bibasilar opacities may reflect compressive atelectasis but infection cannot be completely excluded. No pneumothorax is identified. Severe degenerative changes are noted in both glenohumeral joints with narrowed acromiohumeral intervals bilaterally suggestive of underlying rotator cuff disease. No displaced fractures are visualized.

IMPRESSION: Low lung volumes. Mild pulmonary edema with small to moderate size bilateral pleural effusions. Bibasilar airspace opacities, likely atelectasis, but infection cannot be completely excluded.


SubjectID: 17929966, StudyID: 57168732, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with PVD c/b dry gangrene of left ___/___ toes, CVAx3 (s/p R CEA), AF on coumadin, dCHF (moderate AS and 2+ MR) presenting with dyspnea // interval change, further evaluation of effusions

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Bilateral pleural effusions are large, potentially minimally increased. No change in low lung volumes and substantial pulmonary edema bilateral demonstrated   Keywords: no change. Bibasal consolidations are unchanged.


SubjectID: 17929966, StudyID: 53642182, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF // lung volumes, PNA. CHF lung volumes, PNA. CHF

IMPRESSION: In comparison with the study of ___, there again are extremely low lung volumes. The degree of pulmonary edema has substantially increased, as have the bibasilar opacifications consistent with layering effusions and underlying compressive atelectasis   Keywords: increase.


SubjectID: 17929966, StudyID: 57284165, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF: assess for interval change // Is there improvement in CHF, effusions, atelectasis?

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Pulmonary edema has markedly improved   Keywords: improve. Small to moderate right effusion is a stable, with increased in the adjacent atelectasis . Small left effusion has improved. There is no pneumothorax. Cardiac size cannot be evaluated. There are low lung volumes.


SubjectID: 17929966, StudyID: 55770639, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with nausea/SOB. // assess interval change and for pulmonary edema

IMPRESSION: As compared to ___, pulmonary edema and bilateral pleural effusions have slightly worsened   Keywords: worse.


SubjectID: 17929966, StudyID: 54746718, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF. // assess for interval change

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Bilateral pleural effusions and bibasal consolidations and pulmonary edema are unchanged   Keywords: unchanged. No pneumothorax is seen. Cardiomediastinal silhouette is unchanged. Atelectasis in the right lower lung is re- demonstrated.


SubjectID: 17929966, StudyID: 51525976, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with CHF. // assess interval change of pulmonary edema

FINDINGS: Allowing for differences in technique and positioning, there has been no substantial change in appearance of the chest since recent radiograph of 1 day earlier.

COMPARISON: ___.


SubjectID: 17929966, StudyID: 54874642, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF // worsening effusion?

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: As compared to the prior study there is no change in large bilateral effusions and moderate pulmonary edema   Keywords: no change. Bibasal consolidations are unchanged.


SubjectID: 17933313, StudyID: 58666279, Comparison: None

FINAL REPORT

INDICATION: Pleural effusion status post attempted right thoracocentesis. Rule out pneumothorax or other complication.

COMPARISON: ___.

FINDINGS: Compared with most recent prior radiograph, there is no significant change in dense right pleural effusion reaching the minor fissure. Change in the appearance is likely related to postural change of the patient. No pneumothorax is present. No left pleural effusion is present. Unchanged cardiomediastinal silhouettes.


SubjectID: 17933313, StudyID: 58012905, Comparison: worse

FINAL REPORT

INDICATION: Shortness of breath. Evaluate for acute process.

COMPARISON: Chest radiograph from ___ in conjunction with CT chest from ___.

FINDINGS: Large right pleural effusion, tracking into the fissure with associated atelectasis is unchanged from yesterday. Mild pulmonary edema on the left is new   Keywords: new. No pneumothorax or left pleural effusion. Unchanged cardiomediastinal silhouette.


SubjectID: 17933313, StudyID: 56577573, Comparison: same

WET READ: ___ ___ 8:47 PM Status post right thoracocentesis with significant decrease in right pleural effusion with a small effusion likely persisting. No pneumothorax. Otherwise, little change compared to prior radiograph from today. Please refer to CT from ___ for better evaluation of multiple positive findings including possible infection/aspiration in the left lower lobe, multiple osseous lesions, and large intra-abdominal mass. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: B-cell lymphoma, thoracocentesis, evaluation for pneumothorax.

COMPARISON: ___, 10:22.

FINDINGS: As compared to the previous radiograph, the patient has undergone right thoracocentesis. A pigtail catheter is in place in the right pleural space. The pre-existing pleural effusion has substantially decreased in extent. There is no evidence of pneumothorax. Otherwise, unchanged radiographic appearance   Keywords: unchanged radiograph.


SubjectID: 17933313, StudyID: 53436128, Comparison: None

FINAL REPORT

HISTORY: Lymphoma with malignant effusion, now with chest tube placement.

FINDINGS: In comparison with the study of ___, the right chest tube remains in place and there is no evidence of pneumothorax. The degree of right effusion appears to be further decreasing. Increased opacification at the left base most likely reflects atelectasis and small effusion. If there are appropriate clinical symptoms, superimposed pneumonia would have to be considered.


SubjectID: 17933313, StudyID: 53219019, Comparison: None

FINAL REPORT

HISTORY: Lymphoma with malignant left effusion and chest tube placement.

FINDINGS: In comparison with study of ___, the right chest tube remains in place. There is a bibasilar opacification, somewhat more prominent on the left, consistent with effusion and atelectasis. In the appropriate clinical setting, supervening pneumonia would have to be considered.


SubjectID: 17933313, StudyID: 51372593, Comparison: None

FINAL REPORT

INDICATION: B-cell lymphoma with large right pleural effusion treated by chest tube. Evaluate for reaccumulation of effusion or pneumothorax.

COMPARISONS: Chest radiograph, ___. Chest radiograph, ___. CT chest, ___.

FINDINGS: There is a right pigtail chest tube in unchanged position. There is hazy opacification over the right base, consistent with a small amount of reaccumulated pleural effusion. Additionally, there is a new rounded opacity at the left base, which could represent infection or aspiration. There is no evidence of pneumothorax. There is no pulmonary edema. The cardiomediastinal silhouette is unchanged.

IMPRESSION: 1. Interval reaccumulation of a small right pleural effusion. Chest tube in unchanged position. No pneumothorax. 2. New left lower lobe opacity, concerning for infection or aspiration. Results were discussed with Dr. ___ ___ resident) at 15:57 on ___ via telephone by Dr. ___.


SubjectID: 17933313, StudyID: 50840184, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: B-cell lymphoma, malignant pleural effusion, status post right chest tube, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the right pleural drain is in unchanged position. The right effusion has slightly decreased. Overall, the lung volumes have increased, and, as a consequence, the basal areas of atelectasis have decreased. No new parenchymal opacities   Keywords: new. Unchanged borderline size of the cardiac silhouette and tortuosity of the thoracic aorta. Unchanged lymph node calcifications at the right hilus.


SubjectID: 17948002, StudyID: 57180382, Comparison: None

WET READ: ___ ___ ___ 10:58 AM Prominent pulmonary vasculature without frank edema. ______________________________________________________________________________

FINAL REPORT

INDICATION: History: ___M with recent admission for CHF, returns with SOB. // eval for pulmonary edema

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiographs dated ___ through ___.

FINDINGS: The lungs are well-expanded. Prominence of the pulmonary vasculature is noted, without frank edema. The heart is enlarged. An AICD device is present, with leads ending in the right atrium and right ventricle, unchanged. No pleural effusion, consolidation, or pneumothorax.

IMPRESSION: Prominent pulmonary vasculature without frank edema.


SubjectID: 17948002, StudyID: 56590713, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with SOB and crackles // ? pulmonary edema

IMPRESSION: As compared to previous study of 1 day earlier, cardiomegaly is accompanied by persistent pulmonary vascular congestion without overt pulmonary edema   Keywords: persistent.


SubjectID: 17948002, StudyID: 55472889, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with decompensated heart failure // evaluate for interval change

IMPRESSION: In comparison to ___ chest radiograph, a Swan-Ganz catheter has been removed, with no visible pneumothorax. Cardiomegaly and pulmonary vascular congestion are accompanied by minimal interstitial edema.


SubjectID: 17948002, StudyID: 55329896, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with heart failure // evaluate for interval change

IMPRESSION: In comparison to ___ chest radiograph, there has not been appreciable change in the appearance of the chest.


SubjectID: 17948002, StudyID: 51496697, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M PMHx HFrEF (EF ___% ___), ICD pacer (___), ventricular tachycardia, T2DM, admitted with dry cough and weight gain, found to have decompensated heart failure. PA line appears to be in wedge. // evaluate PA line placement evaluate PA line placement

IMPRESSION: Comparison to ___. Swan-Ganz catheter has been pulled back. The tip is now at the outflow tract of the right atrium. No relevant change otherwise   Keywords: no relevant change. No pneumothorax.


SubjectID: 17956685, StudyID: 58839928, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with no past medical history presenting with anasarca in acute heart failure // pulmonary edema improvment

TECHNIQUE: Portable AP radiograph of the chest.

COMPARISON: ___.

FINDINGS: Lung volumes are low. Moderate bilateral pleural effusions with bibasilar subsegmental atelectasis are unchanged. There is bronchovascular crowding with worsening superimposed pulmonary edema   Keywords: worse.

IMPRESSION: Increased pulmonary edema   Keywords: increase. No significant interval change in moderate bilateral pleural effusions with bibasilar subsegmental atelectasis.


SubjectID: 17956685, StudyID: 54278768, Comparison: None

FINAL REPORT

INDICATION: ___M with resp distress // eval for pna effusions ptx

TECHNIQUE: Single portable view of the chest.

COMPARISON: None.

FINDINGS: Low lung volumes are noted with secondary crowding of the bronchovascular markings with superimposed pulmonary edema. Bibasilar opacities are seen likely due to moderate pleural effusions with component of atelectasis, infection not excluded. Linear opacity in the right midlung likely due to atelectasis. There is no pneumothorax. Moderate enlargement of the cardiac silhouette is only partially visualized.

IMPRESSION: Cardiomegaly with pulmonary edema, bilateral pleural effusions and likely atelectasis noting that infection is not excluded.


SubjectID: 17958052, StudyID: 58781820, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p AVR, MVr with large chest tube output // eval for widened mediastinum, hemothorax

IMPRESSION: Since ___, the patient has been extubated, and additional support devices have been removed with no visible pneumothorax. Cardiomediastinal contours are stable. Slight improvement in left retrocardiac atelectasis. Small bilateral pleural effusions.


SubjectID: 17958052, StudyID: 52620120, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p ct pull // eval for ptx

COMPARISON: ___

IMPRESSION: As compared to the previous image, the right chest tube was pulled. There is no evidence of a pneumothorax. The mediastinal drains were also removed. Unchanged mild mild to moderate cardiomegaly without pulmonary edema   Keywords: unchanged. The alignment of the sternal wires is constant.


SubjectID: 17958052, StudyID: 54477232, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with s/p AVr/MVr // eval pleural effusions

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the extent of the known bilateral pleural effusions is not substantially changed. The effusions are better evaluated on the lateral than on the frontal radiograph. The areas of subsequent bilateral basal atelectasis are also unchanged. Unchanged appearance of the mediastinal contours. Unchanged alignment of the sternal wires. No evidence of pneumonia.


SubjectID: 17958052, StudyID: 52190647, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___F with recent aortic valve replacement who is now presenting with several days of worsening DOE and orthopnea.

TECHNIQUE: Chest PA and lateral

COMPARISON: ___

FINDINGS: Heart size is difficult to assess given the presence of small bilateral pleural effusions, left greater than right. The pleural effusion on the left appears slightly increased in size while the effusion on the right is unchanged. Mediastinal contour is unchanged with mild atherosclerotic calcification noted at the aortic knob. Prosthetic aortic valve is again demonstrated. The pulmonary vasculature is normal. There is compressive atelectasis at the lung bases. No pneumothorax is detected. No acute osseous abnormality is identified.

IMPRESSION: Small bilateral pleural effusions, increased in size on the left, and unchanged in size of the right with associated compressive bibasilar atelectasis.


SubjectID: 17962324, StudyID: 58141612, Comparison: same

WET READ: ___ ___ ___ 8:44 PM Mod cardiomegaly. Mild L hemidiaphragm elevation, small L effusion. L ___ rib fx. ______________________________________________________________________________

FINAL REPORT

AP CHEST, 6:36 P.M. ON ___

HISTORY: Postop splenectomy.

IMPRESSION: AP chest compared to ___ and ___. Mild cardiomegaly is new, but there is no pulmonary edema or pleural effusion   Keywords: new. Aside from mild left infrahilar atelectasis, lungs are clear and there is no pleural effusion or pneumothorax. Left upper quadrant drain in place.


SubjectID: 17962324, StudyID: 56599347, Comparison: None

WET READ: ___ ___ 8:15 PM Normal chest. CABG. No pneumoperitoneum. No signif healing of L 9th rib fx. ______________________________________________________________________________

FINAL REPORT

REASON FOR

EXAMINATION: Evaluation of the patient with history of splenic pseudoaneurysm, bradycardia, and shortness of breath. Portable AP chest radiograph was reviewed in comparison to ___. Heart size is top normal and stable as well as tortuous aorta. Lungs are clear. There is no pleural effusion or pneumothorax. Hyperinflation is noted on the right that might be consistent to substantial emphysema.

IMPRESSION: No evidence of abnormality to explain the patient's symptoms.


SubjectID: 17967161, StudyID: 55611350, Comparison: worse

FINAL REPORT

INDICATION: History of poorly controlled diabetes, neuropathy. Please evaluate.

COMPARISON: Chest radiograph from ___.

TECHNIQUE: Single AP portable exam of the chest.

FINDINGS: The heart size is normal. There is increased fullness of the left hilum. There also appears to be a subtle increase in opacification overlying the right upper lung. There is no pneumothorax. There is mild bibasilar atelectasis. No large pleural effusion is identified.

IMPRESSION: 1. Subtle increase in opacification overlying the upper right lung which could be secondary to asymmetric pulmonary edema, however an infectious process cannot be excluded   Keywords: increase. 2. Increased fullness at the left hilum likely secondary to reactive lymphadenopathy, however a CT is recommended for further evaluation. Findings were discussed with Dr. ___ at 6:___p on ___ by Dr. ___ by telephone.


SubjectID: 17967161, StudyID: 54755896, Comparison: None

FINAL REPORT

INDICATION: History of poorly controlled diabetes, neuropathy. Please evaluate.

COMPARISON: Multiple chest radiographs dated back to ___, most recently ___.

TECHNIQUE: Single AP portable exam of the chest.

FINDINGS: The heart size is normal. The hilar and mediastinal contours are unremarkable. The lung volumes are low. No focal consolidations concerning for infection are identified. Note is made of mild bibasilar atelectasis. There is no pneumothorax or pleural effusion.

IMPRESSION: Mild bibasilar atelectasis. No evidence of pneumonia or pulmonary edema.


SubjectID: 17967857, StudyID: 56102875, Comparison: worse

FINAL REPORT

HISTORY: Pulmonary artery catheter and intra-aortic balloon pump. Evaluate lines.

TECHNIQUE: Semi erect portable frontal chest radiograph.

COMPARISON: Chest radiograph ___ and ___.

FINDINGS: A right internal jugular pulmonary arterial catheter terminates in the descending right pulmonary artery. A intra-aortic balloon pump has advanced from yesterday, now terminating 4.3 cm above the left mainstem bronchus. The heart remains moderately enlarged. There is increased ground-glass opacity throughout the lungs, consistent with worsening mild pulmonary edema   Keywords: worse. There is no definite pleural effusion. There is no pneumothorax.

IMPRESSION: 1. Intra-aortic balloon pump has advanced since yesterday and should be repositioned 2 cm for better positioning. 2. Pulmonary arterial catheter terminates in the descending right pulmonary artery, the catheter could be pulled back 2 cm to terminate in the right main pulmonary artery. 3. Slight worsening of mild pulmonary edema   Keywords: worse. These findings were discussed with Dr. ___ by Dr. ___ at 10:27 on ___ by telephone at the time of discovery.


SubjectID: 17967857, StudyID: 55778086, Comparison: same

FINAL REPORT

HISTORY: Intra-aortic balloon pump, evaluate.

TECHNIQUE: Portable frontal chest radiograph.

COMPARISON: Chest radiograph 8:07 today.

FINDINGS: The right internal jugular pulmonary arterial catheter has been withdrawn, now terminating in the right main pulmonary artery. The intra-aortic balloon pump has also been withdrawn now terminating 2.7 cm above the left mainstem bronchus and approximately 2cm from the apex of the aortic arch. There is unchanged mild pulmonary edema   Keywords: unchanged. There is no definite pleural effusion. The cardiac silhouette remains moderate the enlarged. A mitral valve prosthesis is again noted.

IMPRESSION: 1. Satisfactory position of lines. 2. Unchanged mild pulmonary edema   Keywords: unchanged.


SubjectID: 17967857, StudyID: 55395946, Comparison: worse

FINAL REPORT

PORTABLE AP CHEST X-RAY.

INDICATION: Patient with mitral valve replacement with mitral regurgitation and mitral stenosis, cardiogenic shock, balloon pump.

COMPARISON: ___.

FINDINGS: The intra-aortic balloon pump ends 2.2 cm below the aortic knob and 1.8 cm above the left mainstem which is adequate but should not be higher. Right-sided Swan-Ganz has been slightly pulled back and now ends in the right pulmonary artery. Moderate pulmonary edema, more localized in the right upper lobe may be due to mitral valve regurgitation. Prior sternotomy was done for mitral valve repair in this patient with significant cardiomegaly. There is no pleural effusion or pneumothorax. New 18 mm very dense opacity is seen in the left upper quadrant, probably in the stomach which could represent ingested pill or even a tooth.

CONCLUSION: 1. Tube and lines are in adequate position. Intra-aortic balloon pump should not be higher. 2. Increase in moderate pulmonary edema more localized in the right upper lobe could reflect mitral valve regurgitation   Keywords: increase. 3. Probable ingested material in the stomach could be a pill but also a tooth. This has been discussed at 10:58 a.m. with nurse practitioner, ___. The patient is in the OR right now and postop x-ray is planned.


SubjectID: 17967857, StudyID: 55450393, Comparison: None

FINAL REPORT

HISTORY: Cardiac surgery with chest tube removal.

FINDINGS: In comparison with the study of ___, the overall appearance of the heart, lungs, and monitoring and support devices is essentially unchanged. Specifically, no evidence of pneumothorax.


SubjectID: 17967857, StudyID: 55369516, Comparison: same

FINAL REPORT

HISTORY: Status post MVR.

COMPARISON: ___.

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.


SubjectID: 17968028, StudyID: 58643890, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with dyspnea, lower extremity swelling, fever

TECHNIQUE: Portable upright AP view of the chest

COMPARISON: ___

FINDINGS: Heart size appears mildly enlarged. The mediastinal and hilar contours are unremarkable. There is mild pulmonary vascular congestion, with patchy bibasilar atelectasis, more pronounced on the right. No pleural effusion or pneumothorax is present. No acute osseous abnormalities identified. Degenerative changes are seen in the thoracic spine.

IMPRESSION: Mild pulmonary edema and bibasilar atelectasis.


SubjectID: 17968028, StudyID: 52167446, Comparison: better

FINAL REPORT

INDICATION: ___ year old woman with CHF, difficulty breathing // eval for interval changes from previous

COMPARISON: Radiographs from ___.

IMPRESSION: Heart size is upper limits of normal. There has been improvement of the pulmonary interstitial edema   Keywords: improve. There is no focal consolidation or pneumothoraces.


SubjectID: 17978572, StudyID: 52433002, Comparison: None

WET READ: ___ ___ ___ 5:39 PM unchanged exam.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: AML, pleural effusion, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the known right pleural effusion shows a slightly different distribution but is overall unchanged in extent. The effusion causes potential right lower lobe atelectasis. Otherwise, the lung parenchyma both on the right and on the left appear unchanged. Moderate cardiomegaly with tortuosity of the thoracic aorta persists. Unchanged position of the left pectoral pacemaker.


SubjectID: 17978572, StudyID: 58113926, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old man with RSV, please assess for interval change.

COMPARISON: Chest radiographs from ___, ___, ___, ___ ___, and ___.

FINDINGS: Since ___, the right pleural effusion has increased, now moderate in size. The perihilar opacities have increased on the right and are stable at the left hilum, partially obscured by the ICD-pacemaker device   Keywords: increase. The heart is enlarged. An enteric tube passes beyond the diaphragm into the stomach, but the tip is not visualized. The endotracheal tube ends 3.5 cm above the carina. A replaced aortic valve is seen.

IMPRESSION: Worsening moderate right effusion and right perihilar opacity. Stable left perihilar opacity.


SubjectID: 17978572, StudyID: 55310567, Comparison: None

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Hypoxia. Question infiltrate or worsening effusion.

COMPARISONS: ___.

TECHNIQUE: Chest, AP upright and lateral views.

FINDINGS: The patient is status post mitral valve replacement. There is also a dual-lead pacemaker/ICD device with leads terminating in the right atrium and ventricle, respectively, as before. The heart is moderately enlarged. There are new vaguely defined but dense bilateral mid lung opacities which are worrisome for multifocal pneumonia, as well as a retrocardiac opacity. In addition, there is new elevation of the right hemidiaphragm with an increasing pleural effusion, probably of moderate size. Increasing streaky right basilar opacification with volume loss suggesting a component of associated atelectasis at the right lung base. There is no pneumothorax.

IMPRESSION: New multifocal opacities worrisome for pneumonia. Increasing right-sided pleural effusion, likely of moderate size with suspected atelectasis.


SubjectID: 17978572, StudyID: 54678947, Comparison: None

FINAL REPORT

PORTABLE CHEST FILM ___ AT 4:31. CLINICAL

INDICATION: ___-year-old with AML, on chemo, with RSV status post extubation, evaluate for interval change. Comparison is made to the patient's prior study of ___ at 4:19. Portable semi-erect chest film ___ at 4:31 is submitted.

IMPRESSION: 1. Interval extubation and removal of the nasogastric tube. The dual-lead left-sided pacer remains in place. The patient is status post median sternotomy with mitral annular ring. There continues to be bilateral diffuse patchy airspace process which does not appear to be significantly changed. No pneumothorax is seen. Heart remains enlarged, which may reflect cardiomegaly, although pericardial effusion cannot be excluded. Overall mediastinal contours are unchanged. Stable bilateral patchy airspace consolidation.


SubjectID: 17978572, StudyID: 53907792, Comparison: better

FINAL REPORT

AP CHEST, 4:29 A.M., ___

HISTORY: ___-year-old man with respiratory failure. Multifocal pneumonia. Intubated.

IMPRESSION: AP chest compared to ___: ET tube, transvenous right atrial pacer and ventricular defibrillator leads are in standard placements. Upper enteric tube passes into the stomach and out of view. Left PIC line can be traced as far as the left subclavian vein, but the tip is obscured. Mild-to-moderate pulmonary edema has improved since ___, 7:39 p   Keywords: improve.m. as have large areas of consolidation in the axillary regions of both lungs. Moderate-to-severe cardiomegaly has decreased. Substantial right pleural effusion is still present. There is no pneumothorax. Overall, findings suggest improvement in cardiac decompensation and clearing of what is probably bilateral pneumonia.


SubjectID: 17978572, StudyID: 51762979, Comparison: worse

FINAL REPORT

HISTORY: Intubation.

TECHNIQUE: Supine AP view of the chest.

COMPARISON: ___ at 15:54.

FINDINGS: Endotracheal tube is new, terminating approximately 8 cm from the carina, at the level of the thoracic inlet. Nasogastric tube tip is suboptimally positioned with the tip terminating above the gastroesophageal junction. The heart remains moderate to severely enlarged. The patient is status post median sternotomy and mitral valve replacement. Left-sided AICD/pacemaker device is noted with leads terminating in the right atrium and right right ventricle. Worsening bilateral parenchymal opacities predominantly in a perihilar distribution are noted with increased confluence, likely reflective of pulmonary edema which is moderate to severe   Keywords: increase, worse. Bibasilar opacities likely reflect atelectasis though infection cannot be excluded. Small right pleural effusion is re- demonstrated. No pneumothorax is identified.

IMPRESSION: 1. Standard positioning of the endotracheal tube. Suboptimal positioning of the nasogastric tube with tip terminating just above the gastroesophageal junction, and should be advanced. 2. Worsening bilateral predominantly perihilar opacities which are more confluent, likely reflective of worsening pulmonary edema   Keywords: worse. Small right pleural effusion persists.


SubjectID: 17978572, StudyID: 57618436, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___ Comparison to the prior chest radiograph from earlier today and CT from ___. CLINICAL

HISTORY: Thoracentesis, question residual effusion.

FINDINGS: PA and lateral views of the chest provided demonstrate midline sternotomy wires, prosthetic cardiac valve, and AICD in unchanged position. Biliary stent is noted in the right upper quadrant. Since the prior exam, there has been right thoracentesis with only minimal residual right pleural effusion. Ground-glass opacities in the right lower lung could reflect re-expansion pulmonary edema versus infection. There is loculated fluid along the minor fissure. The left lung remains clear. Heart size is enlarged. Mediastinal contour is stable. Bony structures are intact.

IMPRESSION: Interval right thoracentesis with only small residual pleural effusion, though ground-glass opacity in the right lower lung raises concern for re-expansion pulmonary edema versus infection. Persistent cardiomegaly.


SubjectID: 17978572, StudyID: 51854168, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with shortness of breath. Rule out infiltrate.

COMPARISONS: Multiple prior chest radiographs, most recently of ___.

FINDINGS: Frontal views of the chest were obtained. Right pleural effusion has increased in size, now large, with underlying consolidation, compatible with left middle and lower lobe collapse on ___ chest CT. A superimposed process cannot be excluded. Left lung appears essentially clear. No pneumothorax. Sternotomy wires appear intact. Wires of left chest wall pacer terminate in similar position to prior. Mitral valve prosthesis is similar to prior.

IMPRESSION: Increased right pleural effusion, now large, with underlying consolidation, compatible with right middle and lower lobe collapse. Superimposed infection may be present.


SubjectID: 17978572, StudyID: 54820469, Comparison: same

FINAL REPORT

INDICATION: ___-year-old man with history of AML who presents for evaluation pleural effusions.

COMPARISON: Chest radiographs from ___, ___, ___, and ___.

TECHNIQUE: Single AP and lateral exam of the chest.

FINDINGS: There appears to be interval increase in the right pleural effusion and atelectasis adjacent to the pleural effusion compared to the prior exam, and approaching the volume prior to the thoracentesis on the scan from ___. There is no pneumothorax. No new focal consolidations are identified. There is stable bilateral pulmonary edema   Keywords: stable. Note is made of slightly more prominent scarring/atelectasis at the left lung base, in comparison to the radiograph from ___. The heart is moderately enlarged, stable compared to exams dating back to at least ___. There is a pacemaker with leads in appropriate position. There is a replaced mitral valve.

IMPRESSION: Interval increase in the right-sided pleural effusion and adjacent atelectasis approaching the volume seen prior to the thoracentesis on ___. These findings were discussed with Dr. ___ at 5:57pm, by telephone, on the day of the exam by Dr. ___.


SubjectID: 17978572, StudyID: 50304969, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post right-sided thoracocentesis, evaluation for pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient is after right thoracocentesis. Extent of the right pleural effusion has decreased. There continues to be evidence of small right basal atelectasis, but no evidence of pneumothorax or other acute lung disease. Unchanged cardiomegaly without pulmonary edema   Keywords: unchanged. Unchanged course of the pacemaker wires, unchanged alignment of the sternal wires.


SubjectID: 17978572, StudyID: 54416872, Comparison: better

WET READ: ___ ___ ___ 8:50 PM Moderate right pleural effusion is increased compared to radiograph from ___. Consolidation at the right lung base cannot be excluded. Minimal left lower lung atelectasis. Right PICC ends in mid-to-upper SVC. Prosthetic valve and left-sided pacemaker with appropriately positioned leads. ______________________________________________________________________________

FINAL REPORT

AP CHEST, 7:21 P.M., ___

HISTORY: ___-year-old man with AML and neutropenic fever.

IMPRESSION: AP chest compared to ___: Previous pulmonary vascular congestion has improved   Keywords: improve. Right lower hemithorax is opacified by a combination of pleural effusion, at least moderate in size and probable right middle and lower lobe collapse. Left lung is clear aside from mild linear atelectasis at the lung base. Heart has been moderately enlarged, now the right heart border is obscured by pleural and parenchymal abnormalities in the right hemithorax, but the left heart contour is smaller. The patient has had median sternotomy, and MVR. Transvenous right atrial pacer and right ventricular pacer defibrillator lead are continuous from the left pectoral pacemaker, and unchanged in their positions. Right PIC line ends in the upper SVC. No pneumothorax.


SubjectID: 17978572, StudyID: 50342432, Comparison: worse

FINAL REPORT

AP CHEST, 1:15 P.M., ___

HISTORY: ___-year-old man with gram-negative bacteremia, febrile neutropenia and shortness of breath. Question focal infection or edema.

IMPRESSION: AP chest compared to ___: Moderate right pleural effusion has increased, responsible for persistent right lower lobe collapse. Increased caliber of the mediastinum suggests dilated mediastinal vessels, worsening volume overload   Keywords: worse. Moderate cardiomegaly and/or pericardial effusion has also increased. Transvenous right atrial pacer and right ventricular pacer leads are in standard placements. Dr. ___ ___ was paged.


SubjectID: 17981003, StudyID: 59844767, Comparison: None

WET READ: ___ ___ ___ 11:54 PM low lung volumes limit assessment. bibasilar atelectasis, left > right, with decreased visualization of diaphragm. retrocardiac consolidation would be difficult to exclude. cardiomegaly with known pericardial effusion. likely small effusions.

WET READ VERSION #1 ___ ___ ___ 11:46 PM low lung volumes limit assessment. bibasilar atelectasis, left > right, with decreased visualization of diaphragm. cardiomegaly. likely small effusions.

WET READ VERSION #2 ___ ___ ___ 11:52 PM low lung volumes limit assessment. bibasilar atelectasis, left > right, with decreased visualization of diaphragm. retrocardiac consolidation would be difficult to exclude. cardiomegaly. likely small effusions. ______________________________________________________________________________

FINAL REPORT

HISTORY: Hypoxia after neck exploration, to assess for pulmonary edema.

FINDINGS: In comparison with the study of ___, there is again huge enlargement of the cardiac silhouette shown to reflect pericardial effusion. There is evidence of elevated pulmonary venous pressure with increasing right pleural effusion. Retrocardiac opacification is consistent with pleural effusion and volume loss in the left lower lobe. The possibility of supervening pneumonia would have to be considered in the appropriate clinical setting. Pacer device remains in place and there is evidence of previous left axillary dissection. Displacement of the lower cervical trachea to the left is presumably related to recent surgery in the region.


SubjectID: 17981003, StudyID: 55678166, Comparison: None

FINAL REPORT

INDICATION: Cough, status post extubation, please evaluate for pulmonary edema.

COMPARISON: ___.

TECHNIQUE: Single AP portable upright chest.

FINDINGS: Since the previous examination, the endotracheal tube, nasogastric tube, and right internal jugular venous access catheter have been removed. Cardiomegaly is unchanged. Left basilar/retrocardiac opacity is probably minimally progressed, and air bronchograms previously seen in this region are no longer visualized which may indicate a degree of mucous plugging. There is increased right retrocardiac opacity suggestive of increased atelectasis and/or consolidation. However, no evidence of interstitial edema. Osseous structures appear unchanged. Multiple surgical clips are seen in the soft tissues of the left chest wall.

IMPRESSION: Interval removal of lines and tubes. Increased bibasilar opacities suggestive of atelectasis and/or consolidation.


SubjectID: 17981003, StudyID: 55118788, Comparison: better

FINAL REPORT

HISTORY: Postoperative pneumonia versus heart failure, for OGT position.

FINDINGS: In comparison with the earlier study of this date, there has been placement of an OG tube that extends well into the distal stomach. Endotracheal tube tip is approximately 5.1 cm above the carina. The lung volumes are substantially improved. This may account for the apparent improvement in pulmonary vascularity, which now is essentially within radiographic limits of normal   Keywords: improve.


SubjectID: 17981003, StudyID: 54945642, Comparison: same

FINAL REPORT

HISTORY: New biventricular pacemaker, evaluate lead placement.

COMPARISON: ___.

FINDINGS: The right generator there 4 leads attached is seen in similar position to yesterday's radiograph. In the pocket of the generator is an air-fluid level. The leads are in unchanged position from yesterday with the new lead placed yesterday extending posterior in the coronary sinus and then looping superior and anterior possibly in the region of the intraventricular groove. It is in unchanged position from yesterday. Otherwise, there is no significant change in severe enlargement of the cardiomediastinal silhouette. A retrocardiac, left lower lobe opacity could be related to old pneumonia and bronchiectasis or recurrent consolidation, but is not significantly changed in appearance dating back to ___. No pneumothorax is present. There is no evidence of pulmonary vascular congestion.

IMPRESSION: 1. No change in the lead placement compared with yesterday's radiograph   Keywords: no change. 2. In the right chest wall pocket for the generator there is an air-fluid level. With the fluid possibly representing seroma, hematoma or pus, and air related to post operative state. Correlate with clinical exam. 3. Retrocardiac opacity could be related to old pneumonia and bronchiectasis or recurrent consolidation, but is not significantly changed in appearance dating back to ___. Findings discussed with Dr. ___ by Dr. ___ at 14:00 on ___ via phone.


SubjectID: 17981003, StudyID: 50493081, Comparison: same

FINAL REPORT

HISTORY: New biventricular pacemaker, evaluate pneumothorax.

COMPARISON: ___.

FINDINGS: A pacemaker generator is seen overlying the right chest with 4 leads attached, 3 in unchanged position, 1 in the expected location the right atrium and 2 in the expected location of the right ventricle. The ___ lead is new, terminating in the position of the obtuse marginal coronary vein with the wire extending through the coronary sinus. Severe enlargement of the cardiomediastinal silhouette with the contour suggestive of an element of pericardial effusion is not significantly changed from ___. The previous right pleural effusion and basilar opacity has resolved. There is no pneumothorax is present. Left lower lung opacities unchanged from ___   Keywords: unchanged. Surgical clips overlie the left axilla.

IMPRESSION: A new ___ pacemaker lead extends through the coronary sinus and terminates in the position of the obtuse marginal coronary vein with unchanged position of other 3 leads. No evidence of complication, particularly no pneumothorax.


SubjectID: 17982428, StudyID: 59663651, Comparison: None

FINAL REPORT

INDICATION: ___-year-old woman with weight gain, CHF, pneumonia.

COMPARISON: None at this institution.

FINDINGS: PA and lateral chest radiographs were obtained. Patchy opacities at the right lung base, right lower lobe are consistent with pneumonia or aspiration. Trace amount of fluid present in the minor fissure. No pleural effusions or pneumothorax are present. Severe cardiomegaly and mild interstitial edema are evident. Midline sternotomy wires are intact and aortic valve prosthesis is in expected location. The ascending aorta is ectatic.

IMPRESSION: 1. Opacity in the right lower lobe consistent with pneumonia or aspiration. 2. Emphysema 2. Severe cardiomegaly with mild interstitial edema.


SubjectID: 17982428, StudyID: 55944895, Comparison: same

FINAL REPORT

INDICATION: Diastolic CHF exacerbation, suggestion of right lower lobe pneumonia on prior chest x-ray, question of worsening CHF or pneumonia.

COMPARISON: Chest radiograph on ___.

FINDINGS: PA and lateral views of the chest. Patient is post-AVR with aortic valve in the appropriate position. Sternotomy wires are appropriately positioned. Moderate to severe cardiomegaly with unchanged mild interstitial pulmonary edema   Keywords: unchanged. Right lower lobe opacity is minimally increased. There is trace fluid in the minor fissure. No pleural effusion. No pneumothorax.

IMPRESSION: 1. Minimally increased right lower lobe opacity, either representing aspiration or pneumonia. 2. Cardiomegaly with unchanged mild interstitial edema   Keywords: unchanged.


SubjectID: 17982428, StudyID: 58848455, Comparison: same

FINAL REPORT

PA AND LATERAL CHEST RADIOGRAPHS, ___

COMPARISON: ___ chest x-ray.

FINDINGS: Cardiac silhouette remains enlarged, and is accompanied by pulmonary vascular congestion and persistent mild pulmonary edema   Keywords: remains, persistent. Small pleural effusions are present bilaterally. Note is made of previous median sternotomy and aortic valve replacement.

IMPRESSION: Cardiomegaly and mild congestive heart failure.


SubjectID: 17982428, StudyID: 53784400, Comparison: worse

FINAL REPORT

AP CHEST, 11:59 A.M., ___

HISTORY: CHF. New delirium and fevers.

IMPRESSION: AP chest compared to ___ through ___: Pulmonary vascular congestion and mediastinal venous engorgement have progressed since ___   Keywords: progressed. The irregularity of the small opacities in the lung could be due to edema in the setting of chronic lung disease or alternatively multifocal infection. Clinical correlation advised. Pleural effusions are presumed, but not substantial. No pneumothorax.


SubjectID: 17986383, StudyID: 59563046, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with dyspnea // eval chf/pna

COMPARISON: ___.

FINDINGS: AP portable upright view of the chest. Cardiomegaly is unchanged with significant enlargement of the main pulmonary artery, unchanged. There is increased opacity in the left lung base consistent with moderate pleural effusion and atelectasis, cannot exclude pneumonia. A small right pleural effusion is also present. Upper lung lucency is suggestive of emphysema. A nodular opacity projects over the right upper lung which appear stable from multiple prior exams. No pneumothorax. A right proximal humeral hardware is partially imaged. Widening of the left AC joint with elevated left distal clavicle is unchanged compatible with an old grade 3 AC joint separation.

IMPRESSION: 1. Bilateral pleural effusions with left basal atelectasis, cannot exclude pneumonia. 2. Probable underlying emphysema. 3. Additional chronic changes as described above.


SubjectID: 17986383, StudyID: 56928391, Comparison: same

WET READ: ___ ___ ___ 8:16 AM Single portable AP chest radiograph demonstrates an enlarged heart. Increased bilateral airspace opacities are noted concerning for worsening pulmonary edema. Cardiomediastinal and hilar contours are stable. Blunting of bilateral costophrenic angles is suggestive of pleural effusions.

WET READ VERSION #1 ___ ___ ___ 8:47 PM Single portable AP chest radiograph demonstrates an enlarged heart. Increased bilateral airspace opacities are noted concerning for worsening pulmonary edema. Cardiomediastinal and hilar contours are stable. Blunting of bilateral costophrenic angles is suggestive of pleural effusions. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF, COPD, worsened shortness of breath // eval for interval change in edema, any cause for worsened dyspnea?

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, there is unchanged moderate cardiomegaly with signs of mild pulmonary edema and bilateral pleural effusions, left more than right   Keywords: unchanged. Markedly enlarged left and right pulmonary arteries are suggesting pulmonary hypertension. Atelectasis in the retrocardiac lung regions is unchanged.


SubjectID: 17986383, StudyID: 51422291, Comparison: -1.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF exacerbation requiring BIPAP // eval for worsening pulmonary edema

TECHNIQUE: Single portable AP view radiograph of the chest.

COMPARISON: Prior chest radiographs dating back to___.

FINDINGS: Compared with the prior radiographs of ___, there is stable moderate cardiomegaly, and a large stable left pleural effusion. Lung volumes are low on the present study causing bronchovascular crowding. Allowing for this, the mild pulmonary edema in the left upper lung field is unchanged   Keywords: unchanged. There is mildly increased density in the right lung field, which may represent slight progression of right-sided pulmonary edema, though the interval change may be attributable to differences in lung volumes   Keywords: progression. The right pleural effusion has likely grown as it now extends into the horizontal fissure. The pulmonary arteries remain enlarged suggesting pulmonary hypertension.

IMPRESSION: 1. Increased density in the right lung field may represent slight progression of pulmonary edema or may be attributable to low lung volumes   Keywords: progression. 2. Likely increase in the small to moderate right pleural effusion, which now extends into the horizontal fissure. 3. Stable cardiomegaly, enlarged pulmonary arteries, left pleural effusion, and left-sided pulmonary edema.


SubjectID: 17986383, StudyID: 59534680, Comparison: same

FINAL REPORT

TYPE OF

EXAMINATION: Chest AP portable single view.

INDICATION: ___-year-old female patient with pulmonary hypertension, now presenting with hypoxic hypercapnic respiratory distress with worsening lung examination. Evaluate for interval change.

FINDINGS: AP single view of the chest has been obtained with patient in supine position. Analysis is performed in direct comparison with the next preceding similar study of ___. Cardiac enlargement and configurational changes compatible with pulmonary hypertension remain. The pulmonary congestive pattern; however, has markedly improved and so have the previous examination's suspected multifocal pulmonary parenchymal infiltrates. The lateral pleural sinuses remain free, so significant pleural effusion is unlikely. No pneumothorax in the apical area. The relatively rapid improvement of the previously-described pulmonary findings suggests that they were mainly related to CHF and atypical appearance of pulmonary edema. As there are some hazy parenchymal densities persisting in the right middle lung field and the left upper lobe area, further followup is recommended   Keywords: persisting.

IMPRESSION: Marked improvement of pulmonary congestive pattern and parenchymal densities, most likely the result of successful treatment of CHF.


SubjectID: 17986383, StudyID: 58214481, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old female with hypoxia. Evaluate for pneumonia.

EXAMINATION: Single frontal chest radiograph.

COMPARISONS: ___, ___, and ___.

FINDINGS: Asymmetrically distributed multifocal opacification is increased since ___, particularly involving the left upper lobe, though also within the right upper lobe and right lower lobe   Keywords: increase. There is a more nodular opacity demonstrated within the right upper lobe which has been previously demonstrated since at least ___. There are no large pleural effusions or pneumothorax. The cardiomediastinal and hilar contours are stable, demonstrating borderline cardiomegaly. There is marked enlargement of the main pulmonary artery, indicative of pulmonary arterial hypertension.

IMPRESSION: 1. Worsening multifocal opacification   Keywords: worse. Recommend clinical correlation for infection, and in the absence of concern for infection, CT of the chest is recommended to exclude the possibility of malignancy. 2. Pulmonary artery enlargement compatible with pulmonary arterial hypertension. Findings were discussed with Dr. ___ at 2 p.m. on ___ via telephone by Dr. ___ ___ telephone.


SubjectID: 17986383, StudyID: 58329656, Comparison: None

FINAL REPORT

AP CHEST, 5:03 A.M. ON ___

HISTORY: Oliguria.

IMPRESSION: AP chest compared to ___ through ___, 7:21 p.m.: Small region of peribronchial opacification in the right lower lobe could be atelectasis or aspiration. It is new since ___. Aneurysmal dilatation of the pulmonary arteries indicating severe pulmonary hypertension, and moderate cardiomegaly are longstanding. Peripheral pulmonary vascular engorgement is more pronounced now than it was in early ___, unchanged since ___. This could represent an element of left heart decompensation, but there is no pulmonary edema and pleural effusions, if present, are small. Right subclavian line ends in the upper right atrium. No pneumothorax or mediastinal widening.


SubjectID: 17986383, StudyID: 53807058, Comparison: better

WET READ: ___ ___ ___ 9:12 PM New right subclavian venous catheter ends in the right atrium. No definite pneumothorax. Otherwise, no significant interval change. ______________________________________________________________________________

FINAL REPORT

AP CHEST, 7:21 P.M., ___

HISTORY: Evaluate central venous catheters.

IMPRESSION: AP chest compared to ___: Tip of the new right subclavian line ends in the upper right atrium approximately 2 cm below the estimated location of the superior cavoatrial junction. Moderate cardiomegaly and aneurysmal dilatation of the pulmonary arteries indicating pulmonary arterial hypertension are longstanding. Pulmonary vascular engorgement has improved since earlier in the day   Keywords: improve. No pneumothorax, mediastinal widening or pleural effusion.


SubjectID: 17986383, StudyID: 57907974, Comparison: None

FINAL REPORT

HISTORY: Hypercarbic respiratory failure.

FINDINGS: In comparison with study of ___, there is continued enlargement of the cardiac silhouette with some element of increased pulmonary venous pressure. Striking prominence of the central pulmonary vessels, consistent with pulmonary arterial hypertension. Elevation of the left hemidiaphragm with blunting of the costophrenic angle is consistent with some atelectatic changes with pleural effusion. Of incidental note is the fixation device in the proximal humerus.


SubjectID: 17986383, StudyID: 52817393, Comparison: None

FINAL REPORT

HISTORY: Hypercarbic respiratory failure.

FINDINGS: In comparison with study of ___, the patient has taken a somewhat better inspiration. Continued enlargement of the cardiac silhouette with some element of mild pulmonary vascular congestion. Striking prominence of the central pulmonary vessels persist, consistent with pulmonary artery hypertension. Elevation of the left hemidiaphragmatic contour with blunting of the costophrenic angle is again consistent with atelectatic changes and pleural effusion.


SubjectID: 17986383, StudyID: 57392001, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF COPD // pleural effusions, PNA pleural effusions, PNA

TECHNIQUE: Single portable AP view radiograph of the chest.

COMPARISON: Prior chest radiographs dating back to___.

FINDINGS: The large left pleural effusion and left lung collapse causing complete opacification of the left hemithorax are unchanged. Increasing airspace opacity in the right lung is concerning for pneumonia. Cross-sectional imaging would be helpful to clarify the relative contributions of effusion, collapse, and consolidation and evaluate for possible bronchial obstruction. Right-sided pleural effusion is small is present at all. There is a well-healed proximal right humeral fracture with partially imaged stabilizing intramedullary rod.

IMPRESSION: 1. Increasing possible right pneumonia. 2. Persistent left lung collapse and pleural effusion. Chest CT could clarify the extent of effusion, collapse, and consolidation and evaluate possible bronchial obstruction.


SubjectID: 17986383, StudyID: 53465941, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF and COPD. // assess interval change assess interval change

IMPRESSION: In comparison with the study of ___, there is increased opacification at the left base consistent with accumulating pleural fluid, atelectasis, or, in the appropriate clinical setting, even superimposed pneumonia. The left pigtail catheter is again seen, though it appears to be kinked at at least 1 position along its course. The area of opacification in the left mid zone is again seen, though the rounded margin is not as apparent. Again, this area should be followed to exclude a neoplastic process, although CT may eventually be necessary for this purpose.


SubjectID: 17986383, StudyID: 52541841, Comparison: same

FINAL REPORT

INDICATION: Shortness of breath.

COMPARISON: Radiograph from ___ at 7:45.

TECHNIQUE: Frontal chest radiograph.

FINDINGS: There is marker worsening of a large left pleural effusion with complete opacification of the left hemithorax. There is continued central pulmonary vascular congestion with mild pulmonary edema   Keywords: continue. Severe degenerative changes throughout the glenoid normal joints are again seen. A right humeral rod is incompletely visualized.

IMPRESSION: 1. Markedly worsened large left pleural effusion. 2. Pulmonary vascular congestion with mild pulmonary edema.


SubjectID: 17986383, StudyID: 57169412, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF and left lung whiteout s/p chest tube // interval change in pleural effusion

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Severe enlargement of pulmonary artery is present. Left pigtail catheter is in place. Right basal consolidation has progressed and might be consistent with progression of pulmonary edema. Infectious process is less likely. No change in suspected minimal left apical pneumothorax is present


SubjectID: 17986383, StudyID: 53975711, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF, pleural effusions. // assess interval change

TECHNIQUE: Single portable AP view radiograph of the chest.

COMPARISON: Prior chest radiographs dating back to___.

FINDINGS: Compared with the immediate prior study of ___, there is little relevant change   Keywords: little relevant change. Significant enlargement of the pulmonary arteries is unchanged, bilateral diffuse airspace opacities are compatible with moderate to severe edema, also unchanged   Keywords: unchanged. The left base pigtail catheter is in unchanged position. No pleural effusion. There is no definite pneumothorax. The heart is stably moderately enlarged.

IMPRESSION: 1. Unchanged severe pulmonary arterial enlargement, and moderate to severe diffuse airspace opacities, compatible with edema. 2. No pleural effusion.


SubjectID: 17986383, StudyID: 56924552, Comparison: None

WET READ: ___ ___ ___ 3:24 AM Interval removal of left chest tube. No substantial change otherwise. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with altered mental status, obtundation, s/p CT removal // r/o PTX

TECHNIQUE: Portable chest

COMPARISON: ___ at 10:00

FINDINGS: Interval removal of left chest tube. No substantial change otherwise. No pneumothorax

IMPRESSION: Interval removal of left chest tube. No substantial change otherwise.


SubjectID: 17986383, StudyID: 56082665, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with COPD, CHF, known pleurla effusion s/p CT that has been clamped, tachypnea to ___ RR // assess PTX, worsening effusion, edema assess PTX, worsening effusion, edema

IMPRESSION: In comparison with the study of ___, there is little overall change in the enlargement of the cardiac silhouette, left pleural pigtail catheter without pneumothorax, and elevated pulmonary vascular pressure. Prominence of the pulmonary arteries is again noted. Incidental note is a fixation device about previous fracture of the proximal right humerus.


SubjectID: 17986383, StudyID: 53358238, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with pleural effusion, removal of chest tube // r/o PTX

TECHNIQUE: Portable chest

COMPARISON: ___.

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change. No pneumothorax


SubjectID: 17986383, StudyID: 52555873, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with dCHF, PHTN, recently in CCU with HCAP. had been off vanc/cefep, afebrile. now febrile to 100.3, resp status stable, on 2l O2, which is baseline. // eval for interval change, new or changing consolidation

TECHNIQUE: Portable chest

COMPARISON: ___.

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change.


SubjectID: 17986383, StudyID: 55188954, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with ___ year old woman with L pleural effusion s/p chest tube, now removed // reaccumulation of L pleural effusion ? consolidation

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Massive enlargement of the pulmonary arteries. Minimal to moderate blunting of the left costophrenic sinus, potentially consistent with a mild to moderate left pleural effusion. No overt pulmonary edema. No pneumonia. Left retrocardiac atelectasis.


SubjectID: 17986383, StudyID: 54469108, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with ___ year old woman with L pleural effusion s/p chest tube, now removed // year old woman with L pleural effusion s/p chest tube, now removed year old woman with L pleural effusion s/p chest tube, now

IMPRESSION: In comparison with the study of ___, there is probably an little overall change or slight worsening of the left pleural effusion. Engorgement of indistinct pulmonary vessels is consistent with elevated pulmonary venous pressure in this patient with substantial enlargement of the cardiac silhouette.


SubjectID: 17986383, StudyID: 54578855, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Increased somnolence, evaluate chest x-ray.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. No acute changes. Known cardiomegaly with signs of massive pulmonary hypertension. No pneumonia, no pleural effusions, no acute cardiac failure.


SubjectID: 17986383, StudyID: 52418589, Comparison: None

FINAL REPORT

STUDY: PA and lateral chest radiograph.

INDICATION: Shortness of breath. To evaluate for pneumonia.

TECHNIQUE: AP and lateral chest radiographs were obtained.

COMPARISON: ___. REPORT. When compared to prior study, a right-sided central line has been removed. Patient's orthopedic hardware is again noted in the right shoulder as is modeling deformity here. The heart is mildly enlarged, although this is an AP radiograph. Unfolding of the thoracic aorta is again seen. Allowing for technique and projection, the lungs are grossly clear. The osseous structures show a dorsal kyphosis. On the lateral view there is a reasonably well identified posterior rounded opacity, present on study dated ___ and which likely reflects the chronic right-sided nodules known to be present in this patient.

CONCLUSION: No definitive acute findings. Extensive chronic changes of pulmonary arterial hypertension. No definitive acute findings.


SubjectID: 17986383, StudyID: 50823013, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with COPD and CHF. // assess interval change

IMPRESSION: As compared to ___, comparison is somewhat limited due to positional differences. Although a moderate left pleural effusion is similar to the prior study, a small right pleural effusion has apparently increased. Markedly enlargement of cardiac silhouette is similar as well as persistent pulmonary vascular congestion   Keywords: persistent, similar.


SubjectID: 17987679, StudyID: 50181227, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: ___. CLINICAL

HISTORY: Edema, history of CHF.

FINDINGS: There is pulmonary edema and small bilateral pleural effusions. Heart size is difficult to assess. The aorta is densely calcified. There is no pneumothorax seen. Bony structures are intact. Dual-lead pacer is unchanged.

IMPRESSION: Findings compatible with pulmonary edema.


SubjectID: 18000379, StudyID: 57516501, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___ WITH

COMPARISON RADIOGRAPH OF EARLIER THE SAME DATE

FINDINGS: Right-sided chest tube remains in place, with a persistent small right apical pneumothorax. Visceral apical pleural line is at the level of the fourth posterior rib level, similar to the prior radiograph, allowing for slight positional differences. Cardiomediastinal contours are stable in appearance in the postoperative period. Multifocal atelectasis in the right mid and both lower lung regions is unchanged.


SubjectID: 18000379, StudyID: 55748408, Comparison: None

WET READ: ___ ___ ___ 9:09 PM No acute intrathoracic process. Moderate cardiomegaly is new from ___. ______________________________________________________________________________

FINAL REPORT

PORTABLE CHEST RADIOGRAPH DATED ___

COMPARISON: ___ radiograph.

FINDINGS: Cardiac silhouette is enlarged and appears increased from the prior radiograph, but accentuation by portable AP technique may contribute to this apparent change. Pulmonary vascular congestion is accompanied by mild interstitial edema and a possible small right pleural effusion.


SubjectID: 18006842, StudyID: 59597753, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man with nausea, vomiting, and epigastric pain for two days status post pacer lead placement. Evaluate for cardiopulmonary process or free air.

COMPARISON: Multiple prior radiographs, most recently ___ ___.

FINDINGS: Frontal and lateral views of the chest were obtained. There is moderate cardiomegaly, similar to prior. There is crowding of pulmonary vasculature, exaggerated by low lung volumes. The lungs are otherwise clear without focal or diffuse abnormality. There is no evidence of pleural effusion, pneumothorax, or pneumoperitoneum. Triple lead left chest wall pacer is seen with wires terminating in the right ventricle, right atrium, and left ventricle via the coronary sinus. No new radiopaque foreign bodies. The osseous structures are unremarkable.

IMPRESSION: No acute cardiopulmonary process. No pneumothorax or pneumoperitoneum.


SubjectID: 18006842, StudyID: 56980205, Comparison: None

FINAL REPORT

HISTORY: ICD lead extraction and replacement.

FINDINGS: In comparison with the study of ___, there is little change in the position of the pacer leads. No evidence of pneumothorax or acute focal pneumonia.


SubjectID: 18006842, StudyID: 54156702, Comparison: None

FINAL REPORT

HISTORY: ICD lead extraction and replacement, to assess for pneumothorax.

FINDINGS: In comparison with study of ___, the leads extending to the right atrium and apex of the right ventricle are unchanged. There now is a coronary sinus lead with the tip positioned along the outer margin of the left ventricle. Specifically, there is no evidence of pneumothorax.


SubjectID: 18006842, StudyID: 56350245, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with hypoxia, dyspnea, chest pressure // evaluate for acute process

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: Triple lead left-sided AICD is again seen with leads in the expected positions of the right ventricle, coronary sinus, and right atrium. The cardiac silhouette is markedly enlarged. The size of the cardiac silhouette appears increased as compared to the prior study although this may in part relate to a AP, portable technique. There is prominence of the hila and central pulmonary vasculature suggesting vascular engorgement and pulmonary vascular congestion with possible mild edema. . No large pleural effusion is seen. There is no evidence of pneumothorax.

IMPRESSION: Marked enlargement of the cardiac silhouette, appears increased in size compared the prior study, however, this may relate to AP, portable technique. Underlying cardiomyopathy or pericardial effusion not excluded. Central pulmonary vascular engorgement, pulmonary vascular congestion.


SubjectID: 18006842, StudyID: 55561052, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF, dyspnea // Please eval for edema

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Cardiomegaly is substantial. There is interval progression of pulmonary edema, currently severe   Keywords: progression. No interval increase in pleural effusion demonstrated. Position of the biventricular pacer leads is unchanged

NOTIFICATION: Discussed with Dr. ___ ___ the phone by Dr. ___ at 09:45 on ___, ___ min after the findings were made


SubjectID: 18026668, StudyID: 53381292, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with new cough // ? consolidation concerning for PNA ? consolidation concerning for PNA

IMPRESSION: In comparison with the study ___ ___, there is little overall change   Keywords: little overall change. Obliquity of the patient is somewhat obscures detail. Mild elevation of pulmonary venous pressure is probably present. There are slightly lower lung volumes.


SubjectID: 18026668, StudyID: 50210966, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female with lower extremities swelling and coronary artery disease. Evaluate for volume overload.

COMPARISON: None available.

FINDINGS: Frontal and lateral radiograph of the chest demonstrates prominent interstitial markings with an enlarged heart concerning for pulmonary edema. Blunting of bilateral costophrenic angles suggests trace pleural effusions. No focal opacity is identified. Patient is rotated to her right likely sequela of scoliosis. Mediastinal contour or demonstrates tortuous descending aorta. Patient is status post median sternotomy with sternotomy wires identified as well as mitral valve repair. Several surgical clips are identified within the anterior mediastinum. No acute osseous abnormality is identified.

IMPRESSION: Interstitial pulmonary edema with mildly enlarged heart.


SubjectID: 18029015, StudyID: 59758478, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST, ___

HISTORY: ___-year-old woman with dyspnea, improving with diuresis.

IMPRESSION: PA and lateral chest compared to ___: Small-to-moderate right pleural effusion and the small region of consolidation at the right lung base, which developed between ___, are unchanged. Mild enlargement of the cardiac silhouette, exaggerated by low lung volumes, is also stable. Upper lungs show mild vascular engorgement but no edema. No pneumothorax.


SubjectID: 18029015, StudyID: 52830428, Comparison: None

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Chest pain.

COMPARISONS: ___.

TECHNIQUE: Chest, PA and lateral.

FINDINGS: The heart is again mildly enlarged. There is similar mild unfolding of the thoracic aorta as well as calcification visualized along the arch. There is a new small-to-moderate right-sided pleural effusion that prominently layers along the right lateral chest wall as well as new patchy right basilar opacity obscuring the left hemidiaphragm. The lateral view suggests a developing posterior consolidation in the right lower lobe. There are also new small patchy left basilar opacities obscuring the lateral side of the left hemidiaphragm. Fissures are also thickened reflecting pleural fluid on the right. Mild degenerative changes are similar along the lower thoracic spine.

IMPRESSION: Developing right lower lobe consolidation with a new right-sided pleural effusion. Patchy left basilar atelectasis, not specific and potentially reflecting either an additional focus of pneumonia or atelectasis.


SubjectID: 18031120, StudyID: 59442461, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with mixed cardiogenic and septic shock // interval change, line placement interval change, line placement

IMPRESSION: Scatter radiation related to the size of the patient greatly obscures detail. In comparison with the study of ___, there again are low lung volumes with substantial enlargement of the cardiac silhouette and pacer device in place. Minimal if any vascular congestion. The tip of the left IJ sheath appears to be in the region of the brachiocephalic vein. The right PICC line is been removed. The left hemidiaphragm is not sharply seen, suggesting possible small effusion and atelectasis.


SubjectID: 18031120, StudyID: 57036753, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with decompensated CHF on bumex drip // interval change

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change.


SubjectID: 18031120, StudyID: 53646431, Comparison: None

WET READ: ___ ___ ___ 6:25 PM Moderate cardiomegaly. Interval placement of a left internal jugular Cordis without pneumothorax. Exact location difficult to delineate, its tip which projects somewhat more inferiorly than expected location of brachiocephalic. Clinical correlation with blood gas to ensure venous placement or alternatively lateral may be helpful for further evaluation. *** ED URGENT ATTENTION *** ______________________________________________________________________________

FINAL REPORT

INDICATION: History: ___M s/p left IJ cordis placement // eval IJ placement, for pneumothorax

TECHNIQUE: Upright portable

COMPARISON: Chest radiograph dated ___ at approximately 11:50

FINDINGS: Portable upright AP chest radiograph demonstrates an enlarged heart. A left chest pacer defibrillator device is present, its leads which appear intact in the in stable configuration relative to prior examination. There has been interval placement of a left internal jugular Cordis, its tip which projects more inferiorly than the expected location of the brachiocephalic vein. There is no pneumothorax. A right PICC terminates within the low superior vena cava. There is no large pleural effusion. Central vascular engorgement is mild. No focal consolidation is identified convincing for pneumonia given low lung volumes, portable technique and patient body habitus.

IMPRESSION: Moderate cardiomegaly. Interval placement of a left internal jugular Cordis without pneumothorax. Exact location difficult to delineate, its tip which projects somewhat more inferiorly than expected location of brachiocephalic. Clinical correlation with blood gas to ensure venous placement or alternatively lateral may be helpful for further evaluation.


SubjectID: 18031120, StudyID: 53299470, Comparison: same

FINAL REPORT

EXAMINATION: Chest radiograph portable.

INDICATION: History: ___M with CHF presents with chest pain and shortness of breath

TECHNIQUE: AP view of the chest, 1 image

COMPARISON: Portable chest x-ray ___

FINDINGS: There is moderate cardiomegaly that is grossly unchanged from ___. Cephalization of the pulmonary vasculature is compatible with mild pulmonary vascular congestion. Lungs are otherwise clear. There is no pleural effusion or focal opacity. Left chest wall AICD with transvenous pacer lead terminating in the expected location of the right ventricle. A right PICC terminates in the upper SVC. No pneumothorax.

IMPRESSION: Moderate cardiomegaly, unchanged from ___, with mild pulmonary vascular congestion, similar to the previous study   Keywords: similar, unchanged. No evidence of pneumonia.


SubjectID: 18031120, StudyID: 59333889, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with shortness of breath, tachycardia, tachypnea

TECHNIQUE: Portable upright AP view of the chest

COMPARISON: ___, ___ chest radiographs

FINDINGS: Left-sided AICD device is noted with single lead terminating in the region of the right ventricle, unchanged. Severe enlargement of cardiac silhouette is again noted. Mediastinal and hilar contours are unchanged. There is mild upper zone vascular redistribution with mild pulmonary vascular engorgement, not changed in the interval and likely chronic. Minimal atelectasis is noted in the right lung base. No focal consolidation, pleural effusion or pneumothorax is identified. No acute osseous abnormality is present.

IMPRESSION: Severe cardiomegaly with mild pulmonary vascular congestion, likely chronic.


SubjectID: 18031120, StudyID: 55643091, Comparison: worse

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___-year-old man with a history of systolic CHF, now with Swan-Ganz catheter.

TECHNIQUE: Portable AP chest radiograph

COMPARISON: Multiple prior chest radiographs, most recent from ___.

FINDINGS: Right IJ Swan-Ganz catheter terminates in the descending pulmonary artery and smaller intracardiac loop reflects interval catheter withdrawal. Left pectoral pacemaker with right ventricular lead following the expected course. Unchanged, moderate to severe cardiomegaly. Mild pulmonary edema with worsening in the right lower lobe   Keywords: worse   Keywords: worse. Unchanged opacity at the left base likely reflects atelectasis.

IMPRESSION: Mild pulmonary edema with worsening in the right lower lobe.


SubjectID: 18031120, StudyID: 58556177, Comparison: better

FINAL REPORT

INDICATION: ___ year old man with CHF and pulmonary congestion // assess status of pulmonary congestion

EXAMINATION: CHEST (PORTABLE AP)

TECHNIQUE: Portable chest radiograph, frontal view

COMPARISON: Chest radiograph ___

FINDINGS: Left pectoral pacemaker has a lead with two electrodes located terminating superior to right atrium and at right ventricle. Right internal jugular Swan-Ganz catheter appears to terminate in the central right pulmonary artery. Mild pulmonary edema is slightly improved   Keywords: improve   Keywords: improve. There is no large pleural effusion. Severe cardiomegaly is unchanged.

IMPRESSION: Mild pulmonary edema is slightly improved.


SubjectID: 18031120, StudyID: 57924498, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF and Swan Ganz in place // ___ year old man with CHF and Swan Ganz in place ___ year old man with CHF and Swan Ganz in place

COMPARISON: Prior chest radiographs ___ through ___ at 07:37.

IMPRESSION: Severe cardiomegaly has increased, mild pulmonary edema not appreciably changed   Keywords: increase. Left trans subclavian right ventricular pacer defibrillator lead unchanged in position. Swan-Ganz catheter ending in the descending right pulmonary artery should be withdrawn 4 cm to standard position. Previous attempt at withdrawal failed to move the catheter tip, instead it reduced the intracardiac loop. Pleural effusion small if any. No pneumothorax.


SubjectID: 18031120, StudyID: 58627394, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with ischemic cardiomyopathy with cough and congestion // evaluate for pnuemonia evaluate for pnuemonia

COMPARISON: Comparison to ___ at 15:23

FINDINGS: Portable upright chest radiograph ___ 11:40 is submitted.

IMPRESSION: Right subclavian PICC line and left-sided pacer/AICD are unchanged in position. The heart remains stably enlarged likely reflecting cardiomegaly, although pericardial effusion should also be considered. There has been interval appearance of mild to moderate pulmonary and interstitial edema. No pneumothorax.


SubjectID: 18031120, StudyID: 57433034, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with heart failure. // Please eval for interval change. Please eval for interval change.

COMPARISON: ___ obtained at 22:34

IMPRESSION: Since the prior study there has been interval improvement in interstitial edema with only vascular congestion currently seen   Keywords: improve. Pacemaker defibrillator is in unchanged position terminating in the right ventricle. Right PICC line tip terminates most likely at the level of lower SVC.


SubjectID: 18031120, StudyID: 56887689, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with vague symptoms including chest pain // r/o occult infection, r/p increasing pulmonary edema r/o occult infection, r/p increasing pulmonary edema

COMPARISON: ___

IMPRESSION: Right PICC line tip is at the level of mid SVC. There is substantial cardiomegaly, similar to previous examination. The patient is in mild interstitial edema that appears to be slightly more pronounced than on the prior studies. No substantial interval increase in pleural effusion demonstrated. No pneumothorax is seen.


SubjectID: 18031120, StudyID: 58360875, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cardiogenic shock and PA line // interval change interval change

IMPRESSION: In comparison with the study of ___, the monitoring and support devices are unchanged. There are low lung volumes with substantial enlargement of the cardiac silhouette with little if any vascular congestion. This discordance raises the possibility of cardiomyopathy or pericardial effusion.


SubjectID: 18031120, StudyID: 57733597, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cardiogenic shock, PA line // line placement, interval changes line placement, interval changes

IMPRESSION: In comparison with the study of ___, there is little change   Keywords: little change. Again there is substantial enlargement of the cardiac silhouette with little change in the appearance of the Swan-Ganz catheter and pacer lead. No evidence of pulmonary edema or acute focal pneumonia.


SubjectID: 18031120, StudyID: 57358080, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with sCHF with swan in place. eval location of swan // evaluate location of PA catheter evaluate location of PA catheter

IMPRESSION: In comparison with the study of ___, the appearance of the Swan-Ganz catheter and pacer device is unchanged. There are slightly better lung volumes with continued enlargement of the cardiac silhouette with little or no vascular congestion, raising the possibility of underlying cardiomyopathy or pericardial effusion.


SubjectID: 18031120, StudyID: 52666812, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with acute decompensated heart failure. // ___ year old man with acute decompensated heart failure. ___ year old man with acute decompensated heart failure.

IMPRESSION: In comparison with the earlier study of this date, there is again substantial enlargement of the cardiac silhouette with minimal if any elevation in pulmonary venous pressure. Monitoring and support devices are unchanged.


SubjectID: 18031120, StudyID: 55533744, Comparison: same

WET READ: ___ ___ ___ 8:11 AM Swan-Ganz catheter is in similar position projecting over the right pulmonary artery. A cardiac pacer is in similar position. The cardiac silhouette is enlarged and stable in size. There is porta breast congestion and mild interstitial edema. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with end stage CHF, on dobutamine and bumex gtt, PA cath adjusted // PA catheter in place?

COMPARISON: ___

IMPRESSION: No relevant change as compared to the previous image   Keywords: no relevant change. The Swan-Ganz catheter is in constant position. Unchanged position of the pacemaker wires. Moderate cardiomegaly and mild fluid overload persist.


SubjectID: 18031120, StudyID: 56477454, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with swan in place // Please evaluate swan position

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the Swan-Ganz catheter has been advanced. Currently, the line should be pulled back by approximately 4 cm given its relatively peripheral location in the right pulmonary artery. Low lung volumes. Moderate cardiomegaly. The other monitoring and support devices are unchanged.


SubjectID: 18031120, StudyID: 54235032, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with possible displaced Swan. // Check Swan

TECHNIQUE: Two portable AP radiographs of the chest.

COMPARISON: ___.

FINDINGS: The radiograph timed stamped ___ hr shows the Swan-Ganz catheter in the distal right pulmonary artery. The radiograph labeled 'AP semi-erect' shows that the Swan-Ganz catheter tip is roughly 2 cm more proximal within the right pulmonary artery. A left pectoral AICD is in place. Moderate pulmonary edema has slightly improved   Keywords: improve. Moderate cardiomegaly despite the projection is stable. There is no pneumothorax.

IMPRESSION: Swan-Ganz catheter tip position described above. Improved moderate pulmonary edema   Keywords: improve. Stable moderate cardiomegaly.


SubjectID: 18031120, StudyID: 52854002, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cardiogenic shock // Eval lines, improvement

COMPARISON: ___.

IMPRESSION: Low lung volumes. Left pectoral Port-A-Cath in situ. On the right, the patient has received a Swan-Ganz catheter. The catheter shows a normal course, the tip is positioned relatively distal in the right lower lobe artery. The tip should be pulled back by approximately 3 cm. No pleural effusions. No pneumothorax. Moderate pulmonary edema.


SubjectID: 18033939, StudyID: 52791103, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Pleural effusion, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the extent of the right pleural effusion and of left pleural effusion are overall unchanged. There is unchanged evidence of severe pulmonary edema with a predominantly vascular and interstitial component   Keywords: unchanged. Unchanged appearance of the cardiac silhouette. No pneumothorax.


SubjectID: 18033939, StudyID: 59589938, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with pulmonary hypertension, pulmonary edema, effusion s/p chest tube placement // interval change

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Moderate cardiomegaly. Extensive bilateral parenchymal opacities with air bronchograms. Minimal left pleural effusion. No new opacities   Keywords: new. No overall change in lung volumes   Keywords: no overall change.


SubjectID: 18033939, StudyID: 57596899, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with severe pulmonary HTN and right sided heart failure here with volume overload and recurrent effusions. // Interval change, effusions

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, there is a minimal improvement of the right-sided component of the mass is bilateral multifocal parenchymal opacities. In the left lung, no change is noted   Keywords: no change. Unchanged appearance of the cardiac silhouette. No new parenchymal opacities   Keywords: new.


SubjectID: 18033939, StudyID: 56659267, Comparison: worse

FINAL REPORT

HISTORY: Severe pulmonary hypertension and right heart failure after aggressive diuresis.

FINDINGS: In comparison with the study of ___, the diffuse bilateral pulmonary opacifications have worsened consistent with severe pulmonary edema, bilateral effusions, and compressive atelectasis at the bases   Keywords: worse.


SubjectID: 18033939, StudyID: 58821667, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman with myelofibrosis and pulmonary hypertension with volume overload and Gram-negative bacteremia, status post thoracentesis.

FINDINGS: Comparison is made to previous study from ___. There has been worsening of the left retrocardiac opacity since the previous study. There are diffuse airspace opacities. Multifocal pneumonia versus overt pulmonary edema are likely both present. There is also likely a right-sided pleural effusion. Increase density at the left apex is likely due to overlying external object.


SubjectID: 18033939, StudyID: 53472532, Comparison: None

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Shortness of breath and congestive heart failure.

COMPARISONS: ___.

TECHNIQUE: Chest, AP upright and lateral views.

FINDINGS: The heart is at least moderately enlarged, although its contours are difficult to completely assess. There is a moderate to large pleural effusion on the left side, which has increased. There is probably at least a small pleural effusion on the right side. Diffuse bilateral hazy opacification of each lung, although somewhat greater on the right than left, is most likely, at least primarily, due to pulmonary edema. Sclerosis of bones may be associated with metabolic abnormalities associated with renal failure.

IMPRESSION: Findings most consistent with pulmonary edema. Short-term radiographic followup is recommended after diuresis to exclude the possibility of coinciding pneumonia.


SubjectID: 18033939, StudyID: 57566617, Comparison: None

FINAL REPORT

HISTORY: Hypoxia.

COMPARISON: Outside hospital chest radiograph from the same day.

FINDINGS: There are bilateral diffuse interstitial opacities, predominantly upper lobes, consistent with severe pulmonary edema. However, underlying consolidation or superimposed infectious process is not cannot be excluded. Heart size is at the upper limits of normal. No acute fractures are identified.

IMPRESSION: Findings concerning for severe pulmonary edema. However, an underlying infectious process is not excluded. Recommend repeat after diuresis.


SubjectID: 18033939, StudyID: 54565922, Comparison: better

FINAL REPORT

HISTORY: Elevated white count and possible change in fluid status.

FINDINGS: In comparison with the study of ___, there has been some decrease in the degree of cardiomegaly and pulmonary vascular congestion, though mediastinal widening and bilateral opacifications persist   Keywords: decrease. In view of the clinical setting, some element of supervening pneumonia must be considered.


SubjectID: 18033939, StudyID: 56531593, Comparison: worse

FINAL REPORT

INDICATION: ___F with PAH and CHF exacerbation, sudden desaturation and non-rebreather requirement. Evaluate for new opacity.

TECHNIQUE: Frontal chest radiographs were obtained with the patient in the upright position.

COMPARISON: Radiograph from ___, ___ and CT from ___.

FINDINGS: The heart continues to be moderately enlarged with vascular engorgement and interval increase in bilateral parenchymal and interstitial opacities   Keywords: increase. There are small bilateral pleural effusions.

IMPRESSION: Cardiomegaly with interval increase in the bilateral parenchymal and interstitial opacities.


SubjectID: 18033939, StudyID: 50866742, Comparison: same

FINAL REPORT

EXAMINATION: Chest radiographs.

INDICATION: Dyspnea.

TECHNIQUE: Chest, PA and lateral.

COMPARISON: ___.

FINDINGS: The heart appears mild to moderately enlarged. Central pulmonary arteries are again prominent in size. Small pleural effusions are present bilaterally. Heterogeneous hazy opacification of each lung is very similar to the prior examination and suggests long chronicity to the parenchymal abnormality without clear acute change   Keywords: similar.

IMPRESSION: Heterogeneous hazy opacification with similar appearance to two months earlier.


SubjectID: 18043096, StudyID: 59577719, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with desaturation episode, known HCAP, recurrent fever, s/p repositioning OGT. // please eval for interval change please eval for interval change

IMPRESSION: Comparison to ___, 05:32. Monitoring and support devices are constant. The pre-existing parenchymal opacity at the right lung base has increased in extent and severity. More air bronchograms are visualized. The time course and morphology of the changes is suggestive of either recurrent aspiration or recurrent pneumonia. No new parenchymal opacities   Keywords: new. Borderline size of the cardiac silhouette.


SubjectID: 18043096, StudyID: 58914031, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with sudden onset hypotension, hypoxia // eval for acute process eval for acute process

IMPRESSION: In comparison with the study of ___, there is increasing opacification at the right base, worrisome for aspiration pneumonia. Monitoring and support devices are stable, as is the appearance of the left lung.


SubjectID: 18043096, StudyID: 55319493, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with HCAP // please eval for interval change; schedule for am rounds ___ please eval for interval change; schedule for am rounds ___

COMPARISON: Chest radiographs ___ through ___.

IMPRESSION: Consolidation and atelectasis at the right lung base, which worsened from ___ to ___, has improved slightly, accompanied by stable small right pleural effusion. No pneumothorax. Borderline cardiomegaly stable. No pulmonary edema. ET tube and left subclavian line are in standard placements and esophageal drainage tube ends in the upper portion of a nondistended stomach.


SubjectID: 18043096, StudyID: 50496703, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with altered mental status with PNA at right lung base // eval pneumonia eval pneumonia

IMPRESSION: In comparison with the study of ___, there is little change in the opacification at the right base silhouetting the hemidiaphragm and consistent with pneumonia. The remainder the study as well as monitoring and support devices are essentially unchanged.


SubjectID: 18043096, StudyID: 56461105, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with decreased O2 sat, rib fractures // ? worsening pulm status

TECHNIQUE: Portable chest

COMPARISON: ___.

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change.


SubjectID: 18043096, StudyID: 50807474, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with OG tube, ETT // ? OGT placement ? OGT placement

IMPRESSION: In comparison with the earlier study of this date, there has been placement of a nasogastric tube that extends at least to the mid to upper body of the stomach, were crosses the lower margin of the image. Otherwise, little change   Keywords: little change.


SubjectID: 18043096, StudyID: 58808266, Comparison: None

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: History: ___M s/p mechanical fall to the left with left back pain // Please do CXR if unable to do CT chest. fracture? acute pulmonary process?

TECHNIQUE: Chest: Frontal and Lateral

COMPARISON: ___

FINDINGS: Patient's chin overlies a medial lung apices, partially obscuring the view. The patient is status post median sternotomy. The cardiac and mediastinal silhouettes are grossly stable. There is moderate pulmonary vascular congestion. There is persistent elevation of the right hemidiaphragm and overlying atelectasis. Bilateral rib fractures, some of which are old and some of which are new for better assessed on preceding CT. No large pleural effusion or pneumothorax is seen.

IMPRESSION: Moderate pulmonary vascular congestion. Persistent elevation of the right hemidiaphragm and overlying atelectasis. Bilateral rib fractures, some of which are old and some which are new, are better seen on preceding chest CT.


SubjectID: 18043096, StudyID: 55146154, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with complex cardiac history p/w rib fractures // acute cardiopulmonary process acute cardiopulmonary process

IMPRESSION: Comparison to ___. Unchanged free right subdiaphragmatic air. The alignment of the sternal wires is constant. The lung volumes have decreased. Mild pulmonary edema persists   Keywords: persists. Mild atelectasis at the right lung bases. No new focal parenchymal opacities   Keywords: new.


SubjectID: 18043096, StudyID: 58446863, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pneumonia, respiratory failure // eval infiltrate

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change.


SubjectID: 18043096, StudyID: 50992802, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with h/o CKD on HD new onset hypotension, sob // please eval for interval change, acute cardiothoracic process please eval for interval change, acute cardiothoracic process

IMPRESSION: In comparison with the study of ___, there is little overall change   Keywords: little overall change. Again there is some enlargement of the cardiac silhouette with mild elevation of pulmonary venous pressure. Bibasilar opacification is consistent with pleural fluid and compressive atelectasis. On the current study, it is difficult to assess the possibility of residual sub diaphragmatic air on the right. A true upright view would be necessary for this evaluation.


SubjectID: 18046197, StudyID: 58859643, Comparison: None

FINAL REPORT

HISTORY: PICC line placement.

FINDINGS: The images just been presented for interpretation. Left subclavian PICC line extends to about the region of the cavoatrial junction. Low lung volumes accentuate the enlargement of the cardiac silhouette. No definite vascular congestion.


SubjectID: 18046197, StudyID: 53316741, Comparison: None

FINAL REPORT

AP CHEST, 12:19 A.M. ON ___

HISTORY: ___-year-old man with hypoxia and dyspnea. Question pulmonary edema.

IMPRESSION: AP chest compared to ___: There is no pulmonary edema. Mild cardiac enlargement is exaggerated by severe mediastinal fat deposition. There is no pleural effusion or pneumothorax and the lungs are clear. Left PIC line ends in the low SVC.


SubjectID: 18054826, StudyID: 58995252, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p arrest, intubated // any evidence of pna, aspiration, pulm edema any evidence of pna, aspiration, pulm edema

IMPRESSION: Comparison to ___. Mild improvement of pre-existing pulmonary edema   Keywords: improve. Increasing bilateral pleural effusions of mild to moderate extent. Stable cardiomegaly. Stable retrocardiac atelectasis.


SubjectID: 18054826, StudyID: 52600575, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with recent EGD s/p arrest // Eval for interval change Eval for interval change

IMPRESSION: Comparison to ___. Decreased lung volumes. All monitoring and support devices have been removed. Signs of mild pulmonary edema. Moderate cardiomegaly. Mild retrocardiac atelectasis. No larger pleural effusions.


SubjectID: 18056245, StudyID: 57998012, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (AP AND LAT)

INDICATION: ___F with hx of CHF with GIB and abdominal pain

COMPARISON: Prior exam from ___.

FINDINGS: AP upright and lateral views of the chest provided. Severe pulmonary edema is noted with bibasilar opacities concerning for atelectasis or pneumonia. No large effusion is seen. Heart is enlarged. Mediastinal contour appears unchanged. Bony structures are intact.

IMPRESSION: Severe pulmonary edema. Bibasilar opacities likely atelectasis or pneumonia. Cardiomegaly.


SubjectID: 18056245, StudyID: 54919956, Comparison: better

FINAL REPORT

INDICATION: ___ year old woman with dCHF, s/p 2u pRBC, now with new O2 requirement. // pulmonary edema vs pneumonia

TECHNIQUE: Chest portable

COMPARISON: ___

FINDINGS: Mild interval improvement in the moderate interstitial edema when compared to the prior examination   Keywords: improve. There is also improved left basal atelectasis. The left pleural effusion has also decreased in size.

IMPRESSION: Interval improvement of the moderate interstitial pulmonary edema that is now mild   Keywords: improve.


SubjectID: 18057037, StudyID: 57717537, Comparison: same

FINAL REPORT

CLINICAL

INDICATION: Shortness of breath. Evaluation for edema, effusion and pneumonia.

COMPARISON: Multiple prior chest radiographs, the most recent of ___.

FINDINGS: Frontal and lateral views of the chest. The lung volumes are very low, which is only slightly worsened since ___. This accentuates the cardiac silhouette which appears stably enlarged. There is mild vascular congestion, but no overt pulmonary edema. The mediastinal contour is stable; the pulmonary artery is enlarged. Patchy bilateral lower lobe opacities likely represent atelectasis. There is a small left pleural effusion. No pneumothorax is seen. There are clips in the left upper quadrant of the abdomen.

IMPRESSION: Very low lung volumes have slightly decreased since ___. Patchy bilateral lower lobe opacities most likely represent atelectasis. A small left pleural effusion is unchanged since ___. Mild pulmonary vascular congestion is unchanged since ___   Keywords: unchanged.


SubjectID: 18057037, StudyID: 52244987, Comparison: worse

FINAL REPORT

HISTORY: ___F with sob.

COMPARISON: Multiple prior chest radiographs of ___.

FINDINGS: Frontal and lateral views of the chest. The cardiac and mediastinal silhouettes are stable. Prominence of the interstitial markings as well as bilateral patchy airspace opacities consistent with pulmonary edema which is new since ___   Keywords: new. Moderate, left greater than right, pleural effusions are unchanged. No pneumothorax is identified. There are surgical clips in the left upper abdomen. There is eventration of the right hemidiaphragm.

IMPRESSION: New mild pulmonary edema and unchanged small bilateral pleural effusions, since ___   Keywords: new.


SubjectID: 18059377, StudyID: 57738530, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with worsened mental status // r/o PNA r/o PNA

IMPRESSION: In comparison with the study of ___, there is some increased opacification at the bases with poor definition of the hemidiaphragms, most likely reflecting a combination of pleural fluid and volume loss in the lower lobes. The upper lungs are clear and there is no definite vascular congestion


SubjectID: 18059377, StudyID: 53518907, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with severe AS s/p valvuloplasty ___ with hypotension, dyspnea s/p ___cc bolus this AM for hypotension // r/o worsening pleural effusions r/o worsening pleural effusions

IMPRESSION: In comparison with the study of ___, there is little change   Keywords: little change. Lack of sharpness of the left hemidiaphragm is consistent with some combination of pleural fluid and atelectasis. No definite vascular congestion. Pacer device is essentially unchanged. Of incidental note is apparent calcification in the region of the carotid bifurcation


SubjectID: 18078466, StudyID: 53917613, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___M with chest pain and leukocytosis // ?pneumonia?

COMPARISON: Prior studies from ___ and ___.

FINDINGS: PA and lateral views of the chest provided. Bilateral pleural effusions are again seen with compressive lower lobe atelectasis as on CT from today. Heart size cannot be assessed. Mediastinal contour is unchanged. Bony structures are intact.

IMPRESSION: Bilateral pleural effusions and compressive lower lobe atelectasis, without significant change from CT performed earlier today.


SubjectID: 18078466, StudyID: 51774616, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hyponatremia, acute CHF // assess pulm edema assess pulm edema

IMPRESSION: As compared to ___,


SubjectID: 18079519, StudyID: 53111635, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluation for pneumothorax, chest tubes on waterseal.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the chest tubes are in unchanged position. There could be millimetric apical pneumothoraces, particularly on the right. However, the extent of these pneumothoraces is minimal. The Swan-Ganz catheter has been removed. The mediastinal drains remain in situ. Unchanged appearance of the heart and of the lung parenchyma.


SubjectID: 18079519, StudyID: 52364301, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: Chest PA and lateral.

INDICATION: ___-year-old male patient, post-operative day 3 post mitral valve replacement, chest tubes removed, evaluate for effusion or pneumothorax.

FINDINGS: PA and lateral chest views were obtained with patient in upright position. Comparison is made with the next preceding portable chest examination obtained six hours earlier during the same day. During the latest examination interval, the bilateral chest tubes have been removed. There remains a tiny less than 1 cm wide apical pneumothorax on the right side, but this finding has not increased after the chest tube removal. No evidence of remaining pneumothorax on the left side. The heart size appears unchanged and so is the position of the metallic components of the mitral valve prosthesis. Comparison is also performed with the pre-operative chest examinations of ___ and ___. The remaining heart size similar to what existed before. The pulmonary congestive pattern has clearly improved with less marked distention of the pulmonary vasculature and absence of upper zone re-distribution pattern. Also the pre-operatively existing pleural effusions have diminished whereas the evidence of pericardial calcifications in the lower and anterior area remains unchanged. Persistent tiny right apical pneumothorax after chest tube removal. No other new pulmonary abnormalities are noted. Almost complete disappearance of pleural effusions.


SubjectID: 18093100, StudyID: 53089637, Comparison: None

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Dyspnea on exertion.

COMPARISONS: ___ and ___.

TECHNIQUE: Chest, PA and lateral.

FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged allowing for differences in technique. A patchy opacity in the left lower lung has largely resolved, although a residual component may be associated with slight atelectasis or scarring. More generally there is a diffuse interstitial abnormality suggesting mild-to-moderate pulmonary vascular congestion. A small pleural effusion is suspected on the left and a trace one on the right. Moderate degenerative changes are similar along the lower thoracic spine.

IMPRESSION: Findings suggesting mild-to-moderate pulmonary congestion.


SubjectID: 18097307, StudyID: 54758890, Comparison: None

FINAL REPORT

HISTORY: Elevated troponin, bilateral lower extremity edema, elevated BNP and shortness of breath.

TECHNIQUE: PA and lateral views of the chest.

COMPARISON: None.

FINDINGS: Heart size is mildly enlarged. The aorta is tortuous and demonstrates calcifications of the aortic knob. Small bilateral pleural effusions with mild pulmonary vascular engorgement is noted. Additionally, patchy opacities in the lung bases may reflect aspiration or infection, and less likely atelectasis. No pneumothorax is seen. There are no acute osseous abnormalities.

IMPRESSION: Mild pulmonary vascular congestion with small bilateral pleural effusions. Patchy bibasilar airspace opacities may reflect pneumonia, aspiration, and less likely atelectasis.


SubjectID: 18097307, StudyID: 51980660, Comparison: same

FINAL REPORT

HISTORY: Pulmonary edema, increasing dyspnea and PND. CHEST, SINGLE AP PORTABLE VIEW

COMPARISON: Chest x-ray from ___ at 17:29 p.m. Compared with the prior from and allowing for technical differences, there is slight increase in the degree of opacity at both lung bases. Otherwise, no significant interval change is detected. Again seen is upper zone redistribution, cardiomegaly, and bibasilar patchy opacities, which could reflect pneumonia or aspiration. Small bilateral effusions are also present. Suspect background COPD. The pulmonary hila appear prominent, with suggestion of a tapered appearance, which could reflect pulmonary hypertension.

IMPRESSION: Bibasilar opacities again seen   Keywords: again. These could reflect penumonia or aspiration. Differential diagnosis could include an atypical distribution of CHF at the bases, but this is considered less likely.


SubjectID: 18098371, StudyID: 58664404, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiograph.

INDICATION: History: ___F with 2 hrs of chest pain, pmhx CHF // eval for pulm edema

TECHNIQUE: AP, portable view of the chest.

COMPARISON: ___.

FINDINGS: Comparison to prior examination is difficult secondary to severe patient rotation and lordosis. The aorta is ectatic. . Right basal opacification is similar to the prior examination and likely atelectasis perhaps with bronchiectasis. There is no definite consolidation, large pleural effusion, pulmonary edema, or pneumothorax identified. Redemonstrated is an incompletely imaged, chronic right humeral fracture, unchanged from the prior examination.

IMPRESSION: Within the limitations of patient positioning, there is no definitive airspace consolidation concerning for pneumonia. If clinically warranted, repeat radiographs could be performed with improved positioning.


SubjectID: 18098371, StudyID: 54150773, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with new onset SOB, HTN evaluate for pulmonary edema.

TECHNIQUE: Portable AP radiograph of the chest from ___.

COMPARISON: ___ at 03:55.

FINDINGS: The patient's chin and overlying soft tissues partially obscure the right lung apex. Lung volumes are low. Right basilar subsegmental atelectasis is unchanged. There are no new consolidations or pleural effusions. The cardiomediastinal silhouette is stable. There is no obvious pneumothorax. Marked generalized osteopenia and a chronic nonunited comminuted proximal right humeral fracture are again noted.

IMPRESSION: No evidence of pulmonary edema or pneumonia. Unchanged right basilar subsegmental atelectasis. Chronic proximal right humeral fracture.


SubjectID: 18108905, StudyID: 59154299, Comparison: None

FINAL REPORT

HISTORY: Status post nasogastric tube placement.

COMPARISON: Multiple chest radiographs between ___ and ___.

FINDINGS: A portable frontal chest radiograph demonstrates a nasogastric tube coiled in the stomach. There is increasing atelectasis, with a nearly collapsed left lung, and a large left pleural effusion which is secondary to atelectasis. The right base opacity slightly improved and there is likely moderate right pleural effusion.

IMPRESSION: 1. Increasing atelectasis, with a nearly collapsed left lung. A large left pleural effusion is secondary to atelectasis. 2. Nasogastric tube coiled in the stomach. 3. Likely moderate right pleural effusion. These findings were communicated via telephone by Dr. ___ to Dr. ___ at ___ on ___.


SubjectID: 18108905, StudyID: 55011453, Comparison: None

FINAL REPORT

CHEST ON ___

HISTORY: NG tube placement.

FINDINGS: The NG tube tip is in the stomach. The appearance of the lungs is unchanged. Residual contrast is seen in the colon.


SubjectID: 18108905, StudyID: 58791315, Comparison: None

FINAL REPORT

REASON FOR EXAM: ___ years old woman with pulmonary edema, assess interval changes.

COMPARISON: Exam is compared to chest x-ray of ___.

FINDINGS: AP single view chest x-ray in upright position shows stable NG tube with tip in the distal stomach. Heart is still moderately enlarged with left lower lobe consolidation/atelectasis and adjacent pleural effusion. Minimal interstitial edema. There is no pneumothorax.


SubjectID: 18108905, StudyID: 55964414, Comparison: None

FINAL REPORT

HISTORY: Question aspiration pneumonia.

COMPARISON: ___.

FINDINGS: There is dense retrocardiac opacity compatible with volume loss/infiltrate/effusion. There is improved aeration left upper lobe. There continues to be some hazy alveolar infiltrate in the right lower lobe. The heart is moderately enlarged, similar to prior. NG tube tip is in the stomach. There is some residual contrast in the colon.

IMPRESSION: Improved aeration in the left upper lobe with worsened appearance of the left lower and right lower lobes.


SubjectID: 18108905, StudyID: 53183005, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Intubation, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the nasogastric tube and the endotracheal tube are unchanged. Change in appearance of the lung parenchyma. Moderate cardiomegaly with mild retrocardiac atelectasis persists. No larger pleural effusions. No pneumonia.


SubjectID: 18108905, StudyID: 58158422, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Intubation, assessment for endotracheal tube placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The monitoring and support devices are constant. Moderate cardiomegaly without pulmonary edema. No larger pleural effusions. No parenchymal opacities suggesting acute lung changes.


SubjectID: 18108905, StudyID: 51016066, Comparison: None

FINAL REPORT

HISTORY: CHF, to assess volume status.

FINDINGS: In comparison with study of ___, there is continued enlargement of the cardiac silhouette with more prominent pulmonary vascular congestion. Hazy opacification at the bases again is consistent with bilateral pleural effusions with compressive atelectasis and substantial volume loss in the left lower lobe.


SubjectID: 18108905, StudyID: 51526262, Comparison: None

FINAL REPORT

HISTORY: Stroke with basilar crackles on the right, to assess for pneumonia or CHF.

FINDINGS: In comparison with study of ___, there is again substantial enlargement of the cardiac silhouette. Relatively mild elevation of pulmonary venous pressure, raising the possibility of cardiomyopathy or pericardial effusion. Hazy opacification at the right base is consistent with pleural effusion. On the left, there is more extensive opacification with poor definition of the hemidiaphragm, consistent with substantial volume loss in the left lower lobe and accompanying effusion.


SubjectID: 18118373, StudyID: 58834547, Comparison: -1.0

WET READ: ___ ___ ___ 8:25 PM low lung volumes cause bronchovascular crowding and limit assessment. if there remains edema, it is mild and improved from the prior exam. there is some retrocardiac atelectasis. ______________________________________________________________________________

FINAL REPORT

INDICATION: History of aortic stenosis status post cystoscopy and bladder fulguration, evaluate for fluid overload post-operatively.

COMPARISON: ___.

TECHNIQUE: Single AP portable semi-upright chest.

FINDINGS: Allowing for differences in patient positioning, heart size and mediastinal contours are unchanged. Previously seen pulmonary edema has improved at the right lung base, but there is persistent left infrahilar opacity slightly worsened in the interval which may represent a combination of edema, atelectasis, and/or superimposed consolidation   Keywords: improve. No evidence of pleural effusion or pneumothorax. The remainder of the lungs are clear. Osseous structures appear unchanged.

IMPRESSION: Improved right-sided pulmonary edema, but increased left infrahilar opacity which could reflect atelectasis, asymmetric edema, and/or superimposed consolidation/aspiration   Keywords: increase.


SubjectID: 18118373, StudyID: 53955923, Comparison: worse

FINAL REPORT

HISTORY: Chest pain and shortness of breath.

TECHNIQUE: Upright AP view of the chest.

COMPARISON: ___.

FINDINGS: Low lung volumes are present. There is moderate cardiomegaly which is relatively unchanged compared to the prior study. The aorta remains tortuous with calcification of the aortic knob again noted. Mild pulmonary edema is new when compared to the prior study   Keywords: new. No large pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities. Previously noted right PICC has been removed.

IMPRESSION: Mild pulmonary edema.


SubjectID: 18118373, StudyID: 56625067, Comparison: None

FINAL REPORT

EXAM: Chest, single frontal view. CLINICAL INFORMATION: Hypotension, chest pain, shortness of breath.

COMPARISON: ___.

FINDINGS: Single frontal view of the chest was obtained. Rounded lingular opacity consistent with patient's known lingular mass is again seen, better evaluated on CT. Bibasilar atelectasis is seen. Slight blunting of the right costophrenic angle may be due to a small pleural effusion. The cardiac and mediastinal silhouettes are stable, as are the hilar contours. Mild left base linear atelectasis is seen.

IMPRESSION: Blunting of the right costophrenic angle may be due to a small pleural effusion and could be further assessed on PA and lateral views. Known lingular mass, better assessed on CT. Stable mild enlargement of the cardiac silhouette.


SubjectID: 18118373, StudyID: 56543919, Comparison: worse

FINAL REPORT

EXAM: Chest, single AP upright portable view. CLINICAL INFORMATION: Chest pain, overload.

COMPARISON: ___ at 15:49.

FINDINGS: Single AP upright portable view of the chest was obtained. Lingular mass was better assessed on recent prior CT. There is an interval development of mild pulmonary edema   Keywords: development. Interval development of increased right medial lung base opacity most likely relates to fluid overload with possible underlying atelectasis rather than infection given its short-term development. There is also increased opacity at the lateral left lung base, again may be due to atelectasis and/or related to fluid overload given short-term development   Keywords: development. The cardiac and mediastinal silhouettes are stable. No large pleural effusion seen. The mediastinum is stable.

IMPRESSION: Interval development of mild pulmonary edema   Keywords: development. Increased bibasilar opacities, as above, most likely related to fluid overload with possible atelectasis rather than infection given the short-term development   Keywords: increase.


SubjectID: 18128235, StudyID: 59716009, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF and bilateral pleural effusions, s/p bilateral thoracentesis with b/l pigtail catheter placement // Any reaccumulation of L pleural effusion s/p pigtail cath removal

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Pigtail catheter has been removed on the left. There is no definitive pneumothorax or re-accumulation of pleural effusion noted. The atelectasis of the left lung base is extensive and unchanged. Right pleural effusion and right basilar basal atelectasis are unchanged as well


SubjectID: 18128235, StudyID: 58372326, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pigtail // pnx

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Heart size is normal. Mediastinum is stable. The left pigtail catheter is in place. There is overall no substantial change in the amount of left pleural effusion. No distinct pneumothorax is seen although small amount cannot be excluded. Right pleural effusion and right basal atelectasis are unchanged.


SubjectID: 18128235, StudyID: 57103123, Comparison: None

FINAL REPORT

HISTORY: Pigtails, question chest tube placement. CHEST, SINGLE AP VIEW.

COMPARISON: Chest x-ray from ___ at 8:23 a.m. Compared to the prior film, the right pigtail catheter is no longer visualized within the chest. No obvious pneumothorax is identified. A left lung base pigtail catheter is again noted, essentially unchanged. Otherwise, I doubt significant interval change. No left-sided pneumothorax is detected. The cardiomediastinal silhouette is stable. Opacities at both lung bases medially are unchanged.

IMPRESSION: Interval removal of right pigtail catheter. Doubt but cannot entirely exclude a tiny right apical pneumothorax. Otherwise, I doubt significant interval change.


SubjectID: 18128235, StudyID: 59415064, Comparison: None

FINAL REPORT

HISTORY: Acute onset of pleuritic chest pain, question pneumothorax. CHEST, SINGLE AP PORTABLE VIEW. There are bilateral pigtail type catheters one seen at each lung base. At the right base, curvilinear lucency is nonspecific and could represent ___ ___ line or, less likely, a very small basilar pneumothorax. On the left side, there is a lobulated density projecting over the left upper zone, with relative paucity of pulmonary markings seen beyond it. The appearance most likely relates to a skin fold, but a pneumothorax might also account for this appearance. The cardiomediastinal silhouette is unchanged, with evidence of left ventricular prominence and the mediastinum remains midline. Prominence of the pulmonary hila is unchanged. Increased retrocardiac density consistent with pleural fluid and/or left lower lobe collapse and/or consolidation and increased right cardiophrenic opacity are again noted, slightly improved on the right. Upper zone redistribution has improved and there is no evidence of CHF on the current film. Severe left glenohumeral osteoarthritis is noted.

IMPRESSION: 1. Bibasilar pigtail catheters. 2. Bibasilar opacities, minimally improved at the right. 3. Findings are equivocal for pneumothorax on both sides. If there is concern for left-sided pneumothorax versus skinfold, then a repeat AP view with attention to overlying skin fold is requested. An expiration or decubitus view might also help to further assess this, if clinically indicated. On the right, q? tiny pneumothorax at lung base or, more likely, an artifactual ___ line. 3. Hila prominent bilaterally, but unchanged.


SubjectID: 18128235, StudyID: 58195290, Comparison: None

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old man with large bilateral effusions s/p bilateral pigtails // ? PTX

COMPARISON: Chest x-ray ___

FINDINGS: Since the prior radiograph on ___, bilateral pigtail catheters have been placed resulting in interval resolution of pleural effusions. There is no pneumonia, pulmonary edema or pneumothorax. Of note, there are two vertical lines that mimic pneumothorax; however, the presence of lung markings lateral to these lines suggests that they are skin folds. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities.

IMPRESSION: Interval placement of bilateral pigtail catheters with complete resolution of pleural effusions. No pneumothorax.


SubjectID: 18128235, StudyID: 52594993, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with bilateral pleural effusions s/p thoracentesis. // Has the drain on the left been dislodged?

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, bilateral pleural drains are seen in unchanged position. No evidence of pneumothorax. There is increasing blunting of both the left and the right costophrenic sinus, likely suggesting the Re accumulation of pleural fluid. Unchanged retrocardiac atelectasis. Unchanged normal cardiac silhouette. The pre-existing platelike atelectasis at the left lung bases has completely resolved.


SubjectID: 18128235, StudyID: 56268501, Comparison: None

FINAL REPORT

INDICATION: Altered mental status and shortness of breath.

COMPARISON: Multiple prior chest radiographs from ___.

FINDINGS: Frontal and lateral chest radiographs. There are large bilateral pleural effusions with bibasilar atelectasis and collapse of the left lower lobe, similar to ___. The cardiac silhouette is obscured. There is no vascular engorgement.

IMPRESSION: Large bilateral pleural effusions with compressive atelectasis, unchanged from ___.


SubjectID: 18128235, StudyID: 56276296, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CAD, +C diff, s/p ERCP for biliary strictures and stent placement, being diuresed now for fluid overload, aspirated today while being fed leading to decrease O2Sat to 80s. // Aspiration, pleural effusion Aspiration, pleural effusion

IMPRESSION: In comparison with the study of ___, there again is enlargement of the cardiac silhouette with substantial bilateral pleural effusions and compressive atelectasis at the bases. Probable continued mild elevation of pulmonary venous pressure, though this is difficult to assess given the other pulmonary findings.


SubjectID: 18128235, StudyID: 54422545, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with NGT // confirm placement

COMPARISON: ___.

IMPRESSION: As compared to the previous examination, the tip of the nasogastric tube is at the seen. The tube is now correctly positioned in the proximal parts of the stomach. The side hole is at the level of the gastroesophageal junction. No complications, notably no pneumothorax. The lucent line along the right chest wall corresponds to a skin fold. No change in appearance of the heart. Unchanged moderate overinflation. No pneumonia or pleural effusions.


SubjectID: 18128235, StudyID: 54370685, Comparison: None

WET READ: ___ ___ 8:30 PM Hernia appears similar to prior radiographs but acute pathology cannot be definitively excluded with plain radiography.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with LUQ pain // r/o worsening paraesophageal hernia, volvulus

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the size of the known hernia is not substantially changed. On the frontal view, the hernia continues to cause minimal local atelectasis. The lungs are otherwise unchanged. No pleural effusions. No pneumonia. No pneumothorax. Normal size of the cardiac silhouette.


SubjectID: 18134008, StudyID: 56939495, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with renal failure // interval progression interval progression

IMPRESSION: In comparison with the study ___ ___, there is continued substantial enlargement of cardiac silhouette with pulmonary edema and bilateral basilar opacifications consistent with layering effusions and compressive atelectasis   Keywords: continue. Right IJ catheter again extends to the mid portion of the SVC.


SubjectID: 18134008, StudyID: 50734519, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with dCHF, ___ // fluid status fluid status

IMPRESSION: In comparison with the study ___ ___, the nasogastric tube and endotracheal tube have been removed. . Continued enlargement of the cardiac silhouette with evidence of elevated pulmonary venous pressure. Left basilar opacification is consistent with volume loss in the lower lobe and layering effusion. On the right, there appears to be increased pleural effusion with extension of fluid into the minor fissure.


SubjectID: 18134008, StudyID: 56855173, Comparison: None

FINAL REPORT

EXAMINATION: Chest, portable semi-erect.

INDICATION: Evaluate positioning of right internal jugular central venous line in a patient status post repair of perforated pyloric ulcer.

COMPARISON: Chest radiograph from ___.

FINDINGS: An endotracheal tube terminates 3.5 cm above the carina. An orogastric tube passes through the esophagus, into the stomach, and terminates inferiorly at of the field of view. A right internal jugular central venous line terminates in the low SVC. Mild cardiomegaly is unchanged. The right lung is clear. There is a left lung opacity obscuring the left hemidiaphragm which may reflect atelectasis, pleural effusion, pneumonia, or some combination thereof. There is no pneumothorax. Pulmonary vascularity is normal. Dense atherosclerotic calcifications in the aortic arch are noted.

IMPRESSION: 1. The right internal jugular central venous line terminates in the low SVC. 2. Left lower lobe opacity which may reflect atelectasis, pneumonia, small pleural effusion, or some combination thereof.


SubjectID: 18134008, StudyID: 54556152, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with hypoxia post op // presece of infiltrate, ptx

TECHNIQUE: Portable chest x-ray.

COMPARISON: Prior chest radiographs dated ___ through ___.

FINDINGS: Portable semi-upright radiograph of the chest demonstrates low lung volumes with resultant bronchovascular crowding. Stable bibasilar opacities are present, likely secondary to atelectasis or aspiration. Small left-sided pleural effusion is stable. Cardiomediastinal and hilar contours are unchanged. Endotracheal tube ends 2.7 cm from the carina. Nasogastric tube courses into the stomach with the last side port below the GE junction. Pneumoperitoneum resolved. Right-sided internal jugular central venous line ends at the mid SVC. No pneumothorax.

IMPRESSION: Stable bibasilar opacities, likely secondary to atelectasis or aspiration and small left-sided pleural effusion. No pneumothorax.


SubjectID: 18138859, StudyID: 58862694, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with history of MVP, moderate MR, AR, CMML, HTN, and recent admission for high degree AV block s/p PPM placement ___ c/b hematoma s/p pericardial drainage now with SOB // cardiac silhouette evaluation, pericardial effusion?

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: There has been improvement of the enlargement of the cardiac silhouette. . Large bilateral effusions are probably unchanged allowing the difference in positioning of the patient. Moderate pulmonary edema has minimally worsened   Keywords: worse. There is no pneumothorax. Pacer leads are in standard position. Pericardial drain is in place


SubjectID: 18138859, StudyID: 53833963, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with recent tamponade, concern for flash pulm edema // progression of pulm edema

COMPARISON: Radiographs from ___

IMPRESSION: There has been no interval change   Keywords: no interval change. There is again seen an intact left dual lead pacemaker. There is unchanged cardiomegaly. There is persistent moderate pulmonary edema   Keywords: persistent. There is a large left retrocardiac opacity and small bilateral pleural effusions. No pneumothoraces are seen.


SubjectID: 18138859, StudyID: 53597994, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pericardial effusion s/p pericardiocentesis // any infiltrate any infiltrate

COMPARISON: ___

IMPRESSION: Pericardial drain is in place. There is interval development of moderate to severe pulmonary edema associated with increase in bilateral pleural effusions   Keywords: development, increase. There is no pneumothorax. Pacemaker leads are in unchanged position.


SubjectID: 18138859, StudyID: 57351055, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with new pacemaker // pneumo, positioning of leads pneumo, positioning of leads

IMPRESSION: No relevant change as compared to ___, 05:52   Keywords: no relevant change. The bilateral pacemaker leads are in correct position. No evidence of pneumothorax. Minimal fluid overload but no overt pulmonary edema. Moderate cardiomegaly. A large hiatal hernia is better visualized on the lateral than on the frontal image.


SubjectID: 18138859, StudyID: 55777024, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with severe MR and complete AV block // ? pulmonary edema and/or effusion

IMPRESSION: As compared to previous radiograph of 1 day earlier, cardiomegaly and pulmonary vascular congestion are now accompanied by moderate pulmonary edema and small pleural effusions.


SubjectID: 18138859, StudyID: 54184071, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CML here with heart block, received PPM ___. // Are there any changes in the AM following PPM placement? Are there any changes in the AM following PPM placement?

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Moderate cardiomegaly with unchanged placement of the pacemaker leads. No new focal parenchymal opacities   Keywords: new. Moderate cardiomegaly, no overt pulmonary edema.


SubjectID: 18144033, StudyID: 59207057, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man with shortness of breath evaluate for CHF.

TECHNIQUE: AP chest radiograph.

COMPARISON: Chest x-ray ___.

FINDINGS: There is stable moderate cardiomegaly. The mediastinal contours are unchanged. Bilateral hila are not well seen. Diffuse bilateral nodular appearing airspace opacities likely represent pulmonary edema, however this appearance is nonspecific and differential includes alveolar hemorrhage in addition to disseminated Wegener's or multifocal infection, possibly septic emboli. Difficult to exclude trace pleural effusions. No pneumothorax.

IMPRESSION: 1. Likely severe pulmonary edema. However given nodular appearance, if patient does not respond to diuresis, consider alternative etiology such as Wegener's or multifocal infection, as above. 2. Stable moderate cardiomegaly.


SubjectID: 18144033, StudyID: 54952036, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with acute on chronic heart failure and progressive renal failure about to start HD // Eval for interval change in pulmonary edema after diuresis

IMPRESSION: Since a recent study of 2 days earlier, widespread bilateral airspace opacities have substantially improved, likely due to improving pulmonary edema, although the nodular configuration of some of the opacities raises the possibility of coexisting infection, including fungal organisms and septic emboli   Keywords: improve.


SubjectID: 18154666, StudyID: 59069847, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with severe CHF // effusions?

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Left pleural effusion appears to be slightly decreased as compared to the prior study although it might be reflected. The due to lordotic projection on the current radiograph, still present at least moderate amount. Right pleural effusion is most likely present, minimal. Vascular congestion is noted, minimal. No pneumothorax is seen.


SubjectID: 18154666, StudyID: 58127730, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with new EF ___% // effusions

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Cardiomegaly is substantial. Bilateral pleural effusions are moderate. The appear to be enlarged since the prior studies. Mild pulmonary edema/ vascular congestion has minimally progressed   Keywords: progressed


SubjectID: 18154666, StudyID: 53560876, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT) PORT

INDICATION: ___ year old woman with dyspnea on exertion. // Signs of volume overload

TECHNIQUE: CHEST (PA AND LAT) PORT

COMPARISON: ___

IMPRESSION: Substantial interval increase in the left pleural effusion which is currently large is demonstrated. Minimal amount of small right pleural effusion is most likely present. No evidence of pulmonary edema is present. Heart size cannot be assessed since obscured by pleural effusion.


SubjectID: 18154666, StudyID: 51899942, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with severe CHF, pleural effusions. // assess interval change

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Moderate cardiomegaly is stable. Right lower lobe atelectasis has resolved. Left lower lobe opacity a combination of small effusion and atelectasis have markedly improved. Vascular congestion has almost completely resolved   Keywords: resolve. There are no new lung abnormalities or pneumothorax


SubjectID: 18155466, StudyID: 55981548, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with chest pain

TECHNIQUE: Upright AP view of the chest

COMPARISON: ___

FINDINGS: Left-sided pacemaker device is noted with single lead terminating in the region of the right ventricle. Moderate to severe cardiomegaly is unchanged. The aorta remains tortuous. Focal consolidative opacity is demonstrated within the right upper lung field concerning for pneumonia. Additionally there is mild pulmonary vascular congestion. No pleural effusion or pneumothorax is identified though assessment of the right apex is obscured due to the patient's chin and neck soft tissues projecting over this region. No acute osseous abnormality is identified.

IMPRESSION: 1. Right upper lung field consolidative opacity concerning for pneumonia. 2. Mild pulmonary vascular congestion.


SubjectID: 18155466, StudyID: 52630177, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___F with a-fib, mild systolic heart failure and HTN presents with shortness of breath, atypical chest pain and possible pneumonia on portable CXR // please assess for pulmonary edema vs pneumonia please assess for pulmonary edema vs pneumonia

COMPARISON: Comparison to ___ at 18:42

FINDINGS: PA and lateral views of the chest ___ at 10:48 are submitted.

IMPRESSION: More focal opacity in the posterior segment of the right upper lobe persists and is concerning for aspiration or pneumonia. Linear opacity at the left base on the frontal view is felt to likely reflect atelectasis. No evidence of pulmonary edema. The heart is enlarged which may reflect cardiomegaly, although pericardial effusion should also be considered. A left single lead pacer remains in place. Increased soft tissue in the right paratracheal region may represent prominent vascular structures, although lymphadenopathy in this area cannot be excluded. No pneumothorax.


SubjectID: 18155466, StudyID: 51692316, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with Afib, valvular disease, decompensated CHF, found to have RUL opacity, being treated wtih levofloxacin, having worsening shortness of breath. // evidence of change in fluid overload, worsening pnemonia? evidence of change in fluid overload, worsening pnemonia?

IMPRESSION: A in comparison with the study of ___, there are lower lung volumes. Continued enlargement of the cardiac silhouette with evidence of pulmonary edema. Coalescent opacification is again seen in the right mid and upper zone, concerning for pneumonia.


SubjectID: 18164811, StudyID: 59809664, Comparison: 0.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with severe MR, CHF, new sob // Acute dyspnea

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, signs indicative of pulmonary edema have decreased in severity   Keywords: decrease. A minimal right pleural effusion is seen on today's radiograph. Unchanged moderate cardiomegaly. No new focal parenchymal opacities   Keywords: new. No pneumothorax.


SubjectID: 18164811, StudyID: 52503013, Comparison: None

FINAL REPORT

INDICATION: ___F with hx CHF EF ___%, c/o SOB, worse supine, worse with exertion. Also c/o nonproductive cough. Denies pain. // Acute process in chest?

TECHNIQUE: AP and lateral views of the chest.

COMPARISON: ___ chest x-ray and ___ chest CT. .

FINDINGS: Dual lead left chest wall pacing device is again seen. Massive enlargement of the cardiac silhouette is as on prior. Indistinct pulmonary vascular markings are seen on the current exam. Small right-sided pleural effusion is apparently new. Increased soft tissue density at the thoracic inlet with rightward deviation of the trachea is compatible with known left-sided thyroid enlargement. Focal opacity projecting over the right anterior third rib is more conspicuous on today's exam.

IMPRESSION: Massive cardiomegaly. Interstitial edema and small right effusion. Focal opacity projecting over the right third rib potentially due to edema but followup after treatment is suggested to document resolution.


SubjectID: 18164811, StudyID: 50649689, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with acute onset of nausea/diaphoresis with known history of CAD and CHF. // ?acute cardiopulmonary process?

COMPARISON: ___

IMPRESSION: Stable marked cardiomegaly accompanied by pulmonary vascular congestion and perihilar edema   Keywords: stable. Asymmetry in degree of airspace opacity in the right lung compared to the left could reflect a symmetrical distribution of pulmonary edema, but followup radiographs would be helpful to exclude other coexisting process such as infectious pneumonia. Small bilateral pleural effusions are also demonstrated, right greater than left. Large left superior mediastinal and lower left neck mass is again demonstrated with marked cyber ___ rightward deviation and narrowing of trachea, consistent with known fibroid note enlargement.


SubjectID: 18164811, StudyID: 57913273, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF, MR/TR here for suspected cardiogenic shock. // Pulm edema?

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Moderate cardiomegaly without pulmonary edema. No pleural effusions. No pneumonia. The pacemaker components are in unchanged normal position.


SubjectID: 18164811, StudyID: 55104358, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with chf with sob // eval pulm edema

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: Left-sided dual lead pacer device is again seen, unchanged in position. The cardiac and mediastinal silhouettes are stable with the cardiac silhouette enlarged. No large pleural effusion or pneumothorax is seen. No definite focal consolidation. No overt pulmonary edema.

IMPRESSION: Left-sided dual lead pacer device is again seen, unchanged in position. The cardiac and mediastinal silhouettes are stable with the cardiac silhouette enlarged. No large pleural effusion or pneumothorax is seen. No definite focal consolidation. No overt pulmonary edema.


SubjectID: 18164811, StudyID: 53531813, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with TR CHF dysphagia s/p right heart cath and swan placement // swan placement

COMPARISON: ___, 07:54

IMPRESSION: As compared to the previous radiograph, the patient has received a right-sided PICC line. The line is coiled at the bottom of the right atrium and must be repositioned. There is no evidence for pneumothorax or other complication. Unchanged borderline size of the cardiac silhouette. No pulmonary edema. No pleural effusions. At the time of dictation and observation, 16:59, on the ___, the referring physician ___. ___ was paged for notification and the findings were discussed ___ min later over the telephone.


SubjectID: 18164811, StudyID: 53157678, Comparison: None

WET READ: ___ ___ 8:22 AM Right subclavian catheter (which appears more like a PICC rather than a Swan-Ganz catheter) has been pulled back. The tip is in the deep right ventricle but is no longer coiled. Cardiomegaly is unchanged. No pneumothorax.

WET READ VERSION #___ ___ ___ ___ 12:09 AM Right subclavian catheter (which appears more like a PICC rather than a Swan-Ganz catheter) has been pulled back. The tip is in the deep right ventricle but is no longer coiled. Cardiomegaly is unchanged. No pneumothorax. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with sCHF, MR, TR, s/p ___ placement today // confirm swan ganz pulled back

TECHNIQUE: Chest single view

COMPARISON: ___

IMPRESSION: Right subclavian catheter (which appears more like a PICC rather than a Swan-Ganz catheter) has been pulled back. The tip is in the deep right ventricle but is no longer coiled. Cardiomegaly is unchanged. No pneumothorax


SubjectID: 18164811, StudyID: 51099775, Comparison: None

WET READ: ___ ___ 7:50 AM Right central venous catheter is coiled in the right atrium. A followup radiograph available the time of this dictation confirms that the catheter has been repositioned.

WET READ VERSION #___ ___ ___ ___ 12:10 AM Right central venous catheter is coiled in the right atrium. A followup radiograph available the time of this dictation confirms that the catheter has been repositioned. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with sCHF, s/p ___ placement // ___ placement

TECHNIQUE: Chest single view

COMPARISON: 829 at 14 13

IMPRESSION: Right central venous catheter is coiled in the right atrium. A followup radiograph available the time of this dictation confirms that the catheter has been repositioned. Although even on the followup film the tip of the catheter is still lower than what would be expected for Swan-Ganz catheter The remainder of the exam is unchanged


SubjectID: 18164811, StudyID: 50006578, Comparison: None

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old woman with hypotension // ?lung fields and cardiac shadow

TECHNIQUE: Portable chest radiograph

COMPARISON: Multiple chest x-rays between ___ and ___

FINDINGS: There are small bilateral pleural effusions, which may be new since ___. No evidence of pneumonia or pulmonary edema. No pneumothorax. The mediastinum and hila are normal. There are atherosclerotic calcifications of the aortic arch. Moderate to severe cardiomegaly, better demonstrated on CT chest dated ___. Transvenous pacer-defibrillator is unchanged in position with leads terminating in the right atrium and right ventricle.

IMPRESSION: 1. Small bilateral pleural effusions, likely new since ___. 2. Chronic moderate to severe cardiomegaly.


SubjectID: 18164811, StudyID: 55372874, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with TR CHF dysphagis // ? pulm edema

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change.


SubjectID: 18174990, StudyID: 58924337, Comparison: better

FINAL REPORT

INDICATION: ___F with SOB, elevated BNP // Eval for infiltrate, edema

TECHNIQUE: AP view of the chest.

COMPARISON: ___.

FINDINGS: When compared to prior, the degree of interstitial edema has decreased   Keywords: decrease. There may be small persistent bilateral effusions, smaller than compared to prior. Streaky left basilar opacity is identified. The cardiac silhouette is enlarged but unchanged. Atherosclerotic calcifications again noted at the aortic arch. Severe degenerative changes of the shoulders bilaterally.

IMPRESSION: Interval decrease in degree of pulmonary edema   Keywords: decrease. Probable small residual bilateral effusions, also decreased. Streaky left basilar opacity potentially atelectasis although infection is not excluded.


SubjectID: 18174990, StudyID: 50117113, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with Afib w/RVR, hx of CHF. // r/o PNA or pulm edema

COMPARISON: ___

IMPRESSION: Cardiomegaly is accompanied by improving pulmonary vascular congestion and resolving interstitial edema   Keywords: resolving, improving. Patchy bibasilar lung opacities are also slightly improved and likely represent atelectasis and less likely infectious consolidation or aspiration. Small pleural effusions are present, left greater than right appear


SubjectID: 18181309, StudyID: 59078571, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with fever and recent CXR with ? retrocardiac opacity with ddx of infiltrate vs atelectasis s/p IS. // ?Persistent retrocardiac opacity ?Persistent retrocardiac opacity

IMPRESSION: Comparison to ___. The pre-existing retrocardiac opacity has slightly decreased in extent and severity. The heart continues to be at the upper range of normal with regard to its diameter. No evidence of pleural effusions. No new focal parenchymal opacities   Keywords: new. No pneumothorax.


SubjectID: 18181309, StudyID: 57455499, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man with cardiomyopathy, fever and chills.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph ___.

FINDINGS: The lungs are clear without focal opacity, pulmonary edema, pleural effusion or pneumothorax. Mild enlargement of the cardiac silhouette may relate to the known cardiomyopathy. The aorta is tortuous.

IMPRESSION: No pneumonia.


SubjectID: 18181309, StudyID: 54527475, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with fever, acute renal failure, cough and crackles at the bases. Please repeat CXR post hydration. // Please evaluate for source of fever

TECHNIQUE: PA and lateral views of the chest provided.

COMPARISON: Chest radiograph dated ___.

FINDINGS: In comparison with chest radiograph from ___, slightly increased left retrocardiac opacity suggests atelectasis or infection. Right lower lobe atelectasis has increased. There is no pleural effusion or pneumothorax. There is no vascular congestion or interstitial pulmonary edema. Mediastinal contours are stable. Mild cardiomegaly and mild tortuosity thoracic aorta are unchanged.

IMPRESSION: 1. Slightly increased left retrocardiac opacity suggests atelectasis or infection. 2. Increased right lower lobe atelectasis.


SubjectID: 18181309, StudyID: 53501419, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with heart failure, fever, altered mental status // Please assess for edema, PNA

IMPRESSION: As compared to ___ radiograph from several hr earlier, cardiomegaly is stable. Pulmonary vascular congestion is accompanied by mild interstitial edema. No new areas of consolidation are identified to suggest a source of infection.


SubjectID: 18181309, StudyID: 53304036, Comparison: better

WET READ: ___ ___ 8:08 AM Mild interstitial pulmonary edema significantly improved from ___. Stable cardiomegaly.

WET READ VERSION #1 ___ ___ ___ 11:12 PM Mild interstitial pulmonary edema significantly improved from ___. Stable cardiomegaly. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with new onset CHF (EF ___%), recent stroke now with fevers // r/o acute process, PNA

IMPRESSION: As compared to ___ radiograph, pulmonary edema has resolved   Keywords: resolve. No definite new areas of consolidation to suggest a source of infection, but standard PA and lateral chest radiographs would provide more complete evaluation of the lung bases and may be considered if clinical suspicion for pneumonia persists.


SubjectID: 18201582, StudyID: 59592096, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with aortic stenosis, new oxygen requirement. // Please assess for pulm edema

IMPRESSION: As compared to ___ chest radiograph, cardiomediastinal contours are stable. Interval improved aeration at the left lung base with residual mild atelectasis. Linear opacities are present in the right mid and lower lung and may reflect linear atelectasis and or scar.


SubjectID: 18201582, StudyID: 51584478, Comparison: same

FINAL ADDENDUM ADDENDUM Please note that in the initial report, at the word hemorrhage should be replaced with heterogeneous ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with AMS, s/p TAVR, requiring 3L O2, breathing seems more labored // Eval for interval change

IMPRESSION: As compared to prior chest radiograph from several hr earlier, there has been worsening hemorrhage opacification in the left lung base. It is uncertain whether this might represent localized aspiration or rapidly developing pneumonia, and short-term followup radiographs may be helpful in this regard. No other relevant change   Keywords: no other relevant change.


SubjectID: 18201582, StudyID: 58089447, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with right effusion s/p attempted thoracentesis, unable to aspirate fluid // ? PTX ? PTX

IMPRESSION: Comparison to the radiograph from ___. Attempted thoracocentesis. The extent of the right pleural effusion is constant. No evidence of pneumothorax. Unchanged appearance of the heart and of the left lung.


SubjectID: 18201582, StudyID: 54498534, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with PICC that was pulled out to 6 cm // Is the PICC in the correct location? Is the PICC in the correct location?

COMPARISON: ___

IMPRESSION: Right PICC line tip is at the level of mid SVC. Replaced aortic valve is in expected position. Heart size and mediastinum are stable. Bilateral, right more than left pleural effusions are unchanged. There is interval progression of vascular congestion   Keywords: progression. No pneumothorax.

RECOMMENDATION(S): Assessment of the patient after diuresis to demonstrate improvement of vascular congestion/ mild interstitial pulmonary edema is recommended.


SubjectID: 18201582, StudyID: 57269410, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with AMS, tachypnea // r/o acute process

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: Patient is status post median sternotomy, CABG, and aortic valve replacement. There is mild elevation of the right hemidiaphragm. Bibasilar opacities are seen which are nonspecific but could be due to aspiration or infection. Alternately there may also be small pleural effusions with overlying atelectasis. Dedicated PA and lateral views would be helpful for further evaluation. Prominence of the central pulmonary vasculature suggests pulmonary vascular engorgement. The cardiac silhouette is top-normal to mildly enlarged. The aorta is calcified.


SubjectID: 18201582, StudyID: 51166767, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with Wegener granulomatosis, infiltrate on CXR, AMS. // eval for infection/edema/flare of Wegener's

COMPARISON: Radiographs from ___

IMPRESSION: Median sternotomy wires are seen. There is an aortic valve replacement. Bibasilar opacities are again seen and may be due to aspiration or infection, unchanged. There are also small bilateral pleural effusions, right slightly greater than left. There is mild pulmonary vascular edema. Heart size is mildly enlarged but stable. Calcifications are again seen of the thoracic aorta.


SubjectID: 18201582, StudyID: 56671240, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with coarse breath sounds after EGD. // Evaluate for interval change, aspiration? Evaluate for interval change, aspiration?

IMPRESSION: As compared to the previous radiograph from ___, there is a new focal parenchymal opacity at the right lung base. The change would be consistent with aspiration pneumonia. In addition, signs of mild pulmonary edema are not substantially changed. Small left pleural effusion persists. Mild cardiomegaly is stable.


SubjectID: 18201582, StudyID: 52826269, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with GIB // tubes/line placement, acute intrapulmonary process tubes/line placement, acute intrapulmonary process

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The internal jugular vein catheter on the right was pulled back. The tip of the catheter now projects over the cavoatrial junction. The appearance of the moderately enlarged cardiac silhouette is unchanged. Unchanged position of the aortic valve replacement and of the sternal wires. The presence of a small pleural effusion cannot be excluded. Bilateral basal areas of atelectasis are not substantially changed. No new parenchymal opacities   Keywords: new.


SubjectID: 18201582, StudyID: 51308113, Comparison: worse

FINAL REPORT

EXAMINATION: Portable AP chest radiograph

INDICATION: ___ year old man with aortic stenosis and dyspnea // pls eval for pulm edema

TECHNIQUE: Chest portable AP

COMPARISON: Portable AP chest radiograph dated ___

FINDINGS: Since the chest radiograph obtained 1 day prior, there is increased pulmonary edema, most prominently within the right upper lung, and there has been interval removal of the right-sided internal jugular central venous catheter   Keywords: increase. Moderate cardiomegaly and moderate bilateral pleural effusions, stable on the right and slightly increased on the left. Median sternotomy wires are midline and intact.

IMPRESSION: Progressive pulmonary edema. Asymmetrical right upper lobe opacity probably reflects a asymmetrical edema and less likely a secondary process such as aspiration.


SubjectID: 18201582, StudyID: 54014501, Comparison: -1.0

FINAL REPORT

EXAMINATION: Portable AP chest radiograph

INDICATION: ___ year old man with O2 desat, tachypnea w/underlying c/f HCAP vs pneumonitis // eval for interval change

TECHNIQUE: Chest portable AP

COMPARISON: Portable AP chest radiograph dated ___.

FINDINGS: Since chest radiograph obtained 1 day prior, the left lung base is less well aerated. There is persistent mild pulmonary edema and pulmonary vascular congestion with a small right pleural effusion and a new, small left pleural effusion +/- adjacent atelectasis   Keywords: persistent. Heart size is top-normal.

IMPRESSION: Increased left basilar opacities may reflect increased left lower lobe atelectasis and pulmonary edema or alternatively a developing left lower lobe pneumonia   Keywords: developing, increase.


SubjectID: 18203271, StudyID: 57088612, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with right internal jugular central venous line placement

TECHNIQUE: Upright AP view of the chest

COMPARISON: ___ at 13:38

FINDINGS: Right internal jugular central venous catheter tip terminates in the mid/low SVC. No pneumothorax is present. Lung volumes are lower compared to the previous study. The cardiac and mediastinal contours are unchanged with persistent mild cardiomegaly. There is crowding of the bronchovascular structures. Bibasilar atelectasis is slightly worse in the interval. A trace left pleural effusion is not excluded. There are no acute osseous abnormalities.

IMPRESSION: Right internal jugular central venous catheter tip in the mid/low SVC. No pneumothorax.


SubjectID: 18203271, StudyID: 51150404, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with likely urosepsis, with increasing O2 requirement // eval for developing PNA or pulm edema

COMPARISON: ___, 15:55

IMPRESSION: No relevant change as compared to the previous image   Keywords: no relevant change. The right internal jugular vein catheter is in unchanged position. Low lung volumes. Moderate cardiomegaly with tortuosity of the descending aorta. Mild fluid overload but no overt pulmonary edema. Small retrocardiac atelectasis is not substantially changed. No pleural effusions. No pneumonia.


SubjectID: 18224196, StudyID: 58314226, Comparison: same

WET READ: ___ ___ ___ 6:40 PM Dobhoff tube tip is below diaphragm although tip not visualized but mid portion is coiled in the esophagus. R CVL unchanged in position. Small right effusion slightly larger than at 9:46am. Unchanged left effusion. ___ d/w ___ by phone at 6:35pm ___ at ___. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: To evaluate for the Dobbhoff tube placement.

TECHNIQUE: Upright portable chest view was reviewed in comparison with multiple prior radiographs through ___ through ___.

FINDINGS: A Dobbhoff tube ends into the stomach; however, coiled in the mid esophagus. Right internal jugular sheath tip is at upper SVC. There is evidence of prior median sternotomy for mitral valve replacement and tricuspid valvuloplasty. Allowing for differences in technique, mild-to-moderate right pleural effusion has minimally increased, while moderate left pleural effusion with complaining left lower lung atelectasis is unchanged over last 24 hours. Very mild pulmonary vascular congestion is unchanged   Keywords: unchanged. Post-operative cardiomediastinal silhouette has an expected post-op appearance and stable. There is no pneumothorax. The findings regarding Dobbhoff tube was already communicated by Dr. ___ with ___ by phone at 6:35 p.m. on ___.


SubjectID: 18224196, StudyID: 58094975, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: ___-year-old woman with status post mitral valve repair, tricuspid valve repair, status post chest tube removal.

TECHNIQUE: Single upright portable chest view was reviewed in comparison with multiple prior radiographs with the most recent from ___.

FINDINGS: Since ___, right chest and mediastinal drain tubes have been removed. There is no appreciable pneumothorax. Left lower lung opacity obscuring the left cardiomediastinal border and the left lung base has minimally worsened since ___ and is combination of moderate left effusion and left lower lung atelectasis. Riight basal atelectasis and presumed small right pleural effusion is unchanged. There is no significant change in the upper mediastinal   Keywords: no significant change. Right internal jugular sheath has its tip ending at the upper SVC. There is evidence of prior median sternotomy and sternal sutures are intact.


SubjectID: 18224196, StudyID: 55169735, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluate for Dobbhoff tube placement.

TECHNIQUE: Portable upright chest view was read in comparison with multiple prior radiographs with the most recent one from ___.

FINDINGS: following repositioning, the coiled Dobbhoff tube in the mid esophagus has resolved. The distal end is within the stomach. Right internal jugular sheath is at upper SVC. Patient is following median sternotomy for mitral valve replacement and sternal sutures are intact. Mild-to-moderate right pleural effusion associated with adjacent lung atelectasis is unchanged since prior radiograph from ___. No other interval changes in the lung   Keywords: no other interval change.


SubjectID: 18224196, StudyID: 54459875, Comparison: same

FINAL REPORT

PORTABLE AP CHEST FILM, ___ AT 08:54 CLINICAL

INDICATION: ___-year-old with Dobbhoff tube in stomach, attempted advancement, evaluate for placement. Comparison is made to the patient's prior study of ___. Portable AP upright chest film, ___ at 08:54 is submitted.

IMPRESSION: 1. The patient is status post median sternotomy with a mitral valve replacement. The cardiac and mediastinal contours are stable in this postoperative patient. A Dobbhoff feeding tube is seen coursing below the diaphragm with the tip not completely identified on this study. A right internal jugular sheath remains in place, unchanged. There are bilateral effusions, left much greater than right, with associated airspace disease, which most likely reflects compressive atelectasis, although pneumonia cannot be entirely excluded. The interstitium appears somewhat coarsened, but no overt pulmonary edema is seen. No pneumothorax. Overall, there has been no significant interval change   Keywords: no significant interval change.


SubjectID: 18224196, StudyID: 57481340, Comparison: None

FINAL REPORT

AP CHEST, 10:49 P.M., ___

HISTORY: ___-year-old woman after mitral and tricuspid valve surgery. Evaluate mediastinum.

IMPRESSION: AP chest compared to ___ through ___ at 1:05 p.m. Since the earliest postoperative study earlier today on ___ following median sternotomy and dual-valve replacements, there has been no change in the essentially normal postoperative cardiomediastinal silhouette. Left lower lobe collapse however has progressed. Small left pleural effusion is presumed. Right pleural effusion is minimal if any and there is no pneumothorax, basal pleural tube in place. ET tube, midline drains are in standard placements. Swan-Ganz catheter ends in the right descending pulmonary artery and should be withdrawn several centimeters to avoid inadvertent cannulation of the middle lobe or superior segmental lower lobe pulmonary arteries. No pneumothorax.


SubjectID: 18224196, StudyID: 57907009, Comparison: better

FINAL REPORT

INDICATION: ___-year-old female with new fevers and oxygen requirement, question of pneumonia.

COMPARISON: Chest radiographs on ___, ___ and ___. CTA of the chest on ___.

FINDINGS: PA and lateral views of the chest. Again seen is hyperinflation of the lungs consistent with emphysema. The previously seen pulmonary edema has resolved   Keywords: resolve. The right-sided pleural effusion is stable. The small left pleural effusion is also stable. A cluster of elliptical opacities in the left lower lobe that were present on study on ___ . There are linear opacities in the left lower lobe and lingula consistent with atelectasis that have improved compared to prior study. Cardiomegaly is stable.

IMPRESSION: 1. No focal consolidation. 2. Resolution of pulmonary edema. 3. Stable right and left pleural effusions. 4. Cluster of elliptical opacities in the left lower lobe that were present on study in ___, recommend followup with conventional CXR when acute issues have resolved.


SubjectID: 18224196, StudyID: 56094236, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with shortness of breath.

COMPARISON: ___.

TECHNIQUE: Single frontal chest radiograph was obtained with the patient in an upright position.

FINDINGS: Small bilateral pleural effusions are increased in size compared to most recent prior exam. There is no focal consolidation. The lungs are hyperinflated with emphysematous changes as seen on prior CT. Heart size is increased, similar compared to prior.

IMPRESSION: 1. Increased small bilateral pleural effusions. 2. Cardiomegaly. 3. Hyperinflated lungs corresponding with known emphysema. These findings were discussed with Dr. ___ by Dr. ___ by telephone at 10:32 a.m. on ___.


SubjectID: 18224196, StudyID: 55452685, Comparison: better

FINAL REPORT

INDICATION: History of hypertension, mitral regurgitation, and AFib with new dyspnea on exertion. Evaluate for pulmonary edema.

COMPARISON: Chest radiograph ___. Chest radiograph ___.

FINDINGS: Moderate bilateral pleural effusions, larger on the right than on the left, are unchanged. The previously noted pulmonary edema has resolved   Keywords: resolve. There is no consolidation. Mild right basilar atelectasis persists. There is no pneumothorax. Moderate enlargement of the cardiomediastinal silhouette is stable.

IMPRESSION: 1. Stable moderate bilateral pleural effusions. 2. Resolution of pulmonary edema.


SubjectID: 18224196, StudyID: 56589683, Comparison: same

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old woman status post mitral valve repair. Evaluate for effusion.

FINDINGS: Comparison is made to previous study from ___ at 8:54 a.m. There are again seen bilateral pleural effusions and a left retrocardiac opacity, stable. The right cordis and feeding tube are stable in position. Aortic valve replacement is again seen and unchanged in position. There is mild prominence of pulmonary interstitial markings, which is stable   Keywords: stable.


SubjectID: 18224196, StudyID: 50425819, Comparison: None

FINAL REPORT

AP CHEST, 7:46 A.M., ___

HISTORY: Mitral valve repair. Evaluate effusion.

IMPRESSION: AP chest compared to ___: Previous mild pulmonary edema has cleared, moderate left and small-to-moderate right pleural effusion and substantial bibasilar atelectasis are still present and moderate enlargement of the postoperative cardiac silhouette which decreased from ___ through ___ is stable. No pneumothorax. Right internal jugular sheath ends at the origin of the SVC and a feeding tube passes into the stomach and out of view. No pneumothorax.


SubjectID: 18224196, StudyID: 55108041, Comparison: None

FINAL REPORT

STUDY: AP portable chest radiograph.

COMPARISON: PA and lateral chest radiograph ___, AP chest radiograph ___.

INDICATION: ___-year-old with new internal jugular catheter.

FINDINGS: There is interval placement of a left internal jugular catheter with tip terminating in the upper SVC. There is no pneumothorax. Cardiomediastinal and hilar silhouettes are stable. There is stable scarring or atelectasis at the left lung base as well as calcifications at the costochondral junction. The lungs are otherwise clear.

IMPRESSION: New left IJ catheter with tip in the upper SVC, no pneumothorax.


SubjectID: 18224196, StudyID: 50929836, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post failed right internal jugular vein placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. There is no right pneumothorax after failed internal jugular vein catheter placement. No evidence of mediastinal widening. No other changes   Keywords: no other change. The previously placed left internal jugular vein catheter has been removed.


SubjectID: 18230098, StudyID: 58531505, Comparison: None

FINAL REPORT

INDICATION: History: ___F with cp. L arm pain // PNA? Clotted fistula?

TECHNIQUE: Chest AP and lateral

COMPARISON: ___

FINDINGS: The heart is mildly enlarged. There is prominence of the pulmonary vasculature with peribronchial cuffing, suggestive of mild pulmonary edema. There is no focal consolidation, pleural effusion, or pneumothorax.

IMPRESSION: 1. No evidence of pneumonia.


SubjectID: 18230098, StudyID: 52985889, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ PMHx ESRD on HD, HTN, CAD, T2DM, dCHF, chronic anginal syndrome, and PAD who presented to ED ___ severe chest pain and hypotension during dialysis admitted for management of chest pain. // Eval for interval change Eval for interval change

IMPRESSION: Comparison to ___. The pre-existing mild pulmonary edema is stable   Keywords: stable. At lower lung volumes, the lung parenchyma on the right appears substantially denser than on the previous examination and shows air bronchograms, not visualized on yesterday's image. The finding is suggestive for developing pneumonia. Moderate cardiomegaly persists. No pleural effusions.


SubjectID: 18230098, StudyID: 58509010, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with chest pain, sob // eval for interval changes eval for interval changes

IMPRESSION: In comparison with the study of ___, there is little change in the cardiomegaly and mild to moderate pulmonary vascular congestion   Keywords: little change. Probable small bilateral effusions with atelectatic changes at the bases.


SubjectID: 18230098, StudyID: 57673516, Comparison: same

FINAL REPORT

INDICATION: ___F with chest pain // eval infiltrate, CHF

TECHNIQUE: Frontal and lateral views the chest.

COMPARISON: ___.

FINDINGS: Compared to recent exam, the degree of edema has not significantly changed   Keywords: not significantly changed. Right midlung opacity on prior has decreased in the interval. There are small bilateral pleural effusions. Cardiac enlargement is similar to prior. Atherosclerotic calcifications again noted at the arch. Degenerative changes seen at the left shoulder.

IMPRESSION: Small bilateral pleural effusions and mild edema. Confluent right midlung opacity seen on prior has decreased in the interval, potentially superimposed infection.


SubjectID: 18230098, StudyID: 57475424, Comparison: same

FINAL REPORT

PORTABLE CHEST OF ___

COMPARISON: Study of one day earlier.

FINDINGS: Status post right internal jugular central venous catheter placement, with tip terminating in the proximal superior vena cava. No visible pneumothorax. Persistent cardiomegaly and pulmonary vascular engorgement without evidence of interstitial edema   Keywords: persistent.


SubjectID: 18230098, StudyID: 52303389, Comparison: 0.0

FINAL REPORT

HISTORY: Coronary disease presenting with chest pain.

COMPARISON: Chest radiographs ___ and ___.

FINDINGS: Frontal and lateral views of the chest were performed. Moderate cardiomegaly is unchanged. There is central vascular congestion, slightly worse from ___, without overt signs of pulmonary edema   Keywords: worse. There is no pneumothorax or focal airspace consolidation. The mediastinal contours are unchanged. The hilar and pleural structures are unremarkable.

IMPRESSION: Unchanged moderate cardiomegaly without pulmonary edema   Keywords: unchanged.


SubjectID: 18230098, StudyID: 57209669, Comparison: None

FINAL REPORT

CHEST TWO VIEWS, ___.

HISTORY: ___-year-old female with history of coronary artery disease, CHF, presents with chest pain. Decreased breath sounds on the left. Question pneumonia or effusion.

FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. As on prior, there are indistinct pulmonary vascular markings seen bilaterally. A persistent vague focal opacity in the left upper lung persists and is of uncertain etiology. There is no confluent consolidation. Trace bilateral pleural effusions are seen with blunting of the posterior costophrenic angles. Cardiomediastinal silhouette is stable, noting mild cardiomegaly. Atherosclerotic calcification is again seen at the aortic arch. Osseous and soft tissue structures are unremarkable.

IMPRESSION: 1. Findings suggestive of pulmonary vascular congestion. No evidence of frank consolidation. 2. Persistent left upper lobe focal opacity, quite vague but a lung nodule is a differential consideration. Chest CT is recommended to evaluate further when clinically appropriate.


SubjectID: 18230098, StudyID: 51012979, Comparison: same

FINAL REPORT

PORTABLE CHEST X-RAY, ___

COMPARISON: ___ radiograph.

FINDINGS: Persistent cardiomegaly and pulmonary vascular congestion accompanied by interstitial edema   Keywords: persistent. Subtle area of developing consolidation in right lower lung, which could reflect either asymmetric edema or a developing pneumonia given clinical suspicion for this entity. Followup radiographs may be helpful in this regard if warranted clinically.


SubjectID: 18230098, StudyID: 54789705, Comparison: better

FINAL REPORT

PA AND LATERAL CHEST X-RAY

INDICATION: End-stage renal disease, hemodialysis, CAD, shortness of breath, fever, concern for pneumonia.

COMPARISON: ___ to ___.

FINDINGS: Moderate pulmonary edema has significantly improved and is now minimal   Keywords: improve. Small bilateral pleural effusions are loculated posteriorly. There is no new lung consolidation and no pneumothorax.

CONCLUSION: 1. There is no evidence of pneumonia. 2. Improvement of pulmonary edema which is now mild   Keywords: improve.


SubjectID: 18230098, StudyID: 53984007, Comparison: better

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: End-stage renal disease. Acute respiratory distress, fluid overload.

COMPARISON: ___.

FINDINGS: Pulmonary edema has slightly improved and is now moderate   Keywords: improve. Pleural effusions are small if any in this patient with moderate cardiomegaly. There is no pneumothorax.

CONCLUSION: Improvement of pulmonary edema which is now moderate   Keywords: improve.


SubjectID: 18230098, StudyID: 54046262, Comparison: None

FINAL REPORT

HISTORY: Shortness of breath.

TECHNIQUE: PA and lateral views of the chest.

COMPARISON: ___.

FINDINGS: Heart size is mildly enlarged but unchanged. The aortic knob is calcified. The mediastinal and hilar contours are unremarkable. There is no pulmonary vascular congestion. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is visualized. There are no acute osseous abnormalities.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 18230098, StudyID: 51493843, Comparison: 0.0

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Cough and fever, possible flu, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the size of the cardiac silhouette has mildly increased, there is evidence of mild pulmonary edema and of an atelectasis at the right lung base   Keywords: increase. No other changes   Keywords: no other change. No pneumothorax.


SubjectID: 18230892, StudyID: 56148624, Comparison: 1.0

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman with volume overload and CHF, now with aggressive diuresis.

FINDINGS: Comparison is made to previous study from ___. Heart size is enlarged. There is improvement in the pulmonary edema since the prior study   Keywords: improve. There is some resolution of the small basilar pleural effusion on the right. There are no pneumothoraces. There remains some mild prominence of the pulmonary interstitial markings   Keywords: remains.


SubjectID: 18230892, StudyID: 54172360, Comparison: None

FINAL REPORT

PORTABLE CHEST OF ___

COMPARISON: Study of earlier the same date.

FINDINGS: Stable mild cardiomegaly with left ventricular configuration, and unchanged tortuosity of the thoracic aorta. No evidence of pulmonary edema or pneumonia. Localized linear scar or atelectasis adjacent to the left heart border with otherwise grossly clear lungs.


SubjectID: 18230892, StudyID: 53249551, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___ radiograph.

FINDINGS: Cardiac silhouette is mildly enlarged but stable in size. Aorta is tortuous. No new focal areas of consolidation are present within the lungs to suggest the presence of pneumonia, and there is no definite evidence of congestive heart failure.


SubjectID: 18230892, StudyID: 50041142, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: NG tube placement

FINDINGS: As compared to the previous radiograph, the patient has received a nasogastric tube. The course of the tube is unremarkable, the tip of the tube projects over the middle parts of the stomach. On the current radiograph, there is substantial patient rotation, which makes subtle changes difficult to evaluate. However, no larger pleural effusions and no pneumothorax is seen. The size of the cardiac silhouette appears to be unchanged.


SubjectID: 18256282, StudyID: 59979708, Comparison: None

WET READ: ___ ___ 12:29 PM Mild cardiomegaly is unchanged. Low lung volumes. No evidence of pneumonia. ______________________________________________________________________________

FINAL REPORT

INDICATION: History: ___F with hypoxia // ?pna

TECHNIQUE: Portable semi-upright AP chest

COMPARISON: Chest radiographs ___ through ___

FINDINGS: Lung volumes are low. Heart size is exaggerated by low lung volumes and likely within normal limits. Previous pulmonary edema has cleared. There is no evidence of pneumonia. There is no pleural effusion or pneumothorax. The aortic arch is calcified.

IMPRESSION: Low lung volumes. No evidence of pneumonia.


SubjectID: 18256282, StudyID: 52499001, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with line placement

TECHNIQUE: Supine AP view of the chest

COMPARISON: ___ at 14:47

FINDINGS: Left internal jugular central venous catheter tip course may be intra-arterial given its position overlying the inferior aspect of the aortic knob and does not course in the expected region of the left brachiocephalic vein. No pneumothorax is demonstrated. The endotracheal tube remains low lying, terminating approximately 2.5 cm from the carina. An enteric tube is within the stomach. The cardiac and mediastinal contours are unchanged with the heart size remaining mild to moderately enlarged. Mild upper zone vascular redistribution is likely due to supine positioning. Atelectasis is demonstrated in both lung bases. No large pleural effusion or pneumothorax is identified on this supine exam. No displaced fractures are apparent.

IMPRESSION: 1. Left internal jugular central venous catheter course is concerning for intra-arterial location. Clinical correlation is recommended. No pneumothorax. 2. Endotracheal tube remains low lying, terminating approximately 2.5 cm from the carina, and should be withdrawn by at least 1 cm.

NOTIFICATION: The concern for intra-arterial course of the left internal jugular catheter was discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 3:48 PM.


SubjectID: 18256282, StudyID: 51188478, Comparison: None

WET READ: ___ ___ 9:04 AM ET tube 1 cm from the carina. Small opacity at the right base could be atelectasis and should be re-evaluated on followup radiographs. *** ED URGENT ATTENTION *** ______________________________________________________________________________

FINAL REPORT

INDICATION: History: ___F with intubation // tube placement

TECHNIQUE: Portable supine AP chest

COMPARISON: Chest radiographs ___ through ___

FINDINGS: ET tube is 1 cm from the carina. Enteric tube terminates in the stomach. Lung volumes are normal. There is moderate cardiomegaly. Mediastinal and hilar contours are normal. The aortic arch is calcified. There is no pneumothorax. There is small faint opacity at the right base.

IMPRESSION: ET tube 1 cm from the carina. Small opacity at the right base could be atelectasis and should be re-evaluated on followup radiographs.


SubjectID: 18256282, StudyID: 58249549, Comparison: better

FINAL REPORT

PORTABLE CHEST FILM, ___ AT 11:56 CLINICAL

INDICATION: ___-year-old with hypoxia on exertion. Evaluate for pulmonary edema, acute abnormality. Comparison to ___. Portable AP upright chest film ___ at 11:56 is submitted.

IMPRESSION: There is stable marked cardiac enlargement. Lung volumes remain relatively low with crowding of the vasculature. However, the previously seen mild interstitial edema has essentially resolved   Keywords: resolve. No focal airspace consolidation to suggest pneumonia. Probable blunting of the left costophrenic angle with adjacent patchy opacity likely reflecting compressive atelectasis in the setting of a small pleural effusion. No pneumothorax.


SubjectID: 18256282, StudyID: 56785336, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST FILM, ___ AT 13:24 CLINICAL

INDICATION: ___-year-old with CHF and worsening pulmonary edema, low-grade fever, decreased breath sounds at the left base. Comparison is made to prior study of ___. PA and lateral views of the chest dated ___ at 13:24 are submitted.

IMPRESSION: The heart remains enlarged. Stable mediastinal contours with somewhat tortuous unfolded aorta. Lung volumes remain low and there is crowding of the pulmonary vasculature. There may be mild interstitial edema as there are prominent interstitial lines in the lung periphery. No evidence of pneumothorax. No focal airspace consolidation to suggest pneumonia.


SubjectID: 18256282, StudyID: 56294945, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP

INDICATION: ___ year old woman with influenza and UTI. Please assess for interval change.

TECHNIQUE: Single portable AP view of the chest.

COMPARISON: Chest radiograph from ___, ___ ___, and CT chest from ___.

FINDINGS: The endotracheal tube terminates 3.5 cm above the carina. The enteric tube passes below the diaphragm mass and continues out of view. Mild to moderate cardiomegaly is stable. Increased right upper lobe opacity may be due to items outside of the patient. Left lower lobe volume loss and small effusion is unchanged. Notably, the left internal jugular catheter, previously described as possibly intra-arterial in course, has not changed in position.

IMPRESSION: 1. Increased the lobe opacity may be due to items outside of the patient and a direct visual check should be performed. 2. Unchanged possible left intra-arterial catheter, left lower lobe volume loss, and small left effusion.


SubjectID: 18276010, StudyID: 59379875, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with aspiration pneumonia.

COMPARISON: ___.

TECHNIQUE: Single frontal chest radiograph was obtained portably with the patient in an upright position.

FINDINGS: There is increased multifocal opacification in the right lung, including the right lower lung, right hilar region, and right upper lobe. Retrocardiac opacification is also noted. No pleural effusion or pneumothorax is detected. Mild bilateral bronchiectasis is seen. Heart size is mildly enlarged. The aorta is calcified and tortuous.

IMPRESSION: Multifocal pulmonary consolidations, concerning for pneumonia, increased in density compared to prior.


SubjectID: 18276010, StudyID: 50461256, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Hypoxia and dyspnea.

COMPARISONS: ___.

TECHNIQUE: Chest, portable AP upright.

FINDINGS: The heart is normal in size. The aorta is somewhat tortuous with calcifications seen along the arch. The main pulmonary artery contour appears prominent. Patchy opacities are noted in each infrahilar region as well as a vague right upper lobe opacity. Although patchy appearance of focal pulmonary edema may potentially explain the findings in the appropriate setting, but they are more typical for pneumonia. There is no pleural effusion or pneumothorax.

IMPRESSION: Multifocal opacities worrisome for pneumonia although not entirely specific.


SubjectID: 18276010, StudyID: 57197256, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Septic shock, UTI, worsening oxygen requirements.

COMPARISON: ___, 1:29 p.m.

FINDINGS: As compared to the previous radiograph, the right lung has minimally increased in transparency, reflecting either a true improvement or an increase in ventilatory pressure. On the left, pre-existing parenchymal opacities have slightly increased in extent and severity. No larger pleural effusions. Borderline size of the cardiac silhouette. The monitoring and support devices are constant. The tip of the endotracheal tube is still slightly too high and should be advanced by 1-2 cm.


SubjectID: 18276010, StudyID: 55044804, Comparison: worse

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: ___ years old with CVL line placement.

COMPARISON: ___.

FINDINGS: The left jugular line has been removed, and there is a new right-sided jugular line in adequate position that ends in the lower SVC. There is no pneumothorax. The endotracheal tube is at 5.8 cm above the carina. The side hole of the nasogastric tube is unchanged and still in the esophageal-gastric junction or slightly above it. It could be advanced. There is progression of the cephalization, ground-glass opacities, and interstitial markings compatible with moderate interstitial pulmonary edema   Keywords: progression. There is no pneumothorax. No pleural effusion.

CONCLUSION: 1. The right-sided new jugular line is in adequate position. 2. The side port of the nasogastric tube is at the gastroesophageal junction or slightly above the junction. It could be advanced. 3. Moderate pulmonary edema.


SubjectID: 18276010, StudyID: 52638612, Comparison: None

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Line placement.

COMPARISON: ___ at 10:45 a.m.

FINDINGS: The new left jugular line is curving back in the mid left subclavian vein. There is no pneumothorax and no pleural effusion. The side port of the NG tube is at the level or slightly above the level of the esophagogastric junction. It could be advanced. Stability of the bilateral multifocal opacities. The mediastinal and cardiac contour are unchanged. The endotracheal tube is in adequate position 5.9 cm above the carina.

CONCLUSION: 1. The left jugular line is in adequate position and is curving back in the mid left subclavian vein. 2. The nasogastric tube can be advanced.


SubjectID: 18276010, StudyID: 51485512, Comparison: None

FINAL REPORT

HISTORY: ETT placement. Assess position.

TECHNIQUE: Portable semi upright chest radiograph.

COMPARISON: None. PROCEDURE:

FINDINGS: AP semi upright portable chest radiograph obtained at. The endotracheal tube tip is located approximately 6.3 centimeters above the carina. The NG tube courses into the left upper quadrant though the tip is located just beyond the GE junction. Bilateral perihilar opacities are concerning for consolidations in the lower lobes which could reflect aspiration given history of trauma. Left CP angle is excluded. No large pneumothorax. Heart size appears within normal limits. The mediastinal contour difficult to assess given patient rotation to the right. No obvious osseous injury.

IMPRESSION: ET tube position appropriately. NG tube may be advanced for more optimal positioning. Bilateral posterior lower lobe opacities likely reflect aspiration.

NOTIFICATION:


SubjectID: 18279430, StudyID: 57700074, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with CHF, cirrhosis, and cKD, s/p hypothermia protocol for PEA arrest and SBP // assess for pulmonary edema

COMPARISON: Radiographs from ___

IMPRESSION: Support lines and tubes are unchanged in position. There is unchanged cardiomegaly. There is a persistent left retrocardiac opacity and left-sided pleural effusion which has increased slightly. No significant pulmonary edema is seen. There are no pneumothoraces.


SubjectID: 18279430, StudyID: 55542621, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with cardiogenic vs. septic shock // ___ year old man with cardiogenic vs. septic shock

COMPARISON: Radiographs from ___

IMPRESSION: Support lines and tubes are unchanged in position. There is extensive cardiomegaly, stable. There is a left retrocardiac opacity and bilateral effusions. New opacity at the right base has developed since previous. There is mild pulmonary edema, unchanged   Keywords: unchanged. There are no pneumothoraces.


SubjectID: 18279430, StudyID: 52514698, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cirrhosis and shock // s/p NGT

IMPRESSION: As compared to the previous radiograph from earlier today, a nasogastric tube is been placed, terminating within the stomach.


SubjectID: 18279430, StudyID: 50978358, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with cirrhosis and CHF with cardiogenic shock // s/p OG tube

COMPARISON: Radiographs from ___ at 11:50.

IMPRESSION: Support lines and tubes are unchanged in position. Despite the given history of an orogastric tube, no feeding tube is seen. Please correlate clinically. There is unchanged cardiomegaly and a left retrocardiac opacity. There is atelectasis at the right lung base.


SubjectID: 18279430, StudyID: 50757671, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with CHF, cirrhosis, ckd, s/p PEA arrest and hypothermia protocol, with SBP // assess for pulmonary edema

COMPARISON: Compared to radiographs from ___

IMPRESSION: The previously seen support lines and tubes are unchanged in position. There has been placement of a new nasogastric tube whose distal tip and side port are below the GE junction. There is unchanged cardiomegaly. There is a persistent left retrocardiac opacity and left-sided pleural effusion which is stable. Atelectasis at the right lung base is also unchanged. There are no pneumothoraces.


SubjectID: 18279430, StudyID: 50754095, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with cardiac arrest, intubated // assess tube placement

IMPRESSION: The tip of the endotracheal tube is again 2 cm above the carina and this could be pulled back 2-3 cm for more optimal placement. Left-sided pacemaker is seen. There is marked cardiomegaly, unchanged. There is a left retrocardiac opacity which has worsened since the previous study. Bilateral pleural effusions are seen. There are no pneumothoraces.


SubjectID: 18279430, StudyID: 50606234, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with no breath sound on left and hypoxic // ?ptx

COMPARISON: Compared to radiographs from ___ at 10:16.

IMPRESSION: The endotracheal tube tip is now 4 cm above the carina. The left-sided pacemaker is again seen. There is marked cardiomegaly. There is an unchanged left retrocardiac opacity and likely large left-sided pleural effusion, stable. There are no pneumothoraces.


SubjectID: 18279430, StudyID: 50456984, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___-year-old man with hx of AWMI s/p CABG, CHF s/p BiV ICD, liver cirrhosis, and CKD, admitted from clinic for diuresis and likely dialysis // ___-year-old man with hx of AWMI s/p CABG, CHF s/p BiV ICD, liver cirrhosis, and CKD, admitted from clinic for diuresis and likely dialysis ___-year-old man with hx of AWMI s/p CABG, CHF s/p BiV ICD, l

IMPRESSION: In comparison with the study of ___, the endotracheal and nasogastric tubes have been. Otherwise, little change, with substantial enlargement of the cardiac silhouette and relatively mild elevation of pulmonary venous pressure, a combination the raises the possibility of cardiomyopathy or pericardial effusion. Bibasilar atelectatic changes with small pleural effusions.


SubjectID: 18279430, StudyID: 55319893, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF, Cirrhosis s/p respiratory arrest and subsequent cardiac arrest s/p intubation. Evaluate position of ET tube post intubation, pulm edema, PNA.

TECHNIQUE: Portable supine chest radiograph

COMPARISON: ___

FINDINGS: Endotracheal tube terminates less than 2 cm from the carina and could be slightly retracted for better positioning. Dual-chamber pacemaker with a lead extending via the coronary sinus is unchanged. Sternal wires are intact. Significant cardiomegaly is stable.No significant pulmonary edema. No evidence of pneumonia.

IMPRESSION: Endotracheal tube terminating less than 2 cm in the carina. This could be slightly retracted to prevent right mainstem intubation.


SubjectID: 18279430, StudyID: 54908269, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___M with CHF exacerbation and SOB // Acute process for SOB

COMPARISON: ___.

FINDINGS: PA and lateral views of the chest provided. Tripolar AICD is unchanged. Midline sternotomy wires is and mediastinal clips are again noted. The heart remains moderately enlarged. The mediastinal contour is stable. There is a small right pleural effusion which is new in the interval. The lungs appear clear without focal consolidation or edema. No pneumothorax. Bony structures are intact.

IMPRESSION: Stable cardiomegaly. New small right pleural effusion.


SubjectID: 18284271, StudyID: 59629967, Comparison: None

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: History: ___F with h/o COPD, CHF, p/w SOB and cough // Please assess for pulm edema or PNA

TECHNIQUE: Chest: Frontal and Lateral

COMPARISON: None.

FINDINGS: Patient is status post median sternotomy. Dual lead left-sided pacemaker is seen with leads extending to the expected positions of the right atrium and right ventricle. There is moderate central pulmonary vascular congestion. No focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac silhouette is mildly enlarged. Mediastinal contours are unremarkable.

IMPRESSION: Cardiomegaly and moderate pulmonary vascular congestion. No focal consolidation.


SubjectID: 18284271, StudyID: 57056537, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with CHF, URi sx. cough wheezing and dyspnea // ? pna, URI CHF ? pna, URI CHF

IMPRESSION: In comparison with study of ___, there is little change and no evidence of acute cardiopulmonary disease   Keywords: little change. Continued enlargement of the cardiac silhouette in a patient with previous surgery and dual-channel pacer in place. No evidence of acute pneumonia, vascular congestion, or pleural effusion. Elevation of the right hemidiaphragmatic contour most likely reflects and eventration.

NOTIFICATION: Dr. ___, at his request.


SubjectID: 18284271, StudyID: 57672820, Comparison: None

WET READ: ___ ___ ___ 12:21 PM Low lung volumes. No focal consolidation to suggest pneumonia. 2.4 x 1.5 cm proximal right humerus chondroid lesion which most likely represents an enchondroma, but is not fully assessed on this study. If this has not been further evaluated previously, recommend dedicated right shoulder or humerus views. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: History: ___F with AMS // evidence of pneumonia

TECHNIQUE: Chest: Frontal and Lateral

COMPARISON: ___

FINDINGS: Patient is status post median sternotomy. Dual lead left-sided pacemaker is seen with leads extending the expected positions of the right atrium and right ventricle. There are low lung volumes. The cardiac and mediastinal silhouettes are grossly stable. No definite focal consolidation is seen. No pleural effusion or pneumothorax is seen. Projecting over the right humeral head and neck, is a 2.4 x 1.5 cm well-defined chondroid lesion which may represent enchondroma, but is not fully assessed on this study. If this has not been further evaluated previously, recommend dedicated right shoulder or humerus views.

IMPRESSION: Low lung volumes. No focal consolidation to suggest pneumonia. 2.4 x 1.5 cm proximal right humerus chondroid lesion which most likely represents an enchondroma, but is not fully assessed on this study. If this has not been further evaluated previously, recommend dedicated right shoulder or humerus views.


SubjectID: 18284271, StudyID: 56151156, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___F with new PICC // picc placement

COMPARISON: ___

FINDINGS: PA and lateral views of the chest provided. There is a left chest wall pacer device with leads extending into the region the right atrium and right ventricle as on prior. There is a right upper extremity access PICC line, new in the interval with its tip in the lower SVC. Sternal closure device with sternotomy wires are noted. Hardware is partially visualized in the lumbar spine. The lungs are clear. No focal consolidation, large effusion, or pneumothorax is seen. The cardiomediastinal silhouette is stable. Bony structures are intact.

IMPRESSION: Appropriately positioned PICC line.


SubjectID: 18284271, StudyID: 56842454, Comparison: None

FINAL REPORT

CHEST, TWO VIEWS: ___

HISTORY: ___-year-old female with fever and wheezing.

COMPARISON: ___.

FINDINGS: Frontal and lateral views of the chest. The lungs are clear of focal consolidation, effusion or overt pulmonary edema. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is identified.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 18284271, StudyID: 54694200, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with h/o asthma, p/w influenza, now w/ ?egophony changes on lung exam // eval for superimposed lobar pneumonia vs pulm edema

COMPARISON: ___ through a eighth ___.

IMPRESSION: Borderline cardiomegaly and generalized mild pulmonary vascular engorgement are long-standing, but there is no pulmonary edema or any focal consolidation to suggest pneumonia. No appreciable pleural abnormality.


SubjectID: 18284271, StudyID: 55958893, Comparison: None

WET READ: ___ ___ ___ 12:54 PM New right IJ central line tip projects in the low SVC. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with RIJ placed. Evaluate placement.

TECHNIQUE: Portable AP view of the chest.

COMPARISON: Chest radiograph of ___.

FINDINGS: A new right IJ central line tip projects in the low SVC. Compared with the prior chest radiograph, lung volumes remain low with bibasilar atelectasis. No evidence of pneumothorax or new focal consolidation. Unchanged positioning of the left-sided cardiac pacer and median sternotomy wires.

IMPRESSION: New right IJ central line tip projects in the low SVC.


SubjectID: 18284271, StudyID: 52077941, Comparison: None

WET READ: ___ ___ ___ 6:38 AM No acute cardiopulmonary abnormality. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: Chest radiograph.

INDICATION: History: ___F with fever, tachypnea // Eval for acute process

TECHNIQUE: AP and lateral views

COMPARISON: Chest radiograph CT ___.

FINDINGS: Cardiac conduction device is contiguous with cardiac leads. The patient status post median sternotomy with wires intact. Lung volumes are low and there is bibasilar atelectasis. The lung bases are not entirely imaged on the lateral view. Lung fields are clear.

IMPRESSION: No acute cardiopulmonary abnormality.


SubjectID: 18284271, StudyID: 54554852, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old s/p AVR and drop in hemoglobin // evel for interval change

TECHNIQUE: Single portable AP view radiograph of the chest.

COMPARISON: Prior chest radiographs dating back to.

FINDINGS: Compared with the immediate prior study of ___, there may be a small to moderate left pleural effusion and increasing retrocardiac atelectasis. Otherwise, there is no change to the postoperative appearance of the mediastinum. There is no pulmonary edema or pneumothorax. A right IJ central venous catheter tip ends at the cavoatrial junction. There is stable mild cardiomegaly.

IMPRESSION: 1. Possible small to moderate left pleural effusion with increasing retrocardiac atelectasis. 2. Unchanged postoperative appearance of the mediastinum.


SubjectID: 18284271, StudyID: 52211514, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with tissue avr, chb sob // chb sob

TECHNIQUE: Portable chest

COMPARISON: ___.

FINDINGS: Compared to the prior study there is slight interval increase in the vascular plethora, cardiomegaly, and small bilateral effusions.

IMPRESSION: Slight worsening in fluid overload   Keywords: worse.


SubjectID: 18284271, StudyID: 50617827, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with a/p AVR, post pull // ?PTX

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph. All monitoring and support devices, with the exception of the right internal jugular vein catheter has been removed. There is no evidence of pneumothorax. No larger pleural effusions. No pneumonia. Unchanged normal postoperative appearance of the cardiac silhouette.


SubjectID: 18305899, StudyID: 58796011, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___-year-old male with recent admission abdominal pain status post cardiac stenting and ileus which was managed conservatively. Evaluate for congestive heart failure, pneumonia and bowel obstruction.

TECHNIQUE: Chest AP upright and lateral

COMPARISON: Chest radiograph from ___. Same-day CT abdomen pelvis

FINDINGS: Midline sternotomy wires noted. Patient status post prior aortic valve replacement. There has been interval removal of a enteric tube. Dense calcified pleural plaques are noted bilaterally. Bibasilar opacities are better assessed on same-day CT abdomen pelvis and may represent atelectasis versus pneumonia. Cardiomediastinal silhouette stable. Bony structures intact.

IMPRESSION: As above.


SubjectID: 18305899, StudyID: 54718160, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with epigastric pain // evaluate for NT placement

COMPARISON: Radiograph of the chest from earlier today.

FINDINGS: AP portable upright view of the chest. There has been interval placement of an NG tube which is seen extending into the stomach. Midline sternotomy wires again noted. Bilateral calcified pleural plaque is noted with opacities projecting over the lower lungs which appear concerning for pneumonia. No large effusion is seen. No pneumothorax. Heart size is difficult to assess. Mediastinal contour is normal. Bony structures are intact.

IMPRESSION: Interval placement of NG tube. Basilar opacities remain concerning for pneumonia.


SubjectID: 18309270, StudyID: 50667278, Comparison: worse

FINAL REPORT

COMPARISON: Portable supine AP chest radiograph ___.

TECHNIQUE: Semi-upright portable AP chest radiograph.

FINDINGS: There has been an increase in bilateral pleural effusion and bibasilar atelectasis. There has also been increase in vascular congestion, pulmonary edema, heart size and mediastinal width   Keywords: increase. These findings are consistent with heart failure. There has been interval removal of an enteric tube. Swan-Ganz catheter remains in place and terminates within the right main pulmonary artery. There is one midline chest tube and two basal pleural tubes, unchanged position. There is no pneumothorax.

IMPRESSION: Slight increase in heart size and mediastinal width along with increased bilateral pleural effusions and pulmonary edema suggests heart failure. There is no pneumothorax.


SubjectID: 18310719, StudyID: 58409082, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with new o2 requirement // Signs of consolidation?

COMPARISON: ___.

IMPRESSION: No relevant change as compared to the previous radiograph   Keywords: no relevant change. Low lung volumes. Borderline size of the cardiac silhouette. No pneumonia, no pulmonary edema, no pleural effusions. Mild atelectasis at both the left and the right lung bases.


SubjectID: 18310719, StudyID: 51579149, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with dyspnea, chest pain

COMPARISON: ___.

FINDINGS: AP portable upright view of the chest. Low lung volumes significantly limit the assessment. There is normal ray shin of the mid upper lungs. The lower lungs cannot be assessed heart size cannot be assessed. No large effusion is or pneumothorax is seen. Bony structures are grossly intact.

IMPRESSION: Limited exam due to markedly low lung volumes. No overt abnormality. Please repeat with more optimized inspiratory effort for a more complete assessment.


SubjectID: 18310719, StudyID: 57772005, Comparison: None

WET READ: ___ ___ 8:02 PM Low lung volumes persist, but there is improved aeration compared to the prior study from ___. Platelike atelectasis is present in the left lung base. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with persistent hypotension, o2 requirement, sleepy // acute process acute process

IMPRESSION: Heart size is are unchanged. Minimal bibasal atelectasis present. There is interval resolution of previously seen interstitial pulmonary edema. No pneumothorax.


SubjectID: 18310719, StudyID: 56958457, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with dCHF, AF, CAD pancreatitis c/b pulmonary edema with increased O2 requirement // eval for edema, infiltrate, effusion eval for edema, infiltrate, effusion

IMPRESSION: Bibasal areas of atelectasis have slightly progressed and there is slight interval progression of vascular enlargement.


SubjectID: 18322589, StudyID: 58349137, Comparison: None

FINAL REPORT

INDICATION: Congestive heart failure and shortness of breath.

COMPARISON: Chest CT, ___ and chest radiograph, ___. AP VIEW OF THE CHEST: Patient is status post median sternotomy, CABG, and mitral valve replacement. A left-sided AICD device is noted with leads terminating in the right atrium, right ventricle, and coronary sinus. Mild enlargement of the cardiac silhouette is redemonstrated, with unchanged tortuosity of the thoracic aorta. There is perihilar haziness with vascular indistinctness and diffuse alveolar opacities compatible with moderate pulmonary edema. No large pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities.

IMPRESSION: Moderate congestive heart failure.


SubjectID: 18322589, StudyID: 57120453, Comparison: same

FINAL REPORT

INDICATION: Intubated for hypoxic respiratory failure, evaluate for interval change.

COMPARISON: Chest radiographs from ___.

FINDINGS: One portable AP semi-erect view of the chest. Severe pulmonary edema is unchanged   Keywords: unchanged. Bilateral pleural effusions are unchanged. Moderate cardiomegaly is stable. There is no evidence of pneumothorax. Sternotomy wires and mitral valve hardware are in appropriate position. Right atrial transvenous pacer lead still passes posteriorly in the right atrium ending at the inferior cavoatrial junction, a nonstandard position. The right ventricular lead is in appropriate position.

IMPRESSION: 1. Unchanged severe pulmonary edema   Keywords: unchanged. Bilateral pleural effusions are unchanged. 2. Right atrial lead still ends at the inferior cavoatrial junction.


SubjectID: 18322589, StudyID: 56196471, Comparison: 0.0

PROVISIONAL

FINDINGS

IMPRESSION (PFI): ___ ___ ___ 3:23 PM 1. Endotracheal tube ends 3 cm from the carina. Better lung volumes after intubation but still severe pulmonary edema   Keywords: still   Keywords: still. ______________________________________________________________________________

FINAL REPORT

INDICATION: CHF and hypoxia and elevated INR, fluid overload versus DAH, status post intubation, evaluate ETT placement.

COMPARISON: Chest radiograph on ___ at 5:34 a.m.

FINDINGS: One AP portable view of the chest. Endotracheal tube ends 3 cm from the carina. Nasogastric tube ends in the stomach. Left AICD device leads terminate in the appropriate positions. After ETT placement, there are increased lung volumes, and still severe pulmonary edema   Keywords: increase. Cardiomegaly is stable. Small right pleural effusion is stable. Retrocardiac atelectasis is unchanged. No evidence of pneumonia. Sternotomy wires are seen.

IMPRESSION: 1. Endotracheal tube ends 3 cm from the carina. Better lung volumes after intubation but still severe pulmonary edema.


SubjectID: 18322589, StudyID: 51231499, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure exacerbation, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is a severe increase in extent of the bilateral parenchymal opacities   Keywords: increase. These are strongly suggestive for severely increasing pulmonary edema   Keywords: increasing. In addition, a small right pleural effusion has newly occurred. There is unchanged evidence of cardiomegaly. No pneumonia, retrocardiac atelectasis is present. At the time of dictation, ___, 8:27 a.m., referring physician, ___. ___, was paged for notification.


SubjectID: 18322589, StudyID: 58137643, Comparison: same

PROVISIONAL

FINDINGS

IMPRESSION (PFI): ___ ___ ___ 11:49 AM

IMPRESSION: Stable mild interstitial edema with small bilateral pleural effusions with associated atelectasis   Keywords: stable   Keywords: stable. ______________________________________________________________________________

FINAL REPORT

HISTORY: ___-year-old male with hypoxic respiratory failure. STUDY: Portable AP upright chest radiograph.

COMPARISON: ___.

FINDINGS: The endotracheal tube tip sits 4 cm above the carina. A right-sided central venous catheter tip sits at the cavoatrial junction. An endogastric tube courses inferiorly below the GE junction. A pacer defibrillator unit projects over the left chest with leads in the right atrium, right ventricle, and coronary sinus. Sternotomy wires, prosthetic valve, and CABG material are unchanged. The heart size is at the upper limits of normal. The mediastinal contours are within normal limits. The lungs demonstrate stable appearance of interstitial edema, and small bilateral pleural effusions with associated atelectasis are present   Keywords: stable. There is no pneumothorax.

IMPRESSION: Stable mild interstitial edema with small bilateral pleural effusions with associated atelectasis.


SubjectID: 18322589, StudyID: 55604705, Comparison: better

FINAL REPORT

HISTORY: ___-year-old male who has been intubated for diffuse alveolar hemorrhage. STUDY: Portable semi-upright AP chest radiograph.

COMPARISON: ___.

FINDINGS/

IMPRESSION: A left pacer defibrillator unit has leads in the right atrium, right ventricle, and coronary sinus. The endotracheal tube seats 3.5 cm above the carina. Midline sternotomy wires and mediastinal clips are unchanged. Right-sided central venous catheter tip seats at the cavoatrial junction. An endogastric tube courses inferiorly with its side port projecting over the stomach. The cardiomediastinal contours are unchanged. Bibasilar atelectasis persists with small bilateral pleural effusions. The lung parenchyma demonstrates minimally improved opacities, signifying improving edema or hemorrhage   Keywords: improve. There is no pneumothorax.


SubjectID: 18322589, StudyID: 52428827, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Diffuse alveolar hemorrhage, intubation, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the monitoring and support devices are unchanged. Slight progression of the bilateral basilar areas of atelectasis. Minimal further enlargement of the cardiac silhouette. Otherwise, the lung parenchyma is unchanged. No pneumothorax, no larger pleural effusions.


SubjectID: 18322589, StudyID: 51044625, Comparison: better

PROVISIONAL

FINDINGS

IMPRESSION (PFI): ___ ___ 10:26 AM Slightly improved pulmonary opacities compatible with moderate pulmonary edema versus pulmonary hemorrhage   Keywords: improve   Keywords: improve. ______________________________________________________________________________

FINAL REPORT

HISTORY: ___-year-old male with diffuse alveolar hemorrhage and renal failure. STUDY: Portable semi-upright AP chest radiograph.

COMPARISON: Multiple chest radiographs from ___ through ___ as well as chest CT from ___.

FINDINGS: The pacer unit leads are unchanged in position. The endotracheal tube tip sits 3 cm above the carina. The endogastric tube side port sits just below the GE junction. A prosthetic mitral valve is noted. The heart size is stable. There has been minimal improvement in the diffuse ground-glass opacities   Keywords: improve. Blunting of both costophrenic angles suggests small pleural effusions along with predominantly retrocardiac atelectasis. There is no pneumothorax.

IMPRESSION: Slightly improved pulmonary opacities compatible with moderate pulmonary edema versus pulmonary hemorrhage.


SubjectID: 18322589, StudyID: 50924449, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Nasogastric tube, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has received a new nasogastric tube. The tube shows a normal course, the tip is not included on the image. Otherwise, there is no relevant change, with the exception of mild decrease of the pre-existing parenchymal opacities caused by pleural effusions and subsequent areas of atelectasis at both lung bases.


SubjectID: 18344237, StudyID: 58024161, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with new ETT // please assess for placement please assess for placement

IMPRESSION: In comparison with the earlier study of this date, there has been placement of an endotracheal tube with its tip approximately 4.5 cm above the carina. Otherwise no change   Keywords: no change.


SubjectID: 18344237, StudyID: 51927675, Comparison: None

FINAL REPORT

INDICATION: ___M with ESRD, hematemesis, evaluate for free air, pneumomediastinum.

TECHNIQUE: AP chest radiograph.

COMPARISON: Chest x-ray ___.

FINDINGS: The cardiomediastinal silhouettes are stable, with unchanged cardiomegaly. The bilateral hila are unremarkable. The lungs are clear without focal consolidation. There is no evidence of pulmonary vascular congestion or pulmonary edema. There is no pneumothorax or pleural effusion. There is no evidence of pneumomediastinum. Fractures of indeterminate age are seen involving several lower left lateral ribs, possibly present on priors but not as well-visualized.

IMPRESSION: 1. No acute cardiopulmonary process. No evidence of pneumomediastinum. Stable cardiomegaly. 2. Fractures of indeterminate age are seen involving several lower left lateral ribs, possibly present on priors but not as well- visualized.


SubjectID: 18344237, StudyID: 51902143, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with respiratory distress // eval for edema, pneumonia, effusions

COMPARISON: None.

FINDINGS: The heart is massively enlarged, though not significantly changed compared with ___. It is, however, considerably larger than on ___. There is mild vascular plethora. Again seen is a small right effusion with underlying collapse and/or consolidation and minimal blunting of the left costophrenic angle with some patchy opacity at the left base as well. The hila are prominent somewhat indistinct, but unchanged compared with the ___ radiograph   Keywords: unchanged.

IMPRESSION: 1. Marked cardiomegaly, considerably increased compared with ___. Is there concern for pericardial effusion? 2. Small bilateral effusions, with bibasilar patchy opacities, unchanged compared with ___ at 22:36.


SubjectID: 18344237, StudyID: 50405088, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with HF exacerbation // ? degree of pulmonary edema

COMPARISON: ___.

FINDINGS: There is marked poly chamber cardiomegaly. Allowing for technical differences, the appearance is similar, but probably slightly worse, compared to ___, and definitely increased compared with ___. The water bottle configuration raises the question of pericardial effusion. The aortic knob does not appear dilated. There is upper zone redistribution, possible mild vascular blurring, and small bilateral effusions, with bibasilar atelectasis. This appearance is similar to the prior film. Prominence of the right hilum is also similar. Background hyperinflation raises question of background COPD.

IMPRESSION: 1. Cardiomegaly, slightly increased compared with ___. Is there concern for pericardial effusion? 2. Mild CHF with small bilateral effusions and bibasilar atelectasis. 3. Prominence of the right hilum, unchanged compared with ___. Attention to this area on followup films, after resolution of acute symptoms, is requested. 4. Possible background COPD.


SubjectID: 18362524, StudyID: 58727030, Comparison: None

FINAL REPORT

INDICATION: ___ y/o F with history of bronchiectasis with radiographic pattern suggestive of pulmonary MAC and status post treatment from ___ to ___, history of aspiration pneumonia + multiple episodes of pneumonia and/or a lower respiratory tract infection, dCHF, pulmonary/peritoneal TB with upper lobe scar, Afib on apixaban, CKD (recent baseline creat 1.2-1.4) and HTN originally presented with 1 week of gradually worsening dyspnea thought to represent acute diastolic heart failure exacerbation in the setting of poor pulmonary function ___ to chronic disease which improved with diuresis, called out to floor on

COMPARISON: Radiographs from ___

IMPRESSION: There is again seen bilateral severe bronchiectasis, emphysematous changes, and scarring. Findings are most prominent within the lung apices and in the perihilar regions. There is suggestion of developing opacity at the lung bases. Attention to these areas is recommended on subsequent exams. No pneumothoraces are seen. Heart size is within normal limits.


SubjectID: 18362524, StudyID: 54441757, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with dyspnea // please eval for interval change please eval for interval change

IMPRESSION: In comparison with the study of ___, there is again severe chronic pulmonary disease with emphysema, fibrous scarring, and bronchiectasis diffusely involving both lungs, especially in the apical and perihilar regions. In the appropriate clinical setting, it would be extremely difficult to exclude the possibility of superimposed acute pneumonia.


SubjectID: 18362524, StudyID: 54534497, Comparison: None

FINAL REPORT

HISTORY: Shortness of breath after ERCP.

FINDINGS: In comparison with study of ___, there is no evidence of pneumothorax. Free intraperitoneal gas would be difficult to detect since this patient may not have been in an upright position sufficiently long for gas to accumulate under the hemidiaphragm. Diffuse interstitial changes are again seen bilaterally, most likely reflecting chronic pulmonary disease. The possibility of supervening pneumonia would have to be considered in the appropriate clinical setting.


SubjectID: 18362524, StudyID: 54340650, Comparison: None

FINAL REPORT

SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Bronchiectasis and new hypoxia. Comparison is made with prior study, ___. There is mild cardiomegaly, unchanged. Right upper lobe consolidation has markedly worsened, consistent with pneumonia. Left upper and left lower lobe opacities have minimally increased. There are small bilateral pleural effusions. There is no pneumothorax. There is stable biapical pleural thickening. Patient has known severe emphysema.

IMPRESSION: Worsening pneumonia.


SubjectID: 18362524, StudyID: 53779759, Comparison: None

FINAL REPORT

INDICATION: Tachypnea and crackles.

TECHNIQUE: AP portable chest radiograph.

COMPARISON: Multiple priors, most recent ___.

FINDINGS: In comparison to ___, there is no change in the distribution of the parenchymal opacities. There is a mild improvement in the left lower lung compared to ___. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is within normal limits.


SubjectID: 18367977, StudyID: 53722930, Comparison: 0.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: This is a ___F w/HFpEF CAD s/p MI and s/p CABG ___yrs ago, HTN, HLD, and DM presenting for worsening SOB and weight gain. // worsening volume overload? pneumonia? worsening volume overload? pneumonia?

COMPARISON: Comparison to ___ at 08:48

FINDINGS: Portable semi-erect chest radiograph ___ at 08:06 is submitted.

IMPRESSION: The pulmonary edema has improved but there is stable right basilar and increasing retrocardiac opacities concerning for worsening aspiration or pneumonia, less likely atelectasis   Keywords: worse, increasing. There is still likely residual mild interstitial edema, however   Keywords: still. The heart remains enlarged. Mediastinal contours are stable. No obvious pneumothorax.


SubjectID: 18367977, StudyID: 52779679, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with dyspnea, recent abx dx, now worsening

TECHNIQUE: Portable upright AP view of the chest

COMPARISON: Chest radiograph ___

FINDINGS: Heart size remains moderately enlarged. Patient is status post CABG. Mediastinal contour is unchanged. Moderate pulmonary edema is present with small bilateral pleural effusions and bibasilar airspace opacities most likely reflective of atelectasis. Infection cannot be completely excluded. No pneumothorax is detected. There are no acute osseous abnormalities.

IMPRESSION: Moderate congestive heart failure with moderate pulmonary edema, small bilateral pleural effusions, and bibasilar airspace opacities likely reflective of atelectasis. Infection in the lung bases, however, cannot be completely excluded.


SubjectID: 18367977, StudyID: 50802890, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F w/decompensated CHF on bipap // interval changes, pulm edema, consolidations interval changes, pulm edema, consolidations

COMPARISON: Comparison to ___ at 17:14

FINDINGS: Portable semi-erect chest radiograph ___ at 8:48

IMPRESSION: There is increasing consolidation at the right lung base as well as slightly increasing pulmonary vasculature indistinctness bilaterally consistent with worsening moderate pulmonary edema, although an infectious process in the right lower lobe cannot be entirely excluded   Keywords: worse. The heart remains stably enlarged. No pneumothorax.


SubjectID: 18376342, StudyID: 59343223, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Pseudoaneurysm, evaluation for line position, questionable pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there was an interval change of a central venous access device over the wire. No evidence of complications, notably no pneumothorax. The tip of a left internal jugular vein catheter projects over the lower SVC. The tip of a right dialysis catheter projects over the right atrium. Unchanged atelectasis at the left lung base. No other parenchymal abnormalities.


SubjectID: 18376342, StudyID: 58476988, Comparison: None

FINAL REPORT

INDICATION: Woman with CFA pseudoaneurysm repair, evaluation for line position.

COMPARISON: ___.

FINDINGS: The new left-sided jugular line is in adequate position in the mid portion of the superior vena cava. There is no pneumothorax. Stability of the left lower lung atelectasis with a mild pleural effusion. The right-sided hemodialysis catheter is unchanged in the right atrium. The mediastinal and cardiac contours are stable and normal.

CONCLUSION: The left jugular line is in adequate position.


SubjectID: 18376342, StudyID: 52177689, Comparison: None

WET READ: ___ ___ 7:39 PM Endotracheal tube in proper position 3.6 cm from the carina. Stable right dialysis catheter in the right atrium and left internal jugular central catheter in the low SVC. No change in bibasilar atelectasis. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Urgently intubation for respiratory distress, evaluation for endotracheal tube position.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, endotracheal tube projects 3.6 cm above the carina with its tip. Stable right dialysis catheter in the right atrium, the left internal jugular vein central catheter, in the lower SVC, unchanged areas of bilateral atelectasis. Unchanged size of the cardiac silhouette.


SubjectID: 18376342, StudyID: 50378996, Comparison: None

FINAL REPORT

INDICATION: Patient with left CFA pseudoaneurysm resection, worsening oxygenation, rule out effusion.

COMPARISON: ___.

FINDINGS: The patient has been extubated since the previous exam. The right hemodialysis catheter ends in the right atrium. There is a new retrocardiac density with volume loss, mostly compatible with atelectasis. There is also a mild right lung base atelectasis. The cardiac and mediastinal contours are normal. New very mild left pleural effusion. There is no pneumothorax.

CONCLUSION: Progression of the left lower lung atelectasis without other significant change.


SubjectID: 18376342, StudyID: 58972618, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Questionable pneumonia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has received an additional nasogastric tube. The course of the tube is unremarkable, the tip of the tube is not visualized on the image. A second esophageal device was also inserted. The tip of this device projects over the mid to lower esophagus. No evidence of complications. Increase in transparency of the lung parenchyma at the left lung base, likely reflecting improved ventilation. The area of right perihilar and basal atelectasis is unchanged. Unchanged size of the cardiac silhouette.


SubjectID: 18394695, StudyID: 54393504, Comparison: None

FINAL REPORT

INDICATION: ___M with h/o cirrhosis w/ AMS // please eval for infection, other acute process. please include doppler studies

TECHNIQUE: AP and lateral views of the chest.

COMPARISON: ___ and ___ chest x-rays. Chest CT from ___.

FINDINGS: Lower lung volumes seen on this current exam accentuating the findings on prior including bilateral parenchymal opacities most conspicuous at the right lung apex and left midlung. The cardiomediastinal silhouette is unchanged. Dense atherosclerotic calcifications noted in the thoracic aorta. Metallic densities projecting over left lung apex are again noted.

IMPRESSION: Chronic changes in the lungs without definite superimposed acute cardiopulmonary process.


SubjectID: 18394695, StudyID: 52950405, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with cirrhosis p/w AMS // eval for PNA

IMPRESSION: As compared to ___, pulmonary vascular congestion and pulmonary edema have resolved   Keywords: resolve. Baseline lung, pleural and airway abnormalities related to previous granulomatous infection appear similar to ___ radiograph.


SubjectID: 18396526, StudyID: 59874026, Comparison: None

FINAL REPORT

HISTORY: Tracheostomy placement.

FINDINGS: In comparison with the earlier study of this date, there has been placement of a tracheostomy tube without evidence of pneumothorax or pneumomediastinum. Otherwise, little change in the appearance of the heart and lungs.


SubjectID: 18396526, StudyID: 59300283, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Respiratory failure, evaluation for pneumonia or pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The monitoring and support devices are constant, including the nasogastric tube, the endotracheal tube, the right pleural pigtail catheter and the right PICC line. The extent of the left pleural effusion with subsequent atelectasis is constant. Also constant is the moderate cardiomegaly with bilateral areas of atelectasis and signs of mild fluid overload. No pneumothorax. No larger right pleural effusion.


SubjectID: 18396526, StudyID: 55201903, Comparison: None

FINAL REPORT

INDICATION: Pneumothorax and chest tube placement, on positive pressure ventilation.

COMPARISON: ___.

TECHNIQUE: Portable frontal chest radiograph.

FINDINGS: Cardiac silhouette is moderately-to-severely enlarged. Postoperative appearance of the mediastinum from prior AVR. A trach tube is in standard position. A left pectoral pacer is in place with leads in the right atrium and the right ventricle. A right PICC terminates in the mid SVC. A right pleural drainage catheter remains at the right lung base without residual pneumothorax. There is bibasilar left-greater-than-right atelectasis with mild-to-moderate pulmonary edema and mild-to-moderate left-greater-than-right pleural effusion.

IMPRESSION: 1. Right chest tube remains in place without remnant pneumothorax. 2. Mild-to-moderate pulmonary edema with left-greater-than-right effusion and bibasilar atelectasis.


SubjectID: 18396526, StudyID: 52723049, Comparison: worse

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with trach placement. Known pulmonary edema, effusion, chest tube. Interval change.

COMPARISON: ___ to ___.

FINDINGS: Tracheostomy, atrioventricular pacemaker and right-sided PICC line are in unchanged position and adequate. Moderate pulmonary edema has slightly worsened since previous exam   Keywords: worse. Patient has prior sternotomy for AVR and MVR and moderate cardiomegaly. Bilateral moderate layering pleural effusions are stable. There is no pneumothorax.

CONCLUSION: 1. Tube and lines are in adequate position. 2. Moderate pulmonary edema has worsened   Keywords: worse. 3. Unchanged bilateral moderate layering pleural effusion.


SubjectID: 18396526, StudyID: 59862408, Comparison: 0.0

FINAL REPORT

HISTORY: Check ET tube placement and interval change over.

COMPARISON: ___.

FINDINGS: The ETT is 4.1 cm above the carina. There is no significant change in the other lines or tubes. There continues to be fluid overload with bilateral pleural effusions and volume loss at both bases and pulmonary vascular redistribution   Keywords: continue. compared to the prior exam that alveolar infiltrates are slightly worse   Keywords: worse.

IMPRESSION: Slightly worsened fluid status.


SubjectID: 18396526, StudyID: 57069248, Comparison: worse

FINAL REPORT

HISTORY: Valve replacement with sepsis.

COMPARISON: ___.

FINDINGS: Again seen is severe cardiomegaly. There is marked pulmonary vascular redistribution with ill-defined vasculature and alveolar infiltrates left greater than right. There is a large left effusion and a small right effusion. There is volume loss in both lower lungs. Underlying infectious infiltrate cannot be excluded. The ET tube, NG tube, and pacemaker are unchanged. The patient is status post valve replacement with sternotomy wires. The right-sided pigtail catheters again seen.

IMPRESSION: 1. Increased CHF   Keywords: increase. 2. Dense retrocardiac and lower lobe opacities. Cannot exclude underlying infectious infiltrate.


SubjectID: 18396526, StudyID: 57350400, Comparison: same

FINAL REPORT

PORTABLE CHEST X-RAY, ___

COMPARISON: Chest x-ray of ___.

FINDINGS: Right pigtail pleural catheter remains in place, with a probable small right pneumothorax, best visualized at the right lateral costophrenic sulcus and also manifested by an unusually sharp contour of the right heart border. Cardiac silhouette remains enlarged, accompanied by pulmonary vascular congestion and persistent moderate to large left pleural effusion as well as small right pleural effusion and adjacent basilar atelectasis, left greater than right   Keywords: remains, persistent.


SubjectID: 18396526, StudyID: 54813347, Comparison: worse

FINAL REPORT

HISTORY: ___-year-old man after AVR, atrial fibrillation. Now with intraoral contents sepsis and to lesser medications.

COMPARISON: ___ through ___.

FINDINGS: Large bilateral pleural effusions, moderate to severe pulmonary edema, and worsened chronic cardiomegaly are all unchanged since ___, worsened since ___   Keywords: worse. ET tube and right internal jugular line are in standard placement, an upper enteric tube can be traced disorder has the diaphragm and passes out of view. Transvenous pacer leads are unchanged in their expected positions. No pneumothorax.

IMPRESSION: No change since ___ in severe, worsening pulmonary edema, large pleural effusions and acute on chronic severe cardiomegaly   Keywords: worse.


SubjectID: 18396526, StudyID: 51708398, Comparison: worse

FINAL REPORT

HISTORY: ___-year-old man with sepsis and bacteremia, intubated. Evaluate interval change.

COMPARISON:

FINDINGS:

IMPRESSION: AP chest at 3:41 compared to ___ 4:09 a.m. The severity of mild to moderate pulmonary edema is exaggerated by increasing large bilateral pleural effusions which are responsible for substantial bibasilar atelectasis, also worsening   Keywords: increasing. There is no pneumothorax. Severe cardiomegaly is a chronic problem, but never worse. Mediastinal caliber suggests elevated central venous pressure or volume or both. ET tube is in standard placement, an upper enteric drainage tube can be traced only as far as the mid esophagus, although it may go further, a right jugular line and ends in the mid to low SVC. Transvenous right atrial and right ventricular pacer leads are probably in standard positions, although the atrial lead is partially obscured.


SubjectID: 18396526, StudyID: 50844138, Comparison: better

FINAL REPORT

INDICATION: Sepsis and right pleural effusion status post tube placement, evaluate for pneumothorax.

COMPARISON: ___, 4:34 a.m.

TECHNIQUE: Portable frontal chest radiograph.

FINDINGS: There has been interval placement of right base chest tube without evidence of pneumothorax and there has been near-complete resolution of the large right pleural effusion. Left pleural effusion is also greatly improved with small to moderate amount of remnant fluid. Pulmonary edema is improved   Keywords: improve. Bibasilar atelectasis is noted. Right internal jugular catheter, upper enteric tube and left pectoral pacer are unchanged in position.

IMPRESSION: Interval placement of right base chest tube without evidence of pneumothorax. Significant interval improvement of bilateral effusions and edema   Keywords: improve.


SubjectID: 18396526, StudyID: 56384847, Comparison: None

FINAL REPORT

PORTABLE CHEST X-RAY OF ___

COMPARISON: Chest x-ray of ___.

FINDINGS: Indwelling support and monitoring devices are in standard position. Cardiomediastinal widening appears similar compared to the prior study allowing for marked rightward patient's rotation. Pulmonary vascular congestion is accompanied by mild edema. Moderate right pleural effusion has decreased in size, but a small left pleural effusion is apparently new. Persistent bilateral retrocardiac opacities which probably reflect atelectasis.


SubjectID: 18396526, StudyID: 51858718, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Respiratory failure, evaluation for pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the changes are minimal. The opacity at the bases of the right upper lobe is constant in extent and severity. The right pigtail catheter in the pleural space is in unchanged position. Unchanged moderate left pleural effusion, unchanged overall mild-to-moderate pulmonary edema. The size and appearance of the cardiac silhouette is constant. The left pectoral pacemaker is in unchanged position.


SubjectID: 18396526, StudyID: 52221160, Comparison: same

FINAL REPORT

PORTABLE CHEST

COMPARISON: Chest x-ray, ___.

FINDINGS: Status post removal of right-sided chest tube, with persistent small right pleural effusion, but no visible pneumothorax. Otherwise, no relevant change in the appearance of the chest since the recent radiograph of one day earlier   Keywords: no relevant change.


SubjectID: 18396526, StudyID: 52021360, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Pneumothorax with chest tube clamped. Evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the chest tube has been clamped. The lung volumes have slightly increased, potentially indicating improved ventilation. There is no evidence of a right pneumothorax. On the left, the preexisting pleural effusion is unchanged. Unchanged left basal atelectasis and moderate cardiomegaly with mild-to-moderate pulmonary edema. Unchanged position of the pacemaker leads, unchanged tracheostomy tube.


SubjectID: 18410503, StudyID: 57910865, Comparison: better

FINAL REPORT

INDICATION: Evaluate for interval change in a patient with heart failure.

COMPARISON: Chest radiographs from ___, ___, ___, ___.

FINDINGS: A portable frontal chest radiograph again demonstrates a left chest wall pacer with leads overlying the right atrium and ventricle. Severe cardiomegaly is unchanged. Mild pulmonary edema is resolved   Keywords: resolve. There is no focal consolidation or pneumothorax. Right base opacity is consistent with a small pleural effusion. The visualized upper abdomen is unremarkable.

IMPRESSION: Resolution of mild pulmonary edema. Right base opacity consistent with a small pleural effusion.


SubjectID: 18410503, StudyID: 51475988, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with congestive heart failure. // evaluate for interval change

COMPARISON: Radiographs from ___

IMPRESSION: Since the previous study, the Swan-Ganz catheter has been removed. The left-sided pacemaker with distal lead tips in the right atrium and right ventricle is unchanged. There is marked cardiomegaly which is stable. There is unchanged mild pulmonary edema   Keywords: unchanged. Bilateral pleural effusions are also stable. There are no pneumothoraces. Severe degenerative changes of the right glenohumeral and a high riding humeral head consistent with rotator cuff rupture are unchanged.


SubjectID: 18410503, StudyID: 56648514, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with acute CHF undergoing tailored therapy with Swan // eval interval change

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the Swan-Ganz catheter is in unchanged position, in the proximal parts of the right lower lobe pulmonary artery. Small right pleural effusion and moderate cardiomegaly with elongation of the descending aorta persists. Mild fluid overload is constant. Constant appearance of the left pectoral pacemaker.


SubjectID: 18410503, StudyID: 54654487, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with RIJ and catheter that won't draw // catheter kinking?

IMPRESSION: As compared to the previous radiograph of 1 day earlier, a distal position of the Swan-Ganz catheter is again demonstrated projecting just beyond the central right hilar structures. This could be withdrawn several cm for standard positioning. Stable marked cardiomegaly accompanied by improving pulmonary edema and apparently decrease in right pleural effusion   Keywords: decrease, improving.


SubjectID: 18417736, StudyID: 57723573, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with moderate/severe AS, at least moderate MR, CHF with diastolic dysfunction // ___ year old man with moderate/severe AS, at least moderate MR, CHF with diastolic dysfunction ___ year old man with moderate/severe AS, at least moderate MR, CHF with diastolic dysfunction

IMPRESSION: In comparison with the study of ___, the cardiac silhouette is within normal limits, as is the pulmonary vascularity. No definite pleural effusion or acute focal pneumonia at this time.


SubjectID: 18417736, StudyID: 55063049, Comparison: worse

WET READ: ___ ___ ___ 7:15 AM Moderate interstitial edema. ______________________________________________________________________________

FINAL REPORT

INDICATION: History: ___M with dyspnea // acute process

TECHNIQUE: Chest PA and lateral

COMPARISON: ___

FINDINGS: Increased interstitial markings bilaterally is indicative of moderate interstitial edema   Keywords: increase. There is no pleural effusion or pneumothorax. Heart size is normal. Osseous structures are intact.

IMPRESSION: Moderate interstitial edema.


SubjectID: 18417736, StudyID: 57476010, Comparison: 0.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CAD, ___, AS, p/w acute chest pain dyspnea, pulmonary edema on admission CXR // any interval changes in pulmonary edema? any interval changes in pulmonary edema?

IMPRESSION: In comparison with the earlier study of this date, there has been some decrease in the bilateral pulmonary opacifications, consistent with improving, though still substantially elevated, pulmonary venous pressure   Keywords: decrease, improving. Otherwise little change   Keywords: little change.


SubjectID: 18417736, StudyID: 57158691, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with hx CHF, CAD with CP, evaluate for pneumothorax, pneumonia, CHF.

TECHNIQUE: AP chest radiograph.

COMPARISON: Chest x-ray ___.

FINDINGS: Again noted are multiple median sternotomy wires. The cardiomediastinal silhouettes are stable, within normal limits. The bilateral hila are unremarkable. There is evidence of pulmonary vascular congestion and moderate to severe interstitial pulmonary edema. There is no pneumothorax or pleural effusion.

IMPRESSION: Moderate to severe pulmonary interstitial edema.


SubjectID: 18417736, StudyID: 54615078, Comparison: 1.0

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old man with CAD, severe AS presenting with SOB. // Please assess for pulmonary edema

TECHNIQUE: Portable chest

COMPARISON: Portable chest radiograph dated ___

FINDINGS: In comparison to the chest radiograph obtained 1 day prior, mild pulmonary edema has decreased   Keywords: decrease. Small, bilateral pleural effusions have minimally increased in size. Mild cardiomegaly is unchanged with mild persistent pulmonary vascular congestion   Keywords: persistent, unchanged. Moderate calcification of the aortic knob is unchanged. Median sternotomy wires are well aligned and intact.

IMPRESSION: Mild pulmonary edema has improved   Keywords: improve. Increased, but small, bilateral pleural effusions.


SubjectID: 18417736, StudyID: 51808477, Comparison: same

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ yo M with PMHx CAD s/p CABG ___, NSTEMI in ___ with unsuccessful DESx3 to SVG-OM, DES to SVG-PDA in ___, HTN, mod-severe AS, dCHF, IDDM2, CKD stage 4, who is presenting with cough and shortness of breath. // lobe reinflated?

TECHNIQUE: Portable chest

COMPARISON: Portable chest radiograph dated ___ at 08:37

FINDINGS: In comparison to the chest radiograph obtained 2.5 hours prior, small, bilateral pleural effusions have decreased in size with improvement in bibasilar atelectasis. No other relevant changes are appreciated   Keywords: no other relevant change.

IMPRESSION: Decreased, small, bilateral pleural effusions with improved bibasilar atelectasis.


SubjectID: 18417736, StudyID: 50975277, Comparison: 1.0

FINAL REPORT

INDICATION: ___ year old man with decompensated CHF // pna, pulm edema

FINDINGS: As compared to chest radiograph from 1 day prior, interval worsening of mild pulmonary edema   Keywords: worse. Bilateral pleural effusions have decreased. There is improved aeration of the lungs with interval decrease of the bibasilar opacities   Keywords: decrease.

IMPRESSION: Interval worsening of pulmonary edema with interval decrease in bilateral pleural effusions   Keywords: worse.


SubjectID: 18417736, StudyID: 52788096, Comparison: -1.0

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old man with CAD, CKD, presenting with SOB // please assess for pulmonary edema

TECHNIQUE: Portable chest

COMPARISON: PA and lateral chest radiographs dated ___

FINDINGS: In comparison to the chest radiographs obtained 1 day prior, moderate pulmonary edema has resolved   Keywords: resolve. Increased bibasilar opacities are combination of increased bilateral pleural effusions and bibasilar atelectasis. Mild cardiomegaly is unchanged. Median sternotomy wires are well aligned and intact.

IMPRESSION: Interval improvement of pulmonary edema with development of bilateral effusions and bibasilar atelectasis are consistent with a natural course of resolving edema   Keywords: development.


SubjectID: 18417736, StudyID: 51770298, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiographs

INDICATION: History: ___M with cough // eval for pna

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiographs dated ___.

FINDINGS: Mild cardiomegaly and moderate interstitial pulmonary edema is noted. A small right pleural effusion is seen. There is no left-sided pleural effusion. No pneumothorax or focal consolidation. The heart is mildly enlarged. The patient is status post median sternotomy and CABG.

IMPRESSION: Mild cardiomegaly and moderate pulmonary edema. Small right pleural effusion.


SubjectID: 18426683, StudyID: 59961973, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with s/p CABG/resp failure // eval pulmonary edema/possible pneumonia eval pulmonary edema/possible pneumonia

IMPRESSION: In comparison with the study of ___, the monitoring and support devices are essentially unchanged. There is continued enlargement of the cardiac silhouette with elevation of pulmonary venous pressure and bilateral effusions with compressive atelectasis, especially substantial volume loss in the left lower lobe.


SubjectID: 18426683, StudyID: 57030130, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with s/p CABG w/ hypoxemia // eval pneumonia eval pneumonia

IMPRESSION: In comparison with the earlier study of this date, the monitoring and support devices remain in place. The right hemidiaphragm is more sharply seen. Although this could be a manifestation of decreasing pleural effusion, more likely reflects a more upright position of the patient. Retrocardiac opacification process, consistent with volume loss in left lower lobe and pleural fluid. There is an area of increased opacification on a horizontally in the right mid zone. This could represent pleural fluid within the minor fissure.


SubjectID: 18426683, StudyID: 56780282, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with re-intubation // placement of ETT placement of ETT

IMPRESSION: In comparison with the earlier study of this date, the patient has been reintubated with the tip of the endotracheal tube approximately 7.7 cm above the carina. Continued enlargement of the cardiac silhouette in a patient with intact midline sternal wires. An continued pulmonary edema with probable bilateral effusions and compressive atelectasis at the bases   Keywords: continue. In the appropriate clinical setting, the possibility of superimposed pneumonia would be difficult to exclude. The left subclavian line has been pulled back somewhat so that the tip is in the region of the junction of the left brachiocephalic vein with the superior vena cava.


SubjectID: 18426683, StudyID: 54612531, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with desaturation // Eval roe interval change Eval roe interval change

IMPRESSION: In comparison with the study of ___, the endotracheal and nasogastric tubes and been removed. The area of widening in the the right superior mediastinum is less prominent. However, there is again substantial enlargement of cardiac silhouette with increasing pulmonary edema   Keywords: increasing. Left hemidiaphragm is poorly seen, suggesting volume loss in the left lower lobe. In the appropriate clinical setting, superimposed pneumonia would have to be considered, both in the area of confluent opacification at the right base and the poorly visualized retrocardiac region.


SubjectID: 18426683, StudyID: 53650383, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with resp failure/pneumonia s/p CABG // eval pneumonia eval pneumonia

IMPRESSION: In comparison with the study of ___, the monitoring and support devices remain in place. There again is some haziness at the bases of the lungs with poor definition of the hemidiaphragms, consistent with layering pleural effusions and compressive atelectasis at the bases. The area of increased opacification horizontally in the right mid zone is no longer seen. Continued enlargement of the cardiac silhouette with evidence of elevated pulmonary venous pressure.


SubjectID: 18426683, StudyID: 59838924, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pneumonia now with new effusion. // compare to prior

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Since the prior study there has been interval decrease in left pleural effusion, potentially after drainage. The Dobbhoff tube tip is in the stomach. Central venous line catheter tip is in the right atrium. Widespread consolidations are bilateral and can be better appreciated on the current study after decrease in left pleural effusion. Tracheostomy is in place.


SubjectID: 18426683, StudyID: 59377398, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with PNA trach with new PMV // worsening consolidation off vent

COMPARISON: ___.

IMPRESSION: As compared to the previous image, the tracheostomy tube and the feeding tube as well as the hemodialysis catheter on the right are in unchanged position. The bilateral multifocal consolidations show moderate progression, both in severity and extent. There likely is presence of a mild to moderate left pleural effusion with subsequent atelectasis in the retrocardiac lung regions. Moderate cardiomegaly persists. Unchanged evidence of mild to moderate pulmonary edema   Keywords: unchanged. Unchanged normal alignment of the sternal wires.


SubjectID: 18426683, StudyID: 52394170, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with trach, psuedomonas PNA // consolidation

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the lung volumes have increased, likely reflecting improved ventilation. As a consequence, the multifocal parenchymal opacities, predominating in the right upper lobe and in the left mid lung zones, have decreased in severity. Moderate cardiomegaly persists. Unchanged extent of a small to moderate left pleural effusion and the subsequent left retrocardiac atelectasis. No new focal parenchymal opacities   Keywords: new. All monitoring and support devices continue to be in correct position.


SubjectID: 18426683, StudyID: 50480006, Comparison: None

FINAL REPORT

INDICATION: L PICC pulled back 2cm and ___ ___ ___ year old man with L PICC repo // L PICC pulled back 2cm and ___ ___ ___

EXAMINATION: CHEST (PORTABLE AP)

TECHNIQUE: Portable Chest radiograph, frontal view

COMPARISON: Chest radiograph ___ 15:42

FINDINGS: Left PICC line terminates at the upper SVC and abuts the dialysis catheter. There is opacification of the left hemithorax sparing the left lung apex, suggestive of increased atelectasis and large left pleural effusion. This is worse compared to ___ and stable from 1 hr ago. Diffuse opacities in the right lung is unchanged from ___. Cardiomegaly is unchanged. Tracheostomy tube and Dobbhoff tube position is stable.

IMPRESSION: 1. Left PICC line terminates at the upper SVC and abuts the dialysis catheter. 2. There is opacification of the left hemithorax sparing the left lung apex, suggestive of increased atelectasis and large left pleural effusion. This is significantly worse compared to ___. Diffuse opacities in the right lung is unchanged since ___.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 5:54 PM.


SubjectID: 18426683, StudyID: 59612243, Comparison: None

WET READ: ___ ___ ___ 7:34 AM No evidence of significant pneumothorax on this semi-erect view. Status post right pleural drainage catheter placement with decreased size of right pleural effusion. Otherwise unchanged position of support devices.

WET READ VERSION #1 ___ ___ ___ 5:43 PM No evidence of significant pneumothorax on this semi-erect view. Status post right pleural drainage catheter placement with decreased size of right pleural effusion. Otherwise unchanged position of support devices. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with new R pigtail placement // evaluate effusion size, ?ptx

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, a new chest tube was introduced on the right. The tube has a fissures the drained a pre-existing right pleural effusion that has substantially decreased in extent. The effusion is now limited to the bases of the right hemi thorax and to the area of the costophrenic sinus. Retrocardiac atelectasis. Moderate cardiomegaly persists. The other monitoring and support devices are in constant unchanged position.


SubjectID: 18426683, StudyID: 59149284, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p cardiac surgery with pna, now s/p drainage of effusions // size of effusions, chest tube position, infiltrate quality ___ year old man with new dobhoff tube // new dobhoff tube position

TECHNIQUE: Portable AP radiograph of the chest from ___.

COMPARISON: ___.

FINDINGS: The initial radiograph of 08:34 shows interval removal of the nasogastric tube. Sternotomy wires are intact and aligned. Bilateral pigtail catheters are unchanged in position. An endotracheal tube terminates at the level of the clavicles. A left IJ central venous catheter terminates at the junction of the brachiocephalic vein and SVC. There is no pneumothorax. Moderate right and small left layering pleural effusions are slightly increased on the right. Moderate cardiomegaly despite the projection is also unchanged. An unchanged retrocardiac airspace opacity may either be due to infection or atelectasis. The followup radiograph of 10:17 shows interval placement of a feeding tube, which enters the stomach. Aeration at the left lung base continues to improve. There is no other significant interval change   Keywords: no other significant interval change.

IMPRESSION: Nasogastric tube replaced with a feeding tube, which enters the stomach. Slightly improved aeration at the left lung base. Otherwise no significant interval change   Keywords: no significant interval change.


SubjectID: 18426683, StudyID: 54853249, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p CABG // eval for worsening infiltrate

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: ET tube tip is 6.6 cm above the carinal. NG tube tip is in the stomach. Left subclavian line tip is at the level of mid SVC. Bilateral pleural effusions and bibasal consolidations are overall unchanged. The only area that appears to be slightly worse is in the left lower lung where a layering pleural effusion versus developing consolidation is a possibility, attention to this area on the subsequent studies is required. There is no evidence of pneumothorax


SubjectID: 18426683, StudyID: 54095778, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p urgent pump assisted/beating heart CABG x3(LIMA-LAD,SVG-Diag-OM) // eval for DHT position

TECHNIQUE: Portable AP radiograph of the chest from ___.

COMPARISON: Earlier the same day.

FINDINGS: The recently placed feeding tube has been advanced further into the stomach with its tip now projecting over the distal stomach. Otherwise, there has been no appreciable interval change since the earlier exam. Supplemental images of the abdomen show a nonobstructive bowel gas pattern. Extensive vascular calcifications are incidentally noted.

IMPRESSION: Feeding tube advanced to expected location of the distal stomach. Otherwise no significant interval change in the chest   Keywords: no significant interval change. Nonobstructive bowel gas pattern.


SubjectID: 18426683, StudyID: 52993097, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p cardiac surgery with pna, now s/p drainage of effusions // size of effusions, chest tube position, infiltrate quality ___ year old man with new dobhoff tube // new dobhoff tube position

TECHNIQUE: Portable AP radiograph of the chest from ___.

COMPARISON: ___.

FINDINGS: The initial radiograph of 08:34 shows interval removal of the nasogastric tube. Sternotomy wires are intact and aligned. Bilateral pigtail catheters are unchanged in position. An endotracheal tube terminates at the level of the clavicles. A left IJ central venous catheter terminates at the junction of the brachiocephalic vein and SVC. There is no pneumothorax. Moderate right and small left layering pleural effusions are slightly increased on the right. Moderate cardiomegaly despite the projection is also unchanged. An unchanged retrocardiac airspace opacity may either be due to infection or atelectasis. The followup radiograph of 10:17 shows interval placement of a feeding tube, which enters the stomach. Aeration at the left lung base continues to improve. There is no other significant interval change   Keywords: no other significant interval change.

IMPRESSION: Nasogastric tube replaced with a feeding tube, which enters the stomach. Slightly improved aeration at the left lung base. Otherwise no significant interval change   Keywords: no significant interval change.


SubjectID: 18426683, StudyID: 52665953, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with new trach // new trach

COMPARISON: ___

IMPRESSION: As compared to the previous image, the endotracheal tube was removed and replaced by a tracheostomy tube. The position of the tracheostomy tube is unremarkable, there is no evidence of complications, notably no pneumothorax. The other monitoring and support devices, including the bilateral pigtail catheters in the pleural space are constant. On the right, the pleural effusion is constant but the degree of pulmonary over hydration might have minimally increased. On the left, the retrocardiac atelectasis has also increased. No new focal parenchymal opacity.


SubjectID: 18426683, StudyID: 58564904, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with as above // s/p CABG w/increased chest tube output r/o effusion

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The monitoring and support devices, including the bilateral chest tubes, are constant in position. Moderate cardiomegaly and mild fluid overload persist. Blunting of the bilateral costophrenic sinuses continue to suggest the presence of small pleural effusions.


SubjectID: 18426683, StudyID: 56692948, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with as above // s/p CABG w/increasing chset tube output; r/o effusion

TECHNIQUE: Portable AP radiograph of the chest from ___.

COMPARISON: Earlier the same day.

FINDINGS: The patient has had prior median sternotomy. Sternotomy wires are intact and aligned. There is no pneumothorax. A right IJ central venous catheter ends in the lower SVC. The endotracheal tube ends at the level of the clavicles. Bilateral chest tubes and mediastinal drains remain in place. Small layering bilateral pleural effusions with associated bibasilar atelectasis are unchanged. Mild pulmonary edema is unchanged   Keywords: unchanged. The cardiomediastinal silhouette is stable.

IMPRESSION: No significant interval change   Keywords: no significant interval change.


SubjectID: 18426683, StudyID: 52889952, Comparison: same

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___ year old man with AAA sp repair with new chest pain // R/o interval change

TECHNIQUE: Portable frontal view of the chest.

COMPARISON: ___.

FINDINGS: Heart size is mildly enlarged with re- demonstration of tortuosity of the thoracic aorta. There are aortic not calcifications. There is prominence of the central pulmonary vasculature. There is no dense consolidation. Pleural surfaces are clear without effusion or pneumothorax.

IMPRESSION: Mild cardiomegaly and vascular congestion similar to prior study   Keywords: similar.


SubjectID: 18426683, StudyID: 58175029, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with recurrent pseudomonas pneumonia s/p trach // evaluate for pulmonary process evaluate for pulmonary process

IMPRESSION: In comparison with the study of ___, monitoring and support devices are unchanged. There appears to be some partial clearing of the diffuse bilateral pulmonary opacifications.


SubjectID: 18426683, StudyID: 53548252, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with trach, new stent, poor uop // interval change

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Right central venous line is unchanged in appearance. Tracheostomy tip is 6.7 cm above the carinal. Gastrostomy is in place. Right mid lung consolidation is slightly more conspicuous than on the previous study concerning for progression. Perihilar opacities are unchanged as well as the left retrocardiac atelectasis. No interval increase in pleural effusion or development of pneumothorax is demonstrated.


SubjectID: 18426683, StudyID: 50597796, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with left main stem bronchus and PsA pneumonia // interval change interval change

IMPRESSION: In comparison with the study of ___, the monitoring and support devices are unchanged. There are substantially increased lung volumes. Persistent right midlung and perihilar opacities, unchanged since the previous examination. Retrocardiac opacification again is consistent with substantial volume loss in the left lower lobe. Small pleural effusions are seen bilaterally.


SubjectID: 18426683, StudyID: 57968900, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with history of VAP this hospital course // interval change, conslidation. interval change, conslidation.

IMPRESSION: In comparison with the study of ___, the monitoring and support devices and appearance of the heart and lungs are essentially unchanged.


SubjectID: 18426683, StudyID: 56842139, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with history of VAP this hospital course s/p treatment now with elevated lactate. Evaluate for focal consolidation or infection

TECHNIQUE: Single frontal chest radiograph was obtained.

COMPARISON: Multiple priors with direct comparison made to study from ___

FINDINGS: Support and monitoring devices are in unchanged positions. There are unchanged bilateral opacities compatible with multifocal pneumonia. The cardiac silhouette is mildly enlarged, with mild pulmonary edema. There are small bilateral pleural effusions.

IMPRESSION: No significant interval change with multifocal pneumonia, mild pulmonary edema, and small bilateral pleural effusions   Keywords: no significant interval change.


SubjectID: 18426683, StudyID: 57871877, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with as above // s/p CABG w/hypoxia r/o infiltrate s/p CABG w/hypoxia r/o infiltrate

COMPARISON: Comparison to ___ at 08:33

FINDINGS: Portable semi-erect chest film ___ at 08:19

IMPRESSION: Lungs are hyperinflated. There are layering bilateral effusions with retrocardiac consolidation likely reflecting lower lobe atelectasis. There is improving vascular congestion but likely residual mild perihilar edema   Keywords: improving. The patient is status post median sternotomy with stably enlarged cardiac and mediastinal contours. Endotracheal tube, nasogastric tube, right internal jugular dual-lumen catheter, and left subclavian catheter unchanged in position. No pneumothorax.


SubjectID: 18426683, StudyID: 53737170, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p CABG // eval effusion eval effusion

IMPRESSION: In comparison with the study of ___, the monitor and support devices are unchanged. There is continued enlargement of the cardiac silhouette with some enlargement of pulmonary venous pressure. Increasing haziness of the right hemithorax suggests further accumulation of pleural effusion with underlying compressive atelectasis. Retrocardiac opacification is consistent with volume loss left lower lobe, probably with associated pleural fluid.


SubjectID: 18426683, StudyID: 57760605, Comparison: None

FINAL REPORT

EXAMINATION: Portable AP chest x-ray.

INDICATION: ___ year old man s/p open AAA repair // evaluate for ptx

TECHNIQUE: AP projection.

COMPARISON: Portable AP chest x-ray obtained ___.

FINDINGS: In comparison to radiograph from ___, the patient has been extubated. Has been removal of right IJ central line, as well as NG tube. The cardiomediastinal silhouettes are grossly unchanged. There is again seen a calcified aortic arch. There is a right basilar platelike atelectasis. There is left lower lobe volume loss, with silhouetting of the left hemidiaphragm and increased retrocardiac opacification likely representing left basilar atelectasis. There is indistinctness of the left lateral CP angle which may represent a small left layering pleural effusion. There is no pneumothorax.

IMPRESSION: No pneumothorax. Bibasilar atelectasis. Possible small left pleural effusion.

NOTIFICATION: The above findings were discussed over the phone with Dr. ___ by Dr. ___ on ___ at 11:53, approximately 20 minutes after review.


SubjectID: 18426683, StudyID: 55802451, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with s/p open AAA repair who is now s/p chest tube removal.

COMPARISON: Prior exam dated ___ at 08:49.

FINDINGS: AP portable upright view of the chest. Multiple overlying EKG wires are presence somewhat limiting evaluation. Skin ___ along the left flank region noted. There is mild elevation of the left hemidiaphragm. Given the lack of the lateral projection, left lower lobe pathology difficult to exclude. There is likely a small left effusion with left basal atelectasis. Right lung appears clear though the right CP angle is excluded. The heart is top-normal in size. The mediastinal contour is stable with tortuosity of the thoracic aorta noted. No pneumothorax is present. Bony structures are intact.

IMPRESSION: Mild elevation of the left hemidiaphragm. Probable small left effusion with left basal atelectasis. Consider lateral view to better assess for underlying abnormality. Otherwise unremarkable exam.


SubjectID: 18426683, StudyID: 57676082, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with s/p tracheal stent // eval for interval change eval for interval change

IMPRESSION: In comparison with the study of ___, the monitoring and support devices are unchanged. There is probably little overall change in the diffuse bilateral pulmonary opacifications. Left pigtail catheter remains in place and there is no evidence of pneumothorax.


SubjectID: 18426683, StudyID: 57593631, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with chronic pseudomonas pneumonia s/p Y tracheal stent for obtruction from dilated aorta // evaluate stent placement and lung parenchyma

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Cardiomediastinal silhouette is unchanged. Tubes and lines are unchanged. Right mid lung consolidation, perihilar consolidation and lower lobe opacities are unchanged. No pneumothorax is noted. Bilateral pleural effusion


SubjectID: 18426683, StudyID: 55641005, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with new left main stent // post op evaluation of stent post op evaluation of stent

IMPRESSION: In comparison with the study of ___, there is now a stent within the left mainstem bronchus. The monitoring and support devices are essentially unchanged. Little overall change in the appearance of the heart and lungs.


SubjectID: 18426683, StudyID: 57040926, Comparison: None

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old man s/p CABG // eval for ptx s/p CT removal

TECHNIQUE: Portable chest radiograph

COMPARISON: Chest x-ray ___.

FINDINGS: Since the prior radiograph performed yesterday morning, the bilateral chest tubes have been removed. The enteric tube terminates in the stomach. Right IJ introducer and left subclavian line terminates at the mid-SVC. Endotracheal tube is 6.4 cm above the carina. Median sternotomy wires are intact. There is some persistent layering pleural effusions bilaterally. Bibasilar atelectasis also noted. No pneumothorax. Right paramediastinal opacity described on the ___ CXR is re-demonstrated, and the possibility of a mediastinal hematoma should be considered. Persistent cardiomegaly. Atherosclerotic calcifications are noted in the aortic arch. Some surgical clips are noted in the left upper quadrant.

IMPRESSION: 1. Interval removal of bilateral chest tubes. No pneumothorax. 2. ETT is 6.4cm above the carina. 3. Persistent right paramediastinal opacity, which may represent a mediastinal hematoma. Close attention on follow-up.


SubjectID: 18426683, StudyID: 51660082, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p CABG // eval for ptx s/p CT removal, follow up edema

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the lung bases have increased in radiodensity, reflecting improved ventilation. Unchanged normal monitoring and support devices. Moderate cardiomegaly. No overt pulmonary edema. No pneumothorax. Retrocardiac atelectasis is unchanged.


SubjectID: 18426683, StudyID: 56017053, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with recent chest tube placement on left with 1L drainage // interval change? interval change?

IMPRESSION: In comparison with the study of ___, the monitoring and support devices are within normal limits. Right chest tube is in place at the base with decreased pleural effusion on this side. Specifically, there is no evidence of pneumothorax. Otherwise little change   Keywords: little change.


SubjectID: 18426683, StudyID: 53275042, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with L pleural effusion and L mainstem compression here with recurrent pseudomonas pna, acute resp distress, decreased BS in left // acute collapse? acute collapse?

IMPRESSION: In comparison with the study of ___, the Dobbhoff tube has been removed. Again there are diffuse bilateral pulmonary opacifications, especially in the mid zones bilaterally, consistent with recurrent pneumonia. Retrocardiac opacification again is consistent with volume loss in the left lower lobe. Bilateral pleural effusions are again seen. No evidence of acute collapse or shift of the mediastinal structures.


SubjectID: 18426683, StudyID: 55403102, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p cabg // eval for pulm edema eval for pulm edema

COMPARISON: Comparison to ___ at 08:36

FINDINGS: Portable AP upright chest film ___ at 07:35 is submitted.

IMPRESSION: Endotracheal tube, left subclavian central line and nasogastric tube are unchanged in position. Interval removal of the right internal jugular dual-lumen catheter. Stable cardiac and mediastinal contours status post median sternotomy for CABG. There continue be layering bilateral effusions with associated patchy airspace disease likely reflecting partial lower lobe atelectasis. Superimposed pneumonia cannot be excluded. No pneumothorax. No evidence of pulmonary edema.


SubjectID: 18426683, StudyID: 51914547, Comparison: None

FINAL REPORT

INDICATION: Post CABG.

COMPARISON: Chest radiograph from ___.

TECHNIQUE: Frontal chest radiograph.

FINDINGS: The endotracheal tube, orogastric tube, left subclavian intravenous catheter, and a right IJ central venous line are all unchanged in orientation since ___, remaining within appropriate positions. The heart size is top-normal. Sternal wires and mediastinal clips denote recent CABG. Moderate atherosclerotic calcifications throughout the aortic arch are stable. There is no pneumothorax or focal consolidation. There is central pulmonary vascular congestion but no overt edema. Trace bilateral pleural effusions are present.

IMPRESSION: Central pulmonary vascular congestion without overt edema. Trace bilateral pleural effusions.


SubjectID: 18426683, StudyID: 54875905, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p cabg. Evaluate for effusion.

TECHNIQUE: Single portable AP view of the chest.

COMPARISON: Chest radiograph from ___, ___, and ___. PA lateral chest radiograph from ___.

FINDINGS: Compared with the prior radiograph, no change in the right HD catheter in the right atrium, NG tube, and left chest tube. Bilateral parenchymal opacities and small effusions are unchanged. No evidence of pneumothorax.

IMPRESSION: 1. Persistent small bilateral effusions are unchanged. 2. No pneumothorax.


SubjectID: 18426683, StudyID: 54696110, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man, evaluate for pneumothorax and effusion.

TECHNIQUE: Single portable AP view of the chest.

COMPARISON: Chest radiographs from ___, ___ and PA lateral chest radiograph from ___.

FINDINGS: Compared with the prior radiograph, no change in the right HD catheter in the right atrium, NG tube, or left chest tube. The right pleural effusion has increased, but the left has decreased. No evidence of pneumothorax. No new focal consolidation concerning for pneumonia.

IMPRESSION: Interval increase in the right pleural effusion, with decrease in the left pleural effusion. No pneumothorax.


SubjectID: 18426683, StudyID: 50104774, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with dobhoff pulled out and replaced // eval dobhoff placement

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___.

IMPRESSION: Severe cardiomegaly is stable. Tracheostomy tube is in standard position. NG tube tip is in the stomach. HD catheter is in standard position. A moderate right and small left effusions are unchanged. Retrocardiac opacities have markedly improved consistent with improving atelectasis


SubjectID: 18426683, StudyID: 53906284, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with L pigtail pt self d/c'd still had high output prior to pt removing pigtail // eval for ptx, effusion

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

FINDINGS: .

IMPRESSION: Dobbhoff tube tip is in the stomach. Tracheostomy is in place. Right central venous line tip terminates in the right atrium. A left pigtail catheter is not currently seen: Removed? . Loculated right pleural effusion is unchanged. No progression in consolidations effusions or development of pneumothorax demonstrated


SubjectID: 18426683, StudyID: 53251273, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with Right arm // Status Post R PICC pulled out 25cm by patient. Replaced by cath exchange at 53cm double lumen nonhep pow PICC

TECHNIQUE: Single portable view of the chest.

COMPARISON: From from earlier the same day at 07:34.

FINDINGS: Right-sided PICC is seen with catheter tip in the mid SVC. Otherwise, there has been no significant interval change including right-sided dual lumen venous catheter, tracheostomy tube an enteric tube. Appearance of the lungs in cardiomediastinal silhouette is also unchanged with pulmonary edema, bilateral effusions with more confluent left mid lung opacity, potentially superimposed infection   Keywords: unchanged

IMPRESSION: Right PICC tip in the mid SVC. No other change   Keywords: no other change.


SubjectID: 18426683, StudyID: 51497064, Comparison: worse

FINAL REPORT

EXAMINATION: AP chest x-ray.

INDICATION: A ___-year-old man with altered mental status and cough, evaluate for pneumonia.

TECHNIQUE: AP semi-upright chest radiograph.

COMPARISON: Chest x-ray ___.

FINDINGS: The right chest central line is again seen with distal tip projecting over the right atrium. Tracheostomy tube remains in place. An enteric tube courses inferiorly, with distal tip projecting below the lower limit of the radiograph. Multiple median sternotomy wires are again identified. Right PICC line is in stable position, with distal tip projecting over the mid-low SVC. The cardiomediastinal silhouette is stable, consistent with mild to moderate cardiomegaly. The bilateral hila are unremarkable. Bilateral diffuse airspace opacities likely represent pulmonary edema which is worsened in comparison to prior exam; however, a more confluent opacity within the left mid-lung raises the possibility of superimposed pneumonia   Keywords: worse. Moderate bilateral pleural effusions and a focal area of right-sided pleural margin thickening are generally unchanged. There is no pneumothorax.

IMPRESSION: 1. Interval worsening of at least moderate pulmonary edema   Keywords: worse. Confluent opacity within the left mid lung raises the possibility of superimposed infection. 2. Stable moderate bilateral pleural effusions.


SubjectID: 18456328, StudyID: 57407162, Comparison: None

FINAL REPORT

EXAM: Chest, single supine AP portable views. CLINICAL INFORMATION: Abdominal distention. Question of a left-sided PICC.

COMPARISON: ___.

FINDINGS: Patent left-sided PICC is seen terminating projecting over the soft tissue of the medial mid-to-proximal forearm, in inappropriate position. Recommend removal and replacement. Patient is status post median sternotomy and CABG. The cardiac silhouette is enlarged. There is prominence and indistinctness of the hila and prominence of the vessels suggesting pulmonary edema. Patchy left base retrocardiac opacity may be due to atelectasis, but consolidation due to aspiration or infection is not excluded. No pneumothorax seen. No definite pleural effusion is seen.

IMPRESSION: Left PICC terminates in the mid-to-proximal forearm, not in appropriate position. Pulmonary edema/congestion. Cardiomegaly. Patchy left base retrocardiac opacity may be due to atelectasis, but consolidation due to aspiration or infection is not excluded. Findings regarding left-sided PICC in inappropriate position discussed with Dr. ___ at 3:28 p.m. on ___ via telephone.


SubjectID: 18456328, StudyID: 52419094, Comparison: same

WET READ: ___ ___ 7:50 PM There are increased bilateral pleural effusions, left greater than right. Worsening left retrocardiac opacity is likely in part secondary to pleural effusion although underlying consolidation is not excluded. Mild to moderate cardiomegaly is unchanged. Lung volumes are low. Mild pulmonary edema is not significantly changed. ______________________________________________________________________________

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old man with hypoxia and tachypnea. Evaluate for increased pulmonary edema.

FINDINGS: Comparison is made to prior study from ___. There is again seen mild pulmonary edema   Keywords: again. There are bilateral pleural effusions which have increased. There is a persistent left retrocardiac opacity and unchanged cardiomegaly. There are no pneumothoraces.


SubjectID: 18458646, StudyID: 59570767, Comparison: worse

FINAL REPORT

HISTORY: Patient with shortness of breath after FFP, eval pulmonary edema or pleural effusion.

COMPARISON: ___.

FINDINGS: Portable single frontal chest radiograph was obtained. Lung volumes remain low with crowding of bronchovascular structures. An area of increased opacity is present in the right middle lobe with obscuration of the right heart border. There is a small right pleural effusion. The left lung is clear. The cardiac silhouette is unchanged.

IMPRESSION: 1. Increased right middle lobe opacity likely secondary to low lung volumes and non-cardiogenic edema, but may reflect a developing consolidation   Keywords: developing. This area will need attention on follow-up radiographs. 2. Small right pleural effusion.


SubjectID: 18458646, StudyID: 56732891, Comparison: None

FINAL REPORT

HISTORY: Dyspnea and crackles.

TECHNIQUE: Upright AP and lateral views of the chest.

COMPARISON: ___.

FINDINGS: Low lung volumes are low. This accentuates the size of the cardiac silhouette which is top normal. Mediastinal contour is unchanged. There is crowding of the bronchovascular structures. No overt pulmonary edema is demonstrated. The hila are unremarkable. Patchy opacities in the lung bases likely reflect atelectasis though infection or aspiration cannot be excluded, particularly within the left lung base. A trace left pleural effusion may be present. No pneumothorax is identified. Multilevel degenerative changes are noted in the thoracic spine.

IMPRESSION: Bibasilar airspace opacities, more pronounced on the left, which may reflect atelectasis but infection or aspiration cannot be excluded. Possible trace left pleural effusion. Low lung volumes.


SubjectID: 18458646, StudyID: 58730105, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with possible effusion on AP film, needs PA/lateral for further evaluation // eval for effusion

COMPARISON: Radiograph from ___ and chest CT from ___.

IMPRESSION: Cardiomediastinal silhouette is within normal limits. There is a moderate right-sided pleural effusion which appears partially loculated. There are no pneumothoraces. There is a granuloma in the right upper lung which is better assessed on the CT scan from ___. No focal consolidation or pulmonary edema is seen.


SubjectID: 18458646, StudyID: 55565568, Comparison: None

WET READ: ___ ___ 4:47 PM New right-sided pleural effusion and right basilar atelectasis. In the correct clinical setting, superimposed infection cannot be excluded. No evidence of pulmonary vascular congestion or edema. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with chest pain. Evaluate for CHF.

TECHNIQUE: Single upright AP portable view of the chest.

COMPARISON: Chest radiograph from ___, ___, and CT chest from ___.

FINDINGS: Heart size, mediastinal, and hilar contours are unchanged since the prior radiograph in ___. There is a new moderate right-sided pleural effusion and right basilar atelectasis. No pneumothorax or evidence of pulmonary vascular congestion or edema.

IMPRESSION: New moderate right-sided pleural effusion and right basilar atelectasis. In the correct clinical setting, superimposed infection cannot be excluded. No evidence of pulmonary vascular congestion or edema.


SubjectID: 18476146, StudyID: 56774327, Comparison: same

WET READ: ___ ___ 8:14 AM No significant change since prior examination with persistent heterogeneous perihilar right upper lobe opacity in a patient with known history of sarcoid. Given interval progression since ___ findings are worrisome for infection. Persistent severe cardiomegaly. Mild vascular congestion. No pulmonary edema. The findings were discussed by Dr. ___ with Dr. ___ on the telephoneon ___ at 7:24 PM, 5 minutes after discovery of the findings.

WET READ VERSION #1 ___ ___ ___ 7:26 PM No significant change since prior examination with persistent heterogeneous perihilar right upper lobe opacity in a patient with known history of sarcoid. Given interval progression since ___ findings are worrisome for infection. Persistent severe cardiomegaly. Mild vascular congestion. No pulmonary edema. The findings were discussed by Dr. ___ with Dr. ___ on the telephoneon ___ at 7:24 PM, 5 minutes after discovery of the findings. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with dyspnea and CHF // ?pulm edema ?pulm edema

IMPRESSION: In comparison with the study of ___, there is little change   Keywords: little change. Again there is heterogeneous opacification involving much of the right hemithorax in a patient with known sarcoidosis, which appears more coalescent and is worrisome for superimposed pneumonia. Cardiac silhouette remains enlarged with mild elevation of pulmonary venous pressure.


SubjectID: 18476146, StudyID: 55787696, Comparison: same

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: History: ___F with sob, hypoxia // acute process

TECHNIQUE: Chest: Frontal and Lateral

COMPARISON: ___

FINDINGS: The cardiac silhouette is persistently enlarged, similar compared to ___. Right greater than left hilar prominence is re- demonstrated. Right greater than left perihilar opacities are again seen in this patient with suspicion of sarcoidosis. The right perihilar opacities appear increased as compared to the prior study, and superimposed infectious process is not excluded. No pleural effusion or pneumothorax is seen. There is persistent elevation of the right hemidiaphragm.

IMPRESSION: Persistent prominence of the right greater than left hila right greater than left perihilar opacities again seen this patient with suspicion of sarcoidosis   Keywords: again. Right perihilar opacities appear increased as compared to this prior study, and superimposed infectious process could be present. Persistent elevation of the right hemidiaphragm. Persistently enlarged cardiac silhouette.


SubjectID: 18477137, StudyID: 59739082, Comparison: better

FINAL REPORT

EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Shortness of breath.

COMPARISON: ___

FINDINGS: Frontal and lateral views of the chest were obtained. Left-sided pacer device is seen, with leads in the similar position. There is severe enlargement of the cardiac silhouette which may be due to cardiomyopathy versus pericardial effusion. No focal consolidation is seen. There is no pleural effusion or pneumothorax. Multilevel degenerative changes are seen. There is mild central pulmonary vascular engorgement. However, the previously seen pulmonary edema has improved and essentially resolved since the prior study   Keywords: resolve, improve.

IMPRESSION: Severe enlargement of the cardiac silhouette which may be due to cardiomyopathy or pericardial effusion. Mild central pulmonary vascular engorgement without overt pulmonary edema.


SubjectID: 18477137, StudyID: 58977712, Comparison: same

FINAL REPORT

HISTORY: Male with CHF and epigastric pain with ileus. Assess NG tube placement.

TECHNIQUE: Single frontal portable chest radiograph.

COMPARISON: CT torso, ___, chest radiograph ___, ___.

FINDINGS: NG tube is coiled in the mid thoracic region, projecting lateral to the midportion of the trachea, with tip pointing cephalad. Position favors esophageal location and less likely an inadvertent endotracheal location. Replacement is recommended given clinical and radiological uncertainty of the location. Marked cardiomegaly is again noted with mild vascular engorgement   Keywords: again. Minimal bibasilar atelectasis. No pneumothorax, pleural effusion or focal opacity.

IMPRESSION: 1. Coiling of NG tube in the upper thorax as described. 2. Mild vascular congestion with chronic marked cardiomegaly. 3. Minimal bibasilar atelectasis. Results were conveyed via telephone to the primary team by Dr. ___ on ___ at 4:45 p.m. within five minutes of observation of findings.


SubjectID: 18498678, StudyID: 58533417, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: CHEST AP PORTABLE SINGLE VIEW.

INDICATION: ___-year-old female patient with hypoxia, now postoperative status post total knee replacement, unable to be extubated, evaluate for aspiration versus atelectasis.

FINDINGS: AP single view of the chest has been obtained with patient in semi-upright position. The patient is still intubated, the ETT terminate in the trachea some 5 cm above the level of the carina. The heart appears markedly enlarged. This is possibly accentuated by the AP technique and the markedly recumbent position of the patient. The pulmonary vasculature is very hazy and there exist bilateral mostly centrally located parenchymal infiltrates, most likely representing acute pulmonary edema. No pneumothorax can be seen. No other indwelling tubes are seen. In comparison with the next preceding chest examination of ___, only mild-to-moderate cardiac enlargement exists at that time, and there were no signs of acute pulmonary congestion or pleural effusion.

IMPRESSION: Patient is intubated. Pulmonary findings and cardiac enlargement indicative of severe CHF with pulmonary edema. Referring physician, ___ ___ was paged at 4:40 p.m.


SubjectID: 18498678, StudyID: 55507247, Comparison: None

WET READ: ___ ___ ___ 7:54 PM Improving pulmonary edema. ___ in ___ ______________________________________________________________________________

FINAL REPORT

HISTORY: Hypertension and pulmonary edema with worsening hypoxia.

FINDINGS: In comparison with the earlier study of this date, the pulmonary vascular congestion has essentially cleared. Poor definition of the left hemidiaphragm suggests volume loss in the lower lobe and pleural effusion. No acute focal pneumonia. The endotracheal tube has been removed.


SubjectID: 18498678, StudyID: 52037943, Comparison: better

FINAL REPORT

INDICATION: Flash pulmonary edema.

COMPARISON: Radiographs available from ___. FRONTAL CHEST RADIOGRAPH: An ET tube terminates 4.3 cm above the carina. Moderate cardiomegaly is again seen. The lungs are underinflated, resulting in bronchovascular crowding. Mild pulmonary vascular congestion and mild interstitial edema are improved since ___. There is improved aeration of the upper zones in comparison to the 5:18 a.m. study performed today. There is no pneumothorax. A persistent left lower lobe opacity may represent pleural effusion and/or atelectasis.

IMPRESSION: 1. Improved mild interstitial edema and central pulmonary vascular congestion   Keywords: improve. 2. Improved upper zone aeration. 3. Appropriately positioned ET tube.


SubjectID: 18512911, StudyID: 58891549, Comparison: same

FINAL REPORT

CHEST

HISTORY: CHF exacerbation. REFERENCE EXAM: ___.

FINDINGS: Again seen are bilateral lower lobe opacities, left greater than right   Keywords: again. These have slightly changed their appearance and still could be due to either volume loss or infectious infiltrate. There are probable small bilateral effusions. There is mild pulmonary vascular redistribution and mild cardiomegaly.


SubjectID: 18512911, StudyID: 55001746, Comparison: None

FINAL REPORT

COMPARISON: ___.

FINDINGS: Portable upright chest radiograph demonstrates interval increase in bibasilar opacity, without large pleural effusion or pneumothorax. The cardiac silhouette remains mildly enlarged, the mediastinal contours are normal. The pulmonary vasculature is mildly engorged. There is no edema.

IMPRESSION: Bibasilar opacities, likely atelectases, and mild pulmonary vascular engorgement. If there is clinical concern for infection, recommend repeat dedicated AP and lateral views in the department.


SubjectID: 18519675, StudyID: 57813232, Comparison: same

FINAL REPORT

INDICATION: Status post AVR, question tamponade.

COMPARISON: ___.

FINDINGS: Compared to the most recent prior radiograph, there is no change in enlarged heart size and postoperative appearance of the mediastinum. Low lung volumes persist with retrocardiac opacification consistent with atelectasis and effusion. Pulmonary vascular congestion is unchanged   Keywords: unchanged. No pneumothorax.


SubjectID: 18519675, StudyID: 50071231, Comparison: None

FINAL REPORT

HISTORY: Chest tube removal.

FINDINGS: In comparison with the study of ___, the monitoring and support devices have all been removed. Following chest tube removal, there is no evidence of pneumothorax. Substantial enlargement of the cardiac silhouette persists, accentuated by the relatively low lung volumes. Little change in the appearance of the lungs with retrocardiac opacification consistent with volume loss in the lower lobe and small bilateral effusions with mild elevation of pulmonary venous pressure.


SubjectID: 18521233, StudyID: 58258609, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluation for pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the pre-existing parenchymal opacities predominating at the right lung base have completely cleared. The only opacities that persist are retrocardiac areas of atelectasis. No evidence of pulmonary edema. Unchanged blunting of the left costophrenic sinus, potentially caused by a small pleural effusion. Unchanged size of the cardiac silhouette.


SubjectID: 18521233, StudyID: 55516351, Comparison: worse

FINAL REPORT

HISTORY: Chest pain and shortness of breath.

TECHNIQUE: Semi-upright AP view of the chest.

COMPARISON: ___ at 17: ___.

FINDINGS: This study is slightly limited due to lordotic positioning and slight rotation. The heart size is mildly enlarged. The aorta appears to be slightly unfolded. Perihilar and bibasilar airspace opacities are noted, which likely reflect mild pulmonary edema, worse in the interval   Keywords: worse. Probable small bilateral pleural effusions are present. No pneumothorax is seen. There are no acute osseous abnormalities.

IMPRESSION: Worsening mild pulmonary edema with small bilateral pleural effusions   Keywords: worse.


SubjectID: 18527164, StudyID: 56201635, Comparison: better

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___ radiograph.

FINDINGS: Cardiac silhouette is enlarged but has slightly decreased in size, and diffuse bilateral alveolar opacities have slightly improved, possibly representing pulmonary edema   Keywords: decrease, improve. However, there remains a more consolidative process in the right upper lobe that could reflect a coexisting pneumonia. Bilateral pleural effusions appear similar to the prior radiograph, and a left pleural catheter remains in place. There is no pneumothorax. Left PICC terminates in the left axilla, similar to recent radiographs.


SubjectID: 18527164, StudyID: 55610347, Comparison: 0.0

FINAL REPORT

PORTABLE CHEST RADIOGRAPH DATED ___

COMPARISON: ___ radiograph.

FINDINGS: Asymmetrically distributed bilateral airspace opacities have slightly worsened in the interval, particularly in the right upper lobe   Keywords: worse. These findings could potentially be due to asymmetrical pulmonary edema, but coexisting infection should be considered, particularly for the right upper lobe opacity. Large left pleural effusion and small-to-moderate right pleural effusion have both slightly decreased in size in the interval. Otherwise, no relevant short interval change since the recent radiograph   Keywords: no relevant short interval change.


SubjectID: 18527164, StudyID: 58084086, Comparison: None

FINAL REPORT

AP CHEST, 7:40 A.M. ON ___

IMPRESSION: AP chest compared to ___: Substantial improvement in the small right pleural effusion, reflecting drainage by the right lateral pigtail pleural drainage catheter. Mild-to-moderate interstitial pulmonary abnormality persists. Small-to-moderate left pleural effusion has been stable for several days following drainage on that side. Left PICC line ends in the axilla, as before. The heart shadow is probably moderately enlarged, but there is no longer mediastinal venous engorgement.


SubjectID: 18527164, StudyID: 52192511, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Respiratory failure, bilateral pleural effusions. Evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the lung volumes have decreased. The bilateral pigtail catheters in the pleural space are in constant position. The effusions have bilaterally increased; on the right, this increase is more obvious than on the left. Retrocardiac atelectasis persists. The known right upper lobe parenchymal opacity with air bronchograms and a similar but more subtle opacity on the left are virtually unchanged. Unchanged alignment of the sternal wires.


SubjectID: 18527164, StudyID: 54888772, Comparison: -1.0

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, COPD.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is a minimal increase in severity and extent of the pre-existing already extensive left pleural effusion. The small right pleural effusion is constant. The lung volumes have decreased, which causes an increase in density of all pre-existing parenchymal opacities   Keywords: increase. The overall extent and severity of these opacities, however, is unlikely to have substantially changed. No new parenchymal opacities   Keywords: new. No pneumothorax. The alignment of the sternal wires is constant.


SubjectID: 18527164, StudyID: 55514209, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: COPD, chronic heart failure, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is increasing evidence of a right upper lobe opacity that was not present on the previous film. The opacity could be part of the generalized edematous process but could also represent infection. The patient should be closely monitored. The extent of the relatively large left pleural effusion is overall unchanged, only the distribution is slightly different than on the previous film. Small right pleural effusion with subsequent areas of atelectasis is unchanged. Status post aortic valve replacement. Sternal wires are in situ. Moderate pericardial effusion cannot be excluded.


SubjectID: 18530425, StudyID: 59925708, Comparison: None

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPH

INDICATION: CHF, respiratory distress. Evaluate volume overload.

TECHNIQUE: Portable semi upright frontal views of the chest.

COMPARISON: Chest radiograph from ___.

FINDINGS: Severe cardiomegaly is stable. Patient is status post median sternotomy. Sternal wires appear intact as prior. Lungs are hyperinflated. There is mild-to-moderate moderate prominence of the pulmonary vasculature and moderate pulmonary edema. Dilation of the right costophrenic angle is not included in this chest radiograph. There is no focal consolidation appreciated on these frontal views.

IMPRESSION: Severe cardiomegaly with mild pulmonary edema and pulmonary vascular congestion.


SubjectID: 18530425, StudyID: 54991534, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (AP upright AND LAT)

INDICATION: ___ year old woman with chf, hypoxia, pulmonary edema, fever // please do pa and lateral, especialyl lateral to rule out focal infection (esp at right lower base)

COMPARISON: Prior exam dated ___.

FINDINGS: AP upright and lateral views of the chest provided. Midline sternotomy wires and mediastinal clips are again noted. Cardiomegaly is again noted with small right pleural effusion. Lucency in the upper lungs may reflect emphysema. Patient's chin obscures the superior mediastinum. Mediastinal contour appears grossly unremarkable allowing for left rightward rotation. Bony structures are diffusely demineralized.

IMPRESSION: Cardiomegaly with small right pleural effusion.


SubjectID: 18530425, StudyID: 57276791, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with prior study from ___. CLINICAL

HISTORY: Worsening shortness of breath, assess for volume overload.

FINDINGS: PA and lateral views of the chest were obtained. Midline sternotomy wires and mediastinal clips are again noted. Cardiomegaly is mild-to-moderate. There is pulmonary interstitial and alveolar edema. No large pleural effusions are seen. A coarse calcification residing in the superior mediastinum may represent a lymph node. Imaged osseous structures appear intact. DISH-related changes of the T-spine noted.

IMPRESSION: Cardiomegaly with pulmonary edema.


SubjectID: 18530425, StudyID: 50764185, Comparison: better

FINAL REPORT

PA AND LATERAL CHEST

HISTORY: ___-year-old with heart failure, evaluate for interval change.

IMPRESSION: AP chest compared to ___: Previous mild pulmonary edema has improved   Keywords: improve. Hyperinflation indicates COPD. Severe cardiomegaly, stable. Pleural effusions are small if any. The patient has had median sternotomy, bypass grafting. Sternal wires are intact, but aligned.


SubjectID: 18548050, StudyID: 58460726, Comparison: None

FINAL REPORT

HISTORY: Arrest with pulmonary edema.

FINDINGS: In comparison with the study of ___, the monitoring and support devices are again seen, with the tip of Swan-Ganz catheter terminating in the left retrocardiac region within the distal segmental or subsegmental branch of the lower lobe pulmonary artery. Asymmetric pulmonary edema may be slightly less prominent than on the previous study. Widening of the superior mediastinum is less prominent on the current examination.


SubjectID: 18548050, StudyID: 56134188, Comparison: worse

FINAL REPORT

PORTABLE CHEST X-RAY OF ___ AT 2:08 A.M. No prior studies for comparison.

FINDINGS: Tip of Swan-Ganz catheter projects in left retrocardiac region within the expected distal segmental branch of the left lower lobe pulmonary artery. Dr. ___ has been notified of this finding by telephone at 8:15 a.m. on ___ at the time of discovery. Tip of the endotracheal tube is in standard position terminating about 5 cm above the carina. Cardiac silhouette is enlarged and accompanied by pulmonary vascular engorgement and asymmetrical perihilar edema, worse on the right than the left   Keywords: worse. A more confluent opacity in the right lower lobe could reflect dependent pulmonary edema or a secondary process such as infection. Moderate layering right pleural effusion is also noted. Finally, widening of the mediastinum is present above the level of the aortic arch. Although possibly due to venous distention in the setting of congestive heart failure, the possibility of lymphadenopathy or mass is not excluded in the absence of older radiographs for comparison. With this in mind, careful followup radiographs are recommended following appropriate treatment for congestive heart failure prior to discharge. This finding was also communicated to Dr. ___ at the time of the above communication.

IMPRESSION: 1. Distal position of Swan-Ganz catheter. Please see documentation of communication above. 2. Probable asymmetrical pulmonary edema but follow up radiographs would be helpful to exclude a secondary superimposed process in the right lower lobe. At that time, the mediastinal width may also be reassessed.


SubjectID: 18548050, StudyID: 56001180, Comparison: better

FINAL REPORT

HISTORY: Pneumonia versus congestive failure.

FINDINGS: In comparison with study of ___, there has been substantial decrease in the bilateral opacifications   Keywords: decrease. This most likely reflects some clearing of asymmetric pulmonary edema, though supervening pneumonia could not be excluded in the appropriate clinical setting. Endotracheal tube and nasogastric tube have been removed.


SubjectID: 18548050, StudyID: 55715695, Comparison: same

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph of earlier the same date.

FINDINGS: Tip of Swan-Ganz catheter continues to terminate in the left retrocardiac region within a distal segmental or subsegmental branch of the left lower lobe pulmonary artery. Endotracheal tube and nasogastric tube are in standard position. Asymmetrical pattern of pulmonary edema is again demonstrated as well as a layering moderate right pleural effusion   Keywords: again. Upper mediastinal contour remains widened. Please see separately dictated report under clip ___for documentation of communication regarding the Swan-Ganz catheter and widened mediastinum.


SubjectID: 18548050, StudyID: 56283316, Comparison: worse

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old man with history of multiple cardiac arrests, now with worsening hypoxia and possible pulmonary edema.

FINDINGS: Comparison is made to the previous study from ___. There is stable cardiomegaly. There is a left retrocardiac opacity and left-sided and right-sided pleural effusions. There is prominence of the pulmonary interstitial markings suggestive of developing pulmonary edema   Keywords: developing. This is more prominent within the lung bases.


SubjectID: 18548050, StudyID: 56225004, Comparison: None

FINAL REPORT

INDICATION: Worsening hypoxia in a patient with congestive heart failure and coronary artery disease.

COMPARISON: A series of chest radiograph dating back to ___, most recently from ___.

FINDINGS: There is a new dense consolidation in the inferior aspect of the right upper lobe abutting the minor fissure. Air bronchograms are visible within it. The pleural effusions are now much smaller, although there is a background of mild interstitial pulmonary edema. Atelectasis at the left base has improved considerably. There is no pneumothorax. The heart size is top normal and unchanged.

IMPRESSION: 1. New dense consolidation of the inferior aspect of the right upper lobe concerning for pneumonia or mucous plugging of a segmental bronchus. 2. Mild pulmonary edema. 3. Marked improvement in the pleural effusions.


SubjectID: 18548050, StudyID: 56003500, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with heart failure, status post diuresis, found to have mucus plugging versus ventilator associated pneumonia, assess for interval change.

COMPARISONS: ___. Since previous examination, there is improved aeration of the right upper lobe with increased bibasilar opacities, which may reflect atelectasis, though aspiration could have a similar appearance. There is no pneumothorax with trace bilateral pleural effusions. The heart is moderately enlarged.

IMPRESSION: Increased bibasilar opacities could reflect atelectasis or aspiration.


SubjectID: 18551091, StudyID: 59847164, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: empyema, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is a minimal increase in right-sided pleural fluid. As a consequence, the interstitial structures at the right lung bases appear slightly denser than on the previous image. The heart continues to be moderately enlarged, with bilateral areas of atelectasis at the lung bases. In addition, a pre-existing left pleural effusion is unchanged in extent. No new parenchymal opacities   Keywords: new.


SubjectID: 18551091, StudyID: 59718118, Comparison: None

FINAL REPORT

HISTORY: ___-year-old male with hemothorax.

COMPARISON: Chest radiograph dated through ___.

FINDINGS: Portable frontal chest radiograph demonstrates at but improved aeration in the right lung. There is a small loculated pneumothorax at the level of the right chest tube which is seen projecting to the level of the carina. There is a possible right apical pneumothorax without tension. There is right midlung pulmonary edema likely secondary to re-expansion. The left lung is grossly clear. Cardio mediastinal and hilar contour are stable in appearance. Right IJ seen with its tip terminating at the cavoatrial junction.

IMPRESSION: Small right apical pneumothorax as well as loculated air in the proximity of the right chest tube. Right midlung pulmonary edema, likely secondary to re-expansion.


SubjectID: 18551091, StudyID: 56320648, Comparison: None

FINAL REPORT

INDICATION: Hemothorax and empyema. Evaluate for interval change.

COMPARISON: Chest radiograph from ___.

FINDINGS: A single semi-erect frontal radiograph of the chest was acquired. There has been no significant interval change in the degree of right-sided pleural fluid compared to the study from ___. Right mid to lower lung mild-to-moderate atelectasis is unchanged. There is also unchanged moderate left retrocardiac atelectasis. A small left pleural effusion is unchanged. Moderate cardiomegaly is unchanged. The mediastinal contours are unchanged. Note is made of dense mitral annular calcification. A right internal jugular central venous catheter ends in the low SVC, as before. There is a right-sided pleural catheter ending along the medial aspect of the right hemithorax, not significantly changed in position.

IMPRESSION: Little change compared to the study from ___, including unchanged right-sided pleural fluid, bilateral lower lung atelectasis, and a small left pleural effusion.


SubjectID: 18551091, StudyID: 54285138, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Emphysema, effusion, followup.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has undergone right thoracocentesis. The right drain is in unchanged position. A zone of pleural thickening and of minimal remnant effusion persists. Mild atelectasis at the right lung bases. No convincing evidence for the presence of a right pneumothorax. Unchanged size of the cardiac silhouette. Unchanged appearance of the left lung   Keywords: unchanged appearance. A hyperlucent line paralleling the left chest wall is caused by a skinfold and should not be mistaken for pneumothorax.


SubjectID: 18551091, StudyID: 52595537, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Hypoxia, evaluation for pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is a massive increase in extent of the pleural fluid. Hemothorax could be a likely cause. At the time of dictation and observation, 10:14 a.m., on the ___, the referring physician ___. ___ was paged for notification. However, at that time multiple later radiographs were already performed. Moderate atelectasis at the right lung bases. The left lung shows minimal retrocardiac atelectasis and a normal left heart border. A right pleural drain is in constant position.


SubjectID: 18551091, StudyID: 56552452, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, aortic stenosis, pneumonia, concern for empyema, evaluation.

COMPARISON: ___, 6:07 a.m.

FINDINGS: As compared to the previous radiograph, the fluid collection on the right is unchanged in appearance   Keywords: unchanged in appearance. Only the basal aspects of the collection might have minimally decreased in extent. Unchanged appearance of the left and right lung as well as of the cardiac silhouette. Known severe degenerative shoulder changes bilaterally.


SubjectID: 18551091, StudyID: 54276892, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: Chest PA and lateral.

INDICATION: ___-year-old male patient with chronic bilateral pleural effusions, status post thoracocentesis yesterday with 3 liters drained. Assess changes in spiculated lesion near right cardiac silhouette.

FINDINGS: PA and lateral chest views were obtained with patient in upright position. Analysis is performed in direct comparison with the next preceding portable chest examination of ___. The previously documented successful right-sided thoracocentesis persists and there is no evidence of significant reaccumulation of the right-sided pleural effusion. There exist some increased linear vascular pattern on the right lung base, most likely representing interstitial edema. There is no evidence of new acute pulmonary parenchymal infiltrates and no pneumothorax is seen in the apical area. Findings in the left hemithorax are rather unchanged with obliteration of the left-sided diaphragmatic contour with blunting of the left lateral pleural sinus. The lateral view demonstrates the presence of a left-sided pleural effusion obliterating the entire posterior pleural sinus up to the level of the hila. An estimate suggests volume of about 1 liter. There is no evidence of new pulmonary parenchymal infiltrates and no pneumothorax is noted on either side. Cardiac enlargement is obvious. The appearance of the generally widened aorta with advanced wall calcifications appears unchanged.

IMPRESSION: No reoccurrence of pleural effusion following right-sided thoracocentesis. Significant amount of pleural effusion exists also on the left side.Consider left sided thoracentese as well.


SubjectID: 18551091, StudyID: 59329610, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with prior admission for pneumonia in ___ who now has rising WBC, chills, and persistent cough. Shown to have pulm edema on ___ CXR. Now s/p lasix. // interval consolidation?

COMPARISON: Radiographs from ___

IMPRESSION: Heart size is enlarged but unchanged. There are again seen areas of consolidation and increase density in the right mid lung field, right base, and left base. There is prominence of the pulmonary interstitial markings, unchanged   Keywords: unchanged. There bilateral effusions with loculated pleural fluid along the right lateral chest wall. There are no pneumothoraces. Overall findings are stable.


SubjectID: 18551091, StudyID: 59135973, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with prior admission for pneumonia in ___ who now has rising WBC, chills, and persistent cough. // worsening pna? change in consolidation?

COMPARISON: Radiographs from ___ and ___

IMPRESSION: Areas of parenchymal opacity within the left base and right mid lung field have increased since ___ and is similar to the radiographs from ___. Findings are most consistent with pulmonary edema ; however, underlying pneumonia would be difficult to exclude. There is prominence of the pulmonary vascular markings. Left-sided pleural effusion is seen. There are no pneumothoraces. There are calcifications and tortuosity of the thoracic aorta. Heart size is enlarged but stable.


SubjectID: 18551091, StudyID: 52626894, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with vol.ume overload ___ CHF s/p diuresis // interval change? interval change?

IMPRESSION: In comparison with the study of ___, allowing for differences in degree of patient obliquity, there is probably little change   Keywords: little change. Substantial enlargement of the cardiac silhouette process with some element of pulmonary venous pressure. Bilateral pleural effusions are again seen with apparent loculation of fluid along the right lateral chest wall.


SubjectID: 18551091, StudyID: 56706745, Comparison: better

WET READ: ___ ___ ___ 6:43 AM 1. Persistent opacity at the right mid lung, which may represent a consolidation versus loculated fluid. 2. Moderate bilateral pleural effusions. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___-year-old woman with COPD, evaluate for pneumonia.

TECHNIQUE: Chest PA and lateral

COMPARISON: Multiple prior chest radiographs with direct comparison made to study from ___.

FINDINGS: There has been interval improvement in pulmonary edema although there is a persistent opacity in the right mid lung   Keywords: improve. There are bilateral pleural effusions, moderate in size. The cardiomediastinal silhouette and hilar contours are unchanged, persistent cardiomegaly and tortuosity of the thoracic aorta with aortic knuckle calcification. There is no pneumothorax. Bilateral humeral head deformities are again noted.

IMPRESSION: 1. Persistent opacity at the right mid lung, which may represent consolidation versus loculated fluid. Interval improvement in pulmonary edema   Keywords: improve. 2. Moderate bilateral pleural effusions.


SubjectID: 18551091, StudyID: 57979177, Comparison: better

FINAL REPORT

HISTORY: ___-year-old male with worsening dyspnea in the setting of congestive heart failure.

TECHNIQUE: Single frontal chest radiograph was obtained portably with the patient in an upright position.

COMPARISON: ___.

FINDINGS: There has been interval redistribution of the moderate-sized right pleural effusion, which now layers dependently rather than in the fissure. Small left pleural effusion has increased. Bibasilar consolidations most likely represent atelectasis, but pneumonia cannot be excluded. Heart size is enlarged. Aortic calcification is seen. Mediastinal contours are otherwise within normal limits. No pneumothorax is detected. Mild interstitial edema may be slightly improved   Keywords: improve. Degenerative change of the left glenohumeral joint is partially imaged.

IMPRESSION: Redistributed moderate right pleural effusion and increased small left pleural effusion. Minimally improved interstitial edema   Keywords: improve. Bibasilar consolidations most likely represent atelectasis, but pneumonia cannot be excluded.


SubjectID: 18551091, StudyID: 54128982, Comparison: worse

FINAL REPORT

INDICATION: Shortness of breath, decreased right breath sounds, evaluate for pneumonia or effusion.

COMPARISON: Multiple prior chest radiographs, most recently from ___.

FINDINGS: Frontal and lateral chest radiographs again demonstrate enlargement of the cardiac silhouette. Cardiomediastinal contour is otherwise unchanged and calcifications in the aortic arch are noted. Small to moderate right pleural effusion has slightly increased. Small left pleural effusion is stable. Fluid is again seen within the minor fissure. Increased opacification at the right base could relate to increased effusion and mild pulmonary edema; but consolidation is not excluded   Keywords: increase. There is no pneumothorax. Extensive degenerative changes of both glenohumeral joints and clavicles are again seen.


SubjectID: 18551091, StudyID: 57441091, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Recurrent right pleural effusion, status post thoracocentesis.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has undergone a right thoracocentesis. The pre-existing extensive right pleural effusion has almost completely cleared. There is reexpansion edema at the right lung bases. On the left, there is a small-to-moderate pleural effusion with left lower lobe atelectasis. Moderate cardiomegaly and tortuosity of the thoracic aorta. No pneumothorax. Known high-grade degenerative changes in both shoulders.


SubjectID: 18551091, StudyID: 57093465, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluation of pleural effusion.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the pleural drainage has been removed. The right pleural effusion has substantially reoccurred. It now occupies relatively ___% of the right hemithorax. Subsequent areas of atelectasis at the right lung bases. On the left, the pre-existing pleural effusion has minimally decreased. The left lung base is slightly better ventilated than before. No lung parenchymal changes. Known severe degenerative disease at the level of the left shoulder. No pneumothorax.


SubjectID: 18551091, StudyID: 56761197, Comparison: worse

FINAL REPORT

HISTORY: Shortness of breath.

COMPARISON: ___.

FINDINGS: There is increased pulmonary vascular redistribution with hazy bilateral vasculature and alveolar infiltrates there is moderate right pleural effusion and small left pleural effusion. The heart is moderately enlarged.

IMPRESSION: Worsened CHF   Keywords: worse.


SubjectID: 18551091, StudyID: 56521594, Comparison: worse

FINAL REPORT

HISTORY: Generalized weakness.

TECHNIQUE: Upright AP and lateral views of the chest.

COMPARISON: ___

FINDINGS: Moderate to severe cardiomegaly persists. Aorta demonstrates diffuse atherosclerotic calcifications. Mediastinal contours are unchanged. There is mild pulmonary edema which is new compared to the prior exam   Keywords: new. Worsening opacification is seen within the right lung base with interval increase in size of a right pleural effusion which is now moderate in extent. Patchy left basilar opacity likely reflects atelectasis, and a small left pleural effusion is not excluded. No pneumothorax is demonstrated. Chronic deformities are again seen involving both shoulders.

IMPRESSION: Findings concerning for right basilar pneumonia with increased size of right pleural effusion, now moderate in extent. Mild pulmonary edema is also present.


SubjectID: 18551091, StudyID: 55535846, Comparison: None

WET READ: ___ ___ ___ 8:20 PM In the interval since the prior study, there has not been a substantial change in the right-sided pneumonia nor the moderate to large pleural effusion. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic pleural effusion, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the right pleural effusion has increased in extent. The pre-existing right basal opacity is consolidated and no longer seen. Minimal blunting of the left costophrenic sinus, likely caused by a small left pleural effusion. Moderate cardiomegaly is unchanged.


SubjectID: 18551091, StudyID: 56301475, Comparison: None

FINAL REPORT

PORTABLE CHEST OF ___

COMPARISON: Recent chest x-ray of one day earlier.

FINDINGS: Right-sided pleural catheter is in place with a small loculated right apical hydropneumothorax, and a persistent moderate-sized, partially loculated right pleural effusion. Cardiac silhouette is enlarged, but similar in size to the previous study. Heterogeneous opacities in the right mid and lower lung regions have slightly improved, and left retrocardiac atelectasis has also slightly decreased. Small left pleural effusion is again demonstrated, and there is no evidence of left pneumothorax.


SubjectID: 18551091, StudyID: 55228337, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with atrial fibrillation, recent change in cough, shortness of breath

TECHNIQUE: Portable AP view of the chest

COMPARISON: ___ chest radiograph

FINDINGS: Moderate cardiomegaly is again re- demonstrated, unchanged. Aorta is tortuous and diffusely calcified. Mediastinal and hilar contours are stable. Lung volumes are slightly lower compared to the previous exam, and cause crowding of the bronchovascular structures without overt pulmonary edema. Linear opacities in the right mid and lower lung fields likely reflect areas of atelectasis or scarring. Partially loculated right pleural effusion is small, and accounting for differences in lung volumes is likely unchanged. Right basilar patchy opacity may reflect atelectasis. Trace left pleural effusion may be minimally improved. No pneumothorax is identified. Marked abnormality of both glenohumeral joints with bony remodeling of the femoral heads is re- demonstrated.

IMPRESSION: No substantial interval change from the prior exam other than decreased lung volumes. Continued small partially loculated right pleural effusion and trace left pleural effusion. Right basilar patchy opacity may reflect atelectasis but aspiration or infection is not completely excluded.


SubjectID: 18551091, StudyID: 53533940, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with dyspnea and cough // R/o CHF, R/o pneumonia

FINDINGS: As compared to ___ chest radiograph, cardiomegaly and tortuosity of the thoracic aorta appear unchanged. Right-sided partially loculated pleural effusion appears slightly increased in size with adjacent increased opacity at the right lung base. Small left pleural effusion is new.

IMPRESSION: 1. Increased size of small to moderate partially loculated right pleural effusion, with adjacent right basilar atelectasis and or infectious consolidation. 2. New small left pleural effusion.


SubjectID: 18551091, StudyID: 55170326, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with cough, epigastric pain, evaluate for cardiopulmonary disease.

COMPARISONS: Multiple prior chest radiographs, most recently from ___.

TECHNIQUE: AP upright and lateral chest radiographs were provided.

FINDINGS: There is moderate pulmonary vascular congestion which is somewhat asymmetric in the right mid and lower lung zones. Moderate cardiomegaly is unchanged. There may be small bilateral pleural effusions. There are degenerative changes of the shoulder joints bilaterally. There is no pneumothorax.

IMPRESSION: 1. Moderate pulmonary vascular congestion, slightly asymmetric. Recommend followup after diuresis to exclude underlying infection. 2. Small bilateral pleural effusions.


SubjectID: 18551091, StudyID: 51450564, Comparison: worse

FINAL REPORT

HISTORY: CHF.

FINDINGS: In comparison with study of ___, the patient has taken a better inspiration. However, there is still substantial enlargement of the cardiac silhouette and worsening pulmonary edema   Keywords: worse. The possibility of bilateral pleural effusions with compressive atelectasis at the base is raised.


SubjectID: 18551091, StudyID: 53690472, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Recurrent pleural effusions, pleural catheter, evaluation for pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the PleurX catheter on the right is in unchanged position. The pre-existing right pleural effusion is substantially improved. There is no pneumothorax. A minimal right effusion persists, combined to some areas of atelectasis. Unchanged small left effusion, with relatively extensive left lower lobe atelectasis. Moderate cardiomegaly. Known degenerative shoulder changes.


SubjectID: 18551091, StudyID: 52566727, Comparison: None

FINAL REPORT

HISTORY: Evaluate for interval change.

TECHNIQUE: PA and lateral views of the chest.

COMPARISON: Multiple chest radiographs the most recent on ___

FINDINGS: The appearance of the right lung is significantly improved from the prior study. There is a small right pleural effusion seen and persistent opacity at the right base. The left lung is also better appearing with some persistent retrocardiac opacity and left lower lobe atelectasis. Left pleural effusion is also improved. The cardiomediastinal and hilar contours are grossly unchanged. There is no pneumothorax.

IMPRESSION: Improved appearance of the lungs bilaterally with small residual right pleural effusion.


SubjectID: 18551091, StudyID: 50279796, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST FILM ___ AT 15:06 CLINICAL

INDICATION: ___-year-old with severe AS, CHF, pleural effusion, questioned pneumonia. Comparison is made to patient's prior study ___. Portable AP chest film ___ at 15:06 is submitted.

IMPRESSION: Right chest tube remains in place. There continue to be layering bilateral effusions, left greater than right, with patchy bibasilar airspace process which may reflect atelectasis or pneumonia. Heart remains enlarged. There is calcification of the aorta consistent with atherosclerosis. No large pneumothorax is seen. No pulmonary edema. There is deformity of the left humeral head and glenoid with sclerosis and remodeling and joint space narrowing. There is resorption of the distal clavicle. All of these changes likely are secondary to remote trauma.


SubjectID: 18551091, StudyID: 50117108, Comparison: same

FINAL REPORT

HISTORY: Severe diastolic CHF, severe aortic stenosis post Pleurx placement on ___. Now with worsening shortness of breath. Evaluation for interval change.

TECHNIQUE: Frontal view of the chest.

COMPARISON: Multiple chest radiographs the most recent on ___.

FINDINGS: A right chest tube is again seen in place. Increasing, now moderate right sided pleural effusion with worsening right airspace opacities concerning for right middle and lower lobe pneumonia. Left pleural effusion is similar in appearance. Also seen is some diffuse interstital edema, similar in appearance to the prior study   Keywords: similar, similar in appearance. There is no evidence of pneumothorax. The heart is enlarged and hilar contours are normal appearing.

IMPRESSION: Worsening right middle and lower lobe opacities are suggestive of pneumonia. Enlarging right pleural effusion, now moderate. Findings communicated to Dr. ___ by telephone at 09:38 on ___ by Dr. ___.


SubjectID: 18551091, StudyID: 53115082, Comparison: None

FINAL REPORT

HISTORY: ___-year-old male with congestive heart failure and COPD, now with worsening shortness of breath and oxygen requirement.

TECHNIQUE: Frontal and lateral chest radiographs were obtained.

COMPARISON: ___.

FINDINGS: Large right and small left pleural effusions are stable to slightly increased. Underlying consolidations most likely represent atelectasis, although underlying infection is difficult to exclude. The aerated upper lungs demonstrate no focal consolidation or pneumothorax; lower right lung and heart are largely obscured by the large effusion and atelectasis. Aortic calcification is again seen.

IMPRESSION: Stable to slightly increased large right pleural effusion.


SubjectID: 18551091, StudyID: 51323534, Comparison: None

FINAL REPORT

PORTABLE AP CHEST FILM ___ AT ___ CLINICAL

INDICATION: ___-year-old with severe COPD, chronic right effusion, critical aortic stenosis, assess for loculated fluid. Portable AP supine chest film ___ at ___ is submitted and compared to a prior study of ___ at ___.

IMPRESSION: 1. Bilateral pleural effusions, right much greater than left, do not appear to be significantly changed. Given that the patient was only imaged in the supine position, evaluation for loculation is not possible and if this remains of clinical concern, imaging in the decubitus or upright position would be advised. The aerated right upper lung and left upper and mid lungs demonstrate prominent vasculature which suggests mild interstitial edema. No pneumothorax is seen. The cardiac size cannot be assessed as it is obscured by the overlying pleural effusions. Calcification in the aortic knob consistent with atherosclerosis. Calcification of the aortic valve is also seen.


SubjectID: 18566607, StudyID: 56254012, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with hypoxia

COMPARISON: ___ and ___.

FINDINGS: AP portable upright view of the chest. The heart is mildly enlarged and there is hilar engorgement compatible with pulmonary vascular congestion. There is no frank pulmonary edema, effusion or pneumothorax. No convincing signs of pneumonia. Bony structures are intact.

IMPRESSION: Cardiomegaly with pulmonary vascular congestion.


SubjectID: 18566607, StudyID: 52341810, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with fever and CHF // r/o pneumonia

IMPRESSION: Since ___, cardiomegaly is accompanied by worsening pulmonary vascular congestion and mild interstitial edema   Keywords: worse. No definite areas of consolidation to suggest a site of infectious pneumonia.


SubjectID: 18581055, StudyID: 54068063, Comparison: None

FINAL REPORT

CHEST, TWO VIEWS: ___

HISTORY: ___-year-old male with crackles and shortness of breath. Question pneumonia or pulmonary edema.

COMPARISON: ___.

FINDINGS: There are bilateral parenchymal opacities and small left greater than right pleural effusions. Cardiac silhouette is enlarged but stable in configuration. Median sternotomy wires and mediastinal clips are noted. Left chest wall single-lead pacing device seen with lead tip in the right ventricular apex.

IMPRESSION: Congestive failure with moderate pulmonary edema and small bilateral effusions.


SubjectID: 18615099, StudyID: 59417593, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Pulmonary edema, intubation, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is an increase in extent of the pre-existing bilateral pleural effusions. The signs of moderate pulmonary edema are unchanged   Keywords: unchanged. Increasing extent of the pre-existing basilar areas of atelectasis. Unchanged size of the cardiac silhouette. Unchanged monitoring and support devices.


SubjectID: 18615099, StudyID: 56961814, Comparison: None

FINAL REPORT

HISTORY: Respiratory distress. Evaluate for pneumonia.

COMPARISON: Multiple prior chest radiographs, most recently ___.

FINDINGS: Single frontal portable view of the chest. Endotracheal tube terminates 4.2 cm above the carina. The side port of a nasogastric tube is below the diaphragm. Pulmonary vasculature is ill-defined, compatible with severe pulmonary edema. Hazy opacity overlying both lungs and blunting of the costophrenic angles are compatible with bilateral pleural effusions. No lobar consolidation or pneumothorax. Mild cardiomegaly is similar to prior. Leads of a left chest wall pacer terminates in the right atrium and ventricle. Median sternotomy wires and numerous mediastinal clips are intact.

IMPRESSION: Severe pulmonary edema with bilateral pleural effusions.


SubjectID: 18615099, StudyID: 57276121, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Failure to thrive and frequent falls. Question pneumonia or rib fracture.

COMPARISONS: Prior radiographs from ___, ___, and ___.

TECHNIQUE: Chest, AP upright and lateral.

FINDINGS: The patient is status post coronary artery bypass graft surgery. A dual-lead pacemaker/ICD device appears unchanged. The mediastinal and hilar contours appear unchanged. The heart appears mildly enlarged. A widespread interstitial abnormality suggests mild vascular congestion. Although there is increased relative opacification of the left mid lung compared to the right, an asymmetric pattern of pulmonary edema has been seen on prior radiographs such as ___   Keywords: increase.

IMPRESSION: Findings most suggestive of mild-to-moderate interstitial pulmonary edema.


SubjectID: 18615099, StudyID: 57165304, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with left lower lung collapse, requiring assessment for persistent collapse and pneumonia.

COMPARISON: Comparison is made with chest radiograph from ___, ___, ___, and ___.

FINDINGS: There is extensive pulmonary edema bilaterally. There are bilateral pleural effusions, left greater than right. There is partial collapse of the left lung secondary to pleural effusion. Part of the right pleural effusion appears to be in the fissure. Cardiomediastinal silhouette is obscured by pulmonary edema and pleural effusions.

IMPRESSION: Extensive pulmonary edema. Bilateral pleural effusions, left greater than right. Partial left lower lobe collapse secondary to effusion.


SubjectID: 18615099, StudyID: 54992879, Comparison: same

FINAL REPORT

HISTORY: Pulmonary edema.

FINDINGS: In comparison with the study of ___, there is continued substantial pulmonary edema with bilateral effusions and compressive atelectasis in a patient with previous CABG and dual-channel pacemaker device in place   Keywords: continue.


SubjectID: 18615099, StudyID: 53498293, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the pre-existing mild pulmonary edema has increased in severity and is now moderate   Keywords: increase. This is reflected by increased vascular diameters and left predominant perihilar haze   Keywords: increase. No pleural effusions. No focal parenchymal opacity suggesting pneumonia. The areas of left basal atelectasis are constant in appearance.


SubjectID: 18615099, StudyID: 50024272, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Sepsis, evaluation for pneumonia.

COMPARISON: ___, 3:56 a.m.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. There is increasing left pleural effusion. In addition, there is increasing parenchymal opacity at the left lung base, potentially reflecting developing pneumonia. The pre-existing signs of mild pulmonary edema are constant in appearance. Unchanged position of the sternal wires and the postoperative clips. Unchanged left pectoral pacemaker. At the time of dictation and observation, 9:01 a.m., on the ___, the referring physician, ___. ___ was paged for notification. Findings were discussed 10 minutes later over the telephone.


SubjectID: 18622135, StudyID: 55824306, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH.

INDICATION: HCC, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the lung volumes have slightly decreased and a minimal right pleural effusion has newly appeared. Signs of mild-to-moderate fluid overload are still present in unchanged manner   Keywords: still, unchanged. Moderate cardiomegaly and moderate tortuosity of the thoracic aorta are unchanged. No evidence of pneumonia.


SubjectID: 18622135, StudyID: 55039486, Comparison: None

FINAL REPORT

CHEST, TWO VIEWS: ___

HISTORY: ___-year-old male with shortness of breath and history of CHF.

COMPARISON: ___.

FINDINGS: There are mildly indistinct pulmonary vascular markings, without confluent consolidation. Blulting of the posterior costophrenic angles are suggestive of small effusions. The cardiac silhouette is enlarged but stable in configuration. Descending thoracic aorta is tortuous. No acute osseous abnormality is identified.

IMPRESSION: Mild pulmonary edema. No focal consolidation.


SubjectID: 18624255, StudyID: 59842093, Comparison: worse

WET READ: ___ ___ ___ 8:09 AM New bilateral pulmonary alveolar opacities and increased interstitial lung markings, with persistent cardiomegaly, consistent with pulmonary edema and worsening heart failure. Followup to resolution is recommended following diuresis.

WET READ VERSION #1 ___ ___ ___ 2:00 AM New bilateral pulmonary alveolar opacities and increased interstitial lung markings, with persistent cardiomegaly, consistent with pulmonary edema. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with SOB. Evaluate for evidence of CHF.

TECHNIQUE: Single portable upright view of the chest.

COMPARISON: Chest radiograph from ___, ___, and ___.

FINDINGS: Compared with the prior radiograph, there are new bilateral pulmonary alveolar opacities, most pronounced in the right lower lung, as well as increased interstitial lung markings, consistent with pulmonary edema   Keywords: new, increase. Small bilateral pleural effusions are also seen. Cardiomegaly is unchanged. Central venous catheter is also unchanged is position, with its tip at the level of the right ventricle. A large hiatal hernia is not as well seen as the prior study, but also present.

IMPRESSION: Findings are most consistent with asymmetrical edema accompanied by bilateral pleural effusions. Considering the asymmetrical distribution, followup radiographs after diuresis may be helpful to exclude superimposed pneumonia in the right lung if warranted clinically.


SubjectID: 18624255, StudyID: 57372839, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with ESRD on HD with dyspnea // Interval change

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The hemodialysis catheter is in unchanged position. Low lung volumes. Moderate cardiomegaly. Moderate right and small left pleural effusion, with subsequent areas of atelectasis as well as a pre-existing perihilar opacity on the right. No new parenchymal opacities   Keywords: new. No pneumothorax.


SubjectID: 18633036, StudyID: 56345854, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: Patient status post chest tube removal.

FINDINGS: Comparison is made to previous study from ___ at 7:52 a.m. There has been removal of the left-sided chest tube. A tiny apical pneumothorax on the left side remains. There is consolidation in the mid-to-lower left lung field as well as of the right lung base, unchanged. There is unchanged cardiomegaly. The right IJ central line is unchanged with the distal lead tip at the cavoatrial junction.


SubjectID: 18633036, StudyID: 55542871, Comparison: None

FINAL REPORT

CHEST ON ___

HISTORY: Chest tube removal, check for pneumothorax.

FINDINGS: The ET tube and NG tube have been removed. The right IJ line and left chest tube is still in place. Swan-Ganz catheter has been removed. There are bilateral pleural effusions and volume loss in both lower lobes. An underlying infectious infiltrate cannot be excluded. There is pulmonary vascular redistribution and right greater than left pleural effusion. No pneumothorax is seen.


SubjectID: 18633036, StudyID: 51103457, Comparison: None

WET READ: ___ ___ ___ 10:09 AM Support devices unchanged. No pneumothorax on this semierect study. Worsening opacification at the left lung base likely from increased pleural effusion and atelectasis, although, infection cannot be excluded. Decrease in right pleural effusion, now small. Pulmonary edema appears worse. ______________________________________________________________________________

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old man status post CABG with left-sided pneumothorax with chest tube.

FINDINGS: Comparison is made to prior study from ___. There are no pneumothoraces identified. There is again seen a left-sided chest tube. There is unchanged cardiomegaly. There is improvement in the right pleural effusion. There is some worsening of the opacification at the left retrocardiac area. There is also likely an element of pulmonary edema. The mediastinal drains and right IJ central line appear unchanged in position.


SubjectID: 18633036, StudyID: 56014194, Comparison: None

FINAL REPORT

INDICATION: Shortness of breath. Evaluation for pneumonia.

COMPARISON: Multiple priors from ___.

FINDINGS: AP and lateral chest radiographs. Median sternotomy wires are intact, and the patient is status post CABG. Moderate cardiomegaly and mild interstitial opacities are unchanged from ___. There are small bilateral pleural effusions, not present on most recent prior, and left basilar opacification, possibly reflecting atelectasis. There is no pneumothorax.

IMPRESSION: Mild interstitial pulmonary edema, small bilateral pleural effusions. Left basilar opacity may reflect atelectasis, though infection cannot be completely excluded.


SubjectID: 18633036, StudyID: 55683610, Comparison: same

FINAL REPORT

PORTABLE CHEST FILM, ___ AT 8:24 CLINICAL

INDICATION: ___-year-old with CHF, assess for pulmonary edema. Comparison is made to the patient's prior study dated ___. Portable erect chest film ___ at 8:25 is submitted.

IMPRESSION: 1. Status post median sternotomy for CABG with stable cardiac enlargement. Given differences in technique, there is likely no significant interval change   Keywords: no significant interval change. There continues to be mild interstitial prominence which may reflect residual mild interstitial edema. There is also layering left effusion with patchy opacity at the left base likely reflecting compressive atelectasis. No pneumothorax.


SubjectID: 18650767, StudyID: 54630742, Comparison: 1.0

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Productive cough and tachycardia.

COMPARISONS: Earlier in the same day.

TECHNIQUE: Chest, PA and lateral.

FINDINGS: The heart is mild to moderately enlarged. There is again a perihilar opacification, and a mild interstitial abnormality is present, worse in the right lung than left, but diffuse   Keywords: worse. Vascularity is also indistinct, suggestive of mild vascular congestion on this examination, similar to improved, but apparent differences may be largely due to technique   Keywords: improve. A focal right lower lung opacity, apparently in the right lower lobe, persists, worrisome for pneumonia without definite change. There is no pleural effusion or pneumothorax. Mild degenerative changes are present along the lower thoracic spine. In addition, there is an irregular appearance along the course of the right anterolateral fifth and possibly sixth ribs, suggestive of possible remote prior rib fractures.

IMPRESSION: 1. Findings suggesting mild pulmonary vascular congestion. 2. Focal right lower lung opacity, possibly pneumonia (atelectasis could also be considered). Correlation with clinical symptoms is recommended and consideration of followup imaging is suggested if clinically indicated.


SubjectID: 18650767, StudyID: 51005387, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Tachycardia and cough.

COMPARISONS: None.

TECHNIQUE: Chest, portable AP.

FINDINGS: The heart is mild to moderately enlarged. There is mild unfolding of the thoracic aorta. There is perihilar fullness bilaterally with indistinct central pulmonary vascularity suggesting pulmonary vascular congestion or fluid overload. In addition, within the right lower lung, there is a potential focal developing opacity, so coinciding pneumonia could be considered. There is no definite pleural effusion or pneumothorax.

IMPRESSION: Findings suggesting mild-to-moderate vascular congestion with a potential developing focal opacity in the right lower lung, possibly pneumonia in the right lower lobe in the appropriate clinical setting (although atelectasis could also be considered)   Keywords: developing.


SubjectID: 18673042, StudyID: 55948607, Comparison: better

FINAL REPORT

PORTABLE AP CHEST

INDICATION: Patient with ICD placement left subclavian access. Rule out pneumothorax.

COMPARISON: ___.

FINDINGS: New left-sided atrioventricular pacemaker is in adequate position. There is no pneumothorax or pleural effusion. Pulmonary edema has completely resolved since ___   Keywords: resolve. Moderate cardiomegaly is unchanged. The aorta is tortuous, stable.

CONCLUSION: 1. No pneumothorax after pacemaker placement. 2. Mild pulmonary edema has completely resolved since ___   Keywords: resolve.


SubjectID: 18673042, StudyID: 53561396, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST X-RAY

INDICATION: Patient with ICD placement, left subclavian access re-positioned.

COMPARISON: ___ at 5:45 p.m.

FINDINGS: Left-sided pacemaker with atrioventricular leads is in adequate position. There is no pneumothorax or pleural effusion. Moderate cardiomegaly is unchanged. Abdominal aorta is possibly dilated up to 3.5 cm and could be further assessed with dedicated study.

CONCLUSION: 1. New atrioventricular pacemaker is in adequate position without complication. 2. Possible abdominal aorta dilatation could be further assessed by a dedicated study.


SubjectID: 18690165, StudyID: 58201307, Comparison: None

FINAL REPORT

INDICATION: Weakness, evaluate for pneumonia.

COMPARISON: ___ chest radiograph.

FINDINGS: PA and lateral views of the chest. Moderate to severe cardiomegaly is again seen and stable. There is no evidence of focal consolidation, pleural effusion or pneumothorax. Multiple calcified pleural plaques are again seen.

IMPRESSION: No evidence of pneumonia. Unchanged moderate to severe cardiomegaly.


SubjectID: 18690165, StudyID: 55415343, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH.

INDICATION: Chronic heart failure, tricuspid regurgitation. Evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is unchanged evidence of cardiomegaly. Enlargement of both the left and the right aspects of the heart. Tortuosity of the thoracic aorta continues to be present. Also unchanged are pleural and parenchymal calcifications. No pleural effusions. No overt pulmonary edema. No pneumonia.


SubjectID: 18690165, StudyID: 56590910, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST, ___

HISTORY: ___-year-old man with pleural effusions.

IMPRESSION: PA and lateral chest compared to chest radiographs since ___, most recently ___: Elevation of the base of the right lung due to subpulmonic pleural effusion and increase caliber of the cardiac silhouette due to a combination of progressive cardiomegaly and pericardial effusion which developed between ___ and ___, documented on a chest CT on ___, is all unchanged. There is no pneumothorax. A questioned soft tissue nodule in the left upper lobe projecting over the upper margin of the anterior third rib has no corresponding abnormality on the chest CT and is in stead a portion of the largely calcified pleural plaque in the region.


SubjectID: 18690165, StudyID: 55576834, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Pleural effusion, thoracocentesis on the right, evaluation for pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has undergone right thoracocentesis. The extent of the prior right pleural effusion has substantially decreased. There is no evidence of pneumothorax. Unchanged moderate cardiomegaly without evidence of fluid overload, no parenchymal changes except for the known parenchymal calcifications   Keywords: unchanged.


SubjectID: 18692222, StudyID: 55462208, Comparison: same

FINAL REPORT

HISTORY: Fatigue, cough.

TECHNIQUE: Frontal and lateral views of the chest.

COMPARISON: ___.

FINDINGS: Dual lead left-sided AICD is stable in position, with leads extending to the expected positions of the right atrium and right ventricle. The cardiac and mediastinal silhouettes are stable. Overall, there has been no significant interval change   Keywords: no significant interval change. No new focal consolidation is seen. There is no pleural effusion or pneumothorax.

IMPRESSION: No significant interval change   Keywords: no significant interval change. No acute cardiopulmonary process.


SubjectID: 18692222, StudyID: 55320438, Comparison: None

FINAL REPORT

HISTORY: MDS, neutropenic with wet cough, low-grade fevers, crackles in left lower lung, question pneumonia. CHEST, TWO VIEWS.

COMPARISON: Chest x-ray from ___ at 18:30 p.m. Left-sided pacemaker-type device (apparently an ICD) is present, with lead tips over right atrium and right ventricle. The lungs are hyperinflated and the diaphragms are flattened, consistent with COPD. There is mild-to-moderate cardiomegaly. The aorta is calcified and minimally unfolded. There are some patchy opacities at both lung bases, which have progressed compared with ___, and which could represent pneumonic infiltrates. Minimal stranding in the lingula is likely also present. Right upper zones remain clear. No CHF. Minimal blunting of the posterior costophrenic angle, but no gross effusion. A small density in the right upper zone overlying the right clavicle measures approximately 3.8 mm and could correspond to the nodular density seen on the ___ CT scan.

IMPRESSION: 1. COPD and cardiomegaly. 2. Patchy opacities in both lower lobes posteriorly, that could represent pneumonic infiltrates and that have progressed compared with the CXR from ___ at 18:30 p.m. Lingular stranding likely also present. 3. Small nodular density (3.8 mm) right upper zone, likely corresponds to finding on the ___ CT scan.


SubjectID: 18693746, StudyID: 59908528, Comparison: worse

FINAL REPORT

PORTABLE CHEST OF ___

COMPARISON: ___ chest x-ray.

FINDINGS: Cardiac silhouette remains enlarged. Confluent perihilar and basilar opacities are again demonstrated and have minimally progressed in the interval   Keywords: progressed. These are likely due to pulmonary edema. However, more coarse underlying reticular opacities are demonstrated and likely correspond to chronic component of interstitial lung disease. A component of pulmonary ossification is also likely given the appearance on prior CT of ___. Bilateral pleural effusions are again demonstrated, right greater than left.


SubjectID: 18693746, StudyID: 59716116, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior study from ___. CLINICAL

HISTORY: CHF, moderate aortic stenosis, presenting with progressive dyspnea and DOE x 2 days, assess for edema, pneumonia.

FINDINGS: Frontal and lateral views of the chest were obtained. Low lung volumes limit evaluation. There are bilateral pulmonary opacities which are most confluent in the lung bases. Central pulmonary hilar engorgement with interstitial and alveolar edema is present. Bilateral pleural effusions are small to moderate. No pneumothorax. Heart size appears enlarged though poorly assessed. Mediastinal contour is stable with atherosclerotic calcification along the aortic knob. Bony structures are intact.

IMPRESSION: Findings compatible with pulmonary edema/heart failure. Small-to-moderate bilateral pleural effusions also present.


SubjectID: 18693746, StudyID: 56813549, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Worsening chronic heart failure, questionable pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is a decrease in extent of the bilateral pleural effusions. Sequence decrease in severity of the basal areas of atelectasis. Unchanged moderate cardiomegaly, currently without evidence of pulmonary edema   Keywords: unchanged.


SubjectID: 18693746, StudyID: 51962795, Comparison: same

FINAL REPORT

INDICATION: Status post myocardial infarction with heart failure. Evaluate pulmonary edema.

COMPARISON: Chest radiograph ___. Chest radiograph ___.

FINDINGS: A right PICC ends in the upper SVC. Bilateral moderate pleural effusions have slightly increased in size. Widening of the pulmonary vascular pedicle and mediastinal veins and mild-to-moderate interstitial edema are stable   Keywords: stable. Moderate enlargement of the cardiac silhouette is unchanged. There is no consolidation or pneumothorax.

IMPRESSION: 1. Right PICC ends in the upper SVC. 2. Slight enlargement of moderate pleural effusions. 3. Stable mild-to-moderate pulmonary edema   Keywords: stable.


SubjectID: 18696707, StudyID: 56916395, Comparison: same

FINAL REPORT

EXAMINATION: PA and lateral chest

INDICATION: ___ year old man with pleural effusion // eval

TECHNIQUE: Chest PA and lateral

COMPARISON: ___

FINDINGS: Post CABG. Small posterior left-sided pleural effusion is demonstrated , similar in size to prior. Hazy opacity of the lingular region is again noted bordering the major fissure on lateral view   Keywords: again. No significant right pleural effusion. Cardiomegaly. Mild tortuosity of thoracic aorta. No focal consolidation or pneumothorax. Degenerative changes of the spine.

IMPRESSION: Small posterior left-sided pleural effusion, similar in size to prior. Hazy opacity of the lingular region is again noted bordering the major fissure on lateral view, possibly representing loculated pleural fluid. Chest CT is recommended for further evaluation. Cardiomegaly. Post CABG.


SubjectID: 18696707, StudyID: 51793236, Comparison: same

FINAL REPORT

EXAMINATION: PA lateral chest

INDICATION: ___ year old man with CAD s/p CABG c/b persistent left-sided pleural effusion now s/p thoracentesis today // PTX

TECHNIQUE: Chest PA and lateral

COMPARISON: Same day 12:29

FINDINGS: There is interval decrease in size of the posterior left pleural effusion. The study is otherwise unchanged from prior, with hazy opacity on frontal view in the lingular region   Keywords: unchanged.

IMPRESSION: Interval decrease in size of the posterior left pleural effusion. No pneumothorax. Persistent moderate cardiomegaly and juxta cardiac pleural fluid loculation.


SubjectID: 18696707, StudyID: 55224292, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man s/p CABG with large left effusion // eval for left effusion

COMPARISON: ___

IMPRESSION: The known left effusion has minimally increased in extent. The effusion occupies approximately ___ percent of the left hemi thorax. Mild displacement of the cardiac silhouette towards the right. Subsequent left lower and midlung atelectasis. The sternal wires are unchanged.


SubjectID: 18696707, StudyID: 52460110, Comparison: None

FINAL REPORT

PORTABLE CHEST

COMPARISON: ___.

FINDINGS: Removal of Swan-Ganz catheter with no visible pneumothorax. Enlarging, now moderate-to-large left pleural effusion with adjacent left lower lobe atelectasis. Hemothorax should be considered given recent surgery. Right lung and pleural surfaces are clear.


SubjectID: 18696707, StudyID: 51382233, Comparison: None

FINAL REPORT

HISTORY: To assess left pleural effusion.

FINDINGS: Frontal and lateral views in an upright position show a large left pleural effusion. Right lung remains essentially clear and there is no definite pulmonary vascular congestion.


SubjectID: 18696707, StudyID: 54644253, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man s/p CABG // eval for pleural effusions, pneumothorax s/p chest tube removal eval for pleural effusions, pneumothorax s/p chest tube ___

IMPRESSION: In comparison with the study of ___, the chest is has been removed. There again appears to be a small apical pneumothorax. Continued enlargement of the cardiac silhouette without definite vascular congestion. Retrocardiac opacification most likely reflect atelectasis.


SubjectID: 18696707, StudyID: 50675595, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man s/p CABG, MAZE // follow up left effusion

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the appearance of the left pigtail catheter in the pleural space is unchanged. Minimal persistent left pleural effusion but no evidence of left postprocedural pneumothorax. Unchanged moderate cardiomegaly with retrocardiac atelectasis. Unchanged normal appearance of the right lung. .


SubjectID: 18696707, StudyID: 51025773, Comparison: None

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPH ___

INDICATION: ___ year old man s/p cabg and ct removal // r/o ptx

TECHNIQUE: Single upright portable view of the chest was obtained.

COMPARISON: Comparison is made to chest radiograph from yesterday.

FINDINGS: Since the prior study, there has been interval removal of a nasogastric tube and endotracheal tube, as well as mediastinal and left pleural drainage catheters. No pneumothorax is identified. The cardiomediastinal silhouette is stable, as is the position of the right internal jugular approach Swan___ catheter, with tip in the pulmonary outflow tract. Median sternotomy wires are intact. Bibasilar atelectasis is again noted, with no consolidation concerning for pneumonia. There is no overt pulmonary edema or large pleural effusion.

IMPRESSION: Status post removal of mediastinal and pleural drainage catheters, with no evidence of pneumothorax.


SubjectID: 18701564, StudyID: 59901174, Comparison: 0.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p mini MV repair // follow up ? Right pneumothorax

TECHNIQUE: Single frontal view of the chest

COMPARISON: Study performed 7 hours earlier

IMPRESSION: There is a small right apical pneumothorax. A right apical chest tube is in place. A second tube that projects over the cardiac silhouette and the tip is in the left hemi thorax is likely a pericardial drain please correlate clinically. Cardiomegaly is a stable. Right upper lobe opacities are grossly unchanged, could represent atelectasis or asymmetric edema   Keywords: unchanged. Right lower opacities have minimally improved   Keywords: improve. MVR is noted


SubjectID: 18701564, StudyID: 56957703, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p mini MVR // eval for pneumothorax with CT on waterseal

TECHNIQUE: AP view of the chest

COMPARISON: ___

FINDINGS: A right internal jugular sheath terminates in the upper SVC. A Swan-Ganz catheter terminates in the right ventricular outflow tract. An endotracheal tube and enteric tube have been removed. Right-sided chest tube is in stable position. No definite pneumothorax is identified. The cardiac silhouette is minimally enlarged, but stable from ___. Diffusely increased density throughout the right lung and left lung (to a lesser degree) is likely related to the patient's recent extubation and a decrease in lung volumes. The stomach is overinflated status post enteric tube removal. No focal consolidation is identified.

IMPRESSION: No definite pneumothorax seen. Increased density throughout the lungs is likely related to recent extubation and lower lung volumes.


SubjectID: 18701564, StudyID: 53633647, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with s/p minimally invasive MV repair // evaluate for effusion

TECHNIQUE: CHEST (PA AND LAT)

COMPARISON: ___

IMPRESSION: Heart size and mediastinum are stable in appearance. Replaced mitral valve is stable. Left retrocardiac consolidation in right basal opacities are overall stable. After discontinuation of the chest tubes there is no definitive evidence of pneumothorax. Small amount of bilateral pleural effusion is noted.


SubjectID: 18701564, StudyID: 52703378, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p Mini MVring // eval for pneumothoraces in patient with airleakPLEASE DO FILM AT 7:30 AM on ___

TECHNIQUE: Portable AP radiograph of the chest.

COMPARISON: ___.

FINDINGS: The patient has had recent mitral valve repair. Two right chest tubes remain in place. Moderate pulmonary edema has slightly decreased   Keywords: decrease. Moderate cardiomegaly despite the projection is also unchanged. Mediastinal contours are stable. There is no definite pneumothorax. Increased obscuration of the left hemidiaphragm is likely due to worsening atelectasis.

IMPRESSION: Slightly decreased moderate pulmonary edema   Keywords: decrease. Increased left basilar subsegmental atelectasis. Stable moderate cardiomegaly.


SubjectID: 18701564, StudyID: 50584154, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p mini-MVring // eval for pneumothorax with all chest tubes clampedPLEASE DO FILM AT 2PM. THANKS!

TECHNIQUE: AP view of the chest.

COMPARISON: Multiple priors most recent on ___.

FINDINGS: Two chest tubes overlying the right hemi thorax, unchanged in position from the prior study. There is a very small right apical pneumothorax. No large pleural effusion is identified. There is mild atelectasis at the right base. A paramedial opacity on the right could represent a small hematoma or pleural collection which is decreasing in size from the prior exam. There is no evidence of pulmonary edema. The heart is enlarged however stable in appearance from the prior exam. Note is made of subcutaneous air along the right chest wall consistent with recent procedure.

IMPRESSION: Very small right apical pneumothorax. Right paramedial opacity which could represent a small hematoma or pleural collection is decreasing in size from the prior exam.

NOTIFICATION: .


SubjectID: 18708817, StudyID: 59006690, Comparison: -1.0

FINAL REPORT

PORTABLE CHEST: ___

HISTORY: ___-year-old female with altered mental status.

FINDINGS: Single AP portable view of the chest is compared to previous exam from ___. Compared to prior, there has been no significant interval change   Keywords: no significant interval change. Mildly increased interstitial markings are seen throughout the lungs bilaterally without frank pulmonary edema   Keywords: increase. Silhouetting of the left hemidiaphragm may be in part due to technique or atelectasis; however, small effusion is not excluded. The cardiac silhouette is massively enlarged but stable.

IMPRESSION: No significant interval change   Keywords: no significant interval change. Mild congestive failure with massive cardiomegaly, unchanged from prior.


SubjectID: 18708817, StudyID: 54337629, Comparison: better

FINAL REPORT

HISTORY: Altered mental status, evaluate for hilar adenopathy. CHEST, TWO VIEWS. The lungs are hyperinflated and the diaphragms are flattened, consistent with COPD. There is severe cardiomegaly, with evidence for marked left atrial enlargement and right as well as left heart enlargement. The hila are prominent, partially obscured by the cardiomediastinal contour. There is upper zone re-distribution. There are increased interstitial markings at both lung bases, in the setting of upper zone re-distribution. Small effusions are present.

IMPRESSION: 1. COPD. 2. Marked cardiomegaly. 3. Likely hilar adenopathy, not optimally visualized due to the cardiomegaly and therefore not fully characterized. 4. UZRD and increased interstitial markings in both mid and lower zones, with small pleural effusions. Compared with ___ at ___ p.m., the interstitial markings are less pronounced, suggesting some interval improvement in CHF findings   Keywords: improve.


SubjectID: 18708817, StudyID: 58288088, Comparison: None

FINAL REPORT

HISTORY: Tube placement.

FINDINGS: In comparison with the earlier study of this date, there has been placement of an endotracheal tube with its tip at the lower clavicular level, approximately 7 cm above the carina. Left subclavian catheter again extends to almost the junction of the left brachiocephalic vein and superior vena cava. OG tube extends well into the stomach where it crosses the lower margin of the image. Continued bilateral pulmonary opacifications with substantial enlargement of the cardiac silhouette.


SubjectID: 18708817, StudyID: 57463785, Comparison: worse

FINAL REPORT

HISTORY: Low ejection fraction, to assess for pulmonary edema.

FINDINGS: In comparison with the study of ___, there are increasing bilateral pulmonary opacifications, consistent with the clinical diagnosis of pulmonary edema in a patient with huge enlargement of the cardiac silhouette consistent with severe cardiomyopathy   Keywords: increasing. In the appropriate clinical setting, supervening pneumonia would have to be considered. Retrocardiac opacification with obscuration of the hemidiaphragm is consistent with substantial volume loss in the left lower lobe. Central catheter has been pulled back to about the junction of the brachiocephalic vein and SVC.


SubjectID: 18709932, StudyID: 51874327, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior study from ___. CLINICAL

HISTORY: Chest pain, assess pneumonia or widened mediastinum.

FINDINGS: AP upright and lateral views of the chest were obtained. Dual-lead pacer is unchanged with a prosthetic cardiac valve. There is diffuse pulmonary edema with bilateral pleural effusions, significantly worse compared with prior study   Keywords: worse. Overall heart size is stable and mildly enlarged. Mediastinal contour is grossly stable. No pneumothorax is seen. Bony structures are intact.

IMPRESSION: Pulmonary edema, new, with bilateral pleural effusions, also increased with stable cardiomegaly   Keywords: new, increase. Findings are compatible with cardiac decompensation.


SubjectID: 18709932, StudyID: 51127550, Comparison: better

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Left-sided chest pain.

COMPARISONS: Two days earlier.

TECHNIQUE: Chest, PA and lateral.

FINDINGS: The patient is status post sternotomy, coronary artery bypass graft surgery and aortic valve replacement. A dual-lead pacemaker/ICD device appears unchanged, with leads terminating in the right atrium and ventricle, respectively. The heart is again moderately enlarged. The mediastinal and hilar contours appear unchanged. There is asymmetric opacification of the right lung more so than left with an interstitial pattern suggesting an asymmetric form of vascular congestion, although overall similar to decreased, particularly in the left lung   Keywords: decrease. Posterior patchy basilar opacities are most suggestive of coinciding atelectasis. There is a better defined opacity loculated along the right lower lateral chest wall, suggestive of a loculated pleural effusion. There is also a small pleural effusion on the left. There is no pneumothorax.

IMPRESSION: Decreased opacification, particularly in the left lung, suggesting improvement in pulmonary congestion   Keywords: decrease, improve. Better definition of basilar opacity suggesting pleural effusions, loculated on the right side to some degree.


SubjectID: 18717547, StudyID: 59273470, Comparison: same

WET READ: ___ ___ ___ 8:17 AM No acute findings. Stable cardiac silhouette.

WET READ VERSION #1 ___ ___ ___ 8:15 PM No acute findings. Stable cardiac silhouette. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p pacer placement with tachycardia and hypotension // r/o tamponade

IMPRESSION: Since a recent study of earlier the same date, lung volumes have slightly increased with associated improved aeration at both lung bases. No other relevant changes since the recent study   Keywords: no other relevant change.


SubjectID: 18717547, StudyID: 56598389, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man s/p BiV PPM. // ___ year old man s/p BiV PPM.

IMPRESSION: A biventricular pacing device is present, with leads in the right atrium, right ventricle and a third lead for biventricular pacing. There is no pneumothorax. Cardiomediastinal contours are stable in appearance compared to the prior study of 1 day earlier, and lungs and pleural surfaces are grossly clear. Compression deformity in the mid thoracic spine has been more fully evaluated by a thoracic spine MR of ___ in this patient with history of myeloma.


SubjectID: 18717547, StudyID: 55623304, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p BiV PPM. Eval for PTX // ___ year old man s/p BiV PPM. Eval for PTX ___ year old man s/p BiV PPM. Eval for PTX

IMPRESSION: As compared to ___, the patient has received a left pectoral pacemaker. 1 lead projects over the coronary sinus, 1 over the right atrium and 1 over the right ventricle. Lung volumes are low. Moderate cardiomegaly without pulmonary edema. Mild retrocardiac atelectasis. No pleural effusions.


SubjectID: 18717547, StudyID: 55589435, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with AV block s/p SJM BiV PPM with delirium // Interval change Interval change

COMPARISON: ___

IMPRESSION: Heart size and mediastinum are stable. Biventricular pacemaker leads are in stable location. Lungs are overall clear with no new abnormality demonstrated.


SubjectID: 18717547, StudyID: 56480372, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with multiple myeloma presenting with cough // Please evaluate for PNA

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Low lung volumes. Moderate cardiomegaly without pulmonary edema or pleural effusions. No pneumonia. Healing left-sided rib fractures. A retrocardiac opacities caused by a slightly elongated descending aorta.


SubjectID: 18717547, StudyID: 52400537, Comparison: None

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPH

INDICATION: ___-year-old man with dyspnea, here to evaluate for acute cardiopulmonary process.

TECHNIQUE: Upright AP and lateral radiographs of the chest.

COMPARISON: None.

FINDINGS: The inspiratory lung volumes are decreased with resultant bronchovascular crowding and accentuation of the cardiomediastinal silhouette. Within this limitation, there is streaky opacification of the right lung base most compatible with atelectasis. A small right pleural effusion is difficult to exclude. No pneumothorax is detected. The cardiac silhouette is likely enlarged. The thoracic aorta is slightly tortuous.

IMPRESSION: Decreased lung volumes with right basilar opacity likely representing atelectasis.


SubjectID: 18718424, StudyID: 57511546, Comparison: worse

FINAL REPORT

HISTORY: Right central line placement.

TECHNIQUE: Upright AP view of the chest.

COMPARISON: ___ at 15:22.

FINDINGS: Central venous catheter entering via a right internal jugular approach terminates at the junction of the SVC and right atrium. No pneumothorax is identified. Moderate pulmonary edema appears slightly worse in the interval   Keywords: worse. There is persistent moderate enlargement of cardiac silhouette. Small bilateral pleural effusions and bibasilar atelectasis persists.

IMPRESSION: Right internal jugular central venous catheter tip at the junction of the SVC and right atrium. No pneumothorax. Slight interval worsening of pulmonary edema, now moderate in extent, with small bilateral pleural effusions and bibasilar atelectasis   Keywords: worse.


SubjectID: 18718424, StudyID: 51942379, Comparison: worse

FINAL REPORT

HISTORY: ___-year-old female with shortness of breath.

COMPARISON: Multiple prior exams, most recently of chest radiographs of ___.

FINDINGS: Frontal view of the chest was obtained. Leads of a left-sided pacer terminate in the right atrium and ventricle. Moderate cardiomegaly with calcification of the aortic knob are stable. Hyperinflated lungs are consistent with chronic obstructive pulmonary disease. Interstitial lung markings are increased, consistent with mild pulmonary edema   Keywords: increase. Retrocardiac and right lung base opacities may represent a combination of atelectasis and effusion.

IMPRESSION: Mild pulmonary edema with bibasilar atelectasis. Stable moderate cardiomegaly.


SubjectID: 18749871, StudyID: 59025687, Comparison: -1.0

FINAL REPORT

HISTORY: Cough, sickle cell crisis, pulmonary emboli, rule out pneumonia. CHEST, SINGLE AP VIEW The lungs are hyperinflated. There is cardiomegaly, with upper zone redistribution and diffuse vascular blurring, consistent with CHF. There are patchy increased interstitial markings at both lung bases, similar but slightly more pronounced than on ___ at 19:33 p.m. Minimal blunting of the right costophrenic angle, without other evidence of effusion. Increased density in the right infrahilar area may include opacity related to the patient's right paraspinal mass, which was attributed to extramedullary hematopoiesis on recent CT scan.

IMPRESSION: 1. CHF with interstitial edema, similar to ___   Keywords: similar. 2. Patchy opacities at both bases, similar but slightly worse compared with ___   Keywords: worse. These could represent atelectasis or scarring, though the possibility of infectious infiltrate, cannot be excluded.


SubjectID: 18749871, StudyID: 50712562, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: ___. CLINICAL

HISTORY: Sickle cell disease with oxygen saturation of 83%, assess for pneumonia.

FINDINGS: AP upright portable chest radiograph is obtained. The heart is mildly enlarged. There is mild interstitial edema. No large effusion or pneumothorax seen. Bibasilar atelectasis noted. Mediastinal contour unremarkable. Bony structures intact.

IMPRESSION: Mild CHF.


SubjectID: 18757167, StudyID: 59920619, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Likely aspiration, pneumonia, evaluation.

COMPARISON: ___.

FINDINGS: In the interval, the patient has received a stent. There is massive scoliosis. In addition, a new parenchymal opacity has occurred at the right lung bases. The morphology of these opacities are highly suggestive of pneumonia caused by aspiration. The cardiac silhouette is unchanged in ___. At the time of dictation and observation, 8:52 a.m., on ___, the referring physician, ___. ___, covered by Dr. ___, was paged for notification.


SubjectID: 18757167, StudyID: 52170076, Comparison: None

FINAL REPORT

HISTORY: Dyspnea for 3 days.

TECHNIQUE: Semi-upright AP view of the chest.

COMPARISON: None.

FINDINGS: Lung volumes are low. The heart size is mildly enlarged. Atherosclerotic calcifications are noted at the aortic knob. A 3.5 x 5.7 cm right paratracheal well-circumscribed mass is identified, as well as a 5.5 x 3.1 cm left paramediastinal lesion. The trachea appears slightly narrowed as a result of these masses. Hilar contours are unremarkable, and no pulmonary vascular congestion is seen. Patchy bibasilar airspace opacities may reflect atelectasis or infection. No pleural effusion or pneumothorax is present. No acute osseous abnormalities demonstrated. S-shaped scoliosis of the thoracolumbar spine is present.

IMPRESSION: Bilateral paramediastinal masses, likely reflecting an enlarged thyroid goiter, with mild tracheal narrowing, but further assessment with chest CT with IV contrast is recommended. Patchy opacities in the lung bases likely reflect atelectasis but infection or aspiration are not excluded.


SubjectID: 18757167, StudyID: 57013868, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Unsuccessful Dobbhoff placement, tracheal stent, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the tracheal stent appears to be in unchanged position. Unchanged bilateral pleural effusions and retrocardiac atelectasis. Unchanged large paramediastinal right-sided soft tissue structure. No evidence of pneumothorax. Mild cardiomegaly.


SubjectID: 18757167, StudyID: 54401803, Comparison: None

FINAL REPORT

HISTORY: Dobbhoff placement.

FINDINGS: In comparison with study of ___, there is now a Dobbhoff tube in place that extends to the lower body of the stomach before the tip turns upward. Little overall change in the appearance of the heart and lungs.


SubjectID: 18767957, StudyID: 57874436, Comparison: None

FINAL REPORT

INDICATION: Questionable pneumonia.

TECHNIQUE: Portable semi-erect chest view was read in comparison with the prior most recent radiograph from ___ acquired less than 24 hours apart.

FINDINGS: Since yesterday retrocardiac opacity and small opacity in the right infrahilar and right lower medial lung is much better, likely atelectasis or aspiration. Both upper lungs are clear. There is no pleural abnormality.

IMPRESSION: Study yesterday, retrocardiac opacity and small opacity in right lower medial and infrahilar region has improved suggesting it was atelectasis or aspiration. There is no pleural abnormality.


SubjectID: 18767957, StudyID: 54957849, Comparison: None

FINAL REPORT

HISTORY: Postoperative, to assess for fluid overload before transfusing.

FINDINGS: In comparison with study of ___, there are slightly lower lung volumes. There is enlargement of the cardiac silhouette with engorgement of indistinct pulmonary vessels consistent with some elevated pulmonary venous pressure. The left hemidiaphragm is not as well seen, suggesting volume loss in the left lower lobe and possible left effusion.


SubjectID: 18767957, StudyID: 51612379, Comparison: 1.0

FINAL REPORT

INDICATION: ___ year old man with HIV, ESRD on HD presented with cough, fever, hypoxia to 80s, pulmonary edema // Reevaluate lungs for evidence of infection including PJP after volume removal in HD

COMPARISON: Radiographs ___

IMPRESSION: Heart size is upper limits of normal. There has been improvement of the pulmonary edema   Keywords: improve. There remains vague opacities at the lung bases   Keywords: remains. This may be due to resolving pulmonary edema versus atelectasis versus residual infiltrate   Keywords: resolving. There are no pneumothoraces.


SubjectID: 18767957, StudyID: 50744964, Comparison: None

FINAL REPORT

INDICATION: Hypoxia.

COMPARISON: Chest radiographs from ___, ___, ___, and ___.

FINDINGS: A portable frontal chest radiograph demonstrate an unchanged cardiomediastinal silhouette, which is top-normal in size. Bilateral opacities are consistent with moderate pulmonary edema. No definite focal consolidation or pneumothorax is identified. There are likely trace bilateral pleural effusions.

IMPRESSION: Moderate pulmonary edema.


SubjectID: 18775105, StudyID: 58391888, Comparison: better

WET READ: ___ ___ ___ 7:55 AM Moderate cardiomegaly. Central pulmonary vascular congestion and edema appears modestly improved from the prior examination   Keywords: improve. Left lower lobe airspace opacity may reflect atelectasis, although superimposed infection is not excluded.

WET READ VERSION #1 ___ ___ 7:52 PM Moderate cardiomegaly. Central pulmonary vascular congestion and edema appears modestly improved from the prior examination. Left lower lobe airspace opacity may reflect atelectasis, although superimposed infection is not excluded. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___ year old woman with increased O2 requirement, concern for atelectasis vs PNA // please evaluate for possible etiology of increasing O2 requirement

TECHNIQUE: Chest PA and lateral

IMPRESSION: Compared to ___, there is Moderate cardiomegaly, unchanged. Central pulmonary vascular congestion and edema appears modestly improved from the prior examination. Left lower lobe airspace opacity may reflect atelectasis, although superimposed infection is not excluded the left central line and vascular stent are unchanged


SubjectID: 18775105, StudyID: 51413494, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with ESRD, hx AVR s/p replacement now with increased oxygen requirement, low-grade temperatures; evaluate for effusion, PNA? // ___F with ESRD, hx AVR s/p replacement now with increased oxygen requirement, low-grade temperatures; evaluate for effusion, PNA?

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: Compared to the prior study there is increase in bilateral lower lobe opacities   Keywords: increase. In addition there is pulmonary vascular redistribution and increase in interstitial markings   Keywords: increase. There is probable bilateral small effusions. .

IMPRESSION: Worsened appearance to the lungs. While some of this could be due to fluid overload an underlying infectious etiology cannot be excluded.


SubjectID: 18775105, StudyID: 58013298, Comparison: None

WET READ: ___ ___ 8:04 AM Left lower lobe triangular-shaped opacity likely represents atelectasis however pneumonia cannot be excluded in the appropriate clinical setting. The findings were discussed by Dr. ___ with Dr. ___ on the telephoneon ___ at 11:47 PM, 5 minutes after discovery of the findings.

WET READ VERSION #1 ___ ___ 11:51 PM Left lower lobe triangular-shaped opacity likely represents atelectasis however pneumonia cannot be excluded in the appropriate clinical setting. The findings were discussed by Dr. ___ with Dr. ___ on the telephoneon ___ at 11:47 PM, 5 minutes after discovery of the findings. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F w/ h/o kidney transplant and ESRD on dialysis c/b secondary hyperparathyroidism now s/p partial parathyroidectomy // rule out pneumonia rule out pneumonia

IMPRESSION: In comparison with the study of ___, there is some increased opacification at the left base. In view of the lower lung volumes, this probably represents atelectasis. However, in the appropriate clinical setting, the possibility of superimposed pneumonia would be difficult to unequivocally exclude, especially in the absence of a lateral view. Remainder of the study is essentially unchanged.


SubjectID: 18775105, StudyID: 56940349, Comparison: better

FINAL REPORT

HISTORY: Evaluate for pleural effusion status post CABG.

TECHNIQUE: Frontal view of the chest.

COMPARISON: Multiple chest radiographs the most recent on ___.

FINDINGS: An endotracheal tube is seen approximately 5.5 cm above the carina and in appropriate position. A left chest tube is unchanged in position and a right Swan-Ganz catheter is seen terminating in the right ventricular outflow tract. Sternotomy wires are unchanged. The lung volumes are low and again seen is mild pulmonary edema, which appears minimally improved   Keywords: improve. There are no pleural effusions. The cardiomediastinal silhouette and hilar contours are grossly unchanged. There is no pneumothorax.

IMPRESSION: No evidence of pleural effusion.


SubjectID: 18775105, StudyID: 56521605, Comparison: worse

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with acute desaturation, fatigue, right shoulder pain, evaluation for interval change.

COMPARISON: ___.

FINDINGS: New mild pulmonary edema   Keywords: new is seen   Keywords: new. There is no pleural effusion or pneumothorax. Moderate cardiac contour enlargement is stable. A stent is in the right brachiocephalic artery.

CONCLUSION: New mild pulmonary edema.


SubjectID: 18775105, StudyID: 55078769, Comparison: better

FINAL REPORT

HISTORY: Prior renal transplant, to evaluate for volume overload.

FINDINGS: In comparison with the study of ___, there is again globular enlargement of the cardiac silhouette. Pulmonary vascular congestion has decreased   Keywords: decrease. No evidence of pleural effusion or acute pneumonia.


SubjectID: 18775105, StudyID: 55889517, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Status post aortic valve replacement.

COMPARISONS: ___.

TECHNIQUE: Chest, portable AP upright.

FINDINGS: A nasogastric tube passes into the stomach, its distal course not imaged. There is again a right subclavian central venous catheter terminating at the cavoatrial junction. The catheter again passes through a right brachiocephalic stent. The heart is moderately enlarged. A moderate interstitial abnormality has worsened including perihilar fullness suggesting moderate interstitial pulmonary edema   Keywords: worse. There is no evidence for pleural effusion on the right. Vague density in the left lower lung suggests patchy atelectasis and a very small pleural effusion is possible on of the left.

IMPRESSION: Findings suggesting moderate, increased interstitial pulmonary edema   Keywords: increase. No evidence for substantial pleural effusions.


SubjectID: 18775105, StudyID: 53575887, Comparison: better

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph of one day earlier.

FINDINGS: Interval intubation with tip of endotracheal tube terminating 6 cm above the carina. New midline drain likely represents a pericardial drain. Cardiomediastinal contours are stable in appearance. Interval improvement in pulmonary edema with only mild residual interstitial edema remaining   Keywords: improve. Improving aeration in left retrocardiac region with residual atelectasis and adjacent small pleural effusion.


SubjectID: 18775105, StudyID: 52833044, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post aortic valve replacement, questionable pneumonia.

COMPARISON: ___.

FINDINGS: As suspected on the previous radiograph, the right lower lung opacity is highly suspicious for pneumonia. The opacity has not changed in appearance since yesterday's image. Also unchanged is relatively extensive left lower lobe atelectasis. Moderate cardiomegaly, overall low lung volumes. Unchanged monitoring and support devices, with the exception of newly introduced nasogastric tube. No larger pleural effusions. At the time of dictation and observation, the referring physician, ___. ___, was paged for notification. Findings were discussed on the telephone.


SubjectID: 18785569, StudyID: 57426865, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with chest pain. Evaluate for acute process.

COMPARISONS: Multiple prior chest radiographs, most recently of ___.

FINDINGS: Single frontal portable view of the chest was obtained. The patient is rotated with respect to the film and is in lordotic position. The heart is of normal size. A large hiatal hernia is similar to prior. Lungs are clear without focal or diffuse abnormality. No pleural effusion or pneumothorax. No radiopaque foreign body. Mild degenerative changes are present in bilateral glenohumeral joints.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 18785569, StudyID: 53235732, Comparison: None

FINAL REPORT

AP CHEST 1:05 A.M., ___

HISTORY: ___-year-old man following attempted right IJ central venous line placement. Assess for complications.

IMPRESSION: AP chest compared to chest radiographs since ___, most recently ___: Since moderate cardiomegaly has worsened, it is possible that increased caliber to the upper mediastinum, particularly to the right, could be due to venous engorgement. There is no way that I can exclude a small mediastinal hematoma, but it would be reasonable to follow this with conventional radiographs rather than jump to a chest CT scan. There is no pneumothorax. Atelectasis, due in part to large hiatus hernia, is slightly more pronounced today than before. There is no pleural effusion.


SubjectID: 18788649, StudyID: 57494295, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with s/p cabg // eval left for effusion

COMPARISON: ___

IMPRESSION: In the interval, the patient has been extubated and the nasogastric tube was removed. The other monitoring and support devices, including the left chest tube, remain in place. No larger pleural effusions. No pneumothorax. Very low lung volumes and areas of atelectasis at the lung bases. Unchanged alignment of the sternal wires. Unchanged moderate postoperative cardiomegaly.


SubjectID: 18788649, StudyID: 51936936, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with s/p cabg // s/p ct removal s/p ct removal

IMPRESSION: In comparison with the earlier study of this date, the left chest tube has been removed. No definite pneumothorax. Continued low lung volumes with


SubjectID: 18796351, StudyID: 56408760, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Postoperative mitral insufficiency, complicated by flash pulmonary edema. Evaluation.

COMPARISON: ___.

FINDINGS: Compared to the previous radiograph, the monitoring and support devices are in unchanged position. The tip of the endotracheal tube projects 5.7 cm above the carina. The nasogastric tube shows unchanged course. The bilateral pleural effusion that pre-existed have minimally decreased in extent and severity. The borders of the cardiac silhouette can be better delineated. No newly occurred focal parenchymal opacities. No pneumothorax.


SubjectID: 18796351, StudyID: 55990109, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: ___. CLINICAL

HISTORY: Acute shortness of breath, low O2 saturation, recent carotid endarterectomy.

FINDINGS: Single AP upright portable chest radiograph is obtained. Pulmonary edema is severe with probable small bilateral effusions. No pneumothorax is seen. Heart size cannot be assessed.

IMPRESSION: Severe pulmonary edema.


SubjectID: 18796351, StudyID: 54850201, Comparison: better

FINAL REPORT

STUDY: CHEST RADIOGRAPH

INDICATION: Recent MI and pulmonary edema, now resolving.

TECHNIQUE: Portable AP radiograph was obtained.

COMPARISON: ___. REPORT: When compared to prior study the ET tube has been removed. The NG tube has also been removed. There is improvement in the amount of bibasilar changes and bilateral pleural effusions with left retrocardiac atelectasis persists. There is modeling deformity of some right ribs suggestive of fractures. There is improvement in the overall amount of pulmonary edema present. A left-sided Swan catheter appears in unchanged position with the proximal right pulmonary artery.

CONCLUSION: Interval improvement in amount of pulmonary edema   Keywords: improve. Swan-Ganz catheter in good position. Ongoing bilateral effusions and atelectasis.


SubjectID: 18796351, StudyID: 51743101, Comparison: None

FINAL REPORT

AP CHEST 8:25 A.M. ___

HISTORY: Acute MI and CHF.

IMPRESSION: AP chest compared to ___ 3:18 p.m.: Upper lungs are clear, but the lower lungs are opacified by a combination of moderate pleural effusions not necessarily changed since ___ and consolidation or atelectasis. Heart is top normal size and mediastinal veins are still distended. ET tube and a left subclavian Swan-Ganz catheter in standard placements. Nasogastric tube passes into the stomach and out of view.


SubjectID: 18796351, StudyID: 50637350, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: Prior study from approximately one hour earlier. CLINICAL

HISTORY: Intubation, check ET tube position.

FINDINGS: Supine portable AP view of the chest was provided. There has been interval intubation with the tip of the endotracheal tube residing approximately 5.2 cm above the carina. An NG tube is seen coursing inferiorly along the midline with its tip excluded from view. There is diffuse pulmonary edema redemonstrated with bilateral pleural effusions likely present.

IMPRESSION: Endotracheal tube positioned appropriately. NG tube appears also to be positioned appropriately, though the tip is excluded from view. Diffuse pulmonary edema with pleural effusions again seen   Keywords: again.


SubjectID: 18797174, StudyID: 59071140, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with SOB // pulm edema pulm edema

COMPARISON: ___

IMPRESSION: Left internal jugular line tip is at the level of lower SVC heart size and mediastinum are overall unchanged since the prior study. Mild vascular congestion is noted, but more pronounced than on the prior study in might be consistent with mild degree of volume overload. No focal consolidations to suggest infectious process demonstrated.


SubjectID: 18797174, StudyID: 53729541, Comparison: None

WET READ: ___ ___ ___ 12:38 AM Newly placed NG tube and tip traverses the diaphragm and projects over the expected region of the stomach. In the side port is probably in the region of the GE junction. I would recommend advancing this tube by about 5 cm to ensure that is in the lumen of the stomach. Aeration of the lungs is probably slightly decreased from the prior exam. An there is probably slight increase in atelectasis and edema. Otherwise, no significant change. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with new small bowel obstruction s/p NGT placement. // evaluate for NGT placement evaluate for NGT placement

IMPRESSION: Comparison ___. Newly placed nasogastric tube. The tip projects over the middle parts of the stomach. The tube should be advanced by another 5 cm to be securely positioned. Decrease in lung volumes. Moderate cardiomegaly. Mild fluid overload. Unchanged position of the left internal jugular vein catheter.


SubjectID: 18797174, StudyID: 52684653, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with concern for worsening heart failure // Please evaluate for pulmonary edema Please evaluate for pulmonary edema

COMPARISON: Prior chest radiographs ___ motor, most recently ___.

IMPRESSION: Mild pulmonary edema has changed in distribution, not in overall severity. Small to moderate right pleural effusion stable. Small left pleural effusion and left basal atelectasis also unchanged. Moderate cardiomegaly stable. No pneumothorax. Left jugular line ends in the low SVC. Nasogastric feeding feeding tube passes into the stomach and out of view


SubjectID: 18797174, StudyID: 52563161, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with volume overload // pulm edema

COMPARISON: Radiograph since ___

IMPRESSION: Support lines and tubes are unchanged in position. Heart size is enlarged but stable. There remains mild pulmonary edema and a left retrocardiac opacity   Keywords: remains. There is a small left-sided pleural effusion, stable. There are no pneumothoraces.


SubjectID: 18798373, StudyID: 58560917, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with hx CHF, dyspnea and hypoxia // Eval for acute process

COMPARISON: ___.

IMPRESSION: As compared to the previous image, no relevant change is seen   Keywords: no relevant change. Mild to moderate pulmonary edema. No pleural effusions. No pneumonia. Borderline size of the cardiac silhouette. Moderate tortuosity of the descending aorta.


SubjectID: 18798373, StudyID: 50265956, Comparison: None

WET READ: ___ ___ ___ 8:07 AM There is slightly improved aeration compared to the prior study. Mild to moderate pulmonary edema is again seen.

WET READ VERSION #1 ___ ___ ___ 7:03 PM There is slightly improved aeration compared to the prior study. Mild to moderate pulmonary edema is again seen. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with labored breathing, CHF // ? pneumonia, interval change in pleural edema ? pneumonia, interval change in pleural edema

IMPRESSION: In comparison with the study ___ ___, the patient has taken a better inspiration. There is continued enlargement of the cardiac silhouette with mild to moderate pulmonary vascular congestion. No evidence of acute focal pneumonia.


SubjectID: 18823293, StudyID: 58713430, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with cough // please assess for PNA v. pulmonary edema

COMPARISON: Chest x-ray from ___ at 01:44

FINDINGS: Compared to the prior study, vascular plethora and vascular blurring has increased, consistent with increasing CHF   Keywords: increase. Increased retrocardiac opacity, consistent with left lower lobe collapse and/or consolidation, is similar to the prior study. Patchy opacity at the right lung base is also similar. Minimal blunting of the right costophrenic angle is consistent with a small right pleural effusion. Presence of a small left effusion cannot be excluded. The cardiomediastinal silhouette is enlarged, but grossly unchanged. Again seen is a left-sided pacemaker, with lead tips over the right ventricle. Probable background COPD. Linear density to left of the trachea at the level of the thoracic inlet likely represents vascular calcification.

IMPRESSION: 1. Increase in the degree of vascular congestion, compared 1 day earlier, consistent with increasing CHF   Keywords: increase. 2. Bibasilar opacities, without significant interval change. This likely represents atelectasis, but an early pneumonic infiltrate would be difficult to exclude.


SubjectID: 18823293, StudyID: 57843866, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with continued hypoxia and cough // please eval pulm edema and for PNA

IMPRESSION: As compared to ___, cardiomegaly and pulmonary vascular congestion are accompanied by a resolving interstitial edema   Keywords: resolving. Residual asymmetrical opacity in right infrahilar region may reflect resolving asymmetrical edema, secondary process such as infection is also possible in the appropriate clinical setting   Keywords: resolving.


SubjectID: 18823293, StudyID: 52784031, Comparison: -1.0

FINAL REPORT

EXAMINATION: PORTABLE AP CHEST RADIOGRAPH

INDICATION: ___ year old man with CHF and hypoxia (o2 sat low 90s). Evaluate for pulmonary edema.

COMPARISON: Chest radiograph dated ___ and ___.

FINDINGS: Slight blunting of the lateral left hemidiaphragm is more conspicuous on today's exam compared to ___ in ___, suggesting slight increase in atelectasis and probable trace left pleural effusion if present. Lung volumes remain low. The heart size is slightly larger than the prior exam, now moderately to severely enlarged. Moderate pulmonary vascular congestion and dependent edema is overall unchanged   Keywords: unchanged. Transvenous pacing lead is unchanged in position. No pneumothorax.

IMPRESSION: Slight interval increase in cardiomegaly with overall unchanged dependent edema and trace, if any, left pleural effusion   Keywords: increase.


SubjectID: 18823293, StudyID: 52052826, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF exacerbation, CAP, with new hypoxia // ? eval pulm edema, infiltarate evolution

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Cardiomegaly is substantial. Interstitial opacities in the lung lower aspect are similar to previous study, consistent with vascular congestion   Keywords: similar. Bibasal atelectasis is noted. No progression of pulmonary edema demonstrated   Keywords: progression. No pneumothorax.


SubjectID: 18823293, StudyID: 57551685, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with afib, multiple medical comorbidities and mild tachypnea, please assess for pulmonary edema given hx of it. // assess for pulmonary edema assess for pulmonary edema

COMPARISON: Prior chest radiographs most recently ___.

IMPRESSION: Previous moderate pulmonary edema has improved   Keywords: improve. Cardiomegaly is severe, pulmonary arteries and mediastinal veins are dilated indicating biventricular component of heart failure. Transvenous right ventricular pacer lead follows the expected course from the left pectoral pacemaker. No pneumothorax. Pleural effusion small if any.


SubjectID: 18823293, StudyID: 54563016, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (AP AND LAT)

INDICATION: ___M with need for mri // patient pre-op. has pacemaker. for mri

COMPARISON: Prior exam from same day

FINDINGS: AP semi upright and lateral views of the chest provided. There is a left chest wall pacer device with a single lead extending into the region of the right ventricle. The heart remains moderately enlarged. There is mild pulmonary edema. No large effusion is seen. No pneumothorax. Mediastinal contour is prominent likely reflecting an unfolded thoracic aorta. No acute bony abnormalities. A punctate hyperdensity within the soft tissues of the right axilla may represent a calcification.

IMPRESSION: Cardiomegaly, mild pulmonary edema and pacemaker in place.


SubjectID: 18823293, StudyID: 56256379, Comparison: same

FINAL REPORT

INDICATION: ___-year-old man with cough, evaluate for pneumonia.

COMPARISON: Comparison is made to chest radiograph from ___.

TECHNIQUE AP and lateral view of the chest.

FINDINGS: Transvenous right pacer lead follows the expected course into the right ventricle. Moderate to severe cardiomegaly is unchanged. Prominence of the pulmonary vasculature, is unchanged, and compatible with mild vascular congestion   Keywords: unchanged. There is no focal lung consolidation. There is no pleural effusion or pneumothorax.

IMPRESSION: Unchanged appearance of the chest with moderate to severe cardiomegaly and mild vascular congestion   Keywords: unchanged appearance. No focal consolidation.


SubjectID: 18826099, StudyID: 59419728, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with respiratory failure, ESRD, shock, pneumonia // eval for interval change

TECHNIQUE: Single portable semi erect frontal image of the chest.

COMPARISON: Comparison is made with chest radiographs from ___ and ___.

FINDINGS: There are low lung volumes. There is mild interstitial edema. Dense bibasilar consolidations are seen, which may represent atelectasis or pneumonia. The mediastinum is chronically widened due to known adenopathy. No pneumothorax is seen. Moderate cardiomegaly is again noted.

IMPRESSION: 1. Dense bibasilar consolidations, which may represent atelectasis or pneumonia. 2. Mild interstitial edema.


SubjectID: 18826099, StudyID: 52744721, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman with hypoxic respiratory failure, status post intubation. Evaluate for any interval changes.

FINDINGS: Comparison is made to previous study from ___. Endotracheal tube, right IJ central line, enteric tube and median sternotomy wires are unchanged in position allowing for differences in technique and patient positioning.


SubjectID: 18826099, StudyID: 59388314, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: Ms. ___ is a ___ year old woman with a PMHx of ESRD on HD(___), CLL, ESRD on HD, OSA on CPAP, COPD on home O2, CAD s/p CABG, s/p bioprosthetic MVR, frequent URIs who presents with a lobar pneumonia and volume overload with in hospital PEA Arrest, s/p extubation now with worsened hypoxia to ___% on nighttime CPAP // eval interval change

COMPARISON: ___.

IMPRESSION: No relevant change as compared to the previous examination   Keywords: no relevant change. Sternal wires in constant position. Clips of the CABG. The left internal jugular vein catheter is constant. Moderate cardiomegaly with a large retrocardiac atelectasis as well as a likely small left pleural effusion are constant. Minimal platelike atelectasis at the right lung bases is unchanged. No evidence of new focal parenchymal opacities   Keywords: new. No overt pulmonary edema.


SubjectID: 18826099, StudyID: 56621502, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: Ms. ___ is a ___ year old woman with a PMHx of ESRD on HD(___), CLL, ESRD on HD, OSA on CPAP, COPD on home O2, CAD s/p CABG, s/p bioprosthetic MVR, frequent URIs who presents with a lobar pneumonia and volume overload with in hospital PEA Arrest. Extubated, worsened respiratory status // interval change

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the current image does not include parts of the left hemi thorax. In the interval the patient has been intubated and a nasogastric tube was removed. The appearance of the right heart border and of the right basal hemithorax is unchanged.


SubjectID: 18826099, StudyID: 56537160, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman on cpap with increased WOB // interval change?

COMPARISON: ___, 04:13

IMPRESSION: On the current image, the patient is severely rotated to the left, causing distortion of the image. There is no apparent change in appearance of the cardiac silhouette and the likely present left pleural effusion, combines to left basilar atelectasis. The pre-existing small areas of atelectasis at the right lung basis have improved. Unchanged position of the left central venous access line.


SubjectID: 18826099, StudyID: 55935304, Comparison: better

FINAL REPORT

INDICATION: ___ year old woman with resp distress s/p intubation, evaluate endotracheal tube position.

TECHNIQUE: Portable chest radiograph.

COMPARISON: Chest radiographs from ___ or ___.

FINDINGS: Since prior, patient has been intubated with an endotracheal tube ending approximately 3.5 cm above the carina. Other monitoring and support devices are unchanged in position. There is no change to large left lower lung opacification, which likely represents a combination of pleural effusion and atelectasis. Basilar atelectasis on the right is stable. There has been mild improvement of vascular congestion   Keywords: improve. There is no pneumothorax.

IMPRESSION: Endotracheal tube ends approximately 3.5 cm above the carina. Mild improvement of vascular congestion   Keywords: improve.


SubjectID: 18826099, StudyID: 58944890, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: New leukocytosis, questionable pneumonia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is mild regression of the pre-existing parenchymal opacities at the lung bases. Simultaneously, there is a slight decrease in severity of the pre-existing signs of fluid overload, although signs of mild pulmonary edema are still clearly present   Keywords: still. Moderate cardiomegaly, unchanged alignment of sternal wires. Unchanged small left pleural effusion.


SubjectID: 18826099, StudyID: 54089397, Comparison: better

FINAL REPORT

HISTORY: CHF and COPD exacerbation, resolving on dialysis.

IMPRESSION: PA and lateral chest compared to ___: Pulmonary vascular congestion has improved slightly since ___   Keywords: improve. I do not believe there is pulmonary edema. Peribronchial infiltration in the lower lobe is seen, best on the lateral view. It is more abnormal than it was in ___, could represent either bronchial inflammation due to aspiration or residual edema. The mass-like lesion in the lingula was shown on the ___, chest CT to have decreased in size since ___, presumably persistent atelectasis. Severe cardiomegaly is longstanding. Overall, findings suggest long-term borderline cardiac decompensation, but no convincing evidence of acute decompensation or pneumonia.


SubjectID: 18826099, StudyID: 53279429, Comparison: None

FINAL REPORT

EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___ year old female with shortness of breath, AP upright and lateral views for better evaluation.

COMPARISON: ___ at 10:47.

FINDINGS: AP upright and lateral views of the chest were obtained. Per the radiology technologist, the patient was falling asleep during the examination and cannot hold head up for optimal AP exam. The patient's chin overlies the medial lung apices, partially obscuring the view. Underpenetration of the lung bases persists due to overlying soft tissue. There is pulmonary vascular congestion and bibasilar atelectasis. Thickening of the minor fissure persists. Lung base patchy opacity seen on the lateral view could relate to fluid overload, not well appreciated on the frontal view, although underlying consolidation may be present. The cardiac silhouette remains enlarged. Mediastinal and hilar contours are stable. No pleural effusion or pneumothorax is seen.

IMPRESSION: Suboptimal as above. Lung base patchy opacity seen on the lateral view could relate to fluid overload, not well appreciated on the frontal view, although underlying consolidation may be present. Cardiac silhouette remains enlarged.


SubjectID: 18826099, StudyID: 51534572, Comparison: None

FINAL REPORT

EXAM: Chest single frontal view. CLINICAL INFORMATION: ___-year-old female with history of chest pain, shortness of breath.

COMPARISON: ___.

FINDINGS: Thickening of the right minor fissure is again seen. There is enlargement of the cardiac silhouette again seen, which partially obscures the left lung base. Overlying soft tissue also used to underpenetration of the lung bases. Mild pulmonary vascular congestion. No definite focal consolidation, pleural effusion, or pneumothorax is seen. Mediastinal and hilar contours are stable.

IMPRESSION: Pulmonary vascular congestion. 2) Enlargement of the cardiac silhouette which partially obscures the left lung base although no definite focal consolidation, pleural effusion, or pneumothorax seen. Dedicated PA and lateral views may be helpful for further evaluation.


SubjectID: 18828251, StudyID: 59257021, Comparison: None

FINAL REPORT

HISTORY: ___-year-old male with cough and shortness of breath. STUDY: PA and lateral chest radiograph.

COMPARISON: ___. ___

FINDINGS/

IMPRESSION: The heart size is enlarged similar to prior study. Its rounded shape raises a question of cardiomyopathy and less likely pericardial effusion. Sternotomy wi


SubjectID: 18828251, StudyID: 50037292, Comparison: None

FINAL REPORT

INDICATION: Chest pain.

COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: The patient is status post median sternotomy and CABG. The heart remains moderate to severely enlarged. The mediastinal contours are stable with aortic knob calcifications visualized. There is consolidative opacity within the right lung, most pronounced within the right upper lobe. Additionally, ill-defined hazy opacity is noted within the left perihilar region. There is no pleural effusion or pneumothorax visualized. Mild degenerative changes are seen within the thoracic spine.

IMPRESSION: 1. Consolidative opacity within the right upper lobe is concerning for pneumonia. 2. Hazy opacity within the right lung base as well as within the left perihilar region may reflect superimposed pulmonary edema, though infection within the right lung base also is not excluded.


SubjectID: 18847983, StudyID: 55478640, Comparison: same

FINAL REPORT

HISTORY: ___-year-old male with fall in the setting of syncope. Evaluate for pneumonia.

TECHNIQUE: Frontal and lateral views of the chest.

COMPARISON: Multiple prior chest radiographs, most recently of ___.

FINDINGS: Moderate to severe cardiomegaly is similar to prior. There is persistent prominence of the pulmonary vascular markings, compatible with mild vascular congestion   Keywords: persistent. No focal consolidation, pleural effusion, or pneumothorax. Sternotomy wires are intact. Numerous CABG clips are present.

IMPRESSION: Stable cardiomegaly with mild vascular congestion   Keywords: stable. No focal consolidation or pulmonary edema.


SubjectID: 18847983, StudyID: 57191196, Comparison: worse

FINAL REPORT

HISTORY: CHF exacerbation.

FINDINGS: In comparison with study of ___, there are lower lung volumes in this patient who has undergone a prior CABG procedure. Continued cardiomegaly with increased pulmonary vascular congestion, the appearance of which may be enhanced by the low lung volumes   Keywords: increase. Mild bibasilar atelectasis persists.


SubjectID: 18847983, StudyID: 55830360, Comparison: same

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___ radiograph.

FINDINGS: The patient is status post previous median sternotomy and coronary artery bypass surgery. Stable cardiomegaly and persistent upper zone vascular redistribution, accompanied by minimal interstitial edema   Keywords: persistent, stable. Marked improvement in bibasilar retrocardiac opacities likely due to atelectasis. Small pleural effusions have improved since the recent radiograph.


SubjectID: 18855412, StudyID: 57112935, Comparison: same

FINAL REPORT

HISTORY: New pacemaker implant. Evaluate for pneumothorax and lead placement.

COMPARISON: ___.

FINDINGS: Frontal and lateral radiographs of the chest again demonstrate a left chest wall ___ ICD device with a single lead terminating in the right ventricle. No pneumothorax is identified. Again noted is a tortuous and enlarged ascending and descending aorta. Again noted are the interstitial abnormalities most prominent in the left upper lobe and right middle to lower lobes   Keywords: again. Cardiomegaly is again seen. Midline sternotomy wires are intact. No pleural effusions identified.

IMPRESSION: Newly placed ___ ICD device with single lead in the right ventricle. No evidence of pneumothorax. Otherwise, unchanged exam compared to the prior radiograph.


SubjectID: 18855412, StudyID: 56672759, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: Chest, AP portable single view.

INDICATION: ___-year-old male patient with new ICD device implanted, evaluate for pneumothorax and lead placement.

FINDINGS: AP single view of the chest has been obtained with patient in semi-upright position. Analysis is performed in direct comparison with the next preceding similar study of ___. Status post sternotomy and moderate cardiac enlargement as before. Again noted is a general widening and elongation of the thoracic aorta, but absence of any local contour abnormalities is absurd. Interstitial pulmonary abnormalities prominent in left upper lobe area and mid portion of right lung appear unchanged. No evidence of new acute pulmonary abnormalities is present and the lateral pleural sinuses remain free. A permanent pacer is now seen in left anterior axillary position being connected to one intracavitary electrode reaching the right atrial area and pointing with its tip towards the tricuspid area and probably entering the proximal portion of the lower right ventricle. The tip position is somewhat unusual as it does not reach far out in the apical area of the right ventricle. Appropriate contact with right ventricular myocardium must be assessed flioroscopically during the placement of electrode. Referring physician, ___, M.D. was paged at 3:30 p.m.


SubjectID: 18855412, StudyID: 50390234, Comparison: worse

WET READ: ___ ___ 5:24 PM Endotracheal tube tip in standard position. Orogastric tube tip is seen to the level of the gastroesophageal junction, but not clearly seen below the diaphragm. Consider dedicated AP view of the abdomen for further assessment of the tip of the orogastric tube. Mild pulmonary edema, worse compared to 11:03 today   Keywords: worse. Patchy opacities in the lung upper lobes, more pronounced on the left, may reflect areas of infection or aspiration. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with intubation.

TECHNIQUE: Supine AP view of the chest

COMPARISON: ___ at 14:34 and 11:03

FINDINGS: Assessment is somewhat limited by patient rotation. An endotracheal tube tip terminates approximately 3.6 cm from the carina. Orogastric tube tip is seen coursing inferiorly below the diaphragm though the tip is not well seen. Patient is status post median sternotomy and CABG. Left-sided AICD/ pacemaker device is noted with single lead terminating in the region of the right ventricle. Heart is moderately enlarged with a left ventricular predominance. The aorta remains tortuous. There is mild pulmonary edema, which has progressed since ___:03 today   Keywords: progressed. More focal ill-defined opacities within the upper lobes bilaterally, greater on the left, may reflect areas of aspiration or infection. No pneumothorax is identified, and no pleural effusion is seen.

IMPRESSION: 1. Endotracheal tube tip in standard position. Orogastric tube courses below the diaphragm. While the tip is not well seen, it is likely within the stomach. 2. Mild pulmonary edema, worse compared to 11:03 today. 3. Patchy opacities in the lung upper lobes, more pronounced on the left, may reflect areas of infection or aspiration.


SubjectID: 18855412, StudyID: 50024420, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF s/p AICD // Pulmonary edema vs aspiration? Pulmonary edema vs aspiration?

IMPRESSION: In comparison with the outside study of ___, there is now an endotracheal tube in place with its tip approximately 4.3 cm above the carina. Nasogastric tube extends well into the stomach. Single lead pacer device extends to the right ventricle. There is enlargement of the cardiac silhouette with pulmonary vascular congestion. In the appropriate clinical setting, the possibility of superimposed aspiration would have to be considered, especially in the left upper and left lower lung zones.


SubjectID: 18870530, StudyID: 58746394, Comparison: None

FINAL REPORT

STUDY: PA and lateral chest, ___. CLINICAL

HISTORY: ___-year-old woman with left axillary seroma, now status post percutaneous drain placement. Evaluate for pneumothorax.

FINDINGS: Comparison is made to prior study from ___. Heart size is upper limits of normal. Lungs are grossly clear without focal consolidation, pleural effusions or pulmonary edema. There are bubbles of gas in the left axilla consistent with a seroma. On the lateral view, a single catheter is seen projecting over the anterior heart. There is some wedging of several thoracic vertebral bodies on the lateral view. No abnormal antero- or retrolisthesis is seen.


SubjectID: 18870530, StudyID: 55219954, Comparison: None

WET READ: ___ ___ ___ 4:32 PM Increased opacity projecting over the right upper lobe, best seen on the lateral view could represent pneumonia in the proper clinical setting. ______________________________________________________________________________

FINAL REPORT

HISTORY: ___-year-old female with fever postop.

COMPARISON: None.

FINDINGS: PA and lateral views of the chest. There is increased opacity, best seen on the lateral view, localizing to the right upper lobe. There is no effusion or pulmonary vascular congestion. Subcutaneous gas projects over the left axilla compatible with patient's history of recent partial mastectomy. Osseous structures are unremarkable.

IMPRESSION: Increased opacity projecting over the right upper lobe, best seen on the lateral view could represent pneumonia in the proper clinical setting.


SubjectID: 18872738, StudyID: 59732633, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with AV block s/p dual chamber pacemaker via L subclavian vein // pneumothorax, lead position

COMPARISON: ___.

IMPRESSION: No change in position of the left pectoral pacemaker. 1 lead continues to project over the right atrium and 1 over the right ventricle. Low lung volumes. No pneumothorax. Minimal bilateral pleural effusions, best appreciated on the lateral image.


SubjectID: 18872738, StudyID: 55844107, Comparison: None

WET READ: ___ ___ 9:38 AM 1. No pneumothorax. 2. Low lung volumes results in bronchovascular crowding. 3. Mild pulmonary vascular congestion. 4. Stable cardiomegaly. 5. Dual lead pacemaker device present, with leads ending in the region of the right atrium and right ventricle.

WET READ VERSION #1 ___ ___ 8:20 PM 1. No pneumothorax. 2. Low lung volumes results in bronchovascular crowding. 3. Mild pulmonary vascular congestion. 4. Stable cardiomegaly. 5. Dual lead pacemaker device present, with leads ending in the region of the right atrium and right ventricle. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with AV block s/p dual chamber pacemaker via L subclavian vein // pneumothorax

COMPARISON: ___, 12:49

IMPRESSION: As compared to the previous radiograph, the patient has received a left pectoral pacemaker. 1 lead projects over the right atrium and 1 over the right ventricle. No evidence of pneumothorax or other complication. No pulmonary edema. Moderate cardiomegaly. No pleural effusions.


SubjectID: 18872738, StudyID: 55021882, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with bradycardia, cough

TECHNIQUE: Portable semi-upright AP view of the chest

COMPARISON: ___ chest radiograph, ___ chest CT

FINDINGS: Study is slightly limited by motion. Heart size remains moderately enlarged. A moderate sized hiatal hernia is again noted. The mediastinal contour is unchanged. Low lung volumes are present with crowding of the bronchovascular structures. Mild pulmonary vascular congestion is likely present. No focal consolidation, pleural effusion or pneumothorax is seen. No acute osseous abnormality is detected.

IMPRESSION: Low lung volumes with mild pulmonary vascular congestion.


SubjectID: 18872738, StudyID: 56782988, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with cvl placement // eval cvl placement

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___ at 13:13

FINDINGS: Right internal jugular central venous catheter is seen terminating in the low SVC/ cavoatrial junction without evidence of pneumothorax. Dual lead left-sided pacer device is similar in position. There has been interval development of obscuration of the left hemidiaphragm, given short term interval, may be due to atelectasis or aspiration. The cardiac silhouette remains enlarged. Mediastinal contours are unremarkable. There is central pulmonary vascular engorgement.

IMPRESSION: Interval placement of right IJ central venous catheter terminating in the low SVC/ cavoatrial junction without evidence of pneumothorax. Increased obscuration of the left hemidiaphragm/left base opacity, given short term interval, may be due to atelectasis or aspiration. Central pulmonary vascular engorgement.


SubjectID: 18872738, StudyID: 52830858, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with sob // ? pna

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: 2 left-sided pacemaker is again seen with leads extending the expected positions of the right atrium and right ventricle. The cardiac silhouette remains enlarged. The aortic knob is calcified. There are relatively low lung volumes. Some patient motion is seen to the lower right hemi thorax. Blunting of the left costophrenic angle may be due to overlying soft tissues, but a trace pleural effusion is not excluded. No pneumothorax is seen.

IMPRESSION: Slight blunting of the left costophrenic angle may be due to overlying soft tissue but a trace pleural effusion is not excluded.


SubjectID: 18891561, StudyID: 59778028, Comparison: worse

FINAL REPORT

PORTABLE CHEST FILM ___ AT 12:49 A.M. CLINICAL

INDICATION: ___-year-old with shortness of breath, question pneumonia, question pulmonary edema. Comparison is made to the patient's prior study of ___ at ___. Portable semi-supine chest film ___ at 12:49 a.m. is submitted.

IMPRESSION: 1. A single-lead left-sided pacer remains in position. The heart remains enlarged, most likely reflecting cardiomegaly, although pericardial effusion cannot be entirely excluded. Overall, there is increased haziness to the lungs, which would favor an element of superimposed interstitial edema, although there does not appear to be substantial peribronchial cuffing   Keywords: increase. There is likely a small left effusion. The retrocardiac area is not well visualized and therefore consolidation in this area cannot be excluded. No pneumothorax. Evidence of a prior right-sided rotator cuff repair. Persistent superior subluxation of the right glenohumeral joint with narrowing of the acromiohumeral distance.


SubjectID: 18891561, StudyID: 50360134, Comparison: same

FINAL REPORT

TYPE OF

EXAMINATION: Chest PA and lateral.

INDICATION: ___-year-old female patient with dementia, frequent delirium, recent fall and history of restrictive lung disease, evaluate for acute process.

FINDINGS: Patient's condition required examination in sitting position using AP frontal and left lateral views. Comparison is made with the next preceding similar study of ___. The chest findings have not undergone any significant interval alteration. Thus, marked cardiac enlargement, permanent pacer in left-sided position connected to a single intracavitary electrode terminating in the right ventricle, chronic pulmonary congestion and moderate amount of bilateral pleural effusions accumulating in the lateral and posterior pleural sinuses. There is no pneumothorax in the apical area. Lateral view discloses linear densities in the posterior segments of the lower lobes compatible with atelectasis. These findings have not undergone any significant interval change. General osteopenic appearance of skeletal structures. No evidence of pneumothorax in the apical area on the frontal view. Comparison with yesterday's examination, no significant interval change   Keywords: no significant interval change.


SubjectID: 18891561, StudyID: 57094770, Comparison: None

FINAL REPORT

EXAM: CHEST, AP UPRIGHT AND LATERAL VIEWS. CLINICAL INFORMATION: History of intracranial hemorrhage, presenting with altered mental status. Frontal and lateral views of the chest were obtained. There are bilateral pleural effusions with overlying atelectasis. There is mild interstitial edema. The cardiac silhouette is enlarged. The aorta is tortuous and unfolded. There is a single-lead left-sided pacemaker with leads in the expected position of the right ventricle. The bones are diffusely osteopenic.

IMPRESSION: Bilateral pleural effusions with overlying atelectasis. Moderate-to-severe enlargement of the cardiac silhouette and minimal interstitial edema suggests fluid overload.


SubjectID: 18902344, StudyID: 57077110, Comparison: None

FINAL REPORT

PORTABLE CHEST: ___

HISTORY: ___-year-old male with weight gain and shortness of breath. Question fluid overload.

FINDINGS: Single AP portable view of the chest is compared to previous exam from ___. Exam is limited secondary to underpenetration. The lungs appear hyperinflated. There is right basilar opacity, more conspicuous than on prior exam, which correlates with prominent mediastinal fat when compared to previous CT of the abdomen and pelvis from ___. Superiorly, the lungs are clear. There is no frank evidence of pulmonary vascular congestion. Cardiomediastinal silhouette is unchanged. Osseous and soft tissue structures are difficult to assess given technique.

IMPRESSION: Limited portable exam without definite acute cardiopulmonary process.


SubjectID: 18902344, StudyID: 51579117, Comparison: None

FINAL REPORT

PORTABLE CHEST X-RAY, ___

COMPARISON: ___ radiograph.

FINDINGS: Cardiac silhouette is upper limits of normal in size and is accompanied by mild pulmonary vascular congestion. A hazy opacity lateral to the right heart border is difficult to compare to the prior study due to projectional differences, but may correspond to a large fat collection on prior CT of ___, either a fat-containing Morgagni hernia or an extremely large pericardial fat pad. If pneumonia is suspected clinically, standard PA and lateral chest radiographs may be helpful to exclude the possibility of associated right lower lobe parenchymal process in this region.


SubjectID: 18902344, StudyID: 54426412, Comparison: worse

FINAL REPORT

PORTABLE CHEST X-RAY ___

COMPARISON: ___ chest radiograph.

FINDINGS: Support and monitoring devices are unchanged in position. Persistent cardiomegaly, pulmonary vascular congestion and slight worsening interstitial edema   Keywords: worse. Peripheral area of consolidation in right apex is unchanged and could be related to an infectious pneumonia in the appropriate clinical setting. Small pleural effusions are similar to the prior study.


SubjectID: 18902344, StudyID: 53331412, Comparison: 1.0

FINAL REPORT

PORTABLE CHEST X-RAY, ___

COMPARISON: ___ radiograph.

FINDINGS: Tip of the endotracheal tube terminates 6.3 cm above the carina. Nasogastric tube is also in place, but tip is not confidently visualized on this exam. Left internal jugular catheter continues to terminate in left brachiocephalic vein. Cardiomediastinal contours are stable in appearance allowing for rightward patient's rotation. As compared to prior study, interstitial edema has improved, and an area of peripheral consolidation at the right lung apex is no longer visualized   Keywords: improve. Otherwise, no relevant changes   Keywords: no relevant change.


SubjectID: 18905773, StudyID: 59334748, Comparison: worse

FINAL REPORT

AP CHEST, 3:59 A.M., ___

HISTORY: Worsening pneumonia, suspect pneumothorax.

IMPRESSION: AP chest compared to ___, 3:10 p.m.: Mild interstitial edema is new, moderate right and small left pleural effusion have increased, obscuring right heart border   Keywords: new. Dual-channel right supraclavicular central venous line ends in the SVC mid and low portions. No pneumothorax.


SubjectID: 18905773, StudyID: 59309893, Comparison: worse

FINAL REPORT

AP CHEST, 4:30 A.M., ___

HISTORY: Pulmonary edema. End-stage renal disease, on hemodialysis. Check ET tube placement.

IMPRESSION: AP chest compared to ___: Mild-to-moderate pulmonary edema has probably worsened since 3:40 a   Keywords: worse.m. Apparent decrease in the previously large right pleural effusion may be a function of supine positioning, but given the appropriate history, could be due to interval thoracentesis. There is no evidence of pneumothorax. Mild cardiomegaly is stable. Endotracheal tube is in standard placement. Dual-channel dialysis catheter ends in the low SVC and upper right atrium. Nasogastric tube passes below the diaphragm and out of view.


SubjectID: 18905773, StudyID: 53603256, Comparison: None

FINAL REPORT

AP CHEST, 3:40 A.M. ON ___

HISTORY: End-stage renal disease, on hemodialysis. CHF. Cough.

IMPRESSION: AP chest compared to ___: Borderline interstitial edema, large right pleural effusion, severe cardiomegaly, moderate left pleural effusion are all unchanged since ___. There is no pneumothorax. Dialysis catheter ends in the low SVC and upper right atrium.


SubjectID: 18905773, StudyID: 58220924, Comparison: None

FINAL REPORT

HISTORY: AFib with RVR, question pulmonary edema.

TECHNIQUE: AP semi upright portable chest radiograph.

COMPARISON: ___

FINDINGS: Single view of the chest was provided. Lung volumes are markedly low and patient's chin obscures the lung apices. Given the limitations, there are bilateral pleural effusions with bibasilar atelectasis. There is mild interstitial edema.

IMPRESSION: Bilateral effusions and lower lung opacity is likely atelectasis with mild interstitial edema. Markedly limited exam.


SubjectID: 18905773, StudyID: 57925248, Comparison: same

FINAL REPORT

AP CHEST, 12:19 A.M., ___.

HISTORY: ___-year-old woman in respiratory distress with pericardial effusion. Check ET tube placement.

IMPRESSION: AP chest compared to ___ at 9:47 p.m.: Tip of the new endotracheal tube is in standard placement. Lung volumes are low, but improved. Moderate bilateral pleural effusions and pulmonary vascular engorgement are unchanged and the cardiac silhouette is very large, due substantially to hemopericardium is seen on the torso CT an hour earlier, which also documents moderate bilateral pleural effusions and severe lower lobe atelectasis, and moderate-to-severe emphysema, but no pneumonia or pulmonary edema   Keywords: unchanged. It also shows an esophagus distended with fluid, which could predispose to aspiration.


SubjectID: 18905773, StudyID: 57433694, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Hemodialysis, fever, questionable pneumonia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is increasing density at the right lung base, potentially reflecting early pneumonia. The signs indicative of fluid overload have decreased in severity   Keywords: decrease. Minimal retrocardiac atelectasis. Unchanged moderate cardiomegaly and bilateral pleural effusions. The monitoring and support devices are constant.


SubjectID: 18905773, StudyID: 56290874, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Hypercarbic respiratory failure, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Constant monitoring and support devices, constant relatively low lung volumes and moderate cardiomegaly. Mild bilateral pleural effusions with signs of mild-to-moderate fluid overload and areas of atelectasis at both lung bases.


SubjectID: 18936722, StudyID: 58513277, Comparison: worse

FINAL REPORT

INDICATION: Shortness of breath and tachypnea.

COMPARISON: Chest radiograph from ___.

TECHNIQUE: Frontal chest radiograph.

FINDINGS: A left PICC terminates at the cavoatrial junction. Moderate bilateral pleural effusions are unchanged. Central pulmonary vascular congestion and mild to moderate pulmonary edema have worsened since ___   Keywords: worse. There is no pneumothorax. The cardiac and mediastinal contours are unchanged.

IMPRESSION: Worsened mild-to-moderate pulmonary edema   Keywords: worse. Unchanged bilateral moderate pleural effusions.


SubjectID: 18936722, StudyID: 58137881, Comparison: worse

FINAL REPORT

INDICATION: Shortness of breath and hypotension. Concern for pulmonary edema.

COMPARISON: Chest radiograph from ___ at 5:56.

TECHNIQUE: Frontal chest radiograph.

FINDINGS: Small bilateral pleural effusions are slightly enlarged since the 5:56 AM examination. There is new pulmonary vascular congestion and mild pulmonary edema   Keywords: new. A left-sided PICC terminates at the lower SVC. There is no pneumothorax.

IMPRESSION: New central pulmonary vascular congestion and mild pulmonary edema, with slight enlargement of small bilateral pleural effusions   Keywords: new.


SubjectID: 18936722, StudyID: 51842722, Comparison: None

FINAL REPORT

INDICATION: Shortness of breath.

COMPARISON: Chest radiograph from ___.

TECHNIQUE: On frontal chest radiograph.

FINDINGS: A left-sided PICC terminates at the lower SVC. The heart size is normal. The hilar and mediastinal contours are within normal limits. A moderately calcified aortic arch is unchanged. Small bilateral pleural effusions are markedly decreased in size since the ___ examination. There is no vascular congestion or pulmonary edema. There is no pneumothorax or superimposed consolidation.

IMPRESSION: Marked interval decrease in size of bilateral pleural effusions, now small. No pulmonary vascular congestion. Normal heart size.


SubjectID: 18936722, StudyID: 58331383, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman s/p MVR Tv ring // eval pneumos eval pneumos

COMPARISON: Comparison to prior study dated ___ at 13 37

FINDINGS: PA and lateral views of the chest ___ at 11:38 are submitted.

IMPRESSION: Left subclavian PICC line unchanged in position. Overall cardiac mediastinal contours are stable. There continue to be layering bilateral effusions with associated patchy airspace disease likely reflecting compressive atelectasis. Lungs are hyperinflated consistent with underlying emphysema. No pulmonary edema. Small bilateral apical pneumothoraces which are less apparent on the current study when compared to prior suggesting possible interval decrease in size versus differences in positioning.


SubjectID: 18936722, StudyID: 57021220, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with mvr/tvr // r/o ptx, s/p ct d/c

TECHNIQUE: The and lateral views of the chest

COMPARISON: Study performed 7 hr earlier

IMPRESSION: Small bilateral pneumothoraces larger on the right have increased. Right chest tube has been removed. Vascular congestion has markedly improved   Keywords: improve. Bibasilar opacity is a combination of small effusions and atelectasis larger on the left are unchanged allowing the difference in positioning of the patient. Cardiomediastinal contours are unchanged. Left PICC tip is in the lower SVC. Patient has known emphysema


SubjectID: 18936722, StudyID: 55163854, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p MVR/TV ring // eval for progression of pneumothoraces in patient with a chest tube to water seal for several hours

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the known right apical pneumothorax is unchanged. A millimetric pneumothorax, that has newly appeared, is now seen on the left. Bilateral areas of basilar atelectasis are developing. The left PICC line and the right chest tube are in constant position. Moderate cardiomegaly persists.

NOTIFICATION: At the time of dictation and observation, 09:53, on the ___, the referring physician ___. ___ was paged for notification.


SubjectID: 18936722, StudyID: 52549603, Comparison: None

WET READ: ___ ___ ___ 9:19 AM Interval removal of left chest tube and endotracheal tube. Right chest tube is unchanged. Left PICC line terminates in the low SVC. Small right apical pneumothorax. No left pneumothorax. -___ discussed with ___ at 547PM on ___.

WET READ VERSION #1 ___ ___ ___ 5:50 PM Interval removal of left chest tube and endotracheal tube. Right chest tube is unchanged. Left PICC line terminates in the low SVC. Small right apical pneumothorax. No left pneumothorax. -___ discussed with ___ at 547PM on ___. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p MVR, TV ring // eval for pleural effusions, pneumothorax s/p chest tube removal

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the patient has been extubated. The nasogastric tube and the Swan-Ganz catheter were removed. Also removed is the left chest tube. There is a small right apical pneumothorax but no convincing evidence is seen for a left pneumothorax. Moderate cardiomegaly. No pleural effusions.


SubjectID: 18940953, StudyID: 58849648, Comparison: same

WET READ: ___ ___ 8:10 AM 1. No significant change. 2. Persistent moderate right pleural effusion with moderate pulmonary edema. 3. Right PICC tip again noted to be in right atrium, unchanged prior examination.

WET READ VERSION #1 ___ ___ ___ 9:54 PM 1. No significant change. 2. Persistent moderate right pleural effusion with moderate pulmonary edema. 3. Right PICC tip again noted to be in right atrium, unchanged prior examination. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with chf exacerbation // progression of pulmonary edema progression of pulmonary edema

IMPRESSION: In comparison with the study of ___, the left IJ catheter is been removed. Otherwise, little overall change   Keywords: little overall change. Again there is some elevation of pulmonary venous pressure with bilateral effusions and compressive basilar atelectasis, more prominent on the right.


SubjectID: 18940953, StudyID: 52211616, Comparison: same

FINAL REPORT

EXAMINATION: DX CHEST PORTABLE PICC LINE PLACEMENT

INDICATION: ___ year old woman with PICC that was in place, nurse changed dressing and feels PICC line is out more now // please eval for PICC placement please eval for PICC placement

IMPRESSION: In comparison with the study of ___, the tip of the left subclavian PICC line again extends to the region of the cavoatrial junction. Continued enlargement of the cardiac silhouette with pulmonary vascular congestion and substantial right pleural effusion with underlying compressive atelectasis   Keywords: continue. Possible small effusion with atelectasis at the left base is well.


SubjectID: 18940953, StudyID: 53502458, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with sepsis, status post left internal jugular central line placement

TECHNIQUE: Portable semi-upright AP view of the chest

COMPARISON: ___ at 21:13

FINDINGS: There has been interval placement of a left internal jugular central venous catheter with tip in the upper SVC. No pneumothorax is identified. Moderate to severe cardiomegaly is unchanged. There is moderate pulmonary edema, not substantially changed in the interval. The mediastinal and hilar contours are similar. Hazy opacification of the right hemi thorax towards the lung base likely reflects the presence of a layering pleural effusion. Bibasilar atelectasis is likely present.

IMPRESSION: Left internal jugular central venous catheter tip in the upper SVC. No pneumothorax. Re- demonstration of moderate pulmonary edema and layering right pleural effusion.


SubjectID: 18940953, StudyID: 53378568, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPH

INDICATION: History: ___F with dyspnea // infiltrate?

TECHNIQUE: Portable upright AP radiograph view the chest

COMPARISON: Chest radiograph dated ___

FINDINGS: Patient slightly rotated. Lung volumes are low. Bilateral increased pulmonary congestion with moderate edema is demonstrated   Keywords: increase. Opacity in the right lower lobe with silhouetting of the right hemidiaphragm likely reflects a combination of a small right pleural effusion, atelectasis, and edema. No pneumothorax. No appreciable left pleural effusion. No acute osseous abnormality. The heart is moderately enlarged, similar to the prior exam.

IMPRESSION: Findings most consistent with congestive heart failure and a right pleural effusion.


SubjectID: 18947160, StudyID: 59162437, Comparison: better

WET READ: ___ ___ ___ 10:34 PM R IJ terminates in upper SVC. No definite ptx although somewhat difficult to exclude given technical limitations. Decreased pulmonary edema. B/l pleural effusion, left greater than right, not appreciably changed from radiograph earlier the same day. ______________________________________________________________________________

FINAL REPORT

PA AND LATERAL CHEST ON ___

HISTORY: ___-year-old with CHF exacerbation. Possible cardiogenic shock. Look for pneumonia and Cordis line placement.

IMPRESSION: AP and lateral chest compared to ___ at 3:16 a.m.: Previous pulmonary vascular congestion has decreased   Keywords: decrease. Small right and small-to-moderate left pleural effusion persist and partially obscure what could be areas of consolidation in both lower lungs. Cardiac silhouette is moderately enlarged. Fullness in the mediastinum in the region of the pulmonary outflow tract raises the possibility of pulmonary hypertension. In addition to a possibility of pneumonia in both lower lobes, particularly the left, clinical attention should be paid to the possibility of pericardial effusion, although I see no evidence of elevated central venous pressure by way of mediastinal widening. Right internal jugular introducer ends at the junction of the brachiocephalic veins. There is no pneumothorax.


SubjectID: 18947160, StudyID: 53729842, Comparison: None

FINAL REPORT

CLINICAL INFORMATION: ___-year-old female with altered mental status.

COMPARISON: None.

FINDINGS: Portable frontal supine chest radiograph demonstrates left basilar opacity. There is linear atelectasis of the right lung base. Bilateral effusions are present, small on the right and moderate on the left. There is indistinctness of the pulmonary vasculature compatible with mild pulmonary edema. Heart size is enlarged, as is the main pulmonary artery. There is calcification of the aortic arch.

IMPRESSION: 1. Left base consolidation, likely representing pneumonia in the appropriate clinical setting. There are small bilateral pleural effusions. Recommend dedicated upright view when clinically able to document resolution. The differential diagnosis includes an obstructive mass, or large pulmonary embolus. 2. Mild cardiac decompensation. Findings were discussed with Dr. ___ ___ the MICU at 8:50AM by phone.


SubjectID: 18948084, StudyID: 59890544, Comparison: None

FINAL REPORT

HISTORY: ___-year-old male status post chest tube, evaluate for progression of pneumothorax.

COMPARISON: ___, ___.

FINDINGS: Portable upright chest radiograph demonstrates unchanged position of a right chest tube with its tip directed at the right lung hilus. A moderate loculated right pleural effusion has increased from ___, though remains smaller than seen on ___. Subsegmental bibasilar atelectasis is not significantly changed. A small component of hydropneumothorax persists apicolaterally. The cardiac silhouette remains markedly enlarged, a combination of cardiomegaly and pericardial effusion. The mediastinal contours are unchanged.

IMPRESSION: 1. Loculated right pleural effusion, increased from ___, though still smaller than seen on ___. 2. Enlargement of the cardiac silhouette is unchanged, the result of cardiomegaly and pericardial effusion.


SubjectID: 18948084, StudyID: 53452043, Comparison: None

FINAL REPORT

HISTORY: Chest tube for pleurodesis and to check for residual pneumothorax.

FINDINGS: In comparison with study of ___, there has been a substantial decrease in the amount of pleural fluid following placement of a chest tube and pleural drain. Some residual fluid persists. Small pneumothorax is seen in the apical region. There is prominence of the cardiac silhouette with mild indistinctness of pulmonary vessels suggesting some elevated pulmonary venous pressure. Retrocardiac opacification most likely represents atelectasis and effusion. However, in the appropriate clinical setting, supervening pneumonia would have to be considered.


SubjectID: 18948084, StudyID: 50934343, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST OF ___

COMPARISON: ___ radiograph.

FINDINGS: Right chest tube remains in place and may potentially be intrafissural based upon its course. A new pleural catheter has been placed inferiorly in the right hemithorax, and is associated with decrease in size of a loculated right pleural effusion. Small apicolateral hydropneumothorax component has also improved. Cardiac silhouette is enlarged but decreased in size from the prior examination. Bibasilar atelectasis is present, slightly better on the right in the interval, and a small left pleural effusion has decreased in size since the previous study.

IMPRESSION: Decreased size of loculated right pleural effusion following placement of new pleural catheter.


SubjectID: 18948084, StudyID: 59606928, Comparison: worse

FINAL REPORT

AP CHEST, 6:18 A.M., ___

HISTORY: Lymphoma. Rituxan therapy.

IMPRESSION: AP chest compared to ___ through ___: Moderate right pleural effusion has increased, pulmonary vascular congestion and mediastinal venous engorgement have increased since ___   Keywords: increase. Atelectasis at both lung bases is worse. Moderate to severe enlargement of the cardiac silhouette is chronic and unchanged. No pneumothorax.


SubjectID: 18948084, StudyID: 58013104, Comparison: None

FINAL REPORT

CHEST ON ___

HISTORY: Heart failure, effusion. REFERENCE EXAM: ___.

FINDINGS: There continues to be a moderately large right pleural effusion which is somewhat smaller on today's study than on the prior. The heart continues to be severely enlarged and there is mild pulmonary vascular re-distribution.


SubjectID: 18948084, StudyID: 53493409, Comparison: better

FINAL REPORT

PORTABLE UPRIGHT CHEST, ___.

COMPARISON: ___ radiograph.

FINDINGS: Cardiac silhouette is enlarged but has decreased in size, and is accompanied by decreased caliber of the pulmonary vessels which appear more distinct than on the prior exam. Bilateral perihilar haziness has also improved in the interval   Keywords: improve. Mild residual peribronchial cuffing is seen on the right. Moderate right pleural effusion has probably decreased in size in the interval and appears to have a subpulmonic component. However, differences in positioning between the studies limit comparison.

IMPRESSION: Marked improvement in congestive heart failure   Keywords: improve. Decrease in size of right pleural effusion with residual moderate right effusion with likely subpulmonic component.


SubjectID: 18948084, StudyID: 59552229, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man with history of right pleural effusion, now with dyspnea x ___ days, right lower lung fields diminished breath sounds, evaluate for infectious process for recurrent effusion.

COMPARISONS: Portable AP chest radiograph from ___, ___ as well as multiple other priors.

FINDINGS: PA and lateral views of the chest were obtained. There is now increased right pleural effusion compared to ___, with consolidation at the right base. There is preservation of right upper lobe aeration. The left lung is clear. The cardiac silhouette remains enlarged. There is no pneumothorax. There are no acute skeletal abnormalities.

IMPRESSION: Interval increase in right pleural effusion with consolidation/collapse of the right middle and lower lobes. Recommend follow up to resolution.


SubjectID: 18948084, StudyID: 55357438, Comparison: None

WET READ: ___ ___ ___ 8:50 PM Interval decrease in R effusion without evidence of ptx. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___-year-old man with chest pain after right thoracentesis.

COMPARISONS: ___.

FINDINGS: Large right-sided pleural effusion has decreased in size after thoracentesis. A small right effusion remains. A thin vertical line at the peripheral right lung base is not explained by a normal structure. Lung markings are seen lateral to this line. Moderate cardiomegaly is unchanged. No consolidation is identified.

IMPRESSION: Decrease in size in right-sided effusion status post thoracentesis. A thin line at the right base could represent a small anterior pneumothorax. Immediate repeat PA and Lateral chest radiograph is recommended. This finding was identified at ___ on ___ and immediately discussed via phone with Dr ___ at ___.


SubjectID: 18948084, StudyID: 58286079, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post pleurodesis, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the right chest tubes are in constant position. The extent of the right pleural effusion has minimally decreased. Unchanged are the right basal areas of atelectasis and moderate cardiomegaly without evidence of pulmonary edema. The left lung continues to be unremarkable.


SubjectID: 18948084, StudyID: 57117484, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluation for pleural effusions.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The two right-sided chest tubes are in unchanged position. The areas of pleural thickening and pleural effusion are constant in extent and severity. Unchanged size of the cardiac silhouette. No pneumothorax. Unchanged appearance of the left lung   Keywords: unchanged appearance.


SubjectID: 18948084, StudyID: 52741569, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old man with recurrent pleural effusions. Status post chest tube placement and pleurodesis.

FINDINGS: Comparison is made to prior study from ___. There is a right-sided chest tube with the distal tip projecting over the mid right lung field. There is a right-sided pleural effusion and some right basilar consolidation. The left lung is relatively clear. There are no pneumothoraces.


SubjectID: 18948084, StudyID: 51083037, Comparison: same

FINAL REPORT

HISTORY: Pleurodesis with chest tube.

FINDINGS: In comparison with the study of ___, there is little overall change   Keywords: little overall change. The right chest tube remains in place without evidence of pneumothorax. Loculated and probably free pleural fluid is again seen.


SubjectID: 18948084, StudyID: 56661310, Comparison: worse

FINAL REPORT

INDICATION: Shortness of breath.

COMPARISON: Radiographs available from ___ through ___. FRONTAL CHEST RADIOGRAPH: Cardiomegaly is again seen, significantly increased since ___, and appearing gradually increased since ___ possibly reflecting pericardial effusion. Pulmonary vascular congestion and edema have increased since the ___, examination. There is an enlarged moderate right pleural effusion. A small left pleural effusion is unchanged. There is no pneumothorax.

IMPRESSION: Worsening pulmonary vascular congestion and interstitial edema, with enlarged moderate right pleural effusion   Keywords: worse. Possible pericardial effusion.


SubjectID: 18948084, StudyID: 52378652, Comparison: better

WET READ: ___ ___ ___ 10:37 PM Inspiratory effort is improved but cardiomegally, moderate pulmonary edmea and moderate right and small left effusion are similar to 3am radiograph. ______________________________________________________________________________

FINAL REPORT

TECHNIQUE: Portable AP upright chest view was read in comparison with prior chest radiographs through ___ with the most recent from ___, acquired around 15 hours apart.

FINDINGS: Moderately enlarged heart size from known pericardial effusion is similar. Moderate pulmonary edema has improved; however, moderate right and mild left pleural effusion and bibasilar atelectasis are little changed   Keywords: improve. There is no demonstrable pneumothorax. Mediastinal and hilar contours are stable.


SubjectID: 18948084, StudyID: 52093609, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH

TECHNIQUE: Single AP upright portable chest was read in comparison with prior chest radiographs through ___ with the most recent from ___.

FINDINGS: Moderate cardiomegaly from known pericardial effusion and mild bilateral pulmonary edema persists, but improved since ___   Keywords: improve. Moderate right and minimal left pleural effusion and bibasilar atelectasis is unchanged. There is no pneumothorax. Mediastinal and hilar contours are stable.


SubjectID: 18948084, StudyID: 52561525, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man status post thoracentesis with minimal pneumothorax on yesterday's exam.

FINDINGS: Small bilateral pleural effusions are stable. The vertical line in the right lower lung seen on yesterday's exam is no longer present. There is no other indication of pneumothorax. Moderate cardiomegaly is unchanged.

IMPRESSION: Small bilateral pleural effusions. No evidence of pneumothorax. Findings were discussed with Dr. ___ ___ telephone at 16:30 on ___.


SubjectID: 18948084, StudyID: 54437390, Comparison: better

FINAL REPORT

PA AND LATERAL CHEST, ___

HISTORY: Lymphoplasmacytic lymphoma. Recent pericardial and pleural effusion.

IMPRESSION: PA and lateral chest compared to ___ through ___: Since ___, mild pulmonary edema has cleared. Pulmonary vascular congestion has decreased   Keywords: decrease. Moderate right pleural effusion is substantially smaller. Moderately severe right basal atelectasis and moderate cardiomegaly are stable. No pneumothorax.


SubjectID: 18948084, StudyID: 51880756, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man with right pleural effusion, status post recent thoracentesis.

COMPARISON: Chest radiograph done earlier today at 14:20 hours. PA AND LATERAL CHEST RADIOGRAPHS: The patient is status post thoracentesis with near-complete resolution of a previously seen right pleural effusion. There is re-expansion of the right lung. The left lung is clear. There is no pneumothorax. The cardiomediastinal and hilar contours are stable, with mild cardiomegaly.

IMPRESSION: No pneumothorax. Interval resolution of right pleural effusion with re-expansion of the right lung.


SubjectID: 18948084, StudyID: 51749427, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man with history of right pleural effusion, status post thoracentesis, now with decreased right breath sounds.

COMPARISON: Chest radiograph, ___ PA AND LATERAL CHEST RADIOGRAPHS: There has been interval reaccumulation of a large right pleural effusion, with a large sub-pulmonic component and near-complete collapse of the right lower lobe. There is no pneumothorax. Mild hyperinflation of the left lung is noted. The hilar and mediastinal contours are normal. Cardiomegaly is unchanged.

IMPRESSION: Reaccumulation of large right pleural effusion with compressive atelectasis of the right lower lobe.


SubjectID: 18991843, StudyID: 59582328, Comparison: 1.0

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with ESRD s/p transplant on immunosuppression with blood cultures positive for GPCs in clusters // eval for consolidation

TECHNIQUE: Chest PA and lateral

COMPARISON: ___

FINDINGS: Cardiomegaly is stable. Mild pulmonary edema has improved   Keywords: improve. Small bilateral effusions with adjacent opacities are unchanged. There is no pneumothorax. There are no other interval changes   Keywords: no other interval change

IMPRESSION: Improved pulmonary edema   Keywords: improve. Bibasilar opacities adjacent to the small bilateral effusions are likely atelectasis but superimposed infection cannot be excluded.


SubjectID: 18991843, StudyID: 53320805, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___F with positive blood cultures // r/o PNA

COMPARISON: ___. CT chest from ___.

FINDINGS: PA and lateral views of the chest provided. Port-A-Cath is unchanged with tip extending to the mid SVC region. Left atrial ligation clip appears unchanged. The heart remains moderately enlarged. There is mild pulmonary edema noted. Small bilateral pleural effusions are present. No pneumothorax. Mediastinal contour is stable. An azygous fissure is noted. Bony structures are intact. Clips in the left upper quadrant are noted.

IMPRESSION: Moderate cardiomegaly with mild pulmonary edema, small bilateral pleural effusions.


SubjectID: 18991843, StudyID: 56996498, Comparison: worse

FINAL REPORT

INDICATION: History of renal transplantation and atrial fibrillation, status post left atrial appendage ligation, now with fevers to 102 degrees and shortness of breath. Evaluate for pleural effusion, infiltrate, or other acute process.

COMPARISON: Chest radiograph from ___.

FINDINGS: A right internal jugular central venous catheter ends in the upper SVC. A left-sided Port-A-Cath ends in the low SVC. Left lower lung consolidation may be minimally increased, possibly atelectasis, although infection cannot be excluded. There is mild interstitial pulmonary edema, increased   Keywords: increase. Marked cardiomegaly is not significantly changed. A small left pleural effusion is not excluded. There is no right pleural effusion. No pneumothorax. The ligation material projecting over the area of the left atrial appendage is unchanged. Surgical clips are noted in the left upper abdominal quadrant.

IMPRESSION: 1. Left lower lung consolidative opacification, possibly atelectasis, although infection is not excluded, minimally increased compared to the prior study from ___. 2. Increased mild interstitial pulmonary edema with unchanged marked cardiomegaly   Keywords: increase.


SubjectID: 18991843, StudyID: 57905128, Comparison: None

FINAL REPORT

HISTORY: Increased O2 requirement, evaluate line placement. CHEST, SINGLE AP PORTABLE VIEW. Rotated positioning. Allowing for this, a left IJ central line is present -- the tip tip lies at or immediately above the confluence with the left subclavian vein. No pneumothorax is detected. Compared with ___ at 13:27 p.m., the NG tube has been removed. Allowing for differences in positioning, marked cardiomegaly and prominence of cardiomediastinal silhouette is similar. There is upper zone redistribution and diffuse increased interstitial and alveolar opacities, consistent with CHF. There are probable small bilateral effusions, with underlying collapse and/or consolidation. The CHF findings have progressed considerably compared with ___. Possibility of an underlying pneumonic infiltrate would be difficult to exclude. Multiple clips noted in the left upper quadrant of the abdomen.

IMPRESSION: 1. Left IJ central line immediately proximal to confluence with the left subclavian, unchanged. 2. Marked cardiomegaly and mediastinal enlargement, probably unchanged, allowing for differences in positioning. 3. CHF findings, bilateral effusions, and underlying collapse and/or consolidation has progressed considerably compared with ___. The possibility of an underlying infectious infiltrate would be difficult to exclude.


SubjectID: 18991843, StudyID: 51731436, Comparison: None

FINAL REPORT

PATIENT

HISTORY: ___ years old woman with fluid overload.

INDICATION: Interval change.

TECHNIQUE: Portable chest x-ray in AP projection.

COMPARISON: Exam is compared to chest x-ray of ___.

FINDINGS: Left IJ tube is unchanged and ends in at the confluence with the left subclavian vein. Lung fields are moderately inflated with reduced opacification bilaterally for reduced vascular congestion and reduced pleural effusion especially in the right base. Heart size is still markedly enlarged.

IMPRESSION: Reduced vascular congestion with reduced consolidation and pleural effusion bilaterally, especially in the right lung. Persists severe cardiomegaly. All monitoring devices are unchanged.


SubjectID: 18991843, StudyID: 57355110, Comparison: worse

FINAL REPORT

HISTORY: Possible pulmonary edema.

FINDINGS: In comparison with the study of ___, there is increased pulmonary opacifications bilaterally consistent with asymmetric pulmonary edema that is worse on the right   Keywords: worse, increase. Enlargement of the cardiac silhouette is seen. The possibility of supervening consolidation would have to be considered in the appropriate clinical setting. Left IJ catheter extends to the mid to lower portion of the SVC. Multiple surgical clips are again seen in left upper quadrant of the abdomen.


SubjectID: 18991843, StudyID: 55917047, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, endotracheal tube placement.

COMPARISON: ___, 4:30 a.m.

FINDINGS: As compared to the previous radiograph, the patient has been intubated, the tip of the endotracheal tube projects 5 cm above the carina. No evidence of complications, notably no pneumothorax. Unchanged appearance of the lung parenchyma   Keywords: unchanged appearance. Newly appeared minimal blunting of the costophrenic sinuses, potentially caused by small pleural effusions. Unchanged size and appearance of the cardiac silhouette.


SubjectID: 18991843, StudyID: 51105422, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is unchanged evidence of mild pulmonary edema   Keywords: unchanged. Massive cardiomegaly, no pleural effusions. No pneumonia. Mild atelectasis in the retrocardiac lung regions.


SubjectID: 19014149, StudyID: 58826385, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with dyspnea, hypoxia // eval for flash pulm edema

TECHNIQUE: AP view of the chest

COMPARISON: Prior radiographs on ___ at 01:53

FINDINGS: The cardiomediastinal and hilar contours are unchanged from 01:53. Bilateral perihilar and bibasilar opacities are new from the prior examination consistent with mild to moderate pulmonary edema, right greater than left   Keywords: new. There is no evidence of pneumothorax.

IMPRESSION: Moderate pulmonary edema, increased from 01:53   Keywords: increase.


SubjectID: 19014149, StudyID: 53434883, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: This is a ___ year old man with ESRD, on HD, secondary to DM-II, as well as poorly-controlled HTN, history of TIA and LTSBI (currently on isoniazid), who presented with dyspnea and orthopnea, felt to be hypervolemic secondary to missed session of HD, now improved and on RA post-HD. // hypothermic, concern for infection.

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Hammer dialysis catheter tip terminates at the level of cavoatrial junction. Cardiomediastinal silhouette is unchanged. There is interval resolution of pulmonary edema. There is no appreciable pleural effusion or pneumothorax.


SubjectID: 19014149, StudyID: 50518062, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___M with ESRD on HD // Eval for pulmonary edema

TECHNIQUE: Chest PA and lateral

COMPARISON: ___

FINDINGS: A right-sided dialysis catheter terminates in the right atrium. Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Subtle airspace opacities are demonstrated throughout both lungs (right greater than left), predominantly at the bases which could represent atypical infection or mild pulmonary edema. No pleural effusion or pneumothorax is seen.

IMPRESSION: Subtle airspace opacities throughout both lungs, predominantly at the bases, which are increased from ___ and could represent atypical infection or mild pulmonary edema.


SubjectID: 19023092, StudyID: 58325692, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___ Comparison with multiple prior studies, most recent of which is dated ___. CLINICAL

HISTORY: Chest pain, question pneumonia.

FINDINGS: PA and lateral views of the chest were provided. Midline sternotomy wires are again noted. Bilateral pleural effusions again noted. There is an ovoid opacity within the right mid-to-lower lung which is slightly increased from prior study and could represent a pseudotumor (loculated fluid within the fissure). Consider CT to further assess. The cardiomediastinal silhouette appears stable. No pneumothorax. Bony structures are intact.

IMPRESSION: Bilateral pleural effusions are small, with increasing size of ovoid opacity in the right mid lung, which likely represents loculated pleural fluid, though given lack of confirmation of this finding, a CT of the chest may be performed to further assess.


SubjectID: 19023092, StudyID: 50974021, Comparison: None

FINAL REPORT

HISTORY: Status post thoracentesis question resolution of diffusion.

COMPARISON: ___.

FINDINGS: The right-sided pigtail catheter is again visualized. The right effusion is decreased. There continues to be a right pneumothorax most apparent on the current study medially with sharp margins of the right heart border and right medial lung. There is small left greater than right pleural effusions. Volume loss is present in both lower lungs. Mediastinal clips and sternal wires are again visualized.

IMPRESSION: Inferomedial pneumothorax.


SubjectID: 19023092, StudyID: 57166557, Comparison: None

FINAL REPORT

HISTORY: Pneumothorax with pigtail catheter.

FINDINGS: In comparison with the study of ___, the right pigtail catheter remains in place. Again, there is pleural effusion on the right with loculation of fluid in the right major fissure. No definite pneumothorax is appreciated. Continued small left pleural effusion with atelectatic changes at the left base.


SubjectID: 19023092, StudyID: 55767854, Comparison: None

FINAL REPORT

HISTORY: ___-year-old male with cough and hypoxia. Fatigue.

COMPARISON: ___.

FINDINGS: AP and lateral views of the chest. There has been significant interval enlargement of the right-sided pleural effusion which is primarily loculated laterally. There is a moderate left-sided effusion which has also increased since prior. Underlying consolidation particularly at the left lung base cannot be excluded. Superiorly the lungs are clear. Cardiomediastinal silhouette is unchanged. Median sternotomy wires are again seen with fracture through the wire which is ___ from the top, unchanged. No acute osseous abnormalities detected.

IMPRESSION: Large right effusion which has increased in size and is largely loculated laterally. Enlargement of moderate left effusion since prior. Underlying consolidation particularly on the left cannot be excluded


SubjectID: 19023092, StudyID: 53829448, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Hypoxia, evaluation of pleural effusions.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the extent of the large right pleural effusion is constant. Also constant are the subsequent areas of atelectasis caused by this effusion. Slightly more extensive than on the previous image is a small left pleural effusion with subsequent retrocardiac atelectasis. The size of the cardiac silhouette remains enlarged. Clips after CABG and sternal wires are in unchanged position.


SubjectID: 19023092, StudyID: 54720784, Comparison: same

FINAL REPORT

INDICATION: History of CHF with shortness of breath, question interval improvement in pulmonary edema.

COMPARISONS: Chest radiograph from ___.

FINDINGS: Overall, there is no significant change since the prior radiograph   Keywords: no significant change. A large right pleural effusion and small left pleural effusion are stable. Left lower lobe atelectasis stable. The heart size remains enlarged. There is no pneumothorax.

IMPRESSION: No significant change since the prior exam   Keywords: no significant change.


SubjectID: 19023092, StudyID: 50779122, Comparison: None

FINAL REPORT

HISTORY: Thoracentesis.

FINDINGS: In comparison with the study of ___, there has been a right thoracentesis with removal of a substantial amount of pleural fluid. No definite pneumothorax. Small residual opacification at the right base laterally. Little change in the degree of left pleural effusion with compressive atelectasis at the base.


SubjectID: 19023232, StudyID: 59323097, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with right pleural effusion s/p thoracentesis. // rule out pneumothorax

COMPARISON: ___.

FINDINGS: AP portable upright view of the chest. There is a persistent opacity at the right mid to lower hemi thorax now with a pigtail drain in place. Given that the opacity persists, a mass is difficult to exclude and for this reason a CT is recommended to further assess. Mild pulmonary edema is new from prior exam   Keywords: new. A tiny left effusion persists.

IMPRESSION: Persistent opacity at the right mid to lower lung status post chest tube placement. Recommend CT to further assess. Interval development of mild pulmonary edema   Keywords: development. Stable trace left effusion.


SubjectID: 19023232, StudyID: 58521800, Comparison: None

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: History: ___F with dyspnea // Eval for pulm edema, PNA

TECHNIQUE: Chest Frontal and Lateral

COMPARISON: ___

FINDINGS: There is persistent large right pleural effusion with overlying atelectasis. Minimal to no left pleural effusion is seen. No pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. There ___ be minimal central pulmonary vascular congestion.

IMPRESSION: Persistent large right pleural effusion. Minimal to no left pleural effusion.


SubjectID: 19028690, StudyID: 55310022, Comparison: None

FINAL REPORT

INDICATION: Volume overload.

COMPARISON: ___. UPRIGHT AP AND LATERAL VIEWS OF THE CHEST: The cardiac silhouette size is unchanged, and appears mildly enlarged. Mediastinal and hilar contours are stable, and there is no evidence of pulmonary edema. No focal consolidation, pleural effusion or pneumothorax is present. There are mild degenerative changes of the thoracic spine.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 19028690, StudyID: 53538935, Comparison: worse

FINAL REPORT

AP CHEST 7:45 A.M. ___

HISTORY: Acute respiratory distress.

IMPRESSION: Two frontal views of the chest show new mild interstitial pulmonary edema   Keywords: new. Interval increase in mediastinal caliber therefore is probably due to distention of mediastinal veins. Heart size is slightly larger but still within normal range. Pleural effusions are minimal, if any. No focal pulmonary abnormality. No pneumothorax. ET tube is in standard placement and a nasogastric tube passes below the diaphragm and out of view.


SubjectID: 19030295, StudyID: 55122644, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hemoptysis, R sided mass on CT c/f compression // eval for R consolidation

TECHNIQUE: Portable semi upright chest radiograph.

COMPARISON: Chest radiograph dated ___. CTA chest dated ___.

FINDINGS: Lobular enlargement of the right hilus is unchanged since ___. Chest radiograph one ___ also shows right hilar adenopathy, but probably not as large. Aside from mild right lower lobe atelectasis, lungs are clear. Heart size is stable. Other central adenopathy seen on the recent CTA is not apparent on the conventional radiograph. The peripheral pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen.

IMPRESSION: 1. Right hilar adenopathy or mass is better evaluated on the CTA dated ___, stable since ___ have been present to some degree in ___. 2. Likely mild right basilar atelectasis, although developing pneumonia cannot be ruled out.


SubjectID: 19030295, StudyID: 54258129, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___F with cough

TECHNIQUE: Chest PA and lateral

COMPARISON: ___

FINDINGS: Mild to moderate enlargement of the cardiac silhouette is unchanged. The aorta remains unfolded. Previous pattern of mild pulmonary edema has essentially resolved   Keywords: resolve. Lungs remain hyperinflated. Previously noted bilateral pleural effusions have also resolved. There is no focal consolidation or pneumothorax. Enlargement of the hila bilaterally appears similar, right larger than left. Cholecystectomy clips are demonstrated in the right upper quadrant of the abdomen. There are no acute osseous abnormalities.

IMPRESSION: 1. Resolution of previously seen pulmonary edema and small bilateral pleural effusions. 2. Bilateral hilar enlargement concerning for underlying lymphadenopathy. Please see subsequent chest CTA report for further details.


SubjectID: 19031225, StudyID: 58833503, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: New fever in a patient with multiple rib fractures.

COMPARISON: CT from ___.

FINDINGS: Lung volumes are low. There is bibasilar atelectasis. The hilar and cardiomediastinal contours are normal. There is no pneumothorax. There is no pleural effusion. Pulmonary vascularity is normal.

IMPRESSION: Low lung volumes with bibasilar atelectasis.


SubjectID: 19031225, StudyID: 58552882, Comparison: None

WET READ: ___ ___ ___ 3:10 PM No acute cardiopulmonary abnormality. No displaced rib fracture within the limitations of routine chest radiographs. ______________________________________________________________________________

FINAL REPORT

INDICATION: History: ___M with s/p fall 6 days prior now with R sided cough associated chest pain // r/o fractures R sided, PNA, atelectesis

TECHNIQUE: Upright PA and lateral chest

COMPARISON: Chest radiographs ___ through ___. CT chest ___.

FINDINGS: The lungs are well-expanded and clear. There is no pleural effusion or pneumothorax. Heart size is normal. The mediastinal and hilar contours are normal. No displaced rib fractures detected.

IMPRESSION: No acute cardiopulmonary abnormality. No evidence of displaced rib fracture within the limitations of routine chest radiographs.


SubjectID: 19031225, StudyID: 56628890, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with possible PNA // PNA PNA

IMPRESSION: As compared to the previous radiograph from ___, the pre-existing opacity at the right lung base has minimally decreased in extent. There is unchanged blunting of the right costophrenic sinus, likely reflecting the presence of a small right pleural effusion. Mild cardiomegaly persists. No pulmonary edema.


SubjectID: 19031225, StudyID: 54625178, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with GI bleed and leukocytosis // ? pneumonia ? pneumonia

IMPRESSION: As compared to ___, there is newly appeared mild to moderate pulmonary edema   Keywords: new. In addition, a right pleural effusion has developed, accompanied by an opacity at the right lung base. Given the asymmetry of this change, pneumonia should be considered in the differential diagnosis. Moderate cardiomegaly. No pneumothorax.


SubjectID: 19043685, StudyID: 59173871, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F w/ HTN, HLD, ESRD on HD, PVD w/ L fem to BK pop bypass left BKA, on ASA/coumadin, now p/w fevers, increased R foot pain, and malodorous discharge, s/p R AKA ___ // eval R lung collapse eval R lung collapse

IMPRESSION: Comparison ___. The pre-existing right lower lobe collapse. Is almost completely resolved. Only the right lung base shows a minimal remnant atelectasis. Otherwise the right lung is well inflated. Unchanged normal appearance of the left lung. , a previously seen left lower lobe atelectasis is completely resolved. Moderate cardiomegaly without pulmonary edema persists   Keywords: persists.


SubjectID: 19043685, StudyID: 57425644, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with as above // s/p AKA w/rising WBC r/o infiltrate s/p AKA w/rising WBC r/o infiltrate

IMPRESSION: Compared to chest radiographs since ___ most recently ___ at 17:48. Right middle and lower lobes ARE still collapsed. Congestion has improved in the right upper lobe. Left lung grossly clear. Heart size stable, probably mildly enlarged. Any right pleural effusion is insignificant physiologically. NO pneumothorax.


SubjectID: 19043685, StudyID: 57310442, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with R lobe collapse // eval for aeration eval for aeration

IMPRESSION: Comparison to ___, 07:22. Minimally improved ventilation of the collapsed right lower lobe with visualization of individual air bronchograms. Overall, the collapse is close to total. Minimal atelectasis at the left lung bases. Unchanged monitoring and support devices.


SubjectID: 19043685, StudyID: 56900537, Comparison: None

WET READ: ___ ___ ___ 9:01 PM Endotracheal tube is in appropriate position, terminating 4.2 cm above the level of carina. An enteric tube courses into the stomach and out of view. Change in patient position compared to the prior study likely accounts for redistribution of layering right pleural effusion. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with resp failure // check ETT and OGT check ETT and OGT

IMPRESSION: Compared to prior chest radiographs ___ through ___. Right lower and PROBABLY right middle lobe collapse have recurred, accompanied by an indeterminate volume of right pleural effusion and congestion in the aerated right upper lobe. Findings point to recurrent airway obstruction. Minimal edema or aspiration is present at the left lung base. Left upper lobe is clear. Heart, shifted to the right, is partially obscured, probably not progressively enlarged. ET tube in standard placement. Esophageal drainage tube passes into the stomach and out of view. Left jugular line ends in the region of the superior cavoatrial junction. Dialysis catheter has been removed. No appreciable right pneumothorax.


SubjectID: 19043685, StudyID: 55688849, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with resp failure found to have collapse of right lung now s/p bronch eval for re-expansion // evaluate for re-expansion of right lung evaluate for re-expansion of right lung

IMPRESSION: Substantial improvement of the aeration of the right lung is demonstrated after bronchoscopy but still present is pole most likely right middle right lower lobe extensive atelectasis. Left basal opacity is more conspicuous it might represent aspiration which potentially could within the cause of the right lung collapse.


SubjectID: 19043685, StudyID: 56408655, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F w/ HTN, HLD, ESRD on HD, PVD w/ L fem to BK pop bypass left BKA, on ASA/coumadin, now p/w fevers, increased R foot pain, and malodorous discharge, s/p R AKA ___ // eval for pneumonia

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Moderate cardiomegaly is stable. Vascular congestion has almost completely resolved   Keywords: resolve. Bibasilar atelectasis are stable. There is no pneumothorax. Right central catheter is in standard position.


SubjectID: 19043685, StudyID: 53958445, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p intubation // s/p Code

TECHNIQUE: Single frontal view of the chest

COMPARISON: Study performed 2 hours earlier

IMPRESSION: ET tube is in standard position. No other interval change from prior study   Keywords: no other interval change.


SubjectID: 19043685, StudyID: 52005910, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with persistent mucus plugging requiring reintubation and bronchoscopy, now with ETT in place. // Eval for interval change s/p bronch.

IMPRESSION: In comparison to previous radiograph of 1 day earlier, the extent of right lung atelectasis has improved, with re-expansion of the right upper lobe. There remains near complete collapse of the right middle and lower lobes, likely due to mucous plugging in the bronchus intermedius. Nonspecific left basilar opacity has worsened in the interval. No other relevant change   Keywords: no other relevant change.


SubjectID: 19043685, StudyID: 50124517, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with R sided collapse // eval for RML collapse

IMPRESSION: In comparison to ___, right middle and right lower lobes are now completely collapsed, likely due to plugging of the bronchus intermedius. Left lung is clear except for patchy and linear atelectasis at the base.


SubjectID: 19043685, StudyID: 50127140, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with respiratory failure, intubated eval for interval change // eval for interval change

TECHNIQUE: Portable semi-upright AP chest

COMPARISON: Chest radiographs ___ through ___

FINDINGS: ET tube is 5 cm from the carina. Left internal jugular central venous catheter is near the superior cavoatrial junction, unchanged. There is persistent collapse of the right middle and lower lobes. The right upper lobe is clear. Atelectasis at the left base is improved. The right heart border is obscured however the heart is likely normal in size. There is no large pneumothorax. There is a presumed small right pleural effusion. There is persistent deformity of the right clavicle.

IMPRESSION: 1. Persistent collapse the right middle and lower lobes. 2. Mild atelectasis at the left base is improved.


SubjectID: 19062760, StudyID: 58952938, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: Prior exam from ___. CLINICAL

HISTORY: Confusion and pedal edema.

FINDINGS: AP upright and lateral views of the chest were provided. A PICC line is unchanged, again seen terminating in the low SVC. Mediastinal clips are again noted as well as hardware in the cervical spine. There is pulmonary edema which is worsened in the interval with small bilateral pleural effusions   Keywords: worse. The heart size cannot be assessed. There is no pneumothorax. Degenerative changes at the left shoulder with high-riding left humeral head is again noted.

IMPRESSION: Worsening pulmonary edema   Keywords: worse.


SubjectID: 19062760, StudyID: 57376967, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Status post esophagogastrectomy.

COMPARISONS: ___.

TECHNIQUE: Chest, AP portable.

FINDINGS: The patient is intubated. The endotracheal tube terminates approximately 4 cm above the carina. An orogastric tube terminates near the inlet of the diaphragm. A right internal jugular venous catheter terminates in the superior vena cava. There is again moderate unfolding of the thoracic aorta. Surgical clips also project over the lower-to-mid mediastinum. Mediastinal widening is consistent with post-operative change. There is new confluent left basilar opacification suggesting atelectasis in the left lower lobe of substantial extent with a pleural effusion, probably small to moderate in size. A small subpulmonic right-sided pleural effusion is difficult to exclude. There is also subcutaneous emphysema, small in amount, along the right lateral chest wall, as well as a right-sided chest tube. The patient is status post incompletely characterized lower cervical fusion. Moderate degenerative change involves the right shoulder.

IMPRESSION: Lines, tubes and drains as described above with post-operative changes, including post-operative mediastinal widening and left lower lobe opacification with a pleural effusion.


SubjectID: 19062760, StudyID: 54438446, Comparison: None

FINAL REPORT

HISTORY: Esophagogastrectomy, the right thoracotomy, to assess for pneumothorax.

FINDINGS: In comparison with the study of ___, the right chest tube remains in place without appreciable pneumothorax. Other monitoring and support devices are unchanged. There is opacification at the bases with obscuration of the hemidiaphragms, consistent with postoperative bilateral pleural effusions and compressive atelectasis.


SubjectID: 19062760, StudyID: 51613506, Comparison: None

FINAL REPORT

HISTORY: Chest tube removal, to assess for pneumothorax.

FINDINGS: In comparison with the study of ___, the right chest tube has been removed. No definite pneumothorax. Basilar opacification is again consistent with pleural fluid and atelectasis, more prominent on the left. Gastric pull-through is identified. The degree of subcutaneous emphysema is decreasing.


SubjectID: 19071652, StudyID: 54169822, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has been extubated and the nasogastric tube has been removed. Moderate-to-severe cardiomegaly persists. Also persisting are signs of mild-to-moderate fluid overload   Keywords: persisting. No larger pleural effusions. No pneumonia.


SubjectID: 19071652, StudyID: 51618209, Comparison: better

WET READ: ___ ___ ___ 8:44 PM Significant improvement in lung aeration and pulmonary edema with minimal opacities persisting at the right base.` ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Pulmonary edema, hypertensive urgency, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the lung volumes have increased and there is a decrease in extent and severity of the pre-existing parenchymal opacities, predominantly at the lung bases. These changes are likely to reflect improvement in pulmonary edema   Keywords: improve. Remnant changes, however, are still seen at the bases of the left and right lung. Moderate cardiomegaly persists. No evidence of larger pleural effusions.


SubjectID: 19073526, StudyID: 59812502, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with pulmonary edema ___ sCHF // ___ year old man with pulmonary edema ___ sCHF

TECHNIQUE: Chest portable

COMPARISON: Chest radiograph ___

FINDINGS: No significant change from ___   Keywords: no significant change. Unchanged moderate cardiomegaly and unchanged pulmonary central vascular congestion   Keywords: unchanged. Unchanged moderate left pleural effusion. Left retrocardiac opacity has persisted and likely represents atelectasis although infection cannot be ruled out. Right-sided AICD is seen with the leads projecting over the right atrium and right ventricle. Abandoned left sided leads are also seen. There is no pneumothorax. Mediastinal wires are normal.

IMPRESSION: Moderate cardiomegaly and mild pulmonary central vascular congestion without evidence of pulmonary edema. Unchanged moderate left pleural effusion and left retrocardiac opacity likely representing atelectasis.


SubjectID: 19073526, StudyID: 58549842, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with shortness of breath, pulmonary edema // ___ year old man with shortness of breath, pulmonary edema

TECHNIQUE: Portable AP chest radiograph.

COMPARISON: Chest radiograph ___.

FINDINGS: Overall, appearances are very similar when compared to the prior study. Lung volumes remain low with a moderate left pleural effusion and left basal airspace opacity. This is likely due to atelectasis but infection cannot be excluded. The right lung appears grossly clear. A right chest wall pacemaker is unchanged in appearance. Leads from a previously removed pacemaker also seen. No pneumothorax seen. Mild prominence of the bilateral hila and pulmonary vasculature is similar in degree when compared to the prior study and consistent with a degree of congestive heart failure. Moderate cardiomegaly.

IMPRESSION: No significant interval change when compared to the prior study   Keywords: no significant interval change.


SubjectID: 19073526, StudyID: 57446963, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pulmonary edema, L pleural effusion, CHF // ___ year old man with pulmonary edema, L pleural effusion, CHF ___ year old man with pulmonary edema, L pleural effusion, CH

IMPRESSION: As compared to ___, no relevant change is seen   Keywords: no relevant change. Moderate left pleural effusion, occupying approximately ___% of the left hemi thorax. Subsequent left basilar atelectasis. Moderate cardiomegaly persists. Unchanged appearance of the of the new pacemaker leads. No pneumothorax.


SubjectID: 19073526, StudyID: 54606255, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (AP AND LAT)

INDICATION: ___M with pain/swelling after fall // r/o fx

COMPARISON: ___.

FINDINGS: AP upright and lateral views of the chest provided. Midline sternotomy wires noted. Right chest wall AICD is again noted with leads extending into the region of the right atrium and right ventricle. Abandoned left-sided leads are noted. There is opacity at the left mid and lower lung, slightly improved from prior though likely reflects persistent left effusion and basal atelectasis. Right lung is partially obscured by pacer device. Right lung appears grossly clear. Heart size cannot be assessed. Mediastinal contour is unchanged. Bony structures are intact. Degenerative changes partially imaged at the shoulders.

IMPRESSION: Persistent left mid and lower lung opacity which is concerning for atelectasis and pleural effusion. Minimal improvement compared with prior. No fracture.


SubjectID: 19073526, StudyID: 58333375, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with history of CHF, restrictive lung disease and recent pneumonia with increased shortness of breath for past week, question pneumonia.

COMPARISON: CT of the chest from ___ and chest radiograph from ___. ONE VIEW OF THE CHEST: The lungs are low in volume and show a mild left lower lobe opacity. The cardiac silhouette is enlarged. The mediastinal silhouette and hilar contours are normal. There may be a small left pleural effusion. A right-sided pacer terminates with its leads in the right atrium and right ventricle. Abandoned leads are noted within the left chest. Sternal wires are intact. Clips suggest prior CABG.

IMPRESSION: Left lower lobe opacity could represent atelectasis or pneumonia with an associated effusion.


SubjectID: 19073526, StudyID: 55507084, Comparison: worse

FINAL REPORT

INDICATION: Extensive cardiac history, restrictive lung disease, recent admission for cough, dyspnea, now concern for left lower lobe pneumonia. Please evaluate.

COMPARISON: Comparison is made to multiple chest radiographs, most recently dated ___ and a CT chest performed ___.

FINDINGS: Chest PA and lateral radiograph demonstrates unchanged mediastinal, hilar, and cardiac contours. Bibasilar opacifications are again evident with minimally improved aeration on the left. Overall, radiograph is relatively unchanged compared to scout image obtained as part of a ___ chest CT, at which time, the opacifications were most consistent with atelectasis. No new opacifications evident   Keywords: new. A right-sided pacemaker has leads terminating in the right atrium and right ventricle. Abandoned pacer leads are also identified in the left chest. Sternotomy sutures are midline and intact.

IMPRESSION: Bibasilar opacifications, left greater than right. Findings similar to ___ CT, at which point, opacities corresponded with atelectasis.


SubjectID: 19075045, StudyID: 58669896, Comparison: worse

FINAL REPORT

HISTORY: History of heart disease, now with low-grade fever. Evaluate for pneumonia.

TECHNIQUE: Single, portable, AP view of the chest with the patient in an upright position.

COMPARISON: Comparison is made to radiographs dated ___.

FINDINGS: There has been interval development of diffuse, mild to moderate interstitial pulmonary edema   Keywords: development. A focal opacity seen in the right middle lobe may represent an early pnemonia in the appropriate clinical setting. Redemonstrated is stable moderate cardiomegaly with small bilateral pleural effusions. Mediastinal and hilar contours are stable. The patient is status post CABG with median sternotomy wires aligned and intact. A transvenous pacemaker is seen with leads terminating in right atrium and right ventricle.

IMPRESSION: 1. Probable right middle lobe pneumonia. Recommend PA/lateral chest radiographs to confirm and further characterize the opacity. 2. Mild to moderate, diffuse interstitial pulmonary edema. 3. Stable moderate cardiomegaly with small bilateral pleural effusions.


SubjectID: 19075045, StudyID: 51128200, Comparison: None

FINAL REPORT

PATIENT

HISTORY: ___-year-old man with coronary artery disease status post CABG, atrial fibrillation with PPM, admitted for dofetilide with low-grade fever and crackles on exam, evaluate for pneumonia.

COMPARISON: Exam is compared to chest x-ray of ___ at 10:42 a.m.

FINDINGS: Lung volume has increased, with reduced opacification of the right lung base, probably for reduced atelectasis. There are no consolidations suspicious for pneumonia. Heart size is still enlarged with mild enlargement of vascular pedicle, normal post-cardiac surgery findings. There is mild vascular congestion. Metallic clips are inline and intact. Right pectoral pacemaker has two leads following their expected courses and ending in the right atrium and right ventricle. There is no pneumothorax or pleural effusion. Patient has had AVR.


SubjectID: 19075045, StudyID: 57544155, Comparison: None

FINAL REPORT

CHEST ON ___

HISTORY: Status post CABG, chest tube removal.

FINDINGS: The left-sided chest tube has been removed. No pneumothorax is visualized. Lung volumes are low and there is continued/increased infiltrate in the left upper lung. There continues to be retrocardiac opacity and a layering left effusion. Vascular plethora and patchy areas of alveolar edema are also seen on the right. The ET tube is 4.3 cm above the carina. The NG tube is in the stomach.

IMPRESSION: Markedly worsened appearance of the left upper lung.


SubjectID: 19075045, StudyID: 56483572, Comparison: None

FINAL REPORT

HISTORY: Left upper lobe opacity.

FINDINGS: In comparison with the study of ___, the monitoring and support devices remain in place. There may be mild increased aeration in the left upper zone. Retrocardiac opacification is consistent with volume loss in the left lower lobe. Hazy opacification bilaterally is consistent with pleural effusions, and there is some increase in pulmonary venous pressure.


SubjectID: 19075045, StudyID: 56319561, Comparison: None

WET READ: ___ ___ 11:01 PM asymmetric pulmonary edema slightly worsened from radiograph performed 4 hours prior. dense left upper lung consolidation may represent atelectasis. ______________________________________________________________________________

FINAL REPORT

HISTORY: Followup CABG. REFERENCE EXAM: ___ at ___.

FINDINGS: There has been some interval improved aeration in the left upper lobe that now permits visualization of the aortic knob and the previously described appearance of question widened mediastinum is now seen to have represented the left upper lobe infiltrate. There continues to be a dense left upper lobe infiltrate with more hazy opacity of the remainder of the left lung that could be due in part to layering effusion. There are increased patchy areas of infiltrate in the right lung. There is pulmonary vascular re-distribution and ill-defined vasculature consistent with fluid overload. The heart size is mildly enlarged. Swan-Ganz catheter tip is in the main pulmonary artery. The ET tube is 4 cm above the carina. Left chest tube and mediastinal drains are unchanged. The dual-lead pacemaker is unchanged.


SubjectID: 19075045, StudyID: 52129079, Comparison: same

FINAL REPORT

CHEST ON ___

HISTORY: Followup pulmonary edema.

FINDINGS: There has been interval improved appearance of the lungs with more well- defined vasculature and decreased left effusion. However, there continues to be a dense left upper lobe infiltrate. It is unclear how much of this is due to volume loss/retained secretions or if there could be an underlying infectious infiltrate. There continue to be patchy areas of alveolar edema; however, the overall appearance of the lungs is markedly improved compared to the study from the prior day   Keywords: continue. The supporting devices, lines and tubes appear similar compared to prior.


SubjectID: 19075045, StudyID: 52020406, Comparison: None

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: Patient status post CABG. Evaluate for infiltrate or effusion.

FINDINGS: Comparison is made to prior study from ___. The Swan-Ganz catheter, left-sided pacemaker, endotracheal tube, feeding tube and mediastinal wires are all unchanged in position. There is a confluent area of opacity in the left upper lobe which is stable. There is an increase in opacity at the right base, which may be due to developing infiltrate or atelectasis. There is an unchanged left retrocardiac area which may represent underlying infiltrate and/or pleural effusion. There is a left ventricular prominence. No pneumothoraces are present.


SubjectID: 19075045, StudyID: 52680917, Comparison: same

FINAL REPORT

PATIENT

HISTORY: ___ years old man with left upper lobe process.

INDICATION: Followup.

TECHNIQUE: Portable AP single two-view chest x-ray in semi-upright position.

COMPARISON: Exam is compared to chest x-ray of ___.

FINDINGS: All the monitoring and support devices are unchanged within standard position. Patient is after sternotomy for cardiac surgery. Lung volume is still low but the left upper lobe opacification is reduced, likely for reabsorption of edema component   Keywords: still. Also, the left base pleural effusion is reduced. The right basilar opacification is slightly increased for increased pleural effusion. Heart is still mildly enlarged. There is no pneumothorax.

IMPRESSION: Reduced left upper lobe opacification likely for reduced edema component. Reduced left base pleural effusion, but increase in the right base.


SubjectID: 19075045, StudyID: 56350217, Comparison: None

FINAL REPORT

HISTORY: Aspiration pneumonia, evaluate interval change. CHEST, SINGLE AP PORTABLE VIEW.

COMPARISON: ___ at 9:44 a.m. A left-sided dual-lead pacemaker is present, with lead tips over the right atrium and right ventricle. The patient is status post sternotomy, with mediastinal clips. The cardiomediastinal silhouette is prominent, but probably unchanged. Again seen is patchy opacity in the left upper zone; left lower lobe collapse and/or consolidation; and probable small left effusion. There is minimal atelectasis at the right lung base. Portion of a right shoulder prosthesis incidentally noted.

IMPRESSION: Overall similar to the most recent prior film. Pleural fluid at the left lung base may be slightly increased.


SubjectID: 19075045, StudyID: 53104217, Comparison: None

FINAL REPORT

HISTORY: Status post CABG, evaluate left lower lobe effusion and atelectasis. CHEST, SINGLE AP PORTABLE VIEW.

COMPARISON: ___ chest x-ray at 8:04 a.m. Compared to the prior film, I doubt significant interval change. Again seen is a pacemaker, sternotomy wires, enlarged cardiomediastinal silhouette, patchy opacity in left upper zone, increased retrocardiac density consistent with left lower lobe collapse and/or consolidation, and a small-to-moderate layering left effusion. The right lung is grossly clear, with minimal vascular plethora, but no overt CHF. Patchy cardiophrenic opacity is slightly improved. No frank consolidation or effusion.

IMPRESSION: Grossly unchanged compared with one day prior.


SubjectID: 19101100, StudyID: 59975684, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with right sided pleural effusion s/p chest tube removal // Eval for interval change

COMPARISON: The comparison is made with prior studies including ___.

IMPRESSION: There is stable consolidation in the right lung base. There may be small bilateral pleural effusions. There is stable cardiomegaly. There is no pneumothorax or CHF. There is no significant interval change   Keywords: no significant interval change.


SubjectID: 19101100, StudyID: 55258483, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with new chest tube // r/o R PTX

COMPARISON: The comparison is made with prior studies including ___.

IMPRESSION: There is cardiomegaly with upper zone redistribution and blurring of vascular detail consistent with CHF. There is a pigtail catheter in the right lung base. There is no pneumothorax. There is a right pleural effusion noted. There is persistent atelectasis in the right lung base.


SubjectID: 19101100, StudyID: 50845235, Comparison: None

WET READ: ___ ___ ___ 10:30 AM Right basilar pigtail catheter has been removed. Right pleural effusion with associated atelectasis grossly unchanged. No large pneumothorax.

WET READ VERSION #1 ___ ___ ___ 6:34 PM Right basilar pigtail catheter has been removed. Right pleural effusion with associated atelectasis grossly unchanged. No large pneumothorax. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___ year old man with alt MS, cirrhosis w/CT placement now pulled out // Eval for PTX, interval change.

COMPARISON: The comparison is made with prior studies including ___.

IMPRESSION: The pigtail catheter at the right lung base is been removed. There are no pneumothoraces. There is a persistent right effusion. There is stable consolidation in the right lung base. There is cardiomegaly an upper zone redistribution with blurring a vascular detail consistent with CHF.


SubjectID: 19101100, StudyID: 59628662, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man who self-extubated, removed OGT, s/p NGT placement // ngt placement ngt placement

IMPRESSION: Comparison to ___. The patient has been extubated. The new nasogastric tube shows an unremarkable course. Minimal decrease in extent of the pre-existing right pleural effusion. Global cardiac enlargement and mild to moderate pulmonary edema are present in unchanged manner   Keywords: unchanged. Slightly increasing retrocardiac atelectasis.


SubjectID: 19101100, StudyID: 54333523, Comparison: None

FINAL REPORT

EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 1 EXAM

INDICATION: ___ year old man with small right loculated effusion s/p chest tube placement ___mL out // ? PTX, ? placement in chest ? PTX, ? placement in chest

IMPRESSION: Severe cardiomegaly is unchanged. Right pigtail catheter is in place with slight interval decrease in right pleural effusion. There is no pneumothorax.


SubjectID: 19101100, StudyID: 58565990, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man with latent TB, recurrent pleural effusions, ESRD on HD, pleural effusions.

COMPARISON: ___.

FINDINGS: PA and lateral chest radiographs are obtained. Right large pleural effusion seen previously extending to the level of mid thorax appears slightly worse. Cardiomediastinal contours are stable. Dialysis catheter is unchanged. Left lung and visualized portion of the right lung are clear. No pneumothorax.

IMPRESSION: Slight increase in the size of the large right pleural effusion.


SubjectID: 19101100, StudyID: 58393243, Comparison: same

FINAL REPORT

TYPE OF

EXAMINATION: Chest PA and lateral.

INDICATION: ___-year-old male patient with end-stage renal disease, on hemodialysis, prior positive PPD, decreased breath sounds on the right. Evaluate for possible re-accumulation of right-sided pleural effusion.

FINDINGS: PA and lateral chest views have been obtained with patient in upright position. Comparison is made with the next preceding chest examinations of ___ and ___. The heart size remains moderately enlarged. No change in configurational abnormality   Keywords: no change. Unchanged appearance of thoracic aorta   Keywords: unchanged appearance. Right internal jugular approach sizable double-lumen catheter remains and terminates in lower SVC, probably entering right atrium. The position, however, is unchanged. No pneumothorax has developed. In comparison with the next preceding examination of ___, the right-sided pleural effusion has recurred and has approximately the same magnitude as on the examination of ___ study. No other new abnormalities are identified.


SubjectID: 19101100, StudyID: 56984947, Comparison: None

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with right-sided pleural effusion post-thoracocentesis, rule out pneumothorax.

COMPARISON: ___.

FINDINGS: There has been significant improvement of moderate pleural effusion on the right side post-thoracocentesis; residual pleural effusion is small and minimal. There is no pneumothorax. Left small pleural effusion has slightly increased. Moderate cardiomegaly is stable. Right-sided hemodialysis catheter is unchanged.

CONCLUSION: Significant improvement of right pleural effusion that is now minimal after thoracocentesis. There is no pneumothorax.


SubjectID: 19101100, StudyID: 56917870, Comparison: None

FINAL REPORT

INDICATION: Low abdominal pain and history of end-stage renal disease, rule out pneumonia or heart failure.

COMPARISONS: ___. AP AND LATERAL VIEWS OF THE CHEST: The heart size is enlarged but unchanged and the interstitial edema is chronic. A right-sided hemodialysis catheter tip terminates in the right atrium. Left base retrocardiac opacity is likely atelectasis although infection is not excluded. There is no pneumothorax. Moderate bilateral pleural effusions which appear slightly increased from prior.

IMPRESSION: Volume overload.


SubjectID: 19101100, StudyID: 55607787, Comparison: None

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Dyspnea and fluid overload.

COMPARISONS: Prior day.

TECHNIQUE: Chest, AP upright and lateral.

FINDINGS: The heart is mildly enlarged. The mediastinal and hilar contours appear unchanged. There is mild perihilar fullness and hazy predominantly perihilar opacification, including upper zone redistribution of the pulmonary vascularity, suggesting mild pulmonary vascular congestion. In addition, a focal opacity in the right lower lobe suggests pneumonia, probably also involving the right middle lobe, not significantly changed. There is a suspected small pleural effusion on the left. Mild-to-moderate rightward convex curvature is centered along the mid thoracic spine.

IMPRESSION: 1. Persistent focal opacities in the right lower lung suggesting pneumonia. 2. Findings suggesting mild vascular congestion.


SubjectID: 19101100, StudyID: 54609043, Comparison: same

FINAL REPORT

CHEST, TWO VIEWS, ___

HISTORY: ___-year-old male with chronic kidney disease, CHF, and dyspnea. Question change since prior.

FINDINGS: AP and lateral views of the chest are compared to previous exam from ___. When compared to prior, there has been interval development of more confluent consolidation identified in the right lower lobe. Indistinctness of the pulmonary vasculature is again seen throughout both lungs   Keywords: again. Obscuration of the left lateral costophrenic angle could be due to fat pad or atelectasis. Cardiac silhouette is enlarged but stable. Osseous and soft tissue structures are unchanged.

IMPRESSION: New right base region of consolidation which could represent pneumonia in the appropriate clinical setting. Otherwise, no significant interval change in findings suggestive of pulmonary vascular congestion   Keywords: no significant interval change.


SubjectID: 19101100, StudyID: 55538472, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with altered mental status now intubated for apnea // Eval for ETT placement

IMPRESSION: In comparison to prior radiograph of several hr earlier, the patient has been intubated, with tip of tube terminating about 6 cm above the carina. There is otherwise no relevant change in the appearance of the chest when consideration is given to the degree of patient rotation on the current study   Keywords: no relevant change.


SubjectID: 19101100, StudyID: 54763436, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with septic shock with unclear source now s/p chest tube to right pleural effusion // eval for location of chest tube, interval change eval for location of chest tube, interval change

IMPRESSION: Right pigtail catheter is in place. Cardiomegaly is substantial, unchanged. No interval change in loculated right pleural effusion is demonstrated. No pneumothorax.


SubjectID: 19101100, StudyID: 54705770, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with septic shock and AMS s/p intubation eval for interval change // eval for interval change

TECHNIQUE: Portable semi-upright AP chest

COMPARISON: Multiple chest radiographs of ___ and ___. CT chest ___

FINDINGS: ET tube is 5.1 cm show the carina. Enteric tube courses into the stomach and beyond the field of view. Loculated right pleural effusion is overall unchanged. There may be slightly improved aeration of the right mid and lower lung.Small left pleural effusion is unchanged. The left lung is otherwise clear. The overall contour of the heart is unchanged with known mild cardiomegaly and moderate pericardial effusion.

IMPRESSION: 1. Unchanged loculated right pleural effusion and small left pleural effusion. 2. Stable enlargement of the cardiac silhouette reflecting mild cardiomegaly and moderate pleural effusion better seen on recent chest CT.


SubjectID: 19101100, StudyID: 52644712, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hypoxemic resp failure with ETT // eval for ETT placement

IMPRESSION: In compares to prior study of 1 day earlier, endotracheal tube and nasogastric tube are in standard position, and cardiomediastinal contours are stable. Moderate right pleural effusion appears similar to the prior study with adjacent slight improvement in right lower lung opacification. On the left, a small effusion has apparently slightly increased in size with adjacent worsening left retrocardiac opacification. No other relevant change   Keywords: no other relevant change.


SubjectID: 19101100, StudyID: 50100144, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with altered mental status and hypotension, s/p removal of right chest tube for effusion. // Eval for interval change s/p chest tube removal

IMPRESSION: In comparison to prior radiograph of 1 day earlier, a right pleural catheter has been removed. Moderate, partially loculated right pleural effusion appear similar with no definite pneumothorax. With the exception of improving aeration at both lung bases, there is otherwise no substantial change in the appearance of the chest since recent study.


SubjectID: 19101100, StudyID: 52335002, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with altered mental status

TECHNIQUE: Portable AP view of the chest

COMPARISON: ___ chest radiograph, CT chest ___

FINDINGS: Severe cardiomegaly is re- demonstrated with similar mediastinal contours. Mild pulmonary vascular congestion is slightly improved compared to the previous study   Keywords: improve. Moderate to large right pleural effusion which is loculated partially laterally appears increased from the previous study. Worsening opacification of right lung base may reflect atelectasis, however infection is not excluded. There is a small left pleural effusion with left basilar atelectasis. No pneumothorax is identified.

IMPRESSION: Worsening opacification in the right lung base may reflect increased atelectasis though infection is not excluded. Increased size of large right partially loculated pleural effusion and trace left pleural effusion. Mild pulmonary vascular congestion, slightly improved in the interval   Keywords: improve.


SubjectID: 19101100, StudyID: 51359955, Comparison: same

FINAL REPORT

INDICATION: ___-year-old with weakness and chronic cough. Please assess for pneumonia.

TECHNIQUE: Frontal and lateral radiographs of the chest were obtained.

COMPARISON: Chest radiograph from ___.

FINDINGS: Compared to ___, there is an unchanged moderate right pleural effusion and partial collapse of the right middle and lower lobes, moderate cardiomegaly, and mild vascular congestion. There is no pneumothorax. A hemodialysis catheter is again seen ending in the proximal right atrium.

IMPRESSION: No change from ___ with cardiomegaly, mild vascular congestion, moderate right effusion and atelectasis   Keywords: no change.


SubjectID: 19101100, StudyID: 51667891, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with dementia, pulm HTN, recent R hip replacement, new O2 requirement and decreased mental status // Acute cardiopulmonary process

COMPARISON: ___

IMPRESSION: As compared to the previous image, the pleural effusion on the right has slightly decreased. Moderate cardiomegaly persists. No left pleural effusion. No evidence of pneumonia. No overt pulmonary edema. No pneumothorax. Leftward deviation of the trachea is unchanged and likely caused by a goiter.


SubjectID: 19101100, StudyID: 51288106, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p NGT placement // NGT placement

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the extent of the pre-existing right pleural effusion has slightly increased. As a consequence, there is more right basilar atelectasis than on the previous image. Moderate cardiomegaly persists. Unchanged small retrocardiac atelectasis. A nasogastric tube has been placed in the interval. The tube is coiled in the stomach. The tip projects over the fundus. No pneumothorax.


SubjectID: 19123301, StudyID: 54660937, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man with new biventricular ICD.

COMPARISON: ___.

TECHNIQUE: PA and lateral chest radiographs.

FINDINGS: Biventricular ICD noted over the left chest with leads properly projecting over the right ventricle, right atrium, and left ventricle. Sternotomy wires and surgical clips are unchanged. The heart is top normal in size. Opacification of the right lung seen previously, likely representing layering of pleural effusion is no longer seen in this upright radiograph. There is a small right-sided effusion seen better on the lateral radiograph. There is a new area of opacity at the right cardiophrenic angle, possibly representing an area of fluid or segmental atelectasis in the lower lobe. No pneumothorax.

IMPRESSION: 1. Small right pleural effusion. 2. Focal opacity at the right cardiophrenic angle likely represents an area of fluid or atelectasis in the medial basal segment of the right lower lobe. Suggest followup chest x-ray to better evaluate this region.


SubjectID: 19123301, StudyID: 55570910, Comparison: None

FINAL REPORT

INDICATION: New pacemaker placement, evaluate for pneumothorax.

COMPARISON: Chest radiograph from ___.

FINDINGS: One frontal view of the chest. Left pacemaker is seen with transvenous leads in the right atrium and right ventricle in appropriate position. Sternotomy wires and mediastinal clips are again seen. Aortic knob calcifications are stable. Cardiomegaly is stable. No pneumothorax, pleural effusion or mediastinal widening. Lungs are clear.

IMPRESSION: Left pacemaker leads are in appropriate position. No pneumothorax or mediastinal widening, or evidence of hemothorax.


SubjectID: 19123301, StudyID: 53373753, Comparison: None

PROVISIONAL

FINDINGS

IMPRESSION (PFI): ___ ___ ___ 11:56 AM Transvenous pacemaker leads in appropriate position. No pneumothorax, mediastinal widening, or evidence of hemothorax. ______________________________________________________________________________

FINAL REPORT

INDICATION: Pacemaker placement, evaluate lead placement.

COMPARISON: Chest radiograph on ___.

FINDINGS: PA and lateral views of the chest. The pacemaker with transvenous leads end in the appropriate positions in the right atrium and right ventricle. Sternotomy wires and mediastinal clips are stable. The cardiac, mediastinal, and hilar contours are normal. The lungs are clear. No pleural effusion or pneumothorax.

IMPRESSION: Transvenous pacemaker leads in appropriate position. No pneumothorax, mediastinal widening, or evidence of hemothorax.


SubjectID: 19139995, StudyID: 59386418, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman sp AVR/MVR/asc aorta replacement // eval for pneumothorax s/p chest tube removal

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: ET tube tip is 3.4 cm above the carinal. Swan-Ganz catheter tip is at the level of the right ventricle outflow tract. Right internal jugular line tip is at the level of lower SVC. Left chest tube is in place, right chest tube is in place. Sternal wires are unremarkable. Replaced aortic valve is in expected position. Cardiomegaly is substantial but unchanged. No pneumothorax or pleural effusion is seen. Mitral valve replacement is noted. The location of the replaced mitral valve is unremarkable.


SubjectID: 19139995, StudyID: 54142971, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with AVR/MVR/TVr, ASC Ao // interval change in fullness around aorta

COMPARISON: None.

FINDINGS: There is very slight rotated positioning. Multiple lines and tubes are present, nominal in position. The right IJ Swan-Ganz catheter tip may lie in the RV or at the origin of the pulmonary outflow tract. No pneumothorax detected. Again seen is cardiomegaly, with sternotomy wires and prosthetic valve. The aortic valve is indistinct, but not clearly changed compared with the most recent prior film. Equivocal slight convexity is seen in the region of the aortopulmonary window, in the setting of air bronchograms and consolidation around the lobar and segmental airways. Mild vascular plethora is again noted, grossly unchanged   Keywords: unchanged, again. Also again seen is left lower lobe collapse and/or consolidation, with obscuration left hemidiaphragm. This has probably increased slightly compare with the prior film. The possibility of a small left effusion cannot be excluded. Minimal atelectasis at the right base is slightly increased. No gross effusion identified.

IMPRESSION: 1. Lines and tubes as described. 2. Cardiomediastinal silhouette, including indistinctness of the aortic arch, is grossly unchanged   Keywords: unchanged. Question minimal new convexity in the aortopulmonary window. 3. Left lower lobe collapse and/or consolidation may be slightly worse. 4. Minimal atelectasis at the right base is slightly increased. 5. No gross pleural effusion is seen on either side. 6. Mild vascular plethora is grossly unchanged   Keywords: unchanged.


SubjectID: 19139995, StudyID: 59367772, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p MVR/AVR - temps // eval for infiltrate/ DHT position

IMPRESSION: Chest radiograph obtained for assessment of a Dobhoff tube demonstrates the tube terminating in the proximal stomach. Stable marked enlargement of cardiac silhouette asymmetrical left perihilar opacification, which could reflect asymmetrical edema or developing pneumonia   Keywords: developing.


SubjectID: 19139995, StudyID: 54513043, Comparison: None

WET READ: ___ ___ ___ 8:03 AM Dobbhoff tube position within the stomach. Massively enlarged cardiac silhouette, not changed. Left heart border not included on this radiograph. Right IJ catheter in place. Endotracheal to tip not clearly seen. Right lung grossly clear.

WET READ VERSION #1 ___ ___ ___ 7:35 PM Dobbhoff tube position within the stomach. Massively enlarged cardiac silhouette, not changed. Left heart border not included on this radiograph. Right IJ catheter in place. Endotracheal to tip not clearly seen. Right lung grossly clear. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p TEE - ? DHT moved // eval for DHT position

IMPRESSION: Radiographs centered at thoracoabdominal junction was obtained to assess for Dobbhoff tube placement, which terminates within the proximal stomach.


SubjectID: 19139995, StudyID: 53003112, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p MVR/AVR/TV ring // eval for infiltrate, OGT placement

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, there is a mild increase in severity of the pre-existing pulmonary edema   Keywords: increase. A minimal right pleural effusion is present. Unchanged massive cardiomegaly, the extent and severity of the left apical parenchymal opacity is constant. A second nasogastric tube has been placed, the course is unremarkable, the tip is not visualized on the image.


SubjectID: 19139995, StudyID: 52831106, Comparison: worse

FINAL REPORT

INDICATION: ___ year old woman s/p avr/mvr-new dophoff // check dophoff placement

TECHNIQUE: Portable chest x-ray.

COMPARISON: Chest radiographs dated ___ through ___.

FINDINGS: Portable semi-upright radiograph of the chest demonstrates persistent marked enlargement of the cardiac silhouette and asymmetrical left perihilar opacification, which appears to have progressed slightly over the interval. A right-sided subclavian central venous line ends in the upper SVC. The endotracheal tube ends 4 cm from the carina. The Dopoff feeding tube ends in the stomach, with its tip in the region of the gastric fundus, near to the GE junction.

IMPRESSION: 1. Feeding tube ends in the stomach, with the tip in the region of the gastric fundus, near to the GE junction. 2. Slight interval increase in the degree of asymmetrical left perihilar opacification, which may reflect asymmetrical edema, or developing pneumonia   Keywords: increase, developing.

RECOMMENDATION(S): Feeding tube ends in the stomach, with the tip in the region of the gastric fundus, near to the GE junction. Recommend repositioning prior to use.

NOTIFICATION: These findings and recommendations were discussed with ___ ___ (PA) by Dr. ___ ___ telephone at 10:10 on ___, 5 minutes after discovery.


SubjectID: 19139995, StudyID: 58225473, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with heart failure // ___ that will not draw back, change in position? Swan that will not draw back, change in position?

COMPARISON: Prior chest radiograph ___.

IMPRESSION: New right transjugular Swan-Ganz catheter ends in the descending right pulmonary artery, approximately 3 cm standard placement. Mild pulmonary edema is new   Keywords: new. Severe cardiomegaly is exaggerated by AP positioning, but not improved. Small bilateral pleural effusions, stable on the left, increased slightly on the right. No pneumothorax or mediastinal widening.


SubjectID: 19139995, StudyID: 57919494, Comparison: worse

FINAL REPORT

EXAMINATION: AP portable chest radiograph

INDICATION: ___ year old woman with CHF, swan-ganz // eval edema

COMPARISON: Chest radiograph dated ___ and ___. .

FINDINGS: The repositioned right Swan-___ catheter tip lies within the mediastinal contours in the region of the right main pulmonary artery. Severe cardiomegaly persists, unchanged from at least ___. Mild pulmonary edema is similar to ___ but new since ___   Keywords: new. No definite pleural effusion. No pneumothorax. Calcifications of the aortic knob are unchanged.

IMPRESSION: No significant interval change from ___ but mild pulmonary edema is new from ___   Keywords: new.


SubjectID: 19139995, StudyID: 56921617, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with acute decompensated HF // Interval change? Interval change?

COMPARISON: Prior chest radiographs ___ through ___.

IMPRESSION: Pulmonary edema improved on ___, but has worsened slightly since ___:30, accompanied by increasing pulmonary vascular congestion   Keywords: worse, increasing. There is greater peribronchial opacification in the right lower lobe than elsewhere suggesting aspiration or early pneumonia which should be followed. Severe cardiomegaly has not changed appreciably. Pleural effusions are small if any. Swan-Ganz catheter is been withdrawn to the pulmonary outflow tract. No pneumothorax.


SubjectID: 19139995, StudyID: 55120760, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with cardiogenic shock. // interval change

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Swan-Ganz catheter tip is at the level of the right ventricular outflow tract. Severe cardiomegaly is noted. Mediastinal silhouette is stable. Vascular enlargement is substantial but unchanged since the prior study   Keywords: unchanged. No interval increase in pleural effusion or development of pneumothorax demonstrated


SubjectID: 19139995, StudyID: 57638734, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p AVR/ MVR/ TVr/ Asc Ao replace POD 9 // eval for PNA, efussions, congestion eval for PNA, efussions, congestion

IMPRESSION: In comparison with the study ___ ___, there is little change in the appearance of the monitoring and support devices. Continued enlargement of the cardiac silhouette with bilateral layering effusions and compressive atelectasis, more prominent on the right. Given the effusions, it is difficult to properly assess the pulmonary vascularity, though no substantial edema is present.


SubjectID: 19139995, StudyID: 52629009, Comparison: 1.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with s/p AVr/MVR/TVr // eval infiltrate

COMPARISON: ___.

IMPRESSION: Mild increase in extent of the right pleural effusion. Mild decrease in severity of pulmonary edema   Keywords: decrease. Minimal decrease in size of the cardiac silhouette. Otherwise unchanged radiograph   Keywords: unchanged radiograph.


SubjectID: 19139995, StudyID: 57307003, Comparison: None

WET READ: ___ ___ ___ 10:35 AM As before there is severe cardiomegaly. Biventricular ICD in the left chest wall has leads in the right ventricle and the other coursing via the coronary sinus to the level of the left ventricular apex. There is no pneumothorax. Pleural effusion at the right base appears smaller.

WET READ VERSION #___ ___ ___ ___ 10:26 PM As before there is severe cardiomegaly. Biventricular ICD in the left chest wall has leads in the right ventricle and the other coursing via the coronary sinus to the level of the left ventricular apex. There is no pneumothorax. Pleural effusion at the right base appears smaller. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___ year old woman s/p BiV ICD implant // PTX, leads

COMPARISON: Chest radiograph dated ___.

FINDINGS: Single portable AP chest radiograph demonstrates interval placement of a left pectorally placed biventricular ICD. The leads appear intact and project over the expected location of the right and left ventricle. There is no pneumothorax. There is severe cardiomegaly without evidence of overt pulmonary edema. Bowel replacement are identified as are median sternotomy wires. Previously seen right pleural effusion is decreased in size.

IMPRESSION: Severe cardiomegaly with interval placement of biventricular ICD, its leads which project over the right and left ventricles. No pneumothorax.


SubjectID: 19139995, StudyID: 54566909, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman s/p BiV ICD implant // PTX, leads PTX, leads

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Massive cardiomegaly. Status post the leads are in expected position. The lateral radiograph reveals the presence of minimal pleural effusions, limited to the costophrenic sinuses.


SubjectID: 19139995, StudyID: 52379569, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with mitral stenosis , HF now with cardiogenic shock and PA catheter in place. // interval change

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Massively enlarged cardiac silhouette with Swan-Ganz catheter. Signs of moderate pulmonary edema with interstitial component. No pneumonia, no pleural effusions.


SubjectID: 19139995, StudyID: 55190179, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with bilateral effusions // interval change interval change

IMPRESSION: In comparison with the study ___ ___, the monitor and support devices are unchanged. Again there is a large right pleural effusion and moderate left effusion with compressive atelectasis in a patient with substantial enlargement of the cardiac silhouette and pulmonary edema.


SubjectID: 19139995, StudyID: 52605222, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with large right effusion s/p chest tube placement // ? PTX ? PTX

IMPRESSION: In comparison with the earlier study of this day, there has been placement of a right chest tube with drainage of a substantial amount of pleural fluid. No definite pneumothorax. Continued enlargement of the cardiac silhouette with residual opacification at the left base.


SubjectID: 19139995, StudyID: 50116255, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p AVR, MVR, TV repair, asc aortic replacement // follow up effusions/edema

IMPRESSION: As compared to ___ chest radiograph, a large right pleural effusion has apparently increased in size as well as a moderate left pleural effusion. Marked enlargement of cardiac silhouette is stable, with new pulmonary vascular congestion and mild to moderate edema   Keywords: new.


SubjectID: 19151064, StudyID: 53138638, Comparison: None

FINAL REPORT

CLINICAL

HISTORY: ___-year-old man with desaturation and altered mental status.

COMPARISON: ___ examination. PORTABLE AP CHEST RADIOGRAPH: Severe cardiomegaly is once again noted and unchanged. No appreciable pulmonary edema. There is unchanged appearance of elevated left hemidiaphragm. Median sternotomy wires are once again seen. No pneumothoraces are seen. Mild pulmonary edema is again present, however there are scattered nodular opacities seen projecting over both lungs. Underlying nodules cannot be excluded.

IMPRESSION: Stable x-ray from ___, with cardiomegaly, elevated left hemidiaphragm and pulmonary edema. The opacities scattered bilaterally are concerning for possible underlying nodules and a non-emergent chest CT can be obtained to further evaluate these.


SubjectID: 19151064, StudyID: 50249152, Comparison: worse

FINAL REPORT

AP CHEST, 3:30 A.M., ___

HISTORY: COPD, question interval change.

IMPRESSION: AP chest compared to ___: Left hemidiaphragm is chronically elevated responsible for persistent severe left lower lobe atelectasis. Increasing opacification in the mid and lower lung zones since ___ could be worsening dependent edema, since there is substantial pulmonary vascular and mediastinal venous engorgement in the setting of severe chronic cardiomegaly, but pneumonia should also be considered, particularly aspiration   Keywords: worse, increasing. The bilateral pleural effusions are unchanged. No pneumothorax.


SubjectID: 19151064, StudyID: 52529046, Comparison: same

FINAL REPORT

PORTABLE CHEST OF ___

COMPARISON: Radiograph of earlier the same date.

FINDINGS: New right internal jugular central venous catheter terminates at the expected junction of the superior vena cava and right atrium, with no evidence of pneumothorax. There is otherwise no relevant change in the appearance of the chest since the recent study performed a few hours earlier   Keywords: no relevant change.


SubjectID: 19151064, StudyID: 52392546, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Shortness of breath and hypotension.

COMPARISONS: ___.

TECHNIQUE: Chest, portable AP upright.

FINDINGS: A left-sided dialysis catheter terminates in the upper atrium. The patient is status post sternotomy. The cardiac, mediastinal and hilar contours appear unchanged. There is similar moderate relative elevation of the left hemidiaphragm with patchy basilar opacification suggesting minor atelectasis. Elsewhere, the lungs appear clear. There is no definite pleural effusion or pneumothorax. A small pleural effusion would be difficult to appreciate on the left side, however, if one were present.

IMPRESSION: No evidence of acute disease.


SubjectID: 19151064, StudyID: 52234727, Comparison: None

FINAL REPORT

EXAM: Chest, single AP upright portable view. CLINICAL INFORMATION: ___-year-old male with history of shortness of breath.

COMPARISON: ___.

FINDINGS: Frontal and lateral views of the chest were obtained. Right-sided central venous hemodialysis catheter is again seen, terminating in the right atrium. Persistent elevation of the left hemidiaphragm is again seen with subsequent shift of the mediastinum/cardiac silhouette to the right. The cardiac silhouette may be enlarged although the left aspect is not well assessed due to the elevated left hemidiaphragm. No pleural effusion or pneumothorax is seen. Patient is status post median sternotomy.


SubjectID: 19151064, StudyID: 52056571, Comparison: same

FINAL REPORT

CLINICAL

HISTORY: ___-year-old man with bacteremia. Evaluate for pneumonia.

COMPARISON: ___.

FINDINGS: In comparison to the prior radiograph, there has been little significant overall change   Keywords: little significant overall change. Elevation of the left hemidiaphragm is once again seen. Cardiac silhouette is difficult to evaluate given the hemidiaphragm elevation, however, does appear to be enlarged. No focal opacities are noted concerning for an infectious process. Patient is status post median sternotomy. Right-sided hemodialysis catheter has been removed.


SubjectID: 19155768, StudyID: 52316582, Comparison: better

FINAL REPORT

INDICATION: Cough and mild chest discomfort, history of CAD, concern for ACS, fluid overload, or pneumonia.

COMPARISON: Chest radiograph on ___.

FINDINGS: PA and lateral views of the chest. Borderline cardiomegaly is stable. Previously seen mild pulmonary vascular congestion and pulmonary edema has decreased   Keywords: decrease. No evidence of pneumonia. No pleural effusion or pneumothorax. Normal mediastinal and hilar contours. Sternotomy wires are in appropriate positions. Aortic valve replacement and tricuspid valvuloplasty are in appropriate position.

IMPRESSION: Decreased pulmonary vascular congestion and pulmonary edema compared to most recent study   Keywords: decrease.


SubjectID: 19155768, StudyID: 51746209, Comparison: same

PROVISIONAL

FINDINGS

IMPRESSION (PFI): ___ ___ ___ 11:39 AM Mild vascular congestion, unchanged from ___   Keywords: unchanged   Keywords: unchanged. ______________________________________________________________________________

FINAL REPORT

INDICATION: Chest pain and CAD. Evaluate for acute cardiopulmonary process.

COMPARISON: Chest x-ray on ___.

FINDINGS: PA and lateral radiographs of the chest again demonstrate an enlarged cardiomediastinal silhouette, unchanged from ___ with intact median sternotomy wires and mediastinal clips. Prosthetic aortic and mitral valves are again noted. There is unchanged mild vascular congestion   Keywords: unchanged. No pneumothorax or pleural effusion is visualized. There is unchanged left basilar atelectasis. There is no other focal airspace consolidation.

IMPRESSION: Mild vascular congestion, unchanged from ___.


SubjectID: 19174686, StudyID: 57132193, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiograph PA and lateral

INDICATION: ___ year old man with CKD and new fever, diarrhea, cough // r/o pneumonia

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest x-ray ___

FINDINGS: There is new focal consolidation at the left lung base adjacent to the left heart border. Lateral view demonstrates an opacity projecting over the lower thoracic spine, suggesting left lower lobe pneumonia. Right lung is essentially clear. Small bilateral pleural effusions are noted, slightly increased since ___. No pneumothorax or pulmonary edema. Mediastinum and hila are within normal limits. Stable mild to moderate cardiomegaly.

IMPRESSION: 1. New left lower lobe pneumonia. Recommend follow-up CXR in ___ weeks after treatment to document resolution. 2. Small bilateral pleural effusions, slightly worse compared to ___.

NOTIFICATION: Findings telephoned to Dr. ___ by Dr. ___ on ___ at 4:47PM, time of discovery.


SubjectID: 19174686, StudyID: 56860215, Comparison: worse

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old man with LLL PNA and respiratory distress. // r/o mucous plugging, collapse, evolving airpsace dz

TECHNIQUE: Portable chest radiograph

COMPARISON: Chest x-ray ___

FINDINGS: The left lower lobe of consolidation that was seen on yesterday's chest x-ray is re-demonstrated. There is also development of new diffuse opacities that are more prominent at the lung bases, likely due to pulmonary edema   Keywords: development, new. No evidence of lobar collapse. Mild pulmonary vascular congestion. Stable mild to moderate cardiomegaly. No acute osseous abnormality.

IMPRESSION: 1. Unchanged appearance of known LLL pneumonia. 2. New mild/moderate pulmonary edema   Keywords: new.


SubjectID: 19184330, StudyID: 59433999, Comparison: None

FINAL ADDENDUM ADDENDUM: The frontal view discloses that the multiple circular wires in the sternotomy of this patient have been ruptured. Cause is unclear. ______________________________________________________________________________

FINAL REPORT

TYPE OF

EXAMINATION: Chest AP portable single view.

INDICATION: ___-year-old female patient status post dual-chamber permanent pacemaker placement on ___ via left subclavian approach. Evaluate for pneumothorax.

FINDINGS: AP single view of the chest has been obtained with patient in semi-upright position. There is status post sternotomy and the presence of multiple surgical clips in the left mediastinal structures are indicative of previous bypass surgery. A permanent pacer is identified in left anterior axillary position seen to be connected to two intracavitary electrodes with termination points compatible with right atrial appendage and apical portion of right ventricle correspondingly. There is mild cardiac enlargement but no evidence of pulmonary vascular congestion is seen and the lateral pleural sinuses are free from any fluid accumulation. No evidence of pneumothorax in the apical area.

IMPRESSION: Apparently appropriately placed dual intracavitary electrode permanent pacer without evidence of pneumothorax.


SubjectID: 19184330, StudyID: 53195640, Comparison: None

FINAL REPORT

HISTORY: ___-year-old woman status post dual-chamber pacemaker on ___ via left subclavian approach. Evaluate lead positioning.

COMPARISON: ___ radiograph.

FINDINGS: A left-sided of battery pack and pacemaker lead is noted with the leads terminating in the right atrium and the right ventricle. Median sternotomy wires are noted to be broken with a small lucency in between then, perhaps a sign of chronic dehiscence. There is mild-to-moderate cardiomegaly, particurally an englarged left ventricle. Hilar contours are normal.

IMPRESSION: Correct lead positioning in the right atrium and right ventricle. Cardiomegaly.


SubjectID: 19192170, StudyID: 52494482, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Status post fall with right femur fracture. Preoperative study.

COMPARISONS: ___.

TECHNIQUE: Chest, AP views.

FINDINGS: The heart is again mild-to-moderately enlarged. The main pulmonary artery contour appears moderately enlarged. The aortic arch is calcified. Opacities at the lung bases have markedly improved, leaving streaky opacities, most prominent at the left retrocardiac region. There is increased interstitial abnormality suggesting mild vascular congestion   Keywords: increase. There is no pleural effusion or pneumothorax. Mild-to-moderate rightward convex curvature centered along the lower thoracic spine with multilevel mild degenerative changes noted along the lower thoracic levels. The bones appear demineralized.

IMPRESSION: 1. Findings suggesting mild vascular congestion, although somewhat increased   Keywords: increase. 2. Marked improvement in basilar opacities with residual streaky opacities, greater on the left than right, suggestive of atelectasis or resolving infection.


SubjectID: 19192170, StudyID: 52483599, Comparison: None

FINAL REPORT

HISTORY: Desaturation and aspiration pneumonia. CHEST, SINGLE AP PORTABLE VIEW.

COMPARISON: Chest x-ray from ___ at 11:55 a.m. There is hyperinflation consistent with COPD. There is moderate to moderately severe cardiomegaly. There is upper zone redistribution, without overt CHF. There is some patchy opacity at the right base and increased retrocardiac density, both of which appear to have progressed compared with ___. Minimal blunting of the right costophrenic angle. No gross effusion on either side. Incidental note is made of calcification adjacent to the left shoulder consistent with calcific tendinitis.

IMPRESSION: 1. COPD. 2. Cardiomegaly. 3. Worsening bibasilar opacities concerning for aspiration pneumonitis versus infectious pneumonic infiltrates.


SubjectID: 19192701, StudyID: 54146515, Comparison: None

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPHS

INDICATION: Bilateral edema in the legs.

COMPARISON: ___.

TECHNIQUE: Chest, AP upright and lateral.

FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged, allowing for differences in technique, including a calcified aortopulmonary window lymph node. There is no pneumothorax or definite pleural effusion. There is mild perihilar congestion, but otherwise the lungs appear clear. Surgical clips project over the upper abdomen.

IMPRESSION: Findings suggesting mild vascular congestion.


SubjectID: 19192701, StudyID: 51330284, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with aortic stenosis and diastolic heart failure with desaturations // ?pulmonary edema ?pulmonary edema

IMPRESSION: In comparison with the earlier study of this date, there may be some on sharpness of the left hemidiaphragm, consistent with atelectatic changes and possible small effusion. However, there is only mild elevation of pulmonary venous pressure.


SubjectID: 19194530, StudyID: 58445391, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with aortic stenosis c/o shortness of breath // eval for pulmonary edema

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: None.

IMPRESSION: Heart size is mildly enlarged. Mediastinal silhouettes are unremarkable. Asymmetric opacities mainly involving the entire right lung as well as left lower lobe are noted and although might represent asymmetric pulmonary edema, infectious process is a possibility. There is no substantial amount of pleural effusion noted and there is no pneumothorax demonstrated.


SubjectID: 19194530, StudyID: 52627702, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ y/o female with a past medical history of moderate to severe AS, dCHF (EF ___%), HTN, DMII, and CKD IV (Cr 1.6-1.9) who presented to an OSH with acute CHF exacerbation was transferred to ___ for TAVR evaluation with worsening SOB // eval for worsening pulm edema

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Widespread parenchymal opacities appear to be unchanged as compared to most recent prior study obtained at 22:16 the day before   Keywords: unchanged. No new consolidations demonstrated. The abnormalities are most likely representing infectious process or interstitial lung disease and unlikely to represent asymmetric pulmonary edema. As previously suggested correlation with chest CT would be beneficial


SubjectID: 19194530, StudyID: 55929098, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF exacerbation, possible PNA // PNA, effusions PNA, effusions

IMPRESSION: In comparison with the study of ___, there has been some improvement in the opacification in the right hemithorax. This could reflect improving pulmonary venous status with decrease in the degree of underlying consolidation. Left basilar opacification is unchanged and could represent any combination of pleural fluid, volume loss, and superimposed pneumonia.


SubjectID: 19194530, StudyID: 54057638, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with respiratory distress. Evaluate for CHF.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest CT and chest radiograph from ___.

FINDINGS: Since the prior radiograph, heterogeneous opacities in the right upper and lower lungs have worsened, resulting in more confluent consolidation. Additionally, new retrocardiac opacity may represent worsening atelectasis or infection. Superimposed pulmonary edema is likely. Heart size and mediastinal contour is unchanged. Small bilateral pleural effusions are likely.

IMPRESSION: Interval worsening in consolidation of the right lung, as well as new consolidation at left lung base. Findings are concerning for multifocal infection. Superimposed pulmonary edema is also likely.


SubjectID: 19206717, StudyID: 59478954, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with respiratory decompensation, transferred to ICU. Please assess for interval change. // assess for interval change

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Relatively low lung volumes, likely reflecting the consolidations and fibrotic changes seen on the recent chest CT. Despite the presence of severe lower lobe predominant bronchiectasis, no signs of overinflation are seen. Moderate cardiomegaly. No pleural effusions.


SubjectID: 19206717, StudyID: 50304647, Comparison: 0.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with COPD exacerbation, impending respiratory failure

TECHNIQUE: Semi-upright AP view of the chest

COMPARISON: CT trachea ___ and chest radiograph ___

FINDINGS: Heart size is mildly enlarged. Mediastinal and hilar contours appear unchanged with enlargement of the pulmonary arteries, better assessed on the previous CT, compatible with pulmonary arterial hypertension. There is upper zone vascular redistribution without overt pulmonary edema. Chronic interstitial opacities are again noted predominantly along the periphery and lung bases with bronchiectasis also noted in the lower lobes   Keywords: again. Patchy ill-defined opacities are re- demonstrated in both lower lung fields as well as within the upper lobes bilaterally, more so on the right. Overall, the findings within the left lung base and left upper lobe appear minimally improved, with the opacities in the right lung base perhaps slightly worse   Keywords: worse. Small bilateral pleural effusions are likely present. No pneumothorax is demonstrated. Remote left-sided rib rib fractures are again seen.

IMPRESSION: Patchy ill-defined opacities within both upper lobes, more so on the right, as well as within both lung bases, findings concerning for superimposed infection on a background of chronic interstitial abnormality and bronchiectasis. Small bilateral pleural effusions.


SubjectID: 19206717, StudyID: 57796374, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with a history of bronchiectasis (prior resistant pseudomonas), asthma, DM2, HTN, HLD, presents with chest pain, shortness of breath and productive cough, found to be hypoxic with leukocytosis, s/p extubation and having respiratory distress with crackles. // Evidence of pulmonary edema? Evidence of pulmonary edema?

IMPRESSION: In comparison with the earlier study of this date, the diffuse areas of heterogeneous opacification are again seen bilaterally in, worrisome for pneumonia. The endotracheal tube and nasogastric tube have been removed.


SubjectID: 19206717, StudyID: 57001221, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with pneumonia // interval change interval change

COMPARISON: Chest radiographs ___ through ___.

IMPRESSION: Mild pulmonary edema has improved since ___, after fluctuating previously since ___   Keywords: improve. Small areas of heterogeneous opacification, presumed pneumonia, persists in the lingula and nondependent lung. Small bilateral pleural effusions are stable. Heart size is normal. ET tube and nasogastric tube are in standard placements. No pneumothorax.


SubjectID: 19206717, StudyID: 50783919, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with a history of bronchiectasis (prior resistant pseudomonas), asthma, DM2, HTN, HLD, presents with chest pain, shortness of breath and productive cough, found to be hypoxic with leukocytosis, treated empirically for PNA in ED, now tachypneic on Bipap // Any interval change? Any interval change?

IMPRESSION: In comparison with the study of ___, the patient has taken a slightly better inspiration. There is little overall change in the appearance of the heart and lungs with diffuse areas of heterogeneous opacification worrisome for pneumonia.


SubjectID: 19206717, StudyID: 50236666, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with a history of bronchiectasis (prior resistant pseudomonas), asthma, DM2, HTN, HLD, presents with chest pain, shortness of breath and productive cough, found to be hypoxic with leukocytosis, treated empirically for PNA in ED, now tachypneic on Bipap. // Any interval change? Any interval change?

IMPRESSION: In comparison with the study of ___, the monitoring and support devices remain unchanged. There is increasing opacification at the left base, which could reflect some worsening pleural effusion and atelectatic changes. Less prominent changes are seen on the right. In the appropriate clinical setting, it would be difficult to exclude the possibility of superimposed consolidation.


SubjectID: 19206717, StudyID: 57510996, Comparison: same

FINAL REPORT

INDICATION: Concern for pneumonia or aspiration.

COMPARISON: Chest radiograph from ___.

TECHNIQUE: Frontal chest radiograph.

IMPRESSION: The heart size is normal. The hilar and mediastinal contours are unchanged since ___. Widespread interstitial reticular opacities, possibly reflecting chronic interstitial disease, remain stable   Keywords: remain, stable. Bibasilar opacities likely reflect moderate atelectasis, however, small consolidations cannot be excluded. This is unchanged since the prior radiograph. There is no pneumothorax.


SubjectID: 19206717, StudyID: 54585660, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with sob // characterization of edema vs. pna

COMPARISON: Prior exam from earlier today.

FINDINGS: AP portable upright view of the chest. There has been no change from prior exam   Keywords: no change. Peripheral and lower lobe opacities are noted which could represent an atypical pneumonia versus aspiration. Small effusions may be present. No large pneumothorax. Cardiomediastinal silhouette is unchanged. No acute bony injuries. Old left rib deformity.

IMPRESSION: Peripheral and lower lobe opacities concerning for atypical infection versus aspiration. Probable small bilateral pleural effusions.


SubjectID: 19206717, StudyID: 54370998, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with dyspnea, hypoxia.

COMPARISON: Prior chest radiograph from ___.

FINDINGS: AP portable upright view of the chest. There are small bilateral pleural effusions with mild pulmonary edema. Lower lobe atelectasis likely present though cannot exclude a component of pneumonia. No large pneumothorax. Overall cardiomediastinal silhouette is stable. Bony structures are intact with inferior spurring at the shoulders. Chronic left rib deformity is noted

IMPRESSION: Mild edema, small bilateral effusions, lower lung atelectasis, difficult to exclude a superimposed pneumonia.


SubjectID: 19206717, StudyID: 54037591, Comparison: None

FINAL REPORT

INDICATION: Bronchiectasis and pneumonia, post intubation.

COMPARISON: Radiograph from ___.

TECHNIQUE: Frontal chest radiograph.

IMPRESSION: The endotracheal tube terminates 4.5 cm above the carina. An orogastric tube terminates within the stomach. Right basilar bronchiectasis is again demonstrated. In comparison to the ___ examination, there is improved pulmonary aeration with decreased bibasilar opacities, reflecting improved atelectasis and/or consolidations. No new consolidation is detected. There are trace bilateral pleural effusions. No pneumothorax is detected.


SubjectID: 19206777, StudyID: 53885046, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, evaluation for pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Pacemaker in expected left pectoral position. No evidence of pneumothorax or other complications. Unchanged borderline size of the cardiac silhouette.


SubjectID: 19206777, StudyID: 53465022, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with pacing-induced CHF evaluate for pneumothorax.

COMPARISON: Prior radiographs from ___.

FINDINGS: Left chest wall pacemaker is seen with leads in unchanged position. Since the prior radiograph, there appears to be increased consolidation at the left base with obscuration of the left hemidiaphragm, possibly due to volume loss; however, this may be due to technical reasons. The right lung is clear. Cardiomediastinal silhouette is unchanged.

IMPRESSION: Increased opacification of the left retrocardiac region and base, which may be due to increased volume loss or technical reasons.


SubjectID: 19206777, StudyID: 53139159, Comparison: None

FINAL REPORT

INDICATION: Cough and chest pain.

COMPARISONS: Chest radiograph, ___.

FINDINGS: The lungs are clear without evidence of pulmonary edema or consolidation. There is no pleural effusion or pneumothorax. Moderate cardiomegaly is unchanged from the prior exam. Atherosclerotic calcifications are noted in the aorta. A dual-chamber pacemaker is present with the wires in proper position. Evidence of an abdominal aortic stent is partially visualized on the lateral radiograph.

IMPRESSION: 1. No acute cardiopulmonary process. 2. Stable moderate cardiomegaly.


SubjectID: 19213219, StudyID: 57651580, Comparison: same

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPHS

INDICATION: Shortness of breath.

TECHNIQUE: Chest, AP and lateral.

COMPARISON: ___.

FINDINGS: The heart is moderately enlarged, especially the left atrium. A moderate interstitial abnormality suggest congestive heart failure. There is a pleural effusion on the left, probably small to moderate in size, and a small right-sided pleural effusion. Fissures appear thickened. There is no pneumothorax. Interstitial type opacification is most confluent in the posterior right lower lobe, although suspicion is that this is also edema.

IMPRESSION: Findings most consistent with moderate interstitial pulmonary edema, accompanied by pleural effusions. Attenation in follow-up suggested regarding more confluent opacity at the right lung base although edema is again the suspected etiology; coinciding pneumonia is not excluded, however   Keywords: again.


SubjectID: 19213219, StudyID: 56017267, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF // Assess for fluid in lungs

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the left pleural effusion with subsequent atelectasis is unchanged. However, a small right pleural effusion has developed in the interval. Mild cardiomegaly with mild pulmonary edema persists   Keywords: persists. No pneumothorax.


SubjectID: 19213219, StudyID: 55235986, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with increasing O2 requirement, afib, Lasix held/received volume // acute process, volume overload

TECHNIQUE: Chest single view

COMPARISON: ___

IMPRESSION: Again visualized is moderate cardiomegaly. There small bilateral pleural effusions left greater than right that have increased slightly compared to prior. There is minimal vascular redistribution. There is a small amount of volume loss in the lower lungs.


SubjectID: 19213219, StudyID: 50095487, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT) PORT

INDICATION: ___F with cough, malaise // PNA?

COMPARISON: ___.

FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. Cardiomegaly is mild. Hila are equivocally prominent. Mediastinal contour is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen.

IMPRESSION: Mild cardiomegaly with subtle hilar prominence which could reflect mild congestion. No convincing evidence for pneumonia.


SubjectID: 19227457, StudyID: 57849161, Comparison: None

FINAL REPORT

INDICATION: Rapid atrial fibrillation and shortness of breath. Evaluate for edema.

COMPARISONS: Chest radiograph from ___.

TECHNIQUE: A single upright AP view of the chest was obtained.

FINDINGS: A left subclavian central venous catheter is present with the tip in the upper SVC. The enteric tube has been removed. Since the prior exam, the lung volumes have improved. There is stable mild bibasilar atelectasis. There is no pleural effusion, pulmonary edema, or pneumothorax. The mediastinal contours are normal. The heart size is mildly enlarged.

IMPRESSION: Improved lung volumes. No evidence of pulmonary edema.


SubjectID: 19227457, StudyID: 51570273, Comparison: None

FINAL REPORT

INDICATION: Status post Whipple, evaluate for pulmonary edema.

COMPARISON: Chest radiograph ___, CT abdomen ___.

FINDINGS: Left internal jugular line is present with tip in the upper SVC. An enteric tube can be followed to the level of the distal esophagus, but the tube cannot be followed beyond that point. There is a small left pleural effusion. There is no pneumothorax or right pleural effusion. There are low lung volumes. Left retrocardiac opacity is present, likely reflecting atelectasis. Pulmonary vasculature is within normal limits. The patient is status post right rotator cuff repair.

IMPRESSION: Small left pleural effusion and left basilar atelectasis. No pulmonary edema.


SubjectID: 19227457, StudyID: 50705414, Comparison: same

FINAL REPORT

PORTABLE CHEST X-___ ___ ___

COMPARISON: ___ radiograph.

FINDINGS: As compared to the recent study of one day earlier, there has been no relevant short interval change in the appearance of the chest   Keywords: no relevant short interval change.


SubjectID: 19231238, StudyID: 56761095, Comparison: worse

FINAL REPORT

INDICATION: History of CHF and hypertension and diabetes, worsening cough and dyspnea. Evaluate for pneumonia or pulmonary edema.

COMPARISON: Chest radiograph on ___.

FINDINGS: AP and lateral views of the chest. There are new diffuse opacities in both lungs, right greater than left likely due to slight leftward rotation   Keywords: new. There are small bilateral pleural effusions, left greater than right. There is mild cardiomegaly. No pneumothorax.

IMPRESSION: New diffuse bilateral opacities likely represent moderate pulmonary edema with mild cardiomegaly and small bilateral effusions, most consistent with CHF exacerbation   Keywords: new. Underlying pneumonia cannot be excluded.


SubjectID: 19231238, StudyID: 51367041, Comparison: better

FINAL REPORT

HISTORY: ___-year-old woman with acute on chronic diastolic congestive heart failure, evaluate interval change after diuresis.

TECHNIQUE: PA and lateral chest radiographs obtained of the patient in the upright position.

COMPARISON: Chest radiograph from ___ and ___.

FINDINGS: Previous pulmonary edema has nearly resolved   Keywords: resolve. The cardiac silhouette continues to is mildly enlarged. Small pleural effusions are present, left greater than right.

IMPRESSION: Near resolution of pulmonary edema.


SubjectID: 19243336, StudyID: 54007415, Comparison: better

WET READ: ___ ___ ___ 11:36 PM No pneumothorax. There is slight decrease in bibasilar atelectasis. Stable positioning of tubes and lines. Stable cardiomediastinal silhouette. ______________________________________________________________________________

FINAL REPORT

HISTORY: Chest tube on waterseal.

FINDINGS: In comparison with the earlier study of this date, the chest tube is on waterseal, and there is no evidence of pneumothorax. The bibasilar opacifications are slightly improved   Keywords: improve. Monitoring and support devices are otherwise unchanged.


SubjectID: 19243336, StudyID: 52849767, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female status post CABG. Evaluate for pneumothorax and pleural effusions. Patient is status post chest tube removal.

COMPARISON: Chest radiograph dated 1 day prior.

FINDINGS: There has been interval removal of mediastinal drain and left sided chest tube. No pneumothorax is identified. The lung parenchyma is essentially unchanged in appearance with mild bibasilar atelectasis. Stable cardiomegaly and mediastinal silhouettes. Monitoring and support devices are otherwise unchanged. Sternotomy wires are intact.

IMPRESSION: No significant changes with removal of left chest tube and mediastinal drain.


SubjectID: 19243336, StudyID: 53888662, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH Status post CABG, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, no relevant change has occurred   Keywords: no relevant change. Mild bilateral plate-like atelectasis in both lungs. Mild pleural effusions. No pneumothorax. No evidence of pneumonia. Unchanged size and appearance of the cardiac silhouette.


SubjectID: 19252302, StudyID: 52440922, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with respiratory distress, CHF // Evaluate for edema, new consolidation

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Mild interstitial edema has increased, superimposed to known mild chronic interstitial lung disease   Keywords: increase. Cardiac size is top-normal. There is no pneumothorax. If any there is a small right effusion


SubjectID: 19252302, StudyID: 52301785, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (AP AND LAT)

INDICATION: History: ___M with congestive heart failure with worsening shortness of breath and leukocytosis

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph ___, CT chest ___

FINDINGS: Heart size is mildly enlarged, unchanged. Mediastinal and hilar contours are similar. Pulmonary vasculature is not engorged. Mild interstitial abnormality is seen within the lung bases, similar to prior, likely reflective of a chronic interstitial lung disease as seen on the prior chest CT   Keywords: similar. No focal consolidation, pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities.

IMPRESSION: No acute cardiopulmonary abnormality. Mild chronic interstitial lung disease.


SubjectID: 19253914, StudyID: 57528350, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male initially presenting with sepsis, now requiring assessment for an infectious source.

COMPARISON: Comparison is made with chest radiographs from ___ and ___.

FINDINGS: PA and lateral views of the chest demonstrate massive elevation of the right hemidiaphragm, reducing lung volume to one-third of the original volume. There is mild elevation of the left hemidiaphragm, as well, which is resulting in bronchovascular crowding at the base. There is no evidence of pneumonia or other focal infectious process on this exam. There is some tortuosity to the aorta. Bowel loops are seen interposed between the diaphragm and the liver.

IMPRESSION: Massive elevation of the right hemidiaphragm reducing the right lung to the one-third of its original volume. No evidence of pneumonia or other focal infection. These findings were communicated to Dr. ___ by telephone at the time they were discovered at 3:04 p.m. on ___.


SubjectID: 19259478, StudyID: 59816687, Comparison: same

FINAL REPORT

HISTORY: Right pleural effusion status post thoracentesis.

TECHNIQUE: Portable frontal chest radiograph.

COMPARISON: Multiple chest radiographs dating from ___ through ___ the same day 10:44.

FINDINGS: There has been interval resolution of the large right-sided pleural effusion status post thoracentesis. There is a new small right pneumothorax with apical and basal components. Mild interstitial edema is unchanged   Keywords: unchanged. Moderate cardiomegaly is unchanged. Stable postsurgical mediastinal contour. A left pacer is in place unchanged in position.

IMPRESSION: Small right postprocedural pneumothorax with apical and basilar components. Interval resolution of right pleural effusion. Results were discussed over the telephone with Dr. ___ at 13:16 on ___ at time of initial review.


SubjectID: 19259478, StudyID: 50776947, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluation for pleural effusion.

COMPARISON: ___.

FINDINGS: As compared to the previous examination, the right pleural drain has been removed. The pre-existing right pleural effusion has moderately increased in extent. It now occupies approximately half of the right hemithorax. Subsequent areas of atelectasis at the right lung base have also increased. The ventilated apical areas of the right lung as well as the left lung are unchanged. Unchanged alignment of sternal wires and position of the pacemaker wires. Mild cardiomegaly and tortuosity of the thoracic aorta.


SubjectID: 19259478, StudyID: 50670816, Comparison: worse

FINAL REPORT

HISTORY: Large volume thoracentesis with small pneumothorax, to assess for change.

FINDINGS: In comparison with the earlier study of this date, there is probably little change in the degree of apical pneumothorax. Fluid is seen in the pleural space at the base. There is suggestion of some increased prominence of pulmonary vessels, consistent with some worsening pulmonary vascular engorgement   Keywords: worse. Enlargement of the cardiac silhouette persists.


SubjectID: 19259478, StudyID: 54177058, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: Chest PA and lateral.

INDICATION: ___-year-old male patient with large right pleural effusion, evaluate for interval change.

FINDINGS: Patient's condition required examination in sitting position using AP frontal and left lateral views. Comparison is made with the next preceding similar study of ___. Status post sternotomy and bypass surgery as well as permanent pacer with dual intravascular electrodes are unchanged. Same holds for the cardiomegaly. On previous examination noted marked perivascular haze in the pulmonary circulation has regressed and almost normalized, indicating successful dehydration. The left-sided pleural effusion is minimal with mild blunting of the lateral and posterior pleural sinus. The large size right-sided pleural effusion is stable and apparently unrelated to the patient's now intermittent episode of pulmonary congestion.


SubjectID: 19259478, StudyID: 54141341, Comparison: same

FINAL REPORT

HISTORY: Syncope and check cardiac leads.

COMPARISON: ___.

FINDINGS: There is a large right and small left pleural effusion with mild pulmonary vascular redistribution and moderate cardiomegaly. The findings are compatible with CHF. Given technique, the extent of the CHF is similar compared to prior   Keywords: similar. Dual lead pacemaker with leads in similar location compared to prior is again seen. The patient is status post sternotomy with sternal wires and mediastinal clips.

IMPRESSION: No significant change   Keywords: no significant change. CHF.


SubjectID: 19259478, StudyID: 52198246, Comparison: worse

FINAL REPORT

HISTORY: Pacemaker.

COMPARISON: One hundred ___. Thirteen.

FINDINGS: There is a new left-sided dual lead pacemaker with tips projecting over the expected location. Heart there is increased right-sided pleural effusion. Moderate cardiomegaly, pulmonary vascular redistribution and alveolar infiltrates, right greater than left compatible with asymmetric pulmonary edema that has worsened compared to the film from the prior day   Keywords: worse. There is no pneumothorax.

IMPRESSION: Worsened pulmonary edema   Keywords: worse.


SubjectID: 19259478, StudyID: 51273610, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with a history of CHF, CKD, CAD, with ejection fraction of 15% to ___% with syncopal episode. Evaluate for evidence of CHF exacerbation.

COMPARISON: Multiple prior chest radiographs, most recent on ___.

TECHNIQUE: Upright AP and lateral chest radiograph.

FINDINGS: There is a large right-sided pleural effusion, slightly increased in size compared with prior exam. There is diffuse increased interstitial markings, Kerley B lines, and upper vascular redistribution, but no focal opacities. Large cardiomegaly is redemonstrated. There is no left-sided pleural effusion and no pneumothorax. Sternotomy wires are intact.

IMPRESSION: Findings compatible with pulmonary edema.


SubjectID: 19263269, StudyID: 54586696, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with sCHF and R pleural effusion. s/p chest tube // r/o pneumo, interval change

COMPARISON: ___

IMPRESSION: As compared to the previous image, the right pigtail catheter has been removed. The patient continues to show a small pneumothorax. The pneumothorax is now also visualized at the lung apex and has a dimension of 1-2 mm. There is severe re-expansion edema at the mid and low lung zones on the right is constant in appearance. Unchanged normal left lung and left heart border.


SubjectID: 19263269, StudyID: 51446228, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with recent chest tube placement now with cough productive of copious pink tinged sputum // Re-expansion pulmonary edema?

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, there is massive re-expansion edema at the mid and lower aspect 's of the right lung. AT now must be followed until resolution. Minimal post procedural basal pneumothorax of the tapping of the right pleural fluid via the pigtail catheter. No tension. Unchanged appearance of the left lung and the cardiac silhouette.


SubjectID: 19263269, StudyID: 50494674, Comparison: same

WET READ: ___ ___ ___ 7:57 AM Right chest tube now in place. Pleural effusion has largely been drained. No pneumothorax. Bibasilar atelectasis. New elevation of left hemidiaphragm may be secondary to gastric distension. Pulmonary vascular engorgement but no frank pulmonary edema.

WET READ VERSION #1 ___ ___ ___ 6:17 PM Right chest tube now in place. Pleural effusion has largely been drained. No pneumothorax. Bibasilar atelectasis. New elevation of left hemidiaphragm may be secondary to gastric distension. Pulmonary vascular engorgement but no frank pulmonary edema. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with sCHF and R pleural effusion. s/p chest tube // s/p chest tube, r/o pnuemo

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the patient has received a right pigtail catheter, position in the pleural space. The pre-existing extensive right pleural effusion has substantially decreased. The effusion is now limited to the lung bases and the costophrenic sinus. Re-expansion edema at the level of the middle and lower lobe. No pneumothorax. Unchanged appearance of the left lung   Keywords: unchanged appearance.


SubjectID: 19275656, StudyID: 57501213, Comparison: better

FINAL REPORT

HISTORY: ___-year-old female status post resection of subaortic membrane and septal myomectomy. Assess for pleural effusions and pneumothorax.

COMPARISON: Chest radiograph ___, ___, ___.

TECHNIQUE: Frontal and lateral chest radiographs.

FINDINGS: Sternotomy wires intact. Right IJ tip is in right atrium. Interval mild decrease in left lower lobe atelectasis, left pleural effusion and pulmonary edema. Slight decrease in otherwise mildly enlarged heart with normal mediastinal contour and hila. The right lung is clear without pleural effusion. No pneumothorax.

IMPRESSION: Interval improvement of pulmonary edema, left lower lobe atelectasis, and left pleural effusion   Keywords: improve. No pneumothorax.


SubjectID: 19276413, StudyID: 56863436, Comparison: None

FINAL REPORT

HISTORY: Diastolic heart failure and shortness of breath, cough and fever. Evaluate for infiltrate.

TECHNIQUE: Frontal and lateral views of the chest.

COMPARISON: Chest radiographs ___ and a ___,013.

FINDINGS: There has been near resolution of the previously seen mild pulmonary edema. Additionally, the small left pleural effusion has improved. There is likely a small right pleural effusion. There is no focal airspace consolidation or pneumothorax. The heart size is normal and improved. Dense calcifications are seen within the mitral valve. There may be a small left lung nodule which is new from ___. The aortic valve prosthesis, right axillary and abdominal clips are unchanged. Wedge compression deformities of the thoracic spine are unchanged. Patient is status post a right mastectomy.

IMPRESSION: 1. Improved small left pleural effusion and near resolution of mild pulmonary edema. 2. Possible left lung nodule for which follow up chest radiograph is recommend in 6 weeks. These findings were discussed with Dr. ___ by Dr. ___ at 11:26 on ___ by telephone at the time of discover.


SubjectID: 19276413, StudyID: 53747481, Comparison: None

FINAL REPORT

HISTORY: ___-year-old woman with shortness of breath and dyspnea on exertion.

COMPARISON: Chest radiograph from ___.

FINDINGS: Upright AP and lateral radiographs of the chest are provided. These images demonstrate pulmonary vascular engorgement, mild interstitial pulmonary edema, enlargement of the cardiac silhouette, and small bilateral pleural effusions. The pattern is most consistent with decompensated congestive heart failure however a concurrent infectious process in the lung bases cannot be fully excluded. An artificial aortic valve surgical clips in the mediastinum and upper abdomen, and median sternotomy cerclage wires are present. There are multiple compression fractures in the thoracic spine which are stable for at least a year.

IMPRESSION: Mild decompensated congestive heart failure. Concurrent infectious process at the lung bases cannot be fully excluded.


SubjectID: 19276413, StudyID: 55292603, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Questionable retrocardiac opacity.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the extent of the pre-described left retrocardiac opacity has slightly increased. In addition, there is now blunting of the costophrenic sinus on the left, suggesting the presence of a small left pleural effusion. Overall, these changes suggest the previously expressed concern for pneumonia, notably given the normal appearance of the left lung. Unchanged borderline size of the cardiac silhouette with tortuosity of the thoracic aorta. Unchanged alignment of the sternal wires. Unchanged right internal jugular vein catheter.


SubjectID: 19276413, StudyID: 52467743, Comparison: None

FINAL REPORT

CLINICAL

HISTORY: ___-year-old female with altered mental status and elevated white blood cell count.

COMPARISON: Multiple priors, most recently from ___.

FINDINGS: A single portable view of the chest is provided which is limited by respiratory motion. Low lung volumes result in bronchovascular crowding. A right-sided central venous catheter is seen terminating in the mid SVC. The patient is status post median sternotomy. Cardiac and mediastinal silhouettes are stable. No pneumothorax is seen. Right axillary clips and upper abdominal clips are again noted.

IMPRESSION: No overt evidence of infectious process.


SubjectID: 19291358, StudyID: 53686774, Comparison: better

FINAL REPORT

STUDY: Portable AP chest radiograph.

COMPARISON EXAM: Portable AP chest radiograph ___.

INDICATION: ___-year-old with multiple comorbidities presenting with ventricular tachycardia. Assess interval change.

FINDINGS: ET tube remains in good position. There is an upper alimentary tube whose tip is not seen, but appears to be coiled towards its distal end. Bilateral diffuse airspace opacities are much improved on this study, but slight increased markings in the bilateral upper lobes and the right lower lobe are still present   Keywords: improve. There is no pleural effusion or pneumothorax. Cardiomediastinal and hilar contours are normal.

IMPRESSION: Almost complete resolution of bilateral diffuse airspace opacifications consistent with diagnosis of pulmonary edema.


SubjectID: 19291358, StudyID: 53333535, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male recently intubated. Evaluate for position of endotracheal tube.

COMPARISON: None available.

TECHNIQUE: Portable supine chest radiograph.

FINDINGS: There are bilateral diffuse airspace opacities, with more confluent consolidations in the lung bases. A nodular component cannot be excluded. Assessment of the pleural sulci is limited as both were left out of the imaging frame. The cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax. Endotracheal tube is seen ending 4.8 cm above the carina. There is no cardiomegaly.

IMPRESSION: 1. Severe diffuse bilateral airspace opacities might represent pulmonary edema, pulmonary hemorrhage or widespread infection. Further assessment with chest CT is recommended. 2. Endotracheal tube ending 4.8 cm above the carina.


SubjectID: 19298963, StudyID: 58263605, Comparison: None

FINAL REPORT

HISTORY: ___-year-old male with inferior Q-waves and new heart failure on echo. Nocturnal dyspnea. Question CHF.

COMPARISON: None.

FINDINGS: Frontal and lateral views of the chest. The lungs are clear. There is no effusion, consolidation, or pulmonary vascular congestion. Cardiac silhouette is slightly enlarged. No acute osseous abnormalities detected.

IMPRESSION: Mild cardiomegaly without definite cardiopulmonary process or congestive failure.


SubjectID: 19299068, StudyID: 57151213, Comparison: None

FINAL REPORT

HISTORY: Interstitial lung disease with desaturation.

FINDINGS: In comparison with the study of ___, there again is extensive scattered radiation related to the size of the patient that greatly obscures the image. There are low lung volumes with enlargement of the cardiac silhouette and pulmonary vascular congestion. More confluent areas of opacification at the bases could reflect extensive atelectasis or supervening pneumonia in the appropriate clinical setting. Once again, standard PA and lateral chest radiographs would be helpful if the condition of the patient permits.


SubjectID: 19299068, StudyID: 52276334, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___.

FINDINGS: The exam is limited by a combination of optimal positioning, relatively low lung volumes, and large body habitus. With these limitations in mind, cardiomegaly and widespread predominantly interstitial opacities appear relatively similar compared to the prior radiograph. Slightly more confluent opacities are present at the lung bases, and there is also suggestion of small pleural effusions, which were not evident on a prior radiograph. When the patient's condition permits, standard PA and lateral chest radiographs would be helpful for more optimal assessment of the lungs and pleura, as well as to allow more accurate comparison to previous radiographs.


SubjectID: 19299811, StudyID: 59694054, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with mucous plugging // progression of lung pathology

IMPRESSION: In comparison to prior radiograph of 1 day earlier, there is continued improved aeration in the left lung with some residual atelectasis in the left lower lobe, accompanied by a small left pleural effusion. Exam is otherwise remarkable for slight worsening of right lower lobe opacity with adjacent small pleural effusion.


SubjectID: 19299811, StudyID: 55288024, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with left lung findings // improvement post bronchoscopy improvement post bronchoscopy

IMPRESSION: ET tube tip is 3.8 cm above the carinal. Left internal jugular line tip is at the level of the left brachycephalic vein. Right Port-A-Cath catheter tip is at the level of cavoatrial junction. Heart size and mediastinum are stable. There is interval improvement in the aeration of the left lung with in particular improved aeration of the left upper lobe is still persistent left lower lobe atelectasis. . Left pleural effusion is substantial. No pneumothorax.


SubjectID: 19299811, StudyID: 54385373, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p abdominal surgery, still intubated // pls eval interval change pls eval interval change

IMPRESSION: In comparison with the study of ___, the monitoring and support devices are unchanged. Continued enlargement of the cardiac silhouette with bibasilar opacifications consistent with pleural effusions and underlying compressive atelectasis.


SubjectID: 19299811, StudyID: 50930406, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with new intubation // ETT position, new lung pathology ETT position, new lung pathology

IMPRESSION: Complete atelectasis of the left lung is present, with the ET tube tip being 2.3 cm above the carinal. Left internal jugular line tip is at the junction of the left brachycephalic vein and SVC. Mediastinal shift to the left is noted. NG tube tip is at the gastroesophageal junction and should be further advanced. Right pleural effusion is noted.


SubjectID: 19299811, StudyID: 59136840, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with ischemic bowel s/p resection, persistent pressor need and resp failure // please eval for interval changes please eval for interval changes

IMPRESSION: In comparison with the study of ___, the monitoring and support devices are stable. Continued enlargement of the cardiac silhouette with moderate pulmonary vascular congestion and bilateral pleural effusions with compressive atelectasis, more prominent on the left.


SubjectID: 19299811, StudyID: 52533163, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with multiple abdominals urgeries, fluid overload, unable to be extubated // fluid overload fluid overload

IMPRESSION: Comparison to ___. No relevant change   Keywords: no relevant change. Small bilateral pleural effusions and subsequent areas of atelectasis at the lung bases are stable. Moderate cardiomegaly persists. Unchanged monitoring and support devices. Mild to moderate pulmonary edema is stable   Keywords: stable.


SubjectID: 19299811, StudyID: 59073199, Comparison: worse

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: ___ year old man w new confusion // pneumonia?

TECHNIQUE: Chest: Frontal and Lateral

COMPARISON: ___

FINDINGS: Large-bore right-sided central venous catheter terminates in the right atrium. There has been interval removal of a left-sided central venous catheter.New bilateral perihilar opacities suggests moderate pulmonary edema although underlying infection is not excluded   Keywords: new. There are small bilateral pleural effusions. No pneumothorax is seen. Cardiac silhouette is mildly enlarged. Mediastinal contours are unremarkable.

IMPRESSION: New bilateral perihilar opacities concerning for moderate pulmonary edema, superimposed infection not excluded   Keywords: new. Small bilateral pleural effusions.


SubjectID: 19299811, StudyID: 58381446, Comparison: None

WET READ: ___ ___ ___ 8:41 AM Left IJ venous line tip is in the left brachiocephalic vein, near the junction with the SVC. ET tube tip is approximately 3 cm above the carina.

WET READ VERSION #1 ___ ___ ___ 1:44 AM Left IJ venous line tip is in the left brachiocephalic vein, near the junction with the SVC. ET tube tip is approximately 3 cm above the carina. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p exlap // confirm position CVL and ETT confirm position CVL and ETT

IMPRESSION: In comparison with the study of ___, there is now an endotracheal tube in place with its tip approximately 3.5 cm above the carina. Nasogastric tube extends to the stomach, with the side port close to the esophagogastric junction. The tube should be pushed forward about 5-10 cm for better positioning. The left IJ catheter extends to the brachiocephalic vein close to the junction with the superior vena cava. Dialysis catheter is unchanged. Basilar opacification at the left is consistent with volume loss in the lower lobe and pleural fluid.


SubjectID: 19299811, StudyID: 51373165, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with h/o chron's, cdiff, now sudden onset severe abdominal pain, s/p ileocecectomy c/b anastomosis dehiscence, end ileostomy // please obtain upright CXR include diaphragm to evaluate for free air under diaphragm

IMPRESSION: Exam does not appear to be performed in a fully upright position based on partial layering of bilateral pleural effusions. With this limitation in mind, no free intraperitoneal air is identified. Given this limitation, either an upright chest radiograph for left lateral decubitus abdominal radiograph would be suggested to more fully exclude the possibility of free air. Exam is otherwise remarkable for improving asymmetrical pulmonary edema and apparent increase in size of bilateral effusions, with no other relevant changes since recent study   Keywords: increase.


SubjectID: 19299811, StudyID: 56899209, Comparison: better

FINAL REPORT

INDICATION: ___ year old man with ileocectomy in ICU. // Evaluate interval changes.

TECHNIQUE: Single portable AP view of the chest.

COMPARISON: Multiple prior radiographs, most recently ___

FINDINGS: An endotracheal tube terminates 3.9 cm above the carina. The left IJ central venous catheter terminates at the origin of the SVC. The right central venous catheter terminates near the cavoatrial junction. Mild pulmonary edema has improved   Keywords: improve. Lung volumes remain no and bibasilar opacities likely reflective of atelectasis persist. A smaller pleural effusion is stable. Heart size top-normal unchanged. No pneumothorax

IMPRESSION: Mild pulmonary edema, improved   Keywords: improve.


SubjectID: 19299811, StudyID: 55800097, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with atelectasis, intubated // progression of lung pathology progression of lung pathology

IMPRESSION: Comparison to ___. No relevant change   Keywords: no relevant change. The monitoring and support devices are in correct position. Moderate cardiomegaly. Moderate pulmonary edema. Bilateral areas of atelectasis and suspicion of a small left pleural effusion. No new focal parenchymal opacities   Keywords: new.


SubjectID: 19299811, StudyID: 55362182, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with mutlipel abd surgeries itnuabted // interval chnage interval chnage

IMPRESSION: Comparison to ___. The left internal jugular vein catheter has been pulled back slightly. The other monitoring and support devices are in stable position. In the interval, the patient has developed bilateral basal parenchymal opacities, likely reflecting atelectasis. A minimal left pleural effusion is stable. Mild pulmonary edema.


SubjectID: 19299811, StudyID: 54748273, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with LLL atelectasis vs pneumonia // progression of lung disease progression of lung disease

IMPRESSION: Comparison to ___. While the right lung is minimally better ventilated than on the previous image, the pre-existing left lower lobe atelectasis persists. This atelectasis could be associated with a minimal left pleural effusion. Minimal fluid overload but no overt pulmonary edema. Monitoring and support devices are stable.


SubjectID: 19299811, StudyID: 50001349, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man intubated // interval change interval change

IMPRESSION: Comparison to ___. Minimal increase in extent of the pre-existing right pleural effusion. The left pleural effusion is stable. Mild cardiomegaly. Unchanged monitoring and support devices.


SubjectID: 19299811, StudyID: 53545698, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with dyspnea // Eval for acute process

COMPARISON: Prior exam from ___.

FINDINGS: AP portable upright view of the chest. Bilateral pleural effusions are noted with hilar congestion and mild pulmonary edema. In addition, lower lobe opacities may represent a superimposed pneumonia. No pneumothorax. Cardiomediastinal silhouette is stable. Bony structures are intact.

IMPRESSION: Pulmonary edema with bilateral pleural effusions. Given the lower lobe opacities, difficult to exclude a superimposed pneumonia.


SubjectID: 19299811, StudyID: 53068315, Comparison: worse

FINAL REPORT

INDICATION: ___ year old man with CHF and hypoxia // ?please evaluate for worsening pulmonary edema

FINDINGS: As compared to ___, mild interstitial pulmonary edema has improved, however there is increased central vascular enlargement   Keywords: increase. There is also persistent left retrocardiac atelectasis. Bilateral small pleural effusions are also stable. The heart is mildly enlarged.

IMPRESSION: Slight interval improvement of interstitial pulmonary edema with worsening central pulmonary vascular congestion   Keywords: worse.


SubjectID: 19336651, StudyID: 58522682, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p TAVR. // Assess for interval change

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Moderate pulmonary edema. Moderate cardiomegaly. Small left pleural effusion. The external pacemaker and the alignment of the sternal wires is constant. No pneumothorax.


SubjectID: 19336651, StudyID: 50212265, Comparison: worse

FINAL REPORT

INDICATION: ___ year old man s/p TAVR with hypoxia // please evaluate for pulmonary edema, pna

EXAMINATION: CHEST (PORTABLE AP)

TECHNIQUE: Chest radiograph, frontal view

COMPARISON: Chest radiograph ___

FINDINGS: Moderate pulmonary edema is increased compared to ___   Keywords: increase. Cardiac silhouette is larger. There is no pneumothorax. Left lower lobe collapse is persistent. Small left pleural effusion is stable. Right internal jugular venous approach temporary pacer terminates in right ventricle. Sternotomy wires are intact. TAVR device is in expected position.

IMPRESSION: Findings consistent with worsened fluid overload   Keywords: worse.


SubjectID: 19336651, StudyID: 58423435, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with PTX, chest tube technical failure with likely entrainment of outside air, now reconnected to new tubing and on suction. // PTX size

COMPARISON: Chest x-ray from ___ at 10:18

FINDINGS: Compared to approximately 1.5 hr earlier, no gross interval change is detected. The right lung apex pneumothorax is again seen, similar to the prior study. A catheter at the right lung base is again noted. The right PICC line tip overlies the mid/ distal SVC, probably unchanged. Cardiomediastinal silhouette and diffuse opacities are also grossly unchanged.

IMPRESSION: Right apical pneumothorax is essentially unchanged.


SubjectID: 19336651, StudyID: 56537636, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with PTX, chest tube technical failure with likely entrainment of outside air, now reconnected to new tubing and on suction. // PTX size

COMPARISON: None.

FINDINGS: Compared with ___ 11:50, there is minimal , if any, interval change. Linear lucency seen along the medial right lung likely also represents a small component pneumothorax, newly seen on this study. Otherwise, the right apical component of the pneumothorax is unchanged. Catheter at the right lung base again noted.

IMPRESSION: As above..


SubjectID: 19336651, StudyID: 54756463, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with right effusion s/p pigtail, evaluate for pneumothorax.

COMPARISON: Chest radiograph from ___, in conjunction to chest CT from ___.

FINDINGS: AP view of the chest provided. Since prior chest radiograph, a right-sided pigtail pleural catheter has been inserted. There is no pneumothorax. Extent of right pleural effusion has decreased slightly. Moderate left pleural effusion is unchanged. Heterogeneous right upper lobe opacities have improved since prior study. Degree of pulmonary edema has also improved   Keywords: improve. Heart size is smaller.

IMPRESSION: No pneumothorax.


SubjectID: 19336651, StudyID: 56732602, Comparison: better

FINAL REPORT

INDICATION: History: ___M with sob // eval for fluid overload

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph from ___.

FINDINGS: Overall, there has been interval improvement in the moderate pulmonary edema compared to the prior exam   Keywords: improve. There has also been interval improvement in the mild cardiomegaly. Small left pleural effusion is overall unchanged compared to the prior exam. Alignment of the sternal wires is stable. There is no evidence of a pneumothorax.

IMPRESSION: Interval improvement in the moderate pulmonary edema compared to the prior exam   Keywords: improve.


SubjectID: 19336651, StudyID: 53678454, Comparison: worse

WET READ: ___ ___ 8:17 AM Mild pulmonary edema is increased compared to ___. Mildly enlarged cardiac silhouette is larger than before. Findings are consistent with volume overload. Small left pleural effusion is persistent.

WET READ VERSION #1 ___ ___ ___ 1:02 AM Mild pulmonary edema is increased compared to ___. Mildly enlarged cardiac silhouette is larger than before. Findings are consistent with volume overload. Small left pleural effusion is persistent. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with GI bleed, recent TAVR now with SOB. // ? pulmonary edema, ? pleural effusion

COMPARISON: ___.

IMPRESSION: New moderate pulmonary edema   Keywords: new. Retrocardiac atelectasis. Small left pleural effusion and moderate cardiomegaly. The alignment of the sternal wires is unchanged.


SubjectID: 19336651, StudyID: 51046023, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with panc cancer, pneumonia. // assess for pna

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the known right upper lobe predominant parenchymal opacity, likely reflecting an pneumonia, is stable in extent and severity. A pre-existing right basal opacity has minimally decreased in extent. The left lung appears unchanged. Mild fluid overload persists   Keywords: persists. Minimal left pleural effusion is present on today's image. Unchanged mild cardiomegaly, stable alignment of the sternal wires.


SubjectID: 19336651, StudyID: 54599504, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___M with dyspnea, history of pneumonia, with leg swelling.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph from ___

FINDINGS: Compared to the prior radiograph from ___, there is increasing opacification of the right upper lobe, and improvement in previously seen opacity in the left upper lobe   Keywords: increasing. Additionally, there is new blunting of the right hemidiaphragm, which likely indicates a small right pleural effusion. Small left pleural effusion is also noted.

IMPRESSION: 1. Interval improvement in appearance of left upper lobe, with increase in opacification of the right lung, concerning for ongoing/worsening infection on the right. 2. Small bilateral pleural effusions.


SubjectID: 19336651, StudyID: 53691192, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: Mr. ___ is a ___M with pancreatic cancer s/p Whipple and recurrent GI bleeds who presented for dark stools found to have GI bleed to Hb 4.6 (from baseline 8) s/p 3u pRBC now with bilateral crackles. // please assess pulm edema and pleural effusion please assess pulm edema and pleural effusion

COMPARISON: Comparison to ___ at 22:43

FINDINGS: Portable upright chest radiograph ___ at 09:57 is submitted.

IMPRESSION: Status post median sternotomy with stable cardiac and mediastinal postoperative contours. Persistent layering small effusions, left greater than right. Retrocardiac consolidation favoring lower lobe atelectasis, although pneumonia or aspiration should also be considered. Probable mild perihilar edema. No pneumothorax.


SubjectID: 19336651, StudyID: 53045297, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with sCHF here for GI bleed. // Please assess for interval change Please assess for interval change

COMPARISON: Chest radiographs since ___ most recently ___ and ___.

IMPRESSION: Moderate left pleural effusion, with a paraspinal component is unchanged since ___. Pulmonary vascular congestion has worsened   Keywords: worse. Moderate to severe cardiomegaly is stable. There is no pulmonary edema. No pneumothorax.


SubjectID: 19348515, StudyID: 59021672, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old man with right pleural effusion status post drainage with small pneumothorax.

FINDINGS: Comparison is made to previous study from ___. There is again seen a very tiny right apical pneumothorax. There are areas of consolidation with lucency at the right base, likely representing loculated pleural fluid. There is volume loss in the right side as well. A small left-sided pleural effusion is seen. Healed right-sided rib fractures are present. The heart size is within normal limits. Median sternotomy wires are present. Overall, there has been no appreciable change.


SubjectID: 19348515, StudyID: 56186616, Comparison: None

FINAL REPORT

HISTORY: ___ years old man with trapped lung on recent chest CT. Followup film.

COMPARISON: Exam is compared to the chest x-ray of ___.

FINDINGS: Interval decrease of left pleural effusion, still with band-like opacity compatible with atelectasis. Patchy opacities are still visible in the right upper lung and correlates with ground-glass opacity described in recent chest CT. Left lung is clear without pleural effusion. Heart size is mildly enlarged. There is no pneumothorax.

IMPRESSION: Interval decrease of right pleural effusion, with still residual small atelectasis. Persistent patchy opacities in the right upper lobe.


SubjectID: 19348515, StudyID: 55082271, Comparison: same

WET READ: ___ ___ 9:38 PM Very small right apical pneumothorax appears stable. Little change in comparison to prior radiograph and CT from the same day. ______________________________________________________________________________

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old male with right pleural effusion status post thoracentesis. Questionable right-sided pneumothorax.

FINDINGS: Comparison is made to previous study from ___. There is a very tiny right apical pneumothorax, which is unchanged. There are again seen bilateral pleural effusions with areas of consolidation in the right base. This likely represents partially loculated fluid. Heart size is upper limits of normal but stable. Overall, there has been no significant change   Keywords: no significant change.


SubjectID: 19348515, StudyID: 57528510, Comparison: better

FINAL REPORT

INDICATION: History of pleural effusion.

COMPARISONS: Chest radiograph from ___.

FINDINGS: A right pigtail catheter is unchanged. The remnant effusion is stable. Again noted is mild pulmonary edema, although improved since the previous exam especially in the right lung   Keywords: improve. Opacity in the left mid lung may represent asymmetric edema, however this seems less likely given the improvement in edema in the right lung   Keywords: improve. The cardiac silhouette is unchanged. Median sternotomy wires are intact.

IMPRESSION: 1. No change in right pleural effusion. 2. Opacity in the right midlung concerning for infection given the improvement in pulmonary edema   Keywords: improve.


SubjectID: 19351906, StudyID: 56990313, Comparison: -1.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pulmonary edema // Interval change? Interval change?

IMPRESSION: In comparison with the study of ___, there is increased opacification at the left base with poor definition of the hemidiaphragm, consistent with developing atelectatic changes. There are slightly lower lung volumes that may be responsible for the slight apparent increase in interstitial markings   Keywords: increase. Otherwise, little change   Keywords: little change.


SubjectID: 19351906, StudyID: 54534152, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with hypoxia

TECHNIQUE: Portable AP of the chest

COMPARISON: ___ chest radiograph, ___ CT chest

FINDINGS: Lung volumes are low. Heart size is at least moderately enlarged. The mediastinal and hilar contours are unchanged. Crowding of the bronchovascular structures is demonstrated without overt pulmonary edema. Patchy opacities are noted in the lung bases, more focal in the left lung base likely reflecting areas of atelectasis. No Large pleural effusion or pneumothorax is identified. Evidence of prior kyphoplasty is seen within the upper lumbar spine.

IMPRESSION: Low lung volumes with patchy bibasilar opacities, more pronounced in the left lung base, likely atelectasis. Please note however that infection cannot be completely excluded.


SubjectID: 19358609, StudyID: 59969313, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with ET tube in place, s/p tx for PNA // Evaluation of ET tube and volume status

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change.


SubjectID: 19358609, StudyID: 59338434, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with resp failure // intubated

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change.


SubjectID: 19358609, StudyID: 58804781, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with chf, multifocal pneumonia, intubated // evaluate for changes in pulmonary edema

TECHNIQUE: Portable chest

COMPARISON: ___.

IMPRESSION: There has been some interval partial clearing of the right-sided infiltrate. However given the extensive distortion of the thoracic anatomy it is difficult to assess for resolution of the acute on chronic changes. The ET tube is unchanged


SubjectID: 19358609, StudyID: 50546404, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with respiratory failure, currently intubated // evaluate for adequate placement of OG tube evaluate for adequate placement of OG tube

IMPRESSION: In comparison with the earlier study of this date, there has been placement of a nasogastric tube that extends to the mid body of the stomach with the side port distal to the esophagogastric junction. Otherwise little change   Keywords: little change.


SubjectID: 19358609, StudyID: 59343870, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with history of LUL lobectomy. intubated with PNA // ETT position, interval change ETT position, interval change

IMPRESSION: In comparison with the study ___ ___, there is little change in the appearance of the heart and lungs and the monitoring and support devices


SubjectID: 19358609, StudyID: 53579425, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with history of LUL lobectomy. intubated with PNA // ETT position, interval change ETT position, interval change

IMPRESSION: In comparison with the study ___ ___, there is little change in the appearance of the heart and lungs and monitoring and support devices.


SubjectID: 19358609, StudyID: 50588678, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with history of LUL lobectomy. intubated with PNA // pulm edema, ETT position, PNA progression pulm edema, ETT position, PNA progression

IMPRESSION: In comparison with the study ___ ___, the monitoring and support devices are unchanged. The opacification in the left mid and upper zone has decreased. Basilar opacification on this side is consistent with postsurgical changes.


SubjectID: 19358609, StudyID: 56325235, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with resp failure // ET tube interval, evaluate pulm edema ET tube interval, evaluate pulm edema

IMPRESSION: ET tube tip points toward the left main bronchus and should be pulled back at least 3 cm. Heart size and mediastinum are stable. Bilateral pleural effusions and bibasal consolidations are extensive but unchanged as compared to the previous study.


SubjectID: 19358609, StudyID: 59002259, Comparison: None

FINAL REPORT

INDICATION: Patient with shortness of breath and cough.

COMPARISONS: Chest radiograph of ___, CT chest of ___.

FINDINGS: Frontal and lateral views of the chest demonstrate a stable postoperative appearance of the left hemithorax status post thoracoplasty. Right apical scarring persists. Right lung base opacity partially obscuring right hemidiaphragm is new since prior exam. Ill-defined left lung base opacity is also noted. No pleural effusion is seen. There is no pulmonary edema. Emphysema predominantly involving upper lung zones is unchanged. Hilar and mediastinal silhouettes are stable. Heart size is normal. Partially imaged upper abdomen is unremarkable.

IMPRESSION: Bibasilar opacities are new since ___ exam, possibly atelectasis, aspiration, or infection in appropriate clinical setting.


SubjectID: 19358609, StudyID: 55623177, Comparison: same

FINAL REPORT

INDICATION: Hypoxia and respiratory distress, evaluate for interval changes and consolidation vs. pleural effusion.

COMPARISON: Chest radiograph on ___.

FINDINGS: One portable AP view of the chest. Patient is post left left upper lobe resection with thoracoplasty. Top normal heart size is stable. Mediastinal and hilar contours are stable. Bibasilar opacities are unchanged   Keywords: unchanged. Mild pulmonary vascular congestion is also unchanged   Keywords: unchanged. Severe emphysematous changes are again seen. Biapical scarring is unchanged. No pleural effusion or pneumothorax.

IMPRESSION: No significant change in bibasilar opacities and pulmonary vascular congestion compared to study done yesterday   Keywords: no significant change.


SubjectID: 19358609, StudyID: 53338001, Comparison: None

FINAL REPORT

HISTORY: ___-year-old male with lung and bladder cancer, now here with signs of pneumonia and oxygen desaturations. STUDY: Portable AP upright chest radiograph.

COMPARISON: ___, ___, ___, and ___.

FINDINGS/

IMPRESSION: The heart size is at upper limits of normal, but stable compared to prior study as are the mediastinal contours. The lungs continue to demonstrate bibasilar opacities, becoming slightly more confluent on the left - a developing pneumonia cannot be excluded. Pulmonary vascular congestion is also present in the setting of severe emphysema. Biapical scarring is unchanged. There is no large pleural effusion or pneumothorax.


SubjectID: 19358609, StudyID: 58676813, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with ETT, pulm edema, PNA // interval change. line and tube position

COMPARISON: Chest radiograph ___, CT chest ___

FINDINGS: The patient's neck is flexed to the right. The ET tube tip appears to be 0.6 cm above the carina. Right PICC tip is in the lower SVC. Side port of the NG tube is likely below the GE junction, with the tip out of view. There is moderate pulmonary edema. Moderate right and small to moderate left effusions appear similar to prior, allowing for differences in patient positioning. Retrocardiac opacity and silhouetting of the left hemidiaphragm are similar to prior. Left upper lung distortion is similar to prior. There is no pneumothorax. The cardiomediastinal silhouette is normal. Aortic calcification projecting over the heart is similar to prior. No free air below the right hemidiaphragm is seen.

IMPRESSION: 1. Evaluation of ET tube location is suboptimal due to patient positioning, but appears low. 2. Right PICC and NG tube are similar to prior. 3. Moderate right and small to moderate left effusions appear similar to prior, allowing for differences in patient positioning. 4. Other findings are similar to ___.


SubjectID: 19358609, StudyID: 54721865, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with respiratory failure // interval ET tube change, PNA progression interval ET tube change, PNA progression

IMPRESSION: Comparison to ___. The patient is of the change of the endotracheal tube. The tip of the tube is within 2 cm of the carina. If possible, the tube should be pulled back by approximately 1 cm. No complications. Stable position of the feeding tube and of the right PICC line. Extensive parenchymal and pleural abnormalities are stable.


SubjectID: 19358609, StudyID: 58119690, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hx. prior lung surgery presenting with pneumonia // eval for progression of pneumonia

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Bibasal opacities and the entire chronic deformity of the chest appears to be similar to the previous study concerning for bibasal multifocal pneumonia


SubjectID: 19358609, StudyID: 57935686, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with PNA with increasing O2 requirement and right chest pain // eval for effusion, PTX eval for effusion, PTX

IMPRESSION: In comparison with the earlier study of this date, there is increased opacification at the left base with poor definition of the hemidiaphragm. This is consistent with developing pneumonia, possibly associated with some volume loss in the left lower lobe and pleural effusion. Increased opacification at the right base could reflect either atelectatic changes or a multifocal infiltrate.


SubjectID: 19358609, StudyID: 53962747, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___M with cough and fever // r/o acute infectious process

TECHNIQUE: CHEST (PA AND LAT)

COMPARISON: ___

IMPRESSION: Substantial distortion of the chest in particular left hemi thorax with chronic changes in the right apex and in the left upper lung are noted. On the other hand there is new right basal and to lesser extent left basal opacity, findings concerning for pneumonia. No definitive evidence of pulmonary edema is present. No pleural effusion demonstrated. Nodular opacity as part of the scarring is demonstrated in the right apex, slightly more conspicuous on current examination and should be reassessed with chest CT to exclude the possibility of growing malignancy


SubjectID: 19358609, StudyID: 51677032, Comparison: None

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPH

INDICATION: Pneumonia and hypoxia and intravenous antibiotics.

TECHNIQUE: Chest, portable AP upright view.

COMPARISON: ___, ___, and ___.

FINDINGS: Superimposed on chronic volume loss, parenchymal scarring, and pleural thickening in the left hemithorax, there is a persistent superimposed opacification in the left lung, which has worsened somewhat between over two days including increased volume loss. Findings in the right lung appear more chronic.

IMPRESSION: Worsening volume loss and opacification of the left lung suggesting pneumonia superimposed on chronic findings.


SubjectID: 19358609, StudyID: 57984800, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p LUL lobectomy, p/w multifocal PNA, has ETT // ETT position

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: Increased opacity at the left upper and lower lung concerning for multi focal pneumonia. Left basilar atelectasis and pleural effusion is present. Small right pleural effusion is also noted. Right apical scarring is unchanged. There is no pneumothorax. The cardiac and mediastinal silhouettes are unchanged. An endotracheal tube is in standard position. Enteric tube terminates in the stomach. A linear tube extending to the level of the endotracheal tube it may represent esophageal probe. The right PICC terminates in the distal SVC.

IMPRESSION: 1. The endotracheal tube is in standard position. 2. Multi focal pneumonia affecting the left upper lower lungs. 3. Moderate left pleural effusion and small right pleural effusion.


SubjectID: 19358609, StudyID: 53839366, Comparison: better

WET READ: ___ ___ ___ 8:16 AM The nasogastric tube and side-hole course below left hemidiaphragm and terminate in the left upper quadrant in the region of the stomach.

WET READ VERSION #1 ___ ___ 6:05 PM The nasogastric tube and side-hole course below left hemidiaphragm and terminate in the left upper quadrant in the region of the stomach. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with NG tube that was coiled in mouth, now replaced // Assess NG tube placement Assess NG tube placement

IMPRESSION: In comparison with the earlier study of this date, the nasogastric tube extends to the mid to upper stomach. Other monitoring and support devices are unchanged. The degree of pulmonary vascular congestion appears to have improved   Keywords: improve. Extensive opacification is again seen involving much of the left hemithorax.


SubjectID: 19358609, StudyID: 50338064, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with ett // ET tube placement

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: There has been interval increase in right lower lobe consolidations /pneumonia. Right apical subpleural consolidation is more conspicuous than before, part of it is chronic scarring. There appears to be also vascular congestion. Right pleural effusion has increased. Multifocal opacities in the left lung are grossly unchanged. There is evidence of loss of volume in the left lung, distortion of the lung architecture and shifting of the cardiomediastinal structures to the left. ET tube is in standard position. Right PICC tip is in the lower SVC. NG tube tip is in the stomach


SubjectID: 19358609, StudyID: 57135581, Comparison: worse

FINAL REPORT

AP CHEST 8:03 A.M., ___

HISTORY: ___-year-old man with pneumonia and respiratory distress.

IMPRESSION: AP chest compared to ___ and ___, and ___ ___: Patient has had left upper thoracoplasty, usually for tuberculosis or lung cancer. Heterogeneous opacification in the right lung has worsened since ___, probably pulmonary edema, accompanied by increasing small right pleural effusion   Keywords: increasing, worse. Predominant abnormality in the axillary region of the right upper lobe could be concurrent pneumonia, but I am not surprised by asymmetric distribution of edema in this patient with moderate-to-severe emphysema and scarring at the right lung apex. Heart size is normal, in the leftward shifted mediastinum. No pneumothorax.


SubjectID: 19358609, StudyID: 50510466, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: History of non-small cell lung cancer, status post right upper lobectomy.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the post-surgical left lung is unchanged. In the right lung, there is an increase in interstitial markings, notably at the lung bases and in the right lower lung. In addition, there is blunting of the right costophrenic sinus, suggesting the presence of a small right pleural effusion. The size of the cardiac silhouette is unchanged. The findings in the right lung might represent a combination of pulmonary edema and pneumonia. At the time of observation and dictation, 1:14 p.m., on ___, the referring physician, ___. ___, was paged for notification and the findings were subsequently discussed over the telephone.


SubjectID: 19358609, StudyID: 52687447, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, lung cancer.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Extensive post-surgical left lung changes with reduction in volume of the left hemithorax, extensive probably post-tuberculous changes in the right apex, known moderate parenchymal changes at the left lung bases. No new focal parenchymal opacity. Normal size of the cardiac silhouette.


SubjectID: 19358609, StudyID: 50685017, Comparison: worse

FINAL REPORT

INDICATION: AFib with right ventricular regurgitation. Evaluate for pneumonia or other infectious process.

COMPARISON: Comparison is made to multiple prior chest radiographs, most recently dated ___.

FINDINGS: Frontal and lateral radiographs demonstrate stable extensive post-surgical changes of the left hemithorax with associated loss of volume. Stable scarring noted in the right lung apex. On a background of chronic lung disease and chronic bibasilar opacifications there is new prominence of the interstitium as well as Kerley B lines consistent with pulmonary edeam   Keywords: new. Heart size is top normal and stable. No pleural effusion or pneumothorax identified.

IMPRESSION: Stable background chronic lung changes. Stable top normal heart size with evidence of volume overload consistent with provided diagnosis of right ventricular regurgitation.


SubjectID: 19368849, StudyID: 56931161, Comparison: better

FINAL REPORT

INDICATION: ___ year old man with PEA arrest after hypoxemic resp failure now intubated // interval change

COMPARISON: The comparison is made with prior studies including ___.

IMPRESSION: The endotracheal tube tip is 3 cm above the carina. This gastric tube tip is in the stomach. There is no pneumothorax. There is patchy atelectasis in both lower lobes. There is cardiomegaly and there has been improvement of the CHF   Keywords: improve.


SubjectID: 19368849, StudyID: 53752309, Comparison: None

WET READ: ___ ___ ___ 11:18 AM An enteric tube courses below the level of diaphragm ends in the stomach. An endotracheal tube ends in the lower thoracic trachea. Cardiomegaly is moderate and mildly increased. Mild pulmonary edema is worsened.

WET READ VERSION #1 ___ ___ 10:33 PM An enteric tube courses below the level of diaphragm ends in the stomach. An endotracheal tube ends in the lower thoracic trachea. Cardiomegaly is moderate and mildly increased. Mild pulmonary edema is worsened. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___ year old man with laryngeal SCC s/p radiation now with dysphagia who had cardiac arrest ___ to acute respiratory failure due to mucus plug in larynx. Now s/p ET tube // ET tube placement

COMPARISON: The comparison is made with prior studies including ___.

IMPRESSION: Nasogastric tube tip projects over the stomach. Endotracheal tube tip is 2 cm above the carina. There is cardiomegaly upper zone redistribution and blurring of vascular detail consistent with pulmonary edema. This is new as compared to the earlier study. There may be a small right pleural effusion. There is no pneumothorax.


SubjectID: 19368849, StudyID: 51399331, Comparison: better

FINAL REPORT

PORTABLE CHEST ___, ___

COMPARISON: Radiograph of one day earlier.

FINDINGS: Support and monitoring devices are in standard position. Heart is enlarged but has decreased in size since recent radiograph, and bilateral asymmetrically distributed airspace opacities have slightly improved   Keywords: improve. These findings may be due to asymmetrical pulmonary edema, likely co-existing with infection. Small bilateral pleural effusions are present, but there is no visible pneumothorax.


SubjectID: 19368849, StudyID: 52507151, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with increasing secretions // ___ year old man with increasing secretions ___ year old man with increasing secretions

IMPRESSION: In comparison with the study of ___, the monitoring and support devices are unchanged. There again is substantial enlargement of the cardiac silhouette with the relatively mild pulmonary vascular congestion and interstitial edema. This discordance raises the possibility of cardiomyopathy or pericardial he fusion. Retrocardiac opacification with obscuration of the hemidiaphragm is consistent with small pleural effusion and substantial volume loss in the left lower lobe. Less prominent changes are seen at the right base.


SubjectID: 19368849, StudyID: 51888525, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with PEA arrest secondary to mucus secretions now s/p trach // interval change

IMPRESSION: Since the prior radiograph of ___, a tracheostomy tube is been placed, with tip in standard position. Possible overdistention of the tracheostomy tube cuff is noted. Marked enlargement of cardiac silhouette (cardiomegaly and/or pericardial effusion) is accompanied by pulmonary vascular congestion and interstitial edema. Bilateral retrocardiac opacities are persistent findings as well as a small left pleural effusion.


SubjectID: 19381010, StudyID: 59296646, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman s/p TAVI; evaluate the position of the recently placed pacemaker leads.

COMPARISON: Chest radiograph dated ___.

FINDINGS: The left-sided two-lead cardiac pacemaker device appears intact and unchanged in position, with one tip terminating in the right atrium and the other tip terminating in the right ventricle. Median sternotomy wires, surgical clips, and cardiac valve replacements appear intact and unchanged in position. The right IJ also appears intact and unchanged in position. Since ___, the left-sided pleural effusion and adjacent compressive atelectasis have improved. Elevation of the left hemidiaphragm persists and is secondary to underlying left lung atelectasis. The lungs are otherwise clear, without focal consolidation or overt pulmonary edema. No pneumothorax. Stable moderate cardiomegaly. Stable post-procedural appearance of the mediastinum.

IMPRESSION: 1. Upper open positioning of the recently placed pacemaker leads. 2. Decreased, now small left pleural effusion with adjacent atelectasis compared to ___.


SubjectID: 19381010, StudyID: 51258570, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p TAVI // eval for pleural effusions

IMPRESSION: Compared to ___ radiograph, cardiomegaly is stable, and accompanied by improving pulmonary vascular congestion and resolving edema   Keywords: resolving, improving. Persistent dense left retrocardiac opacity is probably a combination of atelectasis and pleural effusion. Moderate gastric distension is seen in the upper abdomen.


SubjectID: 19381528, StudyID: 57938782, Comparison: None

FINAL REPORT

INDICATION: Preoperative chest radiograph.

COMPARISON: Chest radiographs available for ___. CT available from ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: The lung volumes are low, resulting in bronchovascular crowding. The heart is mildly enlarged. The hilar and mediastinal contours are within normal limits. A markedly distended loop of large bowel is better visualized on the recent CT examination performed on ___. There is no intraperitoneal air. There is no pneumothorax, focal consolidation, or pleural effusion. Bibasilar opacities reflect mild aspiration or atelectasis, as seen on the CT examination.

IMPRESSION: 1. Bibasilar atelectasis. 2. No pneumothorax or pleural effusion. 3. Distended sigmoid colon, as seen on the CT examination.


SubjectID: 19381528, StudyID: 51912598, Comparison: None

FINAL REPORT

INDICATION: Status post ex lap, assess position of endotracheal tube.

COMPARISON: Comparison is made to chest radiograph performed same day 8 hours earlier.

FINDINGS: Interval placement of endotracheal tube with tip at the level of the clavicles. The nasogastric tube has also been placed with tip at the GE junction, should be advanced several centimeters into the stomach. Unchanged mediastinal, hilar and cardiac silhouette. Increased retrocardiac opacifications likely represents left lower lobe collapse and possibly a small left pleural effusion. Though cannot exclude developing infectious process.

IMPRESSION: 1. Endotracheal tube well positioned. Nasogastric tube should be advanced several centimeters to terminate into stomach. 2. Increased retrocardiac opacity likely representing left lower lobe collapse.


SubjectID: 19394614, StudyID: 58680103, Comparison: None

FINAL REPORT

HISTORY: Worsening dyspnea.

TECHNIQUE: PA and lateral views of the chest.

COMPARISON: ___.

FINDINGS: Left-sided pacemaker device is noted with lead terminating in the right ventricle and two epicardial leads are also re- demonstrated. Cardiac stents are noted, and the patient is status post median sternotomy and CABG. There is mild pulmonary vascular congestion. New right basilar opacity is concerning for pneumonia or aspiration. No left-sided consolidation is seen. There is no pleural effusion or pneumothorax. No acute osseous abnormalities are detected.

IMPRESSION: Right lower lobe opacity concerning for pneumonia or aspiration. Mild pulmonary vascular congestion.


SubjectID: 19394614, StudyID: 57263642, Comparison: worse

FINAL REPORT

HISTORY: Congestive heart failure status post biventricular pacer, coronary artery disease status post CABG, Wegener's granulomatosis presenting with dyspnea on exertion.

TECHNIQUE: Portable frontal chest radiograph.

COMPARISON: Multiple studies dating from ___ through ___.

FINDINGS: Moderate cardiomegaly is unchanged from ___. There has been interval increase in pulmonary vascular congestion and all edema with worsening bilateral patchy opacities particularly in the right mid and lower lung   Keywords: increase, worse. Progressive opacification may be from progressive edema or infection. There is no pleural effusion or pneumothorax.

IMPRESSION: Worsening vascular congestion and pulmonary edema with increased opacities especially in the right mid and lower lung which could be due to progressive edema however infection is not excluded   Keywords: increase, worse. Results were discussed over the telephone with Dr. ___ at 11:43 on ___ at time of initial review by Dr. ___.


SubjectID: 19394614, StudyID: 54841999, Comparison: None

FINAL REPORT

HISTORY: CHF and pneumonia.

FINDINGS: In comparison with study of ___, there again are diffuse bilateral pulmonary opacifications in a patient with enlarged heart and evidence of previous cardiac surgery and pacer device in place. Again, this could reflect widespread pneumonia superimposed on pulmonary vascular congestion, if this were compatible with the clinical history.


SubjectID: 19394614, StudyID: 51381019, Comparison: 0.0

FINAL REPORT

HISTORY: Pneumonia with intubation.

FINDINGS: In comparison with the earlier study of this date, there has been placement of an endotracheal tube with its tip approximately 5 cm above the carina. Nasogastric tube extends well into the stomach where it crosses the lower margin of the image. Continued diffuse bilateral pulmonary opacifications, worse on the right   Keywords: worse. This again could reflect some combination of progressive edema and infection   Keywords: again. No definite pleural effusion.


SubjectID: 19394614, StudyID: 51225792, Comparison: None

FINAL REPORT

INDICATION: Pneumonia and CHF.

COMPARISON: Radiographs available from ___ through ___. FRONTAL CHEST RADIOGRAPH: An endotracheal tube terminating 3.8 cm above the carina, multiple sternal wires, a gastric tube terminating within the stomach, and a left pacemaker projecting a single right ventricular lead are unchanged in position. Moderate cardiomegaly appears stable. Since ___, there is continued improvement of a right mid zone opacity, with waxing and waning adjacent atelectasis, reflective of improved pneumonia. A persistent left retrocardiac opacity remains unchanged. There is no pneumothorax.

IMPRESSION: 1. Improving right basilar pneumonia. 2. Moderate cardiomegaly is unchanged since ___.


SubjectID: 19413444, StudyID: 58083583, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: None. CLINICAL

HISTORY: Shortness of breath, assess for CHF, edema, effusion.

FINDINGS: PA and lateral views of the chest were provided. Midline sternotomy wires and mediastinal clips are noted. The heart is moderately enlarged and there is pulmonary edema with a small right and a moderate left pleural effusion. Associated left lower lobe atelectasis is likely present, though cannot exclude pneumonia. Bony structures appear grossly intact. Vascular calcifications along the thoracic aorta noted. No free air below the right hemidiaphragm. Calcifications projecting over the right upper quadrant likely reflect costal cartilage calcification.

IMPRESSION: Pulmonary edema with bilateral effusions and moderate cardiomegaly.


SubjectID: 19413444, StudyID: 50953213, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Worsening heart failure, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is unchanged evidence of severe cardiomegaly, with status post CABG, signs of mild-to-moderate pleural effusions. Areas of atelectasis are seen at the lung bases. No pneumothorax. Known old fractures at the level of the right humerus.


SubjectID: 19414438, StudyID: 57232790, Comparison: same

FINAL REPORT

HISTORY: OG tube placement.

FINDINGS: In comparison with the earlier study of this date, the orogastric tube extends below the hemidiaphragm in the stomach. The somewhat unusual course suggests that it has gone through a large hiatal hernia. Otherwise, little change   Keywords: little change.


SubjectID: 19414438, StudyID: 55339054, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, dyspnea, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The lung volumes remain low. The coiled nasogastric tube is still positioned in the known large hiatal hernia. Unchanged bilateral areas of atelectasis. Minimal fluid overload is noted on today's image.


SubjectID: 19423670, StudyID: 58358550, Comparison: None

FINAL REPORT

SERIES OF CHEST RADIOGRAPHS DATED ___ No prior studies for comparison.

FINDINGS: A series of portable radiographs were obtained to document placement of a feeding tube. The third and final radiograph of the series demonstrates the tip of the nasogastric tube in the proximal stomach, but side port is above the gastroesophageal junction location. Tip of endotracheal tube terminates 3.7 cm above the carina, and a dialysis catheter terminates at the cavoatrial junction. Heart is upper limits of normal in size. Mild pulmonary vascular congestion is accompanied by minimal interstitial edema. Widespread calcifications in the mid and lower portions of the chest are probably predominantly pleural in location, suggesting prior asbestos exposure. Moderate loculated left and small loculated right pleural effusions are present with or without component of pleural thickening. Associated bibasilar lung opacities (left greater than right), may reflect atelectasis and/or infectious consolidation. Note is made of apparent wall thickening of the right main bronchus, difficult to assess radiographically.


SubjectID: 19423670, StudyID: 57916903, Comparison: same

FINAL REPORT

INDICATION: ___M with repositioned endotracheal tube assess new position.

COMPARISON: Chest radiograph performed earlier today.

TECHNIQUE Portable AP view of the chest.

FINDINGS: There has been interval retraction of the endotracheal tube with its tip now residing 3.2 cm above the carinal. Otherwise, no change   Keywords: no change.

IMPRESSION: Appropriately positioned endotracheal tube.


SubjectID: 19423670, StudyID: 55183504, Comparison: None

WET READ: ___ ___ ___ 12:08 PM 1. Endotracheal tube extends into the right mainstem bronchus. Retraction by at least 3.5 cm is recommended. 2. NG tube tip just beyond the GE junction. Please advance for more optimal positioning. 3. Bilateral pleural effusions and mid to lower lung consolidations concerning for pneumonia. 4. Dialysis catheter appears in good position. *** ED URGENT ATTENTION *** ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with intubated patient presenting from OSH // tube placement

COMPARISON: None

FINDINGS: AP portable upright view of the chest. Endotracheal tube extends into the right mainstem bronchus. Nasogastric tube tip is seen just beyond the GE junction. Dialysis catheter with right IJ insertion extends to the level of the cavoatrial junction. Bilateral pleural effusions are noted, small to moderate in overall size with airspace consolidation in the mid to lower lungs concerning for pneumonia. No large pneumothorax is seen. Bony structures appear grossly intact.

IMPRESSION: No acute intrathoracic process


SubjectID: 19423670, StudyID: 54197327, Comparison: worse

FINAL REPORT

EXAMINATION: Portable AP chest x-ray.

INDICATION: ___ year old man with SOB and increasing requirement // Please evaluate for acute process

TECHNIQUE: AP projection, erect positioning.

COMPARISON: Portable AP chest x-ray obtained ___ at 15:36.

FINDINGS: There is again seen a right-sided dialysis catheter whose distal tip projects over the lower SVC versus cavoatrial junction. This is likely in unchanged position and the appearance of a more distal location of the tip likely reflects decreased lung volumes in comparison to prior radiograph. There has been interval removal of endotracheal tube, as well as removal of previously seen NG tube. The cardio mediastinal contours are grossly unchanged. There is no evidence of pneumothorax. There has been interval increase in opacification of the lower portion of the right upper lobe which may represent developing pulmonary edema, infection, or atelectasis   Keywords: developing, increase. There is again redemonstrated a loculated left pleural effusion without significant interval change. Also again seen is a small right sided pleural effusion.

IMPRESSION: 1. Increased opacification of the lower portion of the right upper lobe which may represent developing pulmonary edema, infection, or atelectasis   Keywords: developing, increase. 2. Stable appearance of left loculated pleural effusion and small right pleural effusion.


SubjectID: 19423670, StudyID: 50033431, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with respiratory distress, ACS, and heart failure s/p 2.5L removal in HD // Evaluate for improvement in pulmonary edema/ effusions

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen in extent of the known left pleural effusion, the moderate cardiomegaly, the right pleural effusion as well as the areas of parenchymal opacities observed over both lungs. No new parenchymal opacities   Keywords: new. No pneumothorax.


SubjectID: 19453139, StudyID: 56829764, Comparison: worse

WET READ: ___ ___ ___ 4:31 AM No acute cardiopulmonary process. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___-year-old woman presenting with syncope. Evaluate for infectious process.

COMPARISON: Chest radiograph from ___.

FINDINGS: The lungs are clear. MILD CARDIOMEGALY AND PULMONARY VASCULAR CONGESTION HAVE INCREASED SINCE ___, CONSISTENT WITH MILD CARDIAC DECOMPENSATION, ALTHOUGH THERE IS NO EDEMA OR PLEURAL EFFUSION   Keywords: increase. . The hilar and mediastinal contours are otherwise normal. There is no pneumothorax. There is no pleural effusion.

IMPRESSION: EARLY CARDIAC DECOMPENSATION.


SubjectID: 19453139, StudyID: 53281738, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman s/p PPM // ptx, leads

TECHNIQUE: Chest two-view.

COMPARISON: ___.

IMPRESSION: There is a new single lead pacemaker with the lead projecting over the expected location of the right ventricle. The heart is moderately enlarged and is slightly larger than the film from the prior day the lungs are clear


SubjectID: 19475604, StudyID: 59971928, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with recurrent VT, now intubated // Eval for ETT tube placement Eval for ETT tube placement

IMPRESSION: In comparison with the study of ___, the monitoring and support devices are essentially unchanged with the endotracheal tube approximately 2.5 cm above the carina. . Continued enlargement of the cardiac silhouette in a patient with pacer device in place. There is still pulmonary vascular congestion, but this has improved since the previous study   Keywords: improve.


SubjectID: 19475604, StudyID: 51332985, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with recent VT arrest, intubated for recurrent ICD shocks. // Eval ETT placement. Also eval PNA vs pulmonary edema

TECHNIQUE: Portable chest

COMPARISON: ___.

FINDINGS: Compared to the prior study the pulmonary edema is worsened   Keywords: worse. The heart is moderately enlarged. There is pulmonary vascular redistribution with hazy alveolar infiltrate right greater than left. Dual lead pacemaker is unchanged. The ET tube is 2.7 cm above the carina. The NG tube tip is in the stomach. There are small bilateral infiltrates.

IMPRESSION: Worsened pulmonary edema   Keywords: worse


SubjectID: 19475604, StudyID: 59709523, Comparison: nan

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with afib and CHF with ongoing wheeze and dyspnea // ? Pulmonary edema

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Mild to moderate pulmonary edema has minimally increased   Keywords: increase. Bibasilar opacities have increased on the right. This a combination of pleural effusion and adjacent consolidation, this consolidations could be atelectasis but superimposed infection cannot be excluded in the appropriate clinical setting. There is no pneumothorax. No other interval change from prior study   Keywords: no other interval change.


SubjectID: 19475604, StudyID: 56636519, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF with worsening dyspnea and hypoxia. Eval for worsening pulm edema, PNA.

TECHNIQUE: Single portable AP view of the chest.

COMPARISON: Chest radiographs from ___, ___, ___. CT chest from ___.

FINDINGS: Lung volumes are persistently low. Moderate to severe pulmonary edema has changed in distribution, but not in overall severity. Mild cardiomegaly is also stable. Bilateral pleural effusions have increased. No focal consolidation concerning for pneumonia. There are 2 coiled leads around the left ICD pacemaker. There is a presumably orphaned right ventricular ICD lead, with intact continuous right atrium and right ventricle leads. The appearance is unchanged since the radiograph from ___. Intact median sternotomy wires and mediastinal clips are unchanged.

IMPRESSION: 1. Increased bilateral pleural effusions, with redistribution of the moderate to severe pulmonary edema. 2. No evidence of pneumonia.


SubjectID: 19475604, StudyID: 53956917, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF, new O2 requirement // eval interval change in pulmonary edema

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Diffuse bilateral opacities are unchanged as well as the position of the pacemaker leads and as the mediastinal contour.


SubjectID: 19475604, StudyID: 59044148, Comparison: worse

FINAL REPORT

INDICATION: ___M with dyspnea // evaluate for fluid overload, pneumonia

TECHNIQUE: AP and lateral views of the chest.

COMPARISON: Chest x-ray from ___.

FINDINGS: Left chest wall pacing device is again noted. There is pulmonary vascular congestion which has progressed since prior   Keywords: progressed. Small bilateral pleural effusions are noted. There is right basilar opacity potentially atelectasis. The cardiomediastinal silhouette remains stable. No acute osseous abnormalities identified.

IMPRESSION: Pulmonary edema slightly worse compared to prior with small effusions   Keywords: worse. Right basilar opacity potentially atelectasis, correlate clinically regarding possibility of superimposed infection.


SubjectID: 19475604, StudyID: 57796651, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old male w/PMH of CAD (s/p CABG), CHF s/p remote cardiac arrest (___) with AICD, DM, and CKD who presents with hypoxia due to acute on chronic sCHF exacerbation due to atrial fibrillation now with increased work of breathing // eval for interval change eval for interval change

COMPARISON: Comparison to ___ at 18:57

FINDINGS: Portable semi-erect chest film ___ at 23:08 is submitted.

IMPRESSION: The left-sided pacer remains in place. Patient is status post median sternotomy with stable cardiac and mediastinal contours. Overall, interval improvement but persistent mild to moderate pulmonary and interstitial edema   Keywords: persistent. No pneumothorax. No large effusions.


SubjectID: 19475604, StudyID: 57928659, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with GI bleed, hx of amiodarone toxicity in lungs developing dyspnea and hypoxia x 1 day // ?pna. Worsened hypoxia and new fever ?pna. Worsened hypoxia and new fever

IMPRESSION: In comparison with the study of earlier in this date, there is again diffuse prominence of the interstitial markings   Keywords: again. Enlargement of the cardiac silhouette is not again seen with pacer device in place. The diffuse interstitial changes could be a manifestation of chronic lung disease, perhaps exacerbated by amiodarone toxicity, pulmonary vascular congestion, or combination of these factors.


SubjectID: 19475604, StudyID: 57389379, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M PMH CAD (s/p CABG), remote cardiac arrest s/p PPM/ICD, sCHF (EF ___%), Afib (on dofetilide/coumadin), DM, CKD who presents w/ melena, and admitted to medicine for further evaluation/management. Now with ambulatory desaturation, also temp of 100.2 // please assess for infiltrate or edema

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the lung volumes have decreased, causing minimal crowding of vascular and bronchial structures at the lung bases. There is mild fluid overload but no overt pulmonary edema. No pleural effusions. No pneumonia. Borderline size of the cardiac silhouette. Unchanged position of the pacemaker in the left pectoral location and of the leads.


SubjectID: 19475604, StudyID: 54303167, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with fevers, heart failure. // eval pulmonary edema, infection eval pulmonary edema, infection

COMPARISON: Chest radiographs since ___ most recently ___.

IMPRESSION: Lung volumes are slightly lower today, exaggerating borderline interstitial edema and mild cardiomegaly. Pleural effusions is small if any. No pneumothorax. Transvenous right atrial ventricular pacer defibrillator leads are in standard placements. 1 of 2 ventricular leads is an orphaned fragment.


SubjectID: 19475604, StudyID: 57131435, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pneumonia and pacemaker in the CCU // acute cardiopulmonary process

IMPRESSION: As compared to ___, pulmonary edema has decreased in severity with mild residual edema remaining as well as small bilateral pleural effusions   Keywords: decrease. Slightly more confluent opacity at the right lung base is noted, an short-term followup radiographs may be helpful to exclude the possibility of developing infection in this region.


SubjectID: 19488061, StudyID: 59343302, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with R ribs ___ fx, pneumothorax, CHF (EF ___%), now with worsening R chest pain // Please assess for fracture displacement, pneumothorax, hemothorax, pulm edema Please assess for fracture displacement, pneumothorax, hemothorax, pulm edema

IMPRESSION: Comparison to ___. Known displaced right rib fractures. Known small right pneumothorax. No evidence of tension. Unchanged borderline size of the cardiac silhouette with mild retrocardiac atelectasis. No pulmonary edema.


SubjectID: 19488061, StudyID: 54112792, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with hemothorax and rib fractures // Please assess for change in hemothorax or other pathology Please assess for change in hemothorax or other pathology

IMPRESSION: New displaced right rib fractures. Small right pneumothorax without evidence of tension. Moderate retrocardiac atelectasis. Right basilar atelectasis. Bilateral pleural effusions of moderate extent are better visualized on the lateral than on the frontal image. Borderline size of the cardiac silhouette without pulmonary edema.

NOTIFICATION: At the time of dictation and observation, 16:55, on the ___, the referring physician ___. ___ was paged for notification.


SubjectID: 19495630, StudyID: 59872759, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Questionable pneumonia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The parenchymal opacity in the right lung, likely reflecting pneumonia, is unchanged in severity and extent. No new parenchymal opacities   Keywords: new. Unchanged atelectasis in the left basal lung zones. Unchanged size and shape of the cardiac silhouette.


SubjectID: 19495630, StudyID: 51031746, Comparison: same

FINAL REPORT

HISTORY: Follow up pneumonia.

FINDINGS: In comparison with study of ___, there is little interval change   Keywords: little interval change. Opacification in the right mid and lower lung is again consistent with the clinical diagnosis of pneumonia. Left basilar atelectasis persists and there is blunting of both costophrenic angles. Some indistinctness of pulmonary vessels raises the possibility of elevated pulmonary venous pressure.


SubjectID: 19495630, StudyID: 59558140, Comparison: None

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with influenza, pneumonia?

COMPARISON: ___.

FINDINGS: Increase in bibasilar consolidation is probably due to lower lung volumes and not real progression of the disease. There is no pleural effusion or pneumothorax. Cardiac contour is normal in this patient with an atrioventricular pacemaker.

CONCLUSION: Increase in bibasilar consolidations is probably technical due to lower lung volumes. There is probably no significant change since the exam of yesterday in the bilateral opacities, probably related to the influenza.


SubjectID: 19495630, StudyID: 57614486, Comparison: None

FINAL REPORT

HISTORY: Hypoxia.

FINDINGS: In comparison with study of ___, the patient has taken a somewhat better inspiration. Opacification in the right mid and lower zones is again seen, though the increased inspiration makes it less coalescent than on the previous study. Atelectatic changes are again seen at the left base and there is continued blunting of both costophrenic angles. Indistinctness of pulmonary vessels could reflect some elevated pulmonary venous pressure.


SubjectID: 19495630, StudyID: 50219660, Comparison: None

FINAL REPORT

HISTORY: COPD and recent pneumonia.

FINDINGS: In comparison with the study of ___, the patient has taken a better inspiration. This may account for the change in the appearance of the bilateral airspace consolidations. The pulmonary vessels are not sharply seen, consistent with some elevation of pulmonary venous pressure.


SubjectID: 19495630, StudyID: 57528887, Comparison: better

FINAL REPORT

HISTORY: Pneumonia and hypoxia.

FINDINGS: In comparison with the study of ___, there has been some progressive improvement in the bilateral pulmonary opacifications   Keywords: improve. The findings would be consistent with a combination of pneumonia and some elevated pulmonary venous pressure. Dual-channel pacemaker device remains in good position.


SubjectID: 19495630, StudyID: 55707463, Comparison: worse

FINAL REPORT

INDICATION: Dyspnea, please evaluate for acute process.

COMPARISON: Comparison is made to multiple prior chest radiographs, most recently dated ___.

FINDINGS: Single portable chest radiograph demonstrates hyperexpansion of lungs with relative lucency of the upper lung zones, consistent with chronic lung disease. There is a persistent asymmetric increased opacity in the right lung base, similar across multiple prior studies and possibly representing combination of scarring and atelectasis. No new focal opacifications evident   Keywords: new. No pleural effusion or pneumothorax identified. Mediastinal and hilar contours are unremarkable. Heart size is top normal. Stable positioning of dual-chamber pacemaker noted. No osseous abnormality is present.

IMPRESSION: No acute intrathoracic process. Stable linear right lower lung opacifications, unchanged across multiple prior studies on background of chronic lung disease.


SubjectID: 19495630, StudyID: 50528461, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST ON ___

HISTORY: ___-year-old man with COPD on home oxygen, had pneumonia in ___, now dyspneic.

IMPRESSION: PA and lateral chest compared to ___ through ___: Compared to ___ there are two new regions where radiodensity in the lungs has changed, on the right side at the level of the third anterior rib is a roughly 3 cm wide geographic region, and on the lateral view, there is partial obscuration of the left hemidiaphragm and a tiny volume of left pleural fluid. Either of both of these regions could be pneumonia, and although exceedingly small, could be clinically significant, because of the patient's very severe emphysema. There is no evidence of cardiac decompensation. Heart size is normal. Transvenous right atrial and right ventricular pacer leads are in standard placements. Dr. ___ was paged at 2:15 p.m.


SubjectID: 19495630, StudyID: 53302261, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: COPD, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The bilateral parenchymal opacities, seen in the retrocardiac lung areas and at the right lung bases, could have minimally increased in severity. The lateral radiograph also shows a minimal dorsal pleural effusion. The heart continues to be normal. Left pectoral pacemaker is in unchanged position.


SubjectID: 19495630, StudyID: 50448310, Comparison: None

FINAL REPORT

HISTORY: Cough and fever.

TECHNIQUE: Upright AP and lateral views of the chest.

COMPARISON: ___ chest radiograph, ___ chest CT.

FINDINGS: Left-sided pacemaker device with leads terminating in the right atrium and right ventricle is again noted. Heart size is normal. Aortic knob is mildly calcified. Mediastinal and hilar contours are unchanged. Upper lobe predominant emphysema is again noted. Streaky bibasilar airspace opacities likely reflect atelectasis. No pleural effusion, pulmonary vascular congestion, or pneumothorax is identified. There are mild degenerative changes in the thoracic spine.

IMPRESSION: Emphysema. Mild bibasilar atelectasis.


SubjectID: 19499830, StudyID: 57491643, Comparison: None

FINAL REPORT

AP CHEST, 7:28 A.M., ___

HISTORY: CHF, bilateral pleural effusions. Respiratory distress after drainage.

IMPRESSION: AP chest compared to ___: Moderate left pleural effusion which reaccumulated following thoracentesis is stable since ___, as are small-to-moderate right pleural effusion, severe cardiomegaly, and pulmonary vascular engorgement. Today, there is no finding of interstitial pulmonary edema. Right jugular line ends centrally. No pneumothorax.


SubjectID: 19499830, StudyID: 55377984, Comparison: None

FINAL REPORT

HISTORY: Tachypnea, evaluate for pleural effusion. CHEST, SINGLE AP PORTABLE VIEW. Right IJ central line tip over lower SVC. Sternotomy wires noted. Moderately severe cardiomegaly. Upper zone re-distribution and diffuse vascular blurring, consistent with CHF. Increased retrocardiac density, with obscuration of left hemidiaphragm, consistent with left lower lobe collapse and/or consolidation. Blunting of both costophrenic angles, consistent with small effusions. On the right, a small amount of underlying collapse and/or consolidation cannot be excluded.

IMPRESSION: Cardiomegaly with CHF and interstitial edema. Small left- greater-than-right effusions, with underlying collapse and/or consolidation. Compared with same day ___ at 16:07 p.m. and allowing for technical differences, I doubt significant interval change.


SubjectID: 19499830, StudyID: 51325477, Comparison: None

FINAL REPORT

AP CHEST 7:37 P.M. ___

HISTORY: CHF, bilateral pleural effusions. Drainage. Shortness of breath.

IMPRESSION: AP chest compared to ___: Moderate to large left pleural effusion is re-accumulating. Small right pleural effusion, severe cardiomegaly and pulmonary venous hypertension unchanged. Lung texture suggests borderline edema. Right jugular line ends in the mid SVC. No pneumothorax.


SubjectID: 19499830, StudyID: 58931095, Comparison: None

FINAL REPORT

AP CHEST, 6:44 P.M., ___

HISTORY: ___-year-old woman with new pulmonary arterial flotation catheter.

IMPRESSION: AP chest compared to ___: Tip of the Swan-Ganz catheter projects over the proximal main pulmonary artery, advanced approximately 3 cm since 7:21 a.m. Mild pulmonary edema most readily visible in the left upper lung has worsened. Moderate right pneumothorax has increased as has moderate cardiomegaly. ET tube is in standard placement and nasogastric tube passes below the diaphragm. Small left pleural effusion remains, with stable thickening of the left apical pleural margin compared to ___. _____ ___ was paged.


SubjectID: 19499830, StudyID: 57659981, Comparison: None

FINAL REPORT

HISTORY: CABG, to assess right pneumothorax.

FINDINGS: In comparison with the study of ___, the right pneumothorax persists. Other monitoring and support devices are essentially unchanged.


SubjectID: 19499830, StudyID: 53515707, Comparison: None

FINAL REPORT

HISTORY: Chest tube placement.

FINDINGS: In comparison with the earlier study of this date, there has been virtually complete reexpansion of the right lung. Monitoring and support devices and appearance of the heart and lungs is otherwise unchanged.


SubjectID: 19499830, StudyID: 58589216, Comparison: same

FINAL REPORT

INDICATION: Status post central line placement. Evaluate line placement and assess for pneumothorax.

COMPARISON: Chest radiograph from ___ at 12:32 p.m.

FINDINGS: A single portable radiograph of the chest was acquired. There has been interval placement of a right internal jugular central venous catheter, ending in the mid-to-low SVC. There is no pneumothorax. A moderate left pleural effusion persists. A small right pleural effusion remains possible. Ill-defined opacities at the right lung base are not significantly changed and could be atelectasis or pneumonia. Left basilar compressive atelectasis is again seen. The cardiac and mediastinal contours are unchanged.

IMPRESSION: Interval placement of a right internal jugular catheter with its tip in the mid-to-low SVC. No evidence of pneumothorax. Otherwise, no interval change   Keywords: no interval change.


SubjectID: 19499830, StudyID: 55241097, Comparison: None

FINAL REPORT

INDICATION: Dyspnea.

COMPARISON: Multiple prior radiographs dating back through ___, including the most recent radiograph from ___.

FINDINGS: A moderate left pleural effusion is markedly increased compared to ___. There is associated compressive atelectasis at the left lung base, underlying consolidation can not be excluded. Ill-defined opacities in the right lower lung are slightly increased compared to the ___ radiograph, consistent with either atelectasis or possibly an infectious process. There may be a tiny right pleural effusion. The cardiac silhouette size is difficult to assess given the left pleural effusion, although moderate-to-severe enlargement does not seem significantly changed. The mediastinal contours are stable. There is no pneumothorax. The patient is status post midline sternotomy and CABG. Aortic calcifications are noted.

IMPRESSION: 1. Increased moderate left pleural effusion with overlying atelectasis, underlying consolidation can not be excluded. Possibly small right pleural effusion. 2. Right lower lobe atelectasis versus infection. Clinical correlation is recommended. Pertinent findings were discussed with Dr. ___ by Dr. ___ at 1:08 p.m. via telephone on the day of the study.


SubjectID: 19499830, StudyID: 50542118, Comparison: None

FINAL REPORT

HISTORY: Possible pneumonia.

FINDINGS: In comparison with the study of ___, there is continued huge enlargement of the cardiac silhouette with relatively moderate vascular congestion. This raises the possibility of pericardial effusion or cardiomyopathy. Opacification at the left base is consistent with atelectasis and effusion. In the appropriate clinical setting, the possibility of supervening pneumonia would have to be considered.


SubjectID: 19499830, StudyID: 53551667, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Shortness of breath.

COMPARISONS: ___.

TECHNIQUE: Chest, portable AP.

FINDINGS: There is increasing left-sided opacification involving the mid to lower lung, probably reflecting increased pleural effusion with associated parenchymal opacity, which is most often due to atelectasis although not specific. There is also a small new right-sided pleural effusion. Pulmonary vascularity is slightly prominent in the upper lungs, suggesting pulmonary venous hypertension, although without frank congestive heart failure. The patient is status post sternotomy and the heart appears again enlarged.

IMPRESSION: Increasing opacification of the left hemithorax, probably reflecting an increasing pleural effusion.


SubjectID: 19499830, StudyID: 57105094, Comparison: None

FINAL REPORT

INDICATION: Assess for ET tube placement.

COMPARISONS: Chest radiographs from ___ to ___.

FINDINGS: ET tube terminates 6 cm above the carina. Right internal jugular central venous catheter tip projects over mid SVC. Sternotomy wires are intact. Multiple surgical clips project over cardiac silhouette. Left lung base consolidation is unchanged. Left costophrenic angle is obscured, suggestive of small pleural effusion, decreased since prior. There is no pneumothorax. Hilar and mediastinal silhouettes are unchanged. Mild-to-moderate cardiomegaly persists. Perihilar vascular congestion is noted.

IMPRESSION: Persistent left lung base consolidation, likely atelectasis. Left pleural effusion has decreased in size since ___.


SubjectID: 19499830, StudyID: 52682671, Comparison: worse

FINAL REPORT

INDICATION: Patient with shortness of breath and tachypnea, please evaluate for pulmonary edema.

COMPARISON: Comparison is made to chest radiographs performed ___.

FINDINGS: There is redemonstration of the enlarged cardiac silhouette, possibly related to cardiomegaly, though as previously mentioned pericardial effusion IS not excluded. There is increased prominence of the interstitial markings, particularly in the perihilar distribution, likely due to increased pulmonary edema   Keywords: increase. A moderately sized left pleural effusion is identical in appearance to chest radiogrpah performed 3 days earlier, though less apparent on intervening radiogrpah, likely due to positioning. Retrocardiac opacity likely represents a combination of effusion and atelectasis, though infectious process cannot be excluded. There has been interval removal of the endotracheal tube. The central venous catheter terminates in the mid superior vena cava. No pneumothorax evident. Sternotomy sutures are midline and intact. No osseous abnormalities identified.

IMPRESSION: Worsening pulmonary edema   Keywords: worse. Moderate-sized left pleural effusion, unchanged compared to ___. Interval removal of endotracheal tube.


SubjectID: 19499830, StudyID: 56770703, Comparison: same

FINAL REPORT

HISTORY: Shortness of breath.

FINDINGS: In comparison with the study of ___, there is little overall change   Keywords: little overall change. Again, there is huge enlargement of the cardiac silhouette with minimal elevation of pulmonary venous pressure. This discordancy raises the possibility of cardiomyopathy or even pericardial effusion. Blunting of the costophrenic angles bilaterally is consistent with mild effusions. The right base now appears relatively clear without definite focal consolidation. Otherwise, little change   Keywords: little change.


SubjectID: 19499830, StudyID: 53816771, Comparison: None

FINAL REPORT

INDICATION: History of cough/shortness of breath. Rule out pneumonia or worsening CHF.

COMPARISONS: Chest radiograph from ___, ___ and ___.

TECHNIQUE: PA and lateral radiographs of the chest.

FINDINGS: Severe cardiomegaly is chronic; however, there is no evidence of pulmonary edema. There is mild pulmonary vascular congestion. There are small bilateral pleural effusions. There is an area of increased opacity in the right lower lobe concerning for pneumonia. There is no evidence of pneumothorax. Patient is status post median sternotomy and coronary bypass grafting. There is a left-sided PIC line which appears to terminate in the left brachiocephalic vein, overall unchanged in position compared to the prior exam. Note is made of an aortic stent.

IMPRESSION: 1. New focal consolidation in the right lower lobe concerning for pneumonia. 2. Mild pulmonary vascular congestion.


SubjectID: 19499830, StudyID: 56027976, Comparison: None

FINAL REPORT

AP CHEST 5:32 A.M.

HISTORY: ___-year-old woman after CABG. Whiteout of a lung. Undrained bleeding.

IMPRESSION: AP chest compared to ___, 1:12 a.m.: Large right pneumothorax has increased in size, although there is no appreciable leftward mediastinal shift. Pulmonary edema was mild to moderate but symmetric four hours ago. Now it is clearing from the right lung suggesting diminished perfusion to that side. With the patient supine I cannot exclude some component of left pneumothorax collected anteriorly, though there are no findings to suggest it. Cardiomediastinal silhouette has a stable post-operative appearance, with a degree of widening expected given the pre-operative heart size. There is either a small to moderate left pleural effusion collected superiorly or extrapleural bleeding responsible for thickening of the apical pleural margin. Clinical correlation is necessary. Dr. ___ ___ I discussed these findings by telephone at the time of dictation. Tip of the intra-aortic balloon pump is no less than 12 cm from the apex of the aortic knob, 4 to 5 cm below usual position. Swan-Ganz catheter tip is in the region of the pulmonic valve. ET tube is in standard placement. Midline and left pleural drains are also in standard position.


SubjectID: 19499830, StudyID: 55916528, Comparison: None

WET READ: ___ ___ ___ 11:23 PM ETT 5cm above carina___ San ___ at the RVOT, NGT in the proximal stomach. Bilateral pleural and mediastinal drains in place. Moderate pulmonary edema. Bibasal atelectasis. Minimal residual left apical ? hematoma. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: CABG, left hemothorax, fast track cardiac surgery.

COMPARISON: ___, 12:32 p.m.

FINDINGS: As compared to the previous radiograph, there has been re-positioning of the left chest tube. The left apicolateral fluid collection has substantially decreased in extent. However, a small medial pneumothorax has newly occurred. The pre-existing basal right pneumothorax seems to have decreased in extent, possibly because of the insertion of a new right ventral chest tube. Moderate post-operative cardiomegaly. All other monitoring and support devices are in unchanged position.


SubjectID: 19499830, StudyID: 53465301, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: None. CLINICAL

HISTORY: Chest pain, question aortic widening or pneumonia.

FINDINGS: AP upright portable chest radiograph obtained. The heart is moderately enlarged. No pleural effusion or pneumothorax. No definite signs of pneumonia. No overt signs of CHF. There is mild prominence of the aortic knob, but this is likely due to tortuosity with faint atherosclerotic calcifications noted. Bony structures are intact.

IMPRESSION: Cardiomegaly with unfolded thoracic aorta likely accounting for prominence of the mediastinum. Please refer to subsequent CTA for further details.


SubjectID: 19499830, StudyID: 53496388, Comparison: None

FINAL REPORT

INDICATION: ___-year-old woman status post CABG. Recent chest tube removal.

COMPARISON: Supine portable chest radiograph ___.

TECHNIQUE: Portable AP semi-erect chest radiograph.

FINDINGS: There has been interval removal of the left-sided chest tube with no development of pneumothorax observed. Also seen has been removal of the aortic balloon and catheter from the ascending aorta. There has been slight interval improvement in the left upper lobe opacity. Otherwise, study is largely unchanged from prior. Swan-Ganz catheter is seen, unchanged in position. Endotracheal tube is seen unchanged in position approximately 5 cm from the carina. Cardiomediastinal silhouette is stable.

IMPRESSION: Successful removal of chest tube and aortic pump balloon with no resulting pneumothorax.


SubjectID: 19499830, StudyID: 54702208, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Swan-Ganz catheter placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the Swan-Ganz catheter has not substantially changed in position. The tip is still located in the right pulmonary artery but has been minimally pulled back. Substantial cardiomegaly, clips after CABG, sternal wires are in unchanged alignment. Minimal right pleural effusion and areas of bilateral basal atelectasis. The left PICC line shows an unchanged course.


SubjectID: 19499830, StudyID: 53762863, Comparison: None

FINAL REPORT

INDICATION: Assess for line placement.

COMPARISON: ___, and CTA chest of ___.

FINDINGS: Portable upright view of the chest demonstrates right PIC catheter tip projecting over mid SVC. Swan-Ganz catheter is positioned at the pulmonary outflow tract. The heart remains markedly enlarged. Perihilar vascular congestion. Costophrenic angles are minimally blunted, suggestive of possible trace pleural effusions. No pneumothorax.

IMPRESSION: In comparison to ___ exam, there is no significant change in severe cardiomegaly and possible trace bilateral pleural effusions.


SubjectID: 19499830, StudyID: 51991481, Comparison: same

FINAL REPORT

HISTORY: PA catheterization.

FINDINGS: In comparison with the study of ___, allowing for some obliquity of the patient, there is probably little change in the appearance of the Swan-Ganz catheter with the tip well into the right pulmonary artery. It could be pulled back several cm to be certain to be within the mediastinal confines. Otherwise, little change in the huge enlargement of the cardiac silhouette and relatively mild vascular congestion, a discordancy that raises the possibility of cardiomyopathy or pericardial effusion   Keywords: little change.


SubjectID: 19499830, StudyID: 52571768, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with history of coronary artery disease status post CABG and right chest tube removal.

COMPARISON: Portable AP upright chest radiograph taken earlier same day.

TECHNIQUE: Portable semi-upright AP chest radiograph.

FINDINGS: There has been interval removal of right-sided chest tube. The previously seen right apical pneumothorax is reduced in size. There are stable moderately low lung volumes with pleural effusion, essentially unchanged. There is stable cardiomegaly. Swan-Ganz catheter now terminates within the right main pulmonary artery. Endotracheal tube is again seen in place, unchanged in position no less than 3 cm from the carina.

IMPRESSION: Interval removal of right chest tube with reduction in previously seen right apical pneumothorax. Remainder of exam is essentially unchanged.


SubjectID: 19499830, StudyID: 51073492, Comparison: worse

FINAL REPORT

HISTORY: Status post CABG, hypoxia.

FINDINGS: The endotracheal tube and NG tube have been removed. The Swan-Ganz catheter has been removed and there continues to be a right IJ Cordis with tip in the SVC. There is dense retrocardiac opacity, consistent with volume loss/infiltrate/effusion. There continues to be alveolar infiltrate in the left mid lung and right lower lung with some interval partial clearing of the upper lobes. The heart is severely enlarged and is slightly larger than on the prior study. The overall impression is that of CHF that is better in some areas and worsened in others   Keywords: worse.


SubjectID: 19508874, StudyID: 58183125, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with anoxic brain injury // please evaluate for interval change

COMPARISON: The comparison is made with prior studies including ___.

IMPRESSION: Tracheostomy and PICC lines are unchanged. There is no pneumothorax. While this study is more lordotic in positioning than the prior exam, there appears to be increased effusion or patchy density in the left base. The right base is stable. There is persistent mild CHF   Keywords: persistent.


SubjectID: 19508874, StudyID: 56577319, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with tracheostomy, bleeding

TECHNIQUE: Portable semi-upright AP view of the chest

COMPARISON: None. Patient is currently listed as EU critical.

FINDINGS: Tracheostomy tube tip terminates approximately 7 cm from the carina. Right PICC tip terminates in the upper SVC. Moderate to severe enlargement of the cardiac silhouette is present. The aorta is diffusely calcified and tortuous. Moderate to severe pulmonary edema is noted along with layering bilateral pleural effusions. More focal opacities in the lung bases may reflect areas of atelectasis, however infection or aspiration cannot be excluded. No pneumothorax is present. There are no acute osseous abnormalities.

IMPRESSION: 1. Tracheostomy tube in standard position. 2. Moderate to severe cardiomegaly with moderate to severe pulmonary edema, layering bilateral pleural effusions, and probable bibasilar atelectasis. Infection or aspiration at the lung bases cannot be excluded.


SubjectID: 19508874, StudyID: 55981798, Comparison: worse

FINAL REPORT

INDICATION: ___ year old woman with anoxic brain injury, bleeding from tracheostomy // interval change

COMPARISON: The comparison is made with prior studies including ___.

IMPRESSION: There is increase in the previously noted CHF   Keywords: increase. There is a moderate-sized left pleural effusion. There is no pneumothorax. The tracheostomy tube and PICC lines are unchanged.


SubjectID: 19508874, StudyID: 55812817, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with bleeding from tracheostomy // interval change

COMPARISON: Comparison is made with prior studies including earlier the same day at 04:28.

IMPRESSION: There is cardiomegaly, upper zone redistribution and blurring of vascular detail suggesting CHF. The tracheostomy tube and PICC lines are unchanged. There is no pneumothorax. There is no significant interval change   Keywords: no significant interval change.


SubjectID: 19508874, StudyID: 55173947, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with trach/PEG, here for concern for ongoing bleeding through trach // r/o interval change

IMPRESSION: In comparison to previous radiograph of 1 day earlier, cardiomegaly and pulmonary edema are persistent findings, accompanied by slight apparent increase in moderate pleural effusions, although positional differences limit comparison between the exams   Keywords: increase.


SubjectID: 19508874, StudyID: 55015393, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with bleeding from tracheostomy // eval for interval change eval for interval change

IMPRESSION: Tracheostomy is in place. Cardiomegaly is moderate, unchanged. Mediastinal silhouette is stable. There is interval improvement of pulmonary edema with only vascular congestion currently present   Keywords: improve. Left pleural effusion is moderate to large and right pleural effusion is moderate, overall similar to previous examination. No pneumothorax.


SubjectID: 19508874, StudyID: 56833633, Comparison: better

FINAL REPORT

INDICATION: ___-year-old female with cough and altered mental status. Bilateral pedal edema. Evaluate for infection or CHF.

COMPARISON: PA and lateral chest radiograph ___. PA AND LATERAL CHEST RADIOGRAPH: Moderate pulmonary edema is again noted, slightly improved since ___. Cardiomegaly is unchanged from ___. The mediastinal and hilar contours are unremarkable. No pleural effusion or pneumothorax is present. Mild retrocardiac atelectasis cannot be completely excluded.

IMPRESSION: Stable cardiomegaly with improved moderate pulmonary edema compared to ___   Keywords: improve. Possible mild retrocardiac atelectasis.


SubjectID: 19508874, StudyID: 55206167, Comparison: same

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with diastolic CHF, pulmonary edema, acute worsening of pulmonary edema.

COMPARISON: ___.

FINDINGS: Mild to moderate interstitial edema is unchanged   Keywords: unchanged. Moderate cardiomegaly is stable. There is no pleural effusion, no pneumothorax. There is no new lung consolidation.

CONCLUSION: Mild to moderate interstitial edema and moderate cardiomegaly is unchanged   Keywords: unchanged.


SubjectID: 19508874, StudyID: 54846105, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with intubation // eval interval change eval interval change

IMPRESSION: In comparison with the study of ___, there is again substantial enlargement of the cardiac silhouette with elevation in pulmonary venous pressure. The monitoring and support devices are unchanged. Increased opacification at the right base silhouetting the hemidiaphragm is consistent with layering pleural effusion and underlying compressive atelectasis. Mild atelectatic changes are seen at the left base.


SubjectID: 19508874, StudyID: 53991734, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with intubation // eval interval change

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change.


SubjectID: 19508874, StudyID: 53216394, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with intubation, CVL placement // eval ET tube postion, CVL placement eval ET tube postion, CVL placement

IMPRESSION: As compared to ___, the patient has been intubated. The tip of the endotracheal tube projects 2.5 cm above the carinal. The patient has also received the nasogastric tube, the tip is not included in the image but the course of the tube is unremarkable. Finally, the patient carries a right internal jugular line. No evidence of pneumothorax. No larger pleural effusions. Moderate cardiomegaly with slightly improved ventilation of the right lung bases. Mild fluid overload but no overt pulmonary edema. No pneumonia.


SubjectID: 19508874, StudyID: 52170969, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ PMHx T2DM, AFib previously on Eliquis, h/o stroke in ___, HTN, CKD and HFpEF who presents with progressive SOB x 1 week, transferred to the MICU on ___ early AM for concern for angioedema who subsequently became obtunded and suffered cardiac arrest. // interval change interval change

IMPRESSION: Comparison to ___. No relevant change   Keywords: no relevant change. Moderate cardiomegaly. Monitoring and support devices are stable. Mild fluid overload but no overt pulmonary edema. The presence of a minimal right pleural effusion cannot be excluded.


SubjectID: 19509569, StudyID: 59310678, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: ICD, evaluation for lead placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The new ICD is projecting over the right ventricle. No complications, notably no pneumothorax. Known scarring and apical thickening in the right lung.


SubjectID: 19509569, StudyID: 57572873, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Rule out pneumothorax.

COMPARISON: ___.

FINDINGS: Status post pacemaker change on the left. An additional wire is now seen projecting over the base of the right ventricle. The generator is intact. No pneumothorax or other complication. Unchanged appearance of the lung parenchyma, with known massive scarring in the right hemithorax.


SubjectID: 19509569, StudyID: 56050756, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post chest tube removal.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the left chest tube has been removed. There is no convincing evidence for the presence of a left pneumothorax. Unchanged appearance of the lung parenchyma and of the cardiac silhouette, including the external pacemaker. The volume loss and scarring in the right lung, pre-described on previous examinations, is stable.


SubjectID: 19509569, StudyID: 55279101, Comparison: same

FINAL REPORT

HISTORY: History of lung cancer status post right upper lobectomy in ___ with low ejection fraction now with cough and dyspnea.

TECHNIQUE: PA and lateral views of the chest.

COMPARISON: Chest radiograph ___ at 10:04 and chest CT ___.

FINDINGS: Left-sided dual-chamber pacemaker device is re- demonstrated with leads terminating in the right atrium right ventricle. The patient is status post right upper lobectomy with expected fluid overlying the right apex. Cardiac, mediastinal and hilar contours are unchanged. Patchy opacities within the right perihilar region, right lung base, and left lung base are unchanged from the exam earlier today, but not clearly evident on the prior CT exam from ___. There is no pulmonary edema. Small bilateral pleural effusions are noted. No pneumothorax is identified.

IMPRESSION: No interval change compared to the prior study from approximately 15 hours earlier   Keywords: no interval change. Continued right perihilar and bibasilar patchy opacities which may reflect areas of infection. Small bilateral pleural effusions.


SubjectID: 19509569, StudyID: 54210917, Comparison: None

FINAL REPORT

HISTORY: Shortness of breath. Evaluate for pneumonia.

COMPARISON: Prior chest CT from ___ and chest radiograph from ___.

TECHNIQUE: PA and lateral chest radiographs.

FINDINGS: There is a left-sided pacemaker with leads terminating in the right atrium and right ventricle, expected location. Patient is status post right upper lobectomy. Opacity in the right apex is likely postsurgical. There is elevation of the right hemidiaphragm. Linear opacities in the right lung could relate to volume loss or radiation changes. There is a small right-sided pleural effusion. The left lung is clear.


SubjectID: 19509694, StudyID: 59162881, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with IPH. VAP // please eval for interval change

IMPRESSION: In comparison to ___ chest radiograph, bibasilar consolidation. Has slightly worsened on the right and minimally improved on the left. No other relevant changes   Keywords: no other relevant change.


SubjectID: 19509694, StudyID: 56606402, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with worsening appearance of CXR this AM // pls eval any interval change since this morning's CXR

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___ at 04:37

FINDINGS: Endotracheal tube terminates approximately 4.1 cm above the level of the carina. Enteric tube courses below the diaphragm, in the field of view. Left-sided subclavian central venous catheter is stable in position. There has been interval increase in left infrahilar opacity. Right base opacity persists. External leads overlie the right upper lung, making evaluation in this region suboptimal. No pleural effusion or pneumothorax seen. Enlargement of the cardiomediastinal silhouette is stable.

IMPRESSION: Persistent bibasilar opacities with interval increase in left infrahilar opacity concerning for worsening pneumonia with possible a component of underlying edema   Keywords: worse, increase. Right upper lung is not optimally assessed due to overlying external leads.


SubjectID: 19509694, StudyID: 55770306, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with IPH poor neuro exam, respiratory decline, icnreasign PEEP and FiO2 // interval change interval change

IMPRESSION: In comparison with the study of ___, the monitoring and support devices are unchanged. Continued enlargement of the cardiac silhouette with indistinctness of pulmonary vessels consistent with elevated pulmonary venous pressure   Keywords: continue. There appears to have been some improvement in the atelectatic changes at the bases, with the hemidiaphragms quite well seen.


SubjectID: 19509694, StudyID: 50456955, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with OGT placement // tip placement tip placement

IMPRESSION: In comparison with the study of ___, allowing for differences in technique there is probably little overall change in the bilateral basilar opacifications. Although some of this could represent elevated pulmonary venous pressure. The a appearance is also consistent with bilateral lower lung consolidations. Monitoring and support devices are essentially unchanged.


SubjectID: 19509694, StudyID: 57994331, Comparison: better

FINAL REPORT

INDICATION: ___-year-old male with fever and productive cough, rule out pneumonia.

COMPARISON: Chest radiograph from ___. TWO VIEWS OF THE CHEST: The lungs are well expanded and show mild interstitial opacities. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. No pleural effusion or pneumothorax is present.

IMPRESSION: Unchanged interstitial opacities were better characterized on recently performed chest CT   Keywords: better. It could be related to chronic interstitial lung disease with overlying edema.


SubjectID: 19509694, StudyID: 55659602, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old gentleman with crackles, presenting with diarrhea, fever, desaturations today to high 80s. ? pneumonia.

COMPARISON: ___.

TECHNIQUE: Portable upright chest radiograph.

FINDINGS: Heart appears to be enlarged as previously seen. There is increased pulmonary vascular congestion, more prominently on the left   Keywords: increase. There is also slight widening of the upper mediastinum on the right, possibly indicating engorgement of the azygous vein. Although no consolidation is noted, the pattern of pulmonary congestion makes it difficult to exclude an overlying developing infilterate. No pleural effusions and no pneumothorax.

IMPRESSION: Increased pulmonary vascular congestion, overlying developing infiltrate cannot be ruled out   Keywords: developing, increase.


SubjectID: 19509694, StudyID: 50559306, Comparison: 1.0

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Crack lung, new onset of cough and fever.

COMPARISON: ___, 3:49 p.m.

FINDINGS: As compared to the previous radiograph, there is unchanged evidence of moderate cardiomegaly, associated with pulmonary edema   Keywords: unchanged. The resulting opacities are more severe on the left than on the right and are predominantly located in the left hilar regions   Keywords: more severe. There is no interval appearance of new parenchymal opacities   Keywords: new. No pleural effusions. No pneumothorax.


SubjectID: 19509694, StudyID: 57726530, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M hx of hep C, schizophrenia, CHF with EF ___%, DMII found to have left SAH and subsequent extensive IPH. // interval change; empiric treatment for VAP

IMPRESSION: In comparison to previous study of 1 day earlier, cardiomegaly, pulmonary vascular congestion and pulmonary edema have slightly improved   Keywords: improve. Bibasilar consolidations have worsened however, and raise the possibility of coexisting aspiration pneumonia in the appropriate clinical setting.


SubjectID: 19509694, StudyID: 57669693, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with SDH and IPH // lines/tubes

IMPRESSION: In compares to the previous study of 1 day earlier, marked cardiomegaly is accompanied by overall improvement in extent of pulmonary edema   Keywords: improve. Confluent opacities at the lung bases probably reflect dependent edema, but aspiration is an additional consideration. Additionally, a heterogeneous opacity has developed in the periphery of the right upper lobe, and short-term followup radiographs are suggested after diuresis to help differentiate asymmetrical edema from the pulmonary infection.


SubjectID: 19509694, StudyID: 55675964, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with ich // Interval chsnge Interval chsnge

IMPRESSION: ET tube tip is 3 cm above the carinal. Left subclavian line tip is at the cavoatrial junction. Cardiomegaly and mediastinal silhouette are unchanged. Interval progression of pulmonary edema is demonstrated   Keywords: progression.


SubjectID: 19509694, StudyID: 57721534, Comparison: worse

FINAL REPORT

HISTORY: ___-year-old male with respiratory failure. Gastric tube placement evaluation.

COMPARISON: Radiographs dated ___, ___, and CT dated ___.

FINDINGS: Single frontal view of the chest demonstrates interval placement of ET tube with tip terminating 2.7 cm above the carina. Compared to 1 day prior, there is massive progressive worsening of widespread pulmonary opacities and near complete white-out of bilateral lungs with relative sparing of the right upper lobe   Keywords: worse. There is new obscuration of the cardiac silhouette as well as a bilateral diaphragmatic contours allowing for which, cardiomegaly is likely unchanged. Bilateral effusions may be present. There is no pneumothorax. The airway remains midline. Note is made of an airdistended stomach.

IMPRESSION: 1. ET tube with tip terminating 2.7 cm above the carina. 2. Marked rapid progression of pulmonary disease with now diffuse dense opacification of bilateral lungs and mild sparing of the right upper lobe, overall appearance suggestive of ARDS   Keywords: progression. 3. Moderate air distended stomach. NGT placement should be considered. Findings discussed with Dr. ___ ___ phone at approximately 1pm on ___.


SubjectID: 19509694, StudyID: 57180479, Comparison: None

FINAL REPORT

INDICATION: Likely crack pneumonitis versus COPD flare or pneumonia with decreased O2 saturations.

COMPARISON: ___, ___.

TECHNIQUE: Portable frontal chest radiograph.

FINDINGS: Cardiac silhouette remains enlarged, unchanged from prior exam. Global heterogeneous opacities with a peripheral predilection are worse compared to ___ with an appearance suggestive of eosinophilic pneumonia. There is no pneumothorax.

IMPRESSION: Worsening bilateral peripheral opacities with a distribution suggestive of eosinophilic pneumonia.


SubjectID: 19509694, StudyID: 55430621, Comparison: None

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Cough and body ache.

COMPARISONS: ___.

TECHNIQUE: Chest, PA and lateral.

FINDINGS: The heart is again mild-to-moderately enlarged.There is new confluent opacification in the left upper lobe, particularly near the apex with lesser involvement elsewhere. To a lesser degree, there is also new right apical opacification. A right lower lung opacity is similar to improved, however. The lungs are hyperinflated. There is no pleural effusion or pneumothorax. Bony structures are unremarkable.

IMPRESSION: Much more extensive lung opacification than seen on the prior study including confluent left apical opacification with a distribution that is not typical for pulmonary edema. An infectious process could be considered, but the process is widespread but heterogenous, with a strikingly peripheral distribution in the left upper lobe which could be seen with an eosinophilic pneumonia, which has been described as a manifestation of cocaine-related lung disease. A coinciding component of pulmonary edema is also possible.


SubjectID: 19509694, StudyID: 52244372, Comparison: -1.0

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with pneumonitis, CHF, intubated, please evaluate for volume status, ETT placement.

COMPARISON: ___ to ___.

FINDINGS: ET tube ends 3.7 cm above the carina. NG tube is in the stomach. There is a right PICC line in mid SVC. Diffuse bilateral lung opacities, significantly worsened between ___ to ___, are still severe but improved since ___   Keywords: worse. There is no pleural effusion. Cardiomegaly is moderate.

CONCLUSION: 1. Tube and lines are in adequate position. 2. Severe widespread opacities are still severe but slightly improved since ___   Keywords: improve.


SubjectID: 19509694, StudyID: 51005798, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Cracked pneumonitis, intubation, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The extent and severity of the pre-existing parenchymal opacities is constant. The size of the cardiac silhouette is still enlarged. Despite the nasogastric tube, there is ongoing gastric overinflation. The endotracheal tube and the right internal jugular vein catheter are in unchanged correct position. No pneumothorax.


SubjectID: 19509694, StudyID: 57593430, Comparison: better

FINAL REPORT

HISTORY: Cocaine abuse.

FINDINGS: In comparison with the study of ___, there is mild improvement in aeration, though diffuse bilateral pulmonary opacifications persist   Keywords: improve.


SubjectID: 19509694, StudyID: 53755746, Comparison: worse

FINAL REPORT

INDICATION: Shortness of breath, pulmonary edema. Please evaluate for acute process.

COMPARISON: Comparison is made to multiple chest radiographs most recently dated ___ well as CT chest performed ___.

FINDINGS: Portable chest radiograph demonstrates unremarkable mediastinal contours. There is stable mildly enlarged cardiac silhouette. There has been interval increase in diffuse alveolar opacities with a basilar predomince, left greater than right with loss of left hemidiaphragm silhouette   Keywords: increase. Given multiple prior studies demonstrating rapid increase and decrease of opacification and previously provided history of cocaine use, findings suggest acute non-cardiac pulmonary edema versus pulmonary toxicity   Keywords: increase.

IMPRESSION: Increased asymmetric predominantly basilar diffuse airspace opacifications likely represent acute non-cardiac edema vs pulmonary toxicity from inhaled substance   Keywords: increase.


SubjectID: 19509694, StudyID: 56342787, Comparison: better

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___ radiograph.

FINDINGS: Stable cardiomegaly, but decreased width of vascular pedicle, and reduction in caliber of pulmonary vasculature, accompanied by improving pulmonary edema with mild residual interstitial edema remaining   Keywords: improving. Small right pleural effusion has also decreased in size.


SubjectID: 19509694, StudyID: 50644873, Comparison: None

FINAL REPORT

HISTORY: COPD and congestive heart failure with shortness of breath.

COMPARISON: Multiple prior studies including chest radiograph from ___ and FDG Tumor Imaging study from ___.

FINDINGS: There are bilateral interstitial opacities, greater at the lung bases, consistent with moderate pulmonary edema. The previously reported right upper lobe spiculated opacity is again noted and better evaluated on prior FDG tumor imaging study. Diffuse emphysematous changes are again noted throughout the lungs. The heart remains moderately enlarged. Mediastinal contours are stable.

IMPRESSION: 1. Moderate pulmonary edema with moderate cardiomegaly. 2. Right upper lobe spiculated opacity again noted and better delineated on prior FDG Tumor Imaging study.


SubjectID: 19509694, StudyID: 56001715, Comparison: None

FINAL REPORT

INDICATION: Patient with new dyspnea on exertion. Assess for pneumonia.

COMPARISONS: Chest radiograph of ___ and CT chest of ___, ___, and ___.

FINDINGS: Frontal and lateral views of the chest demonstrate low lung volumes. Diffuse bilateral consolidate opacities with have recurred since prior exam, but are in different distribution. There is no pleural effusion or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Heart size is top normal.

IMPRESSION: Diffuse bilateral consolidative opacities have recurred in different distribution since prior exams, likely due to interval environmental exposures.


SubjectID: 19509694, StudyID: 52342295, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Pulmonary edema evaluation for interval changes in consolidation.

TECHNIQUE: Portable upright chest view was read in comparison with multiple prior radiographs with the most recent from ___ acquired 10 hours apart.

FINDINGS: The airspace opacities in the left lung and in the right lower lobe which were new on were new on ___ radiograph have minimally improved over last 10 hours. These acute and newly developed opacities between ___ and ___ could reflect asymmetric pulmonary edema or acute pneumonitis   Keywords: develop, new. Conclusion should be drawn in conjunction with clinical history. Top normal heart size is normal. The mediastinal and hilar contours are unremarkable.

IMPRESSION: Bilateral airspace opacities in the left lung and the right lower lobe, new since ___ reflecting pulmonary edema or pneumonitis, have minimally improved   Keywords: new.


SubjectID: 19509694, StudyID: 55938960, Comparison: better

FINAL REPORT

INDICATION: ___-year-old male with congestive heart failure, here to evaluate for acute process.

COMPARISON: Chest radiograph, last performed on ___. PORTABLE FRONTAL CHEST RADIOGRAPH: Diffuse bilateral alveolar opacities persist with mild improvement on the left greater than the right compared to the preceding chest radiograph. The costophrenic angles are clear without pleural effusions. No pneumothorax is present. The cardiomediastinal silhouette is unchanged and within normal limits.

IMPRESSION: Moderate-to-severe pulmonary edema with mild improvement on the left greater than the right since ___   Keywords: improve.


SubjectID: 19509694, StudyID: 51970171, Comparison: None

FINAL REPORT

HISTORY: ___-year-old male with history of COPD and CHF now presenting with tachypnea.

COMPARISON: Chest radiograph from ___ and chest CTs from ___ and ___. PORTABLE FRONTAL CHEST RADIOGRAPH: Diffuse alveolar opacities are new and greater on the left compared to the right. Though findings are typical for pulmonary edema, given the distribution and chronic appearance as compared to multiple prior CTs, consideration should be given to other causes, possibly a fulminant allergic or toxic alveolitis. No large pleural effusions are evident. Mediastinal contours are within normal limits. The cardiac silhouette is normal in size. No pneumothorax is evident.

IMPRESSION: Recurrent diffuse alveolar opacities. Possibly due to pulmonary edema though other etiologies should also be considered given the distribution and chronicity.


SubjectID: 19509694, StudyID: 55916329, Comparison: better

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Chest radiographs dating between ___ and ___.

FINDINGS: Bilateral asymmetrically distributed airspace opacities have rapidly improved, with residual opacities now most prominent in the right lower and left upper and mid lung regions   Keywords: improve. Considering rapid improvement and coexisting cardiomegaly and vascular engorgement, these findings likely represent asymmetrical pulmonary edema   Keywords: improve. Continued radiographic followup would be helpful to exclude other causes of airspace opacification such as pulmonary hemorrhage, aspiration, and infection.


SubjectID: 19509694, StudyID: 53629963, Comparison: None

FINAL REPORT

EXAM: CHEST FRONTAL AND LATERAL VIEWS. CLINICAL INFORMATION: Shortness of breath.

COMPARISON: ___.

FINDINGS: Frontal and lateral views of the chest were obtained. There is interval increase in bibasilar and left perihilar opacities. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable.


SubjectID: 19509694, StudyID: 50729327, Comparison: worse

FINAL REPORT

HISTORY: CHF exacerbation.

FINDINGS: In comparison with the study of ___, there is worsening pulmonary edema with continued substantial enlargement of the cardiac silhouette   Keywords: worse.


SubjectID: 19509694, StudyID: 54125266, Comparison: 1.0

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with brain bleed, persistent vent requirement, now w/ rising WBC // pls eval interval change pls eval interval change

IMPRESSION: ET tube tip is 5 cm above the carinal. Left subclavian line tip is at the level of lower SVC. Cardiomegaly is substantial. Mediastinal silhouette is unremarkable. Bibasal opacities appear to be similar to previous examination   Keywords: similar. Mild interval improvement in pulmonary edema is noted   Keywords: improve. Bibasal opacities might reflect developing infection.


SubjectID: 19509694, StudyID: 53490511, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with IPH, ETT and OGT // intrathoracic process intrathoracic process

IMPRESSION: Comparison to ___. No relevant change   Keywords: no relevant change. Mild to moderate pulmonary edema, causing distension of the vascular structures and mild mid and lower lobe predominant parenchymal opacities with air bronchograms. Moderate cardiomegaly. No pleural effusions. No pneumonia. The monitoring and support devices are stable.


SubjectID: 19509694, StudyID: 55311325, Comparison: None

FINAL REPORT

INDICATION: Multifocal pneumonia, evaluate for interval change.

COMPARISON: ___ at 6:08 p.m.

FINDINGS: One semi-erect AP portable view of the chest. Right internal jugular line ends in the mid to low SVC. Endotracheal tube ends 3 cm from the carina. The diffuse parenchymal opacities with minimal sparing of only the mid right lung are unchanged. No pneumothorax. NG tube in the stomach.

IMPRESSION: No significant change in diffuse parenchymal opacities with minimal sparing in the right mid lung.


SubjectID: 19509694, StudyID: 52297876, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

TECHNIQUE: Single portable upright chest view was read in comparison with multiple prior chest CTs through ___ with the most recent from ___.

FINDINGS: Bilateral multifocal lung opacities reflecting pneumonia which are worse in the left lung are unchanged in distribution and severity since prior chest radiograph from ___. Presumed small bilateral pleural effusions are unchanged. Heart size is normal. Mediastinal and hilar contours are unchanged.

IMPRESSION: Bilateral multifocal lung opacities reflecting multifocal pneumonia are unchanged in severity and distribution.


SubjectID: 19509694, StudyID: 50272962, Comparison: -1.0

FINAL REPORT

INDICATION: Pneumonia and sepsis, now intubated, evaluate for interval change.

COMPARISON: Chest radiograph of ___.

FINDINGS: The ET tube ends 3 cm from the carina. The right internal jugular central venous catheter ends in the mid-to-low SVC. NG tube is out of view. Compared to chest radiograph from ___, the diffuse bilateral parenchymal opacities have worsened   Keywords: worse. There are now increased opacities at the right upper lung and more opacities including the right mid lung. Compared to radiograph from ___, there is no significant change   Keywords: no significant change. The cardiac, mediastinal, and hilar contours are stable. No large pleural effusion. No pneumothorax.

IMPRESSION: 1. Compared to ___, there is worsening diffuse parenchymal opacities   Keywords: worse. Compared to ___, there is no significant change   Keywords: no significant change. 2. Lines and tubes are in appropriate position.


SubjectID: 19509694, StudyID: 54290561, Comparison: None

FINAL REPORT

HISTORY: ___-year-old male with acute onset of shortness of breath after smoking crack. STUDY: Portable AP upright chest radiograph.

COMPARISON: None.

FINDINGS: The heart and mediastinal contours are largely obscured by diffuse pulmonary opacities. The costophrenic angles appear sharp likely signifying no pleural effusion and there is no pneumothorax.

IMPRESSION: Widespread pulmonary opacities, the differential for which includes edema, multifocal pneumonia, or crack lung.


SubjectID: 19509694, StudyID: 54009413, Comparison: None

FINAL REPORT

AP CHEST 2:54 A.M. ___

HISTORY: Crack lung or hypersensitivity pneumonia. History of previous staph pneumonia.

IMPRESSION: AP chest compared to ___ through ___: A severe widespread infiltrative pulmonary abnormality has changed in distribution, somewhat better in the left upper lung, worse on the right, and there has been an increase in cardiac diameter suggesting that much of the abnormality is volume or cardiac related pulmonary edema. Of course concurrent pneumonia and non-cardiac edema would be difficult to recognize. Small bilateral pleural effusions are presumed. No pneumothorax.


SubjectID: 19509694, StudyID: 52549329, Comparison: None

FINAL REPORT

AP CHEST, 3:26 A.M., ___

HISTORY: ___-year-old man with crack lung. Shortness of breath and hypoxia.

IMPRESSION: AP chest compared to ___ through ___: In addition to a severe infiltrative abnormality, with probable confluence in the lung bases, there are many small discrete nodular opacities, which have grown appreciably since ___, probably entirely new since ___. Pattern strongly suggests widespread infection, possibly septic emboli. Heart is moderately enlarged, unchanged. At least small bilateral pleural effusions are presumed. Dr. ___ was paged.


SubjectID: 19509694, StudyID: 53982035, Comparison: same

FINAL REPORT

INDICATION: Evaluation of patient with dyspnea with history of multifocal pneumonia.

COMPARISON: Multiple prior studies including chest radiograph from ___ and CTPA study from ___.

FINDINGS: Severe bilateral diffuse parenchymal opacities are noted and appear similar to that seen previously in ___   Keywords: similar. Cardiomediastinal silhouette remains stable. No acute fractures are identified.

IMPRESSION: Diffuse bilateral severe parenchymal opacities, similar to that seen previously in ___ with multifocal pneumonia. These findings are more consistent with multifocal pneumonia, supperimposed pulmonary edema is possible.


SubjectID: 19509694, StudyID: 53698442, Comparison: same

FINAL REPORT

SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Acute dyspnea. Please evaluate lung abnormalities after diuresis. Comparison is made with prior study performed 6 hours earlier. Diffuse bilateral opacities have mildly improved consistent with improving moderate-to-severe pulmonary edema. There are still interstitial and alveolar opacities diffusely distributed in the lungs, worse in the bases and sparing the central portion of the right upper lobe. Cardiomediastinal contours are unchanged. If any, there are small bilateral pleural effusions.

IMPRESSION Remaining opacities still could represent pulmonary edema or diffuse multilobar pneumonia   Keywords: remain, still. Continued followup is recommended.


SubjectID: 19509694, StudyID: 53619306, Comparison: None

FINAL REPORT

INDICATION: History of congestive heart failure and COPD with acute dyspnea. Evaluate for acute intrathoracic process.

COMPARISON: Chest radiograph from ___.

FINDINGS: There are extensive heterogeneous opacities throughout the entire left lung and right lower lung. The right mid and upper lung is essentially clear. The heart size is within normal limits. The mediastinal contours are normal. There are no definite pleural effusions. No pneumothorax.

IMPRESSION: Diffuse bilateral airspace opacities with sparing of the right mid/upper lung would be a somewhat unusual pattern for asymmetric pulmonary edema and it is thought to be concerning for a multifocal infectious process.


SubjectID: 19509694, StudyID: 53179604, Comparison: same

WET READ: ___ ___ ___ 11:51 PM Endotracheal tube terminates approximately 2 cm above the level of the carina and could be retracted approximately 2 cm for ideal position. The findings were discussed via telephone by Dr. ___ with Dr. ___ on ___ at 11:49 PM, 5 minutes after discovery of the findings. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with new ETT // ETT placement ETT placement

IMPRESSION: ET tube tip is 3 cm above the carinal. Cardiomegaly is unchanged. Interstitial opacities are widespread and similar to previous examination   Keywords: similar. The most likely represent at the combination of edema and indices are opacities seen on the previous chest CT torso. Lymphadenopathy is better appreciated on the CT torso but might be seen as widened right paratracheal strip and aortopulmonic window on the current chest radiograph.


SubjectID: 19509694, StudyID: 50737886, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Followup.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The monitoring and support devices are constant, unchanged severity and extent of the known severe bilateral diffuse parenchymal opacities. No change in appearance of the cardiac silhouette.


SubjectID: 19510234, StudyID: 57356617, Comparison: None

FINAL REPORT

INDICATION: Severe AS with increased shortness of breath following transfusion.

COMPARISON: Radiographs available from ___ and ___. FRONTAL CHEST RADIOGRAPH: The examination is unchanged since ___. The central pulmonary vessels are prominent, but there is no edema. Surgical clips within the right upper chest are again seen, where there is a right upper lobe mass, unchanged over multiple prior studies. There is no pneumothorax or pleural effusion.

IMPRESSION: No pulmonary edema.


SubjectID: 19510234, StudyID: 55349038, Comparison: None

FINAL REPORT

INDICATION: Patient with severe AS, complaining of shortness of breath, interval increase in pulmonary edema. Please assess for interval change.

COMPARISON: Comparison is made to chest radiograph performed ___ and OSH chest CT peformed ___.

FINDINGS: Chest PA and lateral radiograph demonstrates unremarkable mediastinal and hilar contours. Stable mild-to-moderate cardiomegaly. Significant decrease in right pleural effusion with near resolution. Stable right upper lobe opacification with surgical clip and evidence of associated volume loss correlating with known mass treated with cyberknife.

IMPRESSION: No pulmonary edema. Significantly improved, nearly resolved, right pleural effusion. Stable right upper lobe mass and postreatment volume loss.


SubjectID: 19527260, StudyID: 53052074, Comparison: 1.0

FINAL REPORT

CHEST, ___.

HISTORY: Severe aortic stenosis and fluid overload, question change. REFERENCE EXAM: ___.

FINDINGS: Compared to the study from the prior day, there has been some interval mild improvement in the patchy alveolar infiltrate on the right; however, there is persistent alveolar edema   Keywords: persistent. The heart size continues to be mildly enlarged. There is a mildly tortuous aorta.

IMPRESSION: Mild improvement in fluid overload but still persistent   Keywords: improve.


SubjectID: 19527260, StudyID: 51147317, Comparison: better

FINAL REPORT

HISTORY: ___-year-old male with CHF and respiratory distress.

COMPARISON: Multiple prior chest radiographs, most recently ___.

FINDINGS: Single frontal view of the chest was obtained. Heterogeneous opacification of the right lung is increased with increased involvement of the right lower lung. Right upper lobe involvement appears stable. Pulmonary edema is slightly improved   Keywords: improve. Left pleural effusion has decreased in size. No pneumothorax. Mild cardiomegaly is unchanged. Moderate hiatal hernia is chronic. No radiopaque foreign body.

IMPRESSION: 1. Increased heterogeneous opacity of the right lower lung with unchanged involvement of the right upper lung likely reflects worsening infection or pulmonary hemorrhage. 2. Improved pulmonary edema with decreased size of left pleural effusion   Keywords: decrease, improve.


SubjectID: 19527260, StudyID: 50541357, Comparison: None

FINAL ADDENDUM Findings regarding impression were communicated by Dr. ___ to Dr. ___ by phone at 9:18 a.m. on ___. ______________________________________________________________________________

FINAL REPORT

INDICATION: Shortness of breath and history of CHF.

COMPARISON: ___ and ___.

FINDINGS: Portable AP chest radiograph demonstrates mild cardiomegaly, pulmonary vascular congestion, and interstitial edema. However, the right upper lobe is disproportionately consolidated suggestive of pneumonia. There was a smaller consolidation in the same lobe in ___, so either the pneumonia is recurrent or the abnormality is the 'pneumonia' form of bronchioloalveolar cell lung cancer. Another alterhative is asymmetric edema if patient has marked mitral regurgitation. Probable small left pleural effusion. There is no pneumothorax. Moderate hiatus hernia is chronic.

IMPRESSION: 1. Moderate pulmonary edema. 2. Probable right upper lobe pneumonia, alternatively asymmetric edema if patient has marked mitral regurgitation, or bronchioloalveolar carcinoma progressed sinde ___.


SubjectID: 19538920, StudyID: 56740734, Comparison: worse

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph of earlier the same date.

FINDINGS: Stable cardiomegaly accompanied by worsening asymmetrical perihilar edema, right greater than left   Keywords: worse.


SubjectID: 19538920, StudyID: 51084230, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___ radiograph.

FINDINGS: Stable cardiomegaly accompanied by worsening combined alveolar and interstitial pattern probably reflecting pulmonary edema, although co-existing pneumonia in the left lower lobe is possible in the appropriate clinical setting.


SubjectID: 19538920, StudyID: 52077110, Comparison: None

WET READ: ___ ___ ___ 5:24 PM Mild interstitial edema, slightly increased compared to prior, although this may be exaggerated by lower lung volumes. Increased opacification of the left lower lung field, possibly secondary to focal consolidation. The right lung base is not well evaluated due to elevated right hemidiaphragm and low lung volumes without lateral view. Discussed with ___ by phone at 17:22 on ___ at the time of wet read request. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Right lower lobe opacity, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the lung volumes have decreased and the size of the cardiac silhouette has increased. Areas of non-characteristic opacities are seen at both the left and the right lung bases. The extent and distribution of the changes favors atelectasis over pneumonia. In addition, there are signs of vascular distention and blood flow re-distribution, suggesting mild-to-moderate pulmonary edema. No larger effusions are seen. Patient has undergone sternotomy.


SubjectID: 19541392, StudyID: 59779529, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with persistent respiratory failure with thick secretions // Interval change; please evaluate for PNA

COMPARISON: The comparison is made with prior studies including ___.

IMPRESSION: The endotracheal tube tip is 2 cm above the carina. Nasogastric tube tip is in the stomach. The right internal jugular line has been removed and there is a PICC on the right the tip is in the SVC. There is no pneumothorax. There is cardiomegaly and upper zone redistribution with blurring of vascular detail consistent with pulmonary edema. There may be patchy atelectasis in the right lung base. The left base is difficult to evaluate due to technique. Patient is status post sternotomy.


SubjectID: 19541392, StudyID: 51866652, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with resp failure, intubated // Intubated

COMPARISON: The comparison is made with prior studies including ___.

IMPRESSION: There is persistent cardiomegaly and pulmonary edema   Keywords: persistent. Endotracheal tube tip is 3 cm above the carina. Nasogastric tube tip is in the stomach. The PICC line tip is in the SVC. There is no pneumothorax.


SubjectID: 19541392, StudyID: 51282606, Comparison: better

FINAL REPORT

INDICATION: ___ year old man with ARF, vol overload // Eval for interval change

COMPARISON: The comparison is made with prior studies including ___.

IMPRESSION: Tubes and lines are unchanged. There is no pneumothorax. There is improvement in the pulmonary edema   Keywords: improve. . There is no pneumothorax, effusion, consolidation or CHF.


SubjectID: 19541392, StudyID: 58455351, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with multi organ system failure, intubated for hypoxemic resp failure // interval change interval change

IMPRESSION: Comparison to the ___. The normal position of the monitoring and support devices is stable. Unchanged alignment of the sternal wires. Stable moderate cardiomegaly and stable moderate pulmonary edema, the presence of a small left pleural effusion cannot be excluded   Keywords: stable. Extensive atelectasis on the left. No new focal parenchymal opacities   Keywords: new.


SubjectID: 19541392, StudyID: 53688793, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with resp failure // Intubated Intubated

COMPARISON: ___

IMPRESSION: ET tube tip is 4.7 cm above the carinal. NG tube tip is in the stomach. Mediastinal contour in sternotomy wires are unchanged. Left retrocardiac consolidation is unchanged. There is unchanged vascular congestion/ mild interstitial pulmonary edema   Keywords: unchanged. Bilateral pleural effusions are most likely present. There is no pneumothorax.


SubjectID: 19541392, StudyID: 52158323, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with multi organ system failure incl respiratory failure, intubated // interval change interval change

IMPRESSION: Comparison to ___. No relevant change   Keywords: no relevant change. Mild to moderate pulmonary edema. Moderate cardiomegaly and retrocardiac atelectasis. The alignment of the sternal wires is constant. Constant monitoring and support devices.


SubjectID: 19541392, StudyID: 51712708, Comparison: better

FINAL REPORT

INDICATION: ___ year old man with hypoxemic respiratory failure. Interval monitoring bilateral infiltrates, other acute process.

TECHNIQUE: Portable upright AP chest radiograph.

COMPARISON: Chest radiographs from ___, ___ and ___.

FINDINGS: Compared to ___, there is some improvement of the nodular opacities in bilateral lung. Lung volumes are grossly similar compared to prior. More focal opacity at the right hilum may be due to rotation of the patient. Bilateral atelectasis and some pleural effusion is likely, though unchanged from prior. Moderate to severe cardiomegaly is again seen, unchanged from prior. ETT is unchanged in position. The proximal port of the nasogastric tube may be at the GE junction. Sternotomy wires, aortic valve replacement are intact and unchanged from prior.

IMPRESSION: 1. Mildly improved pulmonary edema   Keywords: improve. 2. Proximal port of the nasogastric tube at the GE junction.


SubjectID: 19541392, StudyID: 51282566, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with GIB, ARF, s/p cardiac arrest, OG advanced // OG placement OG placement

COMPARISON: Prior chest radiographs since ___ most recently ___.

IMPRESSION: Mild pulmonary edema is new   Keywords: new. Severe cardiomegaly is stable. Small left pleural effusion likely, increased slightly. No pneumothorax. Mediastinal contours unremarkable. Endotracheal tube in standard position, caliber of the ET tube may be small given the size of the trachea. Sharp definition of the tracheal cuff suggests secretions are pooling above the. Esophageal drainage tube ends in the stomach.


SubjectID: 19541392, StudyID: 51255358, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with hypoxia

TECHNIQUE: Portable upright AP view of the chest

COMPARISON: Chest radiograph ___, CT chest ___

FINDINGS: Patient is status post median sternotomy and aortic valve replacement. Moderate cardiomegaly remains unchanged. Mediastinal contours are similar. There is mild pulmonary edema, with patchy atelectasis noted in the lung bases. A small left pleural effusion appears not substantially changed in the interval. Patchy opacities are noted in the lung bases. No pneumothorax is detected. No acute osseous abnormality is visualized.

IMPRESSION: Continued moderate cardiomegaly and mild pulmonary edema   Keywords: continue. Small left pleural effusion, not substantially changed in the interval. Patchy bibasilar airspace opacities likely reflect atelectasis however infection cannot be excluded.


SubjectID: 19541392, StudyID: 50168937, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___M with CHF. Evaluate for OG tube placement.

TECHNIQUE: Supine AP view of the chest

COMPARISON: ___ at 20:25

FINDINGS: There has been interval placement of an orogastric tube with tip in the stomach. The endotracheal tube remains in standard position. Remainder of the examination is unchanged with continued mild pulmonary edema, small left pleural effusion, and bibasilar airspace opacities   Keywords: unchanged, continue. No pneumothorax. Cardiac and mediastinal contours are unchanged.

IMPRESSION: Orogastric tube tip within the stomach.


SubjectID: 19542943, StudyID: 53277213, Comparison: better

FINAL REPORT

PA AND LATERAL CHEST OF ___

COMPARISON: ___ radiograph.

FINDINGS: Heart is upper limits of normal in size. Pulmonary vascularity is normal, and lungs demonstrate continued improvement in bilateral reticular opacities which appear to correspond to multifocal airways disease on prior CT of ___   Keywords: improve. No focal areas of consolidation are present, and there are no pleural effusions or acute skeletal findings.


SubjectID: 19542943, StudyID: 50189686, Comparison: same

FINAL REPORT

INDICATION: History of altered mental status. Please evaluate for pneumonia.

COMPARISONS: Multiple prior chest radiographs dated back to ___.

TECHNIQUE: PA and lateral radiographs of the chest.

FINDINGS: Mild cardiomegaly is persistent. There is calcification of the aortic knob. Otherwise, the hilar and mediastinal contours are unremarkable. Opacities in the mid to lower lungs have continued to improve and appear interstitial in character, suspected to represent persistent or resolving airway inflammation   Keywords: continue. Degenerative changes are seen throughout the spine. There is no large pleural effusion or pneumothorax.

IMPRESSION: Continued improvement in areas of airway inflammation and possibly pneumonia.


SubjectID: 19584206, StudyID: 57583696, Comparison: None

WET READ: ___ ___ 8:23 AM Cardiomegaly with low lung volumes. Retrocardiac opacification is similar to prior, consistent with a left effusion and atelectasis.

WET READ VERSION #1 ___ ___ 10:10 PM Cardiomegaly with low lung volumes. Retrocardiac opacification is similar to prior, consistent with a left effusion and atelectasis. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p AVR/ MVR with post op bleeding // eval for hemothorax

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the lung volumes have slightly decreased. The size of the cardiac silhouette is unchanged and moderately enlarged. A left lower lung atelectasis has slightly increased in extent. The ___ of the mediastinum, however, are unchanged and no larger pleural effusions are visualized. Should pericardial effusion be suspected, ultrasound should be considered. The monitoring and support devices are unchanged, except for a pulling back of the Swan-Ganz catheter by approximately 3-4 cm.


SubjectID: 19584206, StudyID: 53613189, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p CABG // eval for widened mediastinum

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, no relevant change is noted   Keywords: no relevant change. The mediastinum is not widened. The cardiac silhouette continues to be enlarged. The pericardial effusion could be ruled out by ultrasound. Moderate retrocardiac atelectasis. The monitoring and support devices are constant. No new focal parenchymal opacities   Keywords: new.


SubjectID: 19584206, StudyID: 50622098, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiograph.

INDICATION: ___ year old man s/p mech MVR/AVR // predischarge eval for ptx s/p CT removal

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph from ___.

FINDINGS: There has been interval removal of multiple support devices, including a mediastinal drain, a right-sided thoracostomy tube, orogastric tube, endotracheal tube, and Swan-Ganz catheter. There is no pneumothorax. Multiple intact sternal wires and prosthetic aortic and mitral valves are present. The heart is moderately enlarged.

IMPRESSION: No pneumothorax.


SubjectID: 19584206, StudyID: 52314678, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with biventricular failure s/p swan ganz placement // compare to prior, ___ placment compare to prior, ___ placment

COMPARISON: Comparison to prior study dated ___ at 16:34

IMPRESSION: Interval placement of right internal jugular Swan-Ganz catheter with its tip in the right interlobar artery. The heart remains enlarged which may represent cardiomegaly or pericardial effusion. Clinical correlation is advised. Probable small layering left effusion with retrocardiac opacity suggestive of atelectasis. No evidence of pulmonary edema. No pneumothorax.


SubjectID: 19584206, StudyID: 51398639, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___M with peripheral edema, dilated heart // eval volume overload

COMPARISON: None

FINDINGS: PA and lateral views of the chest provided. The heart is markedly enlarged. There is a tiny left pleural effusion. Mild central congestion noted. No pneumothorax. Mediastinal contour is normal. Bony structures are intact.

IMPRESSION: Marked cardiomegaly, tiny left effusion with central congestion.


SubjectID: 19595757, StudyID: 57495963, Comparison: None

FINAL REPORT

INDICATION: Right effusion status post thoracentesis.

COMPARISON: ___ at 14:28.

FINDINGS: AP view of the chest. Right-sided pleural effusion has significantly resolved. No pleural effusion identified. No left pleural effusion. The sternotomy wires are intact. Mild cardiomegaly is stable. Mediastinal and hilar contours are normal. There is some mild pulmonary vascular congestion. No pneumothorax.

IMPRESSION: Interval resolution of right-sided pleural effusion. Mild pulmonary vascular congestion.


SubjectID: 19595757, StudyID: 50046835, Comparison: None

FINAL REPORT

HISTORY: CABG with dullness at the right base.

FINDINGS: In comparison with study of ___, there has been the development of a substantial right pleural effusion extending into the minor fissure. Volume loss in the lower lung is present. Continued enlargement of the cardiac silhouette with tortuosity of the aorta. No definite vascular congestion or acute focal pneumonia.


SubjectID: 19595757, StudyID: 56111569, Comparison: worse

FINAL REPORT

INDICATION: Dyspnea and cough, hypoxi, on ambulatory saturation today, evaluate for acute process.

COMPARISON: ___.

FINDINGS: Vascular congestion and interstitial pulmonary edema has increased since yesterday   Keywords: increase. In the right medial lung base, there is increased opacity since yesterday which is not clearly seen on the lateral view. Oblique views may be helpful to further characterize, but it is concerning for pneumonia. No pleural effusion or pneumothorax is present.

IMPRESSION: 1. Increasing pulmonary edema and vascular congestion consistent with volume overload   Keywords: increasing. 2. New right medial lung base opacity not clearly seen on the lateral, could consider oblique views to further evaluate, but it is concerning for a developing pneumonia.

NOTIFICATION: Telephone notification to Dr. ___ by Dr. ___ at 12:37 p.m. on ___, 5 minutes after discovery of findings.


SubjectID: 19595757, StudyID: 53142134, Comparison: same

FINAL REPORT

HISTORY: Cough and fever.

TECHNIQUE: PA and lateral views of the chest.

COMPARISON: Chest radiograph ___.

FINDINGS: The patient is status post median sternotomy and CABG. Fracture of the ___ sternotomy wire from the top is unchanged. The heart size appears normal. Aorta remains mildly tortuous and diffusely calcified. Mediastinal contours are unchanged. Mild interstitial pulmonary edema, which is similar compared to the prior exam, with unchanged trace bilateral pleural effusions is re- demonstrated in   Keywords: similar. No pneumothorax is identified. Calcified granuloma within the left upper lobe is unchanged. There is continued kyphosis of the thoracolumbar spine with multilevel degenerative changes again noted.

IMPRESSION: Chronic mild congestive heart failure with small bilateral pleural effusions and mild interstitial pulmonary edema.


SubjectID: 19596157, StudyID: 56851493, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male status post fall, to rule out rib fracture.

COMPARISON: Chest radiograph ___. PA AND LATERAL CHEST RADIOGRAPHS: Marked cardiomegaly, is unchanged. The hilar and mediastinal contours are stable, with moderate enlargement of both main pulmonary arteries. The lungs are clear, without consolidation, pulmonary edema, pleural effusion or pneumothorax. No displaced rib fractures are evident. However, this study is not optimal for assessment of rib fractures. If there is high concern for the same, a dedicated rib series with marker placed at the site of maximum tenderness is recommended. A left chest wall AICD device is in place, with three leads terminating in the right atrium, right ventricle and left ventricle as before. Multiple intact sternotomy wires are noted.

IMPRESSION: 1. Marked cardiomegaly, unchanged. No acute cardiopulmonary pathology. 2. If there is high concern for nondisplaced rib fracture, dedicated rib series can be performed with marker placed at the site of maximum tenderness.


SubjectID: 19623193, StudyID: 59784215, Comparison: worse

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___.

FINDINGS: Interval extubation. Nasogastric tube and right internal jugular vascular catheter in standard position. Lung volumes are increased, consistent with history of COPD. Worsening heterogeneous opacities within the mid and lower lungs bilaterally, with confluent airspace within the lower lungs   Keywords: worse. This likely represents worsening dependent pulmonary edema, but underlying basilar pneumonia is likely given findings on prior CT of ___   Keywords: worse. Known right hilar lymph node enlargement is better detailed on prior CT and is not appreciably changed since recent chest radiographs.


SubjectID: 19623193, StudyID: 50605309, Comparison: better

FINAL REPORT

AP CHEST, 11:15 A.M., ___

HISTORY: ___-year-old woman in the ICU, agitated, pulled out tubes. Check positions.

IMPRESSION: AP chest compared to ___ at 1:33 a.m.: ET tube, right internal jugular line are in standard placements. Nasogastric tube passes below the diaphragm and out of view. Moderate pulmonary edema has improved and previous small right pleural effusion has decreased   Keywords: improve. Moderate cardiomegaly persists with a configuration of a substantial left atrial enlargement.


SubjectID: 19623193, StudyID: 59241121, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: Chest, AP portable, single view.

INDICATION: ___-year-old female patient initially admitted with constipation, now Aspergillus pneumonia and VRE bacteremia, on CPAP. Evaluate for pulmonary edema.

FINDINGS: AP single view of the chest was obtained with patient in sitting semi-upright position. Comparison is made with the next preceding similar study of ___. There is status post sternotomy, apparently related to previous bypass surgery. Moderate cardiac enlargement is noted. The pulmonary vasculature demonstrates an upper zone redistribution pattern and diffuse haze over the bases is consistent with interstitial edema. The previously described superimposed patchy and partially confluenting parenchymal infiltrates have regressed slightly, but persist to some degree bilaterally. The right-sided diaphragm can now be identified again, so that major pleural effusion is unlikely. If evaluation of pleural effusion is essential, one should consider the performance of a lateral view as well.

IMPRESSION: Mild improvement of previously identified scattered parenchymal infiltrates superimposed on chronic CHF.


SubjectID: 19623193, StudyID: 56518324, Comparison: None

FINAL REPORT

AP CHEST, 9:41 A.M., ___

HISTORY: Acute respiratory distress.

IMPRESSION: AP chest compared to ___: Widespread infiltrative pulmonary abnormality which worsened from ___ to ___, particularly in the right lung, has not changed subsequently. Some of the abnormality may be due to pulmonary edema, but most of the extensive right-sided consolidation is pneumonia. Small-to-moderate right pleural effusion is not much changed. The heart is moderately enlarged. No endotracheal tube is seen. Nasogastric tube passes into the stomach and out of view. Right jugular line ends in the mid SVC. No pneumothorax. A right skinfold should not be mistaken for pneumothorax. Dr. ___ was paged.


SubjectID: 19623193, StudyID: 59217291, Comparison: worse

FINAL REPORT

AP CHEST, 1:52 A.M., ___

HISTORY: Bacteremia and respiratory failure. BAL for possible invasive aspergillosis.

IMPRESSION: PA and lateral chest compared to ___ through ___: Increasing background opacification in the right mid lung zone, accompanied by greater vascular congestion suggests this is probably a component of pulmonary edema   Keywords: increasing. However, extensive consolidation elsewhere and the suggestion of nodules in the left lower lung are certainly concerning for infection, including aspergillosis. Right hilar adenopathy has been documented on recent chest CT. Heart size is top normal. Small pleural effusions are new or newly apparent since ___, but not changed appreciably since ___. ET tube and right internal jugular line are in standard placements and a nasogastric tube is traceable as far as the upper stomach and out of view.


SubjectID: 19623193, StudyID: 54079722, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Respiratory failure, intubation, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The monitoring and support devices, including the endotracheal tube, are in unchanged position. The pre-existing relatively extensive bilateral basal parenchymal opacities, right slightly more than left, are overall unchanged in extent and severity   Keywords: unchanged. No parenchymal opacities have newly occurred. The presence of a minimal left pleural effusion cannot be excluded. No right-sided pleural effusion. Unchanged borderline size of the cardiac silhouette with minimal tortuosity of the thoracic aorta.


SubjectID: 19623193, StudyID: 58898954, Comparison: same

FINAL REPORT

INDICATION: Tachypnea, rule out acute process.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is slightly improved ventilation of the lung parenchyma. No interval appearance of pathological changes. However, pre-existing bilateral diffuse opacities are still clearly visible   Keywords: still. Moderate cardiomegaly. Unchanged right PICC line and nasogastric tube.


SubjectID: 19623193, StudyID: 57205141, Comparison: None

PROVISIONAL

FINDINGS

IMPRESSION (PFI): ___ ___ ___ 12:39 PM 1. Endotracheal tube in appropriate position approximately 4 cm above the carina. 2. Worsening bilateral lower lobe pneumonia, consistent with aspiration. ______________________________________________________________________________

FINAL REPORT

INDICATION: Evaluate endotracheal tube in patient status post intubation for respiratory failure.

COMPARISON: Multiple chest radiographs from ___ back to ___. CT abdomen and pelvis from ___. PORTABLE UPRIGHT RADIOGRAPH OF THE CHEST: The endotracheal tube terminates approximately 4 cm above the carina. Additionally, there is a left PICC and nasogastric tube in unchanged position. Compared to the prior radiographs taken on the same day ___ at 02:34, there is worsening of the bilateral lower lobe heterogeneous opacities with airspace features. The upper lung fields are otherwise clear. There is no pneumothorax. There are bilateral small pleural effusions, not markedly changed from the previous radiograph. The sternal cerclage wires and aortic calcification is unchanged.

IMPRESSION: 1. Endotracheal tube in appropriate position. 2. Worsening bilateral lower lobe pneumonia, concerning for evolving pneumonia, possibly secondary to aspiration.


SubjectID: 19623193, StudyID: 57022960, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

TECHNIQUE: Single portable upright radiograph of chest was compared with prior studies through ___ to ___.

FINDINGS: Orogastric tube is positioned into the stomach; however, its distal end is beyond the radiograph view. The tip of the left PICC line has slipped back, now at midline just above the level of the carina, most likely within the brachiocephalic vein before its confluence with IVC. Consider advancing the catheter further by approximately 3-4 cm. Patient is status post median sternotomy, and sternal sutures are intact. Heart size is top normal. Bilateral, predominantly lower lung air space opacities are persisting, overall unchanged in appearance. Bilateral, mild-to-moderate pleural effusions are similar. Medistinal and hilar contours are stable. Since ___, the right internal jugular line has been removed. The findings specific to the left PICC line were conveyed to ICU nurse, ___, on ___ at 10:43 a.m.


SubjectID: 19623193, StudyID: 54257242, Comparison: worse

WET READ: ___ ___ 11:29 PM Increased bilateral lower lobe consolidation, R>L, c/w worsening pneumonia. Given TBB history, components of aspiration + hemorrhage also possible. Small effusions. Emphysema. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post bronchoscopy, evaluation for pneumothorax.

COMPARISON: ___, at 2:09.

FINDINGS: As compared to the previous radiograph, there is a minimal increase in severity of the bilateral lower lobe consolidations. This could represent worsening pneumonia, complicated by pulmonary edema   Keywords: worse. The presence of small bilateral pleural effusions cannot be excluded. Borderline size of the cardiac silhouette. Unchanged monitoring and support devices.


SubjectID: 19623193, StudyID: 54076563, Comparison: same

FINAL REPORT

HISTORY: Cardiac surgery with worsening shortness of breath.

FINDINGS: In comparison with the earlier study of this date, allowing for obliquity of the patient, there is probably little overall change   Keywords: little overall change. Continued enlargement of the cardiac silhouette with evidence of pulmonary vascular congestion. Areas of opacification at the bases could reflect a developing consolidation, though they may merely be a manifestation of atelectasis and effusion in addition to the engorged pulmonary vessels. Once again, a lateral radiograph would be most helpful.


SubjectID: 19623193, StudyID: 51875355, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with hypoxemia.

COMPARISON: ___. SEMI-ERECT PORTABLE CHEST: Nasogastric tube passes to the stomach. A right IJ line extends to the cavoatrial junction. There is no pneumothorax. There is increased opacity at the left lung base, possibly in part reflecting increased atelectasis, though developing pneumonia cannot be excluded. Aeration at the right lung base is also worsened, with new confluence laterally and obscuration of the diaphreagm. Hilar contours are prominent, though unchanged. The heart size is mildly enlarged, stable. There is calcification of the aortic knob and descending aorta, while sternotomy wires and mediastinal surgical clips are in unchanged alignment. There are no acute osseous abnormalities.

IMPRESSION: Interval increased opacity at the left and right lung bases, which could reflect developing pneumonia, though a component of this change on the left could also be accounted for by increased effusion and atelectasis. Clinical correlation or consideration of PA and lateral radiographs is recommended.


SubjectID: 19623193, StudyID: 58797946, Comparison: worse

FINAL REPORT

TYPE OF

EXAMINATION: Chest AP portable single view.

INDICATION: ___-year-old female patient with coronary artery disease, COPD with obstipation and progressive dyspnea. Has received many units of FFP.

FINDINGS: AP single view of the chest has been obtained with patient in sitting semi-upright position. Comparison is made with the next preceding similar study obtained five hours earlier during the same day. Status post sternotomy, previous bypass surgery and moderate cardiac enlargement, appear unchanged. Comparison of the pulmonary vasculature clearly identifies a more marked vascular plethora that has developed during the latest examination interval of less than five hours   Keywords: develop. There is a degree of perivascular haze suggestive of some beginning interstitial edema. The lateral pleural sinuses remain grossly free. No evidence of pneumothorax in the apical area. Review of previous chest examinations including a chest CT dated ___ indicates that the patient had multiple parenchymal densities on the lung bases, as shown on previous CT. There was no evidence of new masses or discrete pneumonic processes.

IMPRESSION: Increased pulmonary vascular pattern clearly developing during the latest four and a half hours examination interval   Keywords: developing, increase. Increased circulating blood volume can explain the increased pulmonary vascular pattern. The suggested finding of perivascular haze on the lung bases indicates some element of left-sided failure in this patient with history of previous bypass surgery and chronic moderate cardiac enlargement. Clinical measures to accomplish dehydration appear indicated and followup chest examination can be used to monitor the success.


SubjectID: 19623193, StudyID: 58720502, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: Chest AP portable single view.

INDICATION: ___-year-old female patient with hyperkalemia, placement of NG tube, check position.

FINDINGS: AP single view of the chest obtained with patient in sitting semi-upright position is analyzed in direct comparison with the next preceding similar study of ___. An NG tube has now been placed, seen to reach well below the diaphragm including the line side port. No pneumothorax or any other placement-related complication is identified. As before, the patient is status post sternotomy, most likely related to previous bypass surgery.


SubjectID: 19623193, StudyID: 57150194, Comparison: worse

FINAL REPORT

AP CHEST, 9:45 P.M., ___

HISTORY: Hypercarbic and hypoxic respiratory failure. Possible cardiac edema or ARDS.

IMPRESSION: AP chest compared to ___ through ___, 4:47 p.m.: The propensity for pulmonary edema was demonstrated on ___, cleared by ___. Vascular engorgement in the upper lungs and involving the right hilus particularly suggests that the widespread opacification that developed over five hours on ___ is probably cardiac or volume related pulmonary edema, improved slightly in the left lung, not in the right over the succeeding six hours   Keywords: develop. Moderate cardiomegaly is slightly worse. Pleural effusions are presumed but small if any. No pneumothorax.


SubjectID: 19623193, StudyID: 56409552, Comparison: nan

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old woman with leukocytosis and bowel obstruction.

FINDINGS: Comparisons were made to prior study from ___. There has been improved aeration of the airspace opacities within the right lung. Persistent opacities at the lung bases are seen   Keywords: persistent. Cardiac size remains enlarged but unchanged. There is calcification in thoracic aorta. The endotracheal tube, nasogastric tube and PICC line are stable in position.

IMPRESSION: Improved aeration of the airspace opacities at the lung bases   Keywords: improve.


SubjectID: 19623193, StudyID: 50336377, Comparison: None

FINAL REPORT

AP UPRIGHT CHEST ___ AT 18:40 HOURS

HISTORY: Shortness of breath.

COMPARISON: Multiple priors, the most recent dated ___.

FINDINGS: There has been improved aeration of the lung bases with slight residual remaining in the retrocardiac left lower lobe. Mild prominence of the pulmonary vasculature is evident and which may be in part indicative of underlying interstitial edema. There has been prior median sternotomy. The cardiac silhouette remains borderline enlarged but stable. No definite effusion or pneumothorax is seen. The osseous structures are unremarkable.

IMPRESSION: Mild interstitial edema, likely cardiogenic in etiology. Recommend repeat radiography after appropriate diuresis to assess for underlying infection.


SubjectID: 19623193, StudyID: 58163197, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Worsening hypoxemia, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the monitoring and support devices are unchanged. The ventilation at the lung bases has improved, the pre-existing parenchymal opacities have decreased in extent and severity   Keywords: improve, decrease. The size of the cardiac silhouette is unchanged. The presence of a small left pleural effusion cannot be excluded.


SubjectID: 19623193, StudyID: 53841965, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Hypoxic respiratory failure, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is minimal improvement in transparency at the right lung base. The pre-existing reticular opacities, however, are still clearly visible   Keywords: still. Minimal left pleural effusion cannot be excluded. Unchanged borderline size of the cardiac silhouette. Unchanged monitoring and support devices.


SubjectID: 19623193, StudyID: 54847169, Comparison: same

FINAL REPORT

HISTORY: Multiple medical issues, to assess for change.

FINDINGS: In comparison with the study of ___, there are continued bilateral pulmonary opacifications especially involving the lower lungs   Keywords: continue. Again this most likely reflects substantial pulmonary edema, though the possibility of supervening consolidation can certainly not be excluded in the appropriate clinical setting   Keywords: again. Monitoring and support devices remain in place. The overall opacification at the left base appears to be somewhat improved since the prior study.


SubjectID: 19623193, StudyID: 54007363, Comparison: same

FINAL REPORT

STUDY: AP chest ___. CLINICAL

HISTORY: ___-year-old woman with COPD, pneumonia. Evaluate interval change.

FINDINGS: The lines and tubes are stable. There are again seen diffuse airspace opacities bilaterally which are more confluent with the lung bases   Keywords: again. Findings are relatively stable. Cardiomediastinal silhouette is upper limits of normal.


SubjectID: 19631559, StudyID: 59951032, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with septic shock and hypoxemic respiratory failure // ___ year old man with septic shock and hypoxemic respiratory failure

TECHNIQUE: Single frontal view of the chest

COMPARISON: CT chest performed 7 hours earlier

IMPRESSION: Almost complete collapse of the lower lobes bilaterally right greater than left is better seen in prior CT. There is moderate cardiomegaly. Widened mediastinum is due to increased in mediastinal fat. Left upper lobe perihilar atelectasis is again noted. There is no pneumothorax or pleural effusion. ET tube is in standard position. Right IJ catheter tip is upper SVC. NG tube tip is out of view below the diaphragm.


SubjectID: 19631559, StudyID: 58702738, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pulmonary septic shock // Infiltrate, pulmonary edema Infiltrate, pulmonary edema

IMPRESSION: In comparison with the study of ___, the right IJ catheter is been removed. Other monitoring and support devices remain in place. Continued low lung volumes accentuates the enlargement of the cardiac silhouette. Indistinctness of pulmonary vessels again suggests elevation of pulmonary venous pressure   Keywords: again. The possibility of superimposed pneumonia would be very difficult to assess, especially in the absence of a lateral view.


SubjectID: 19631559, StudyID: 57861747, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with acute respiratory failure now intubated. // eval for OGT placement

TECHNIQUE: Single frontal view of the chest

COMPARISON: Study performed 1 hour earlier

IMPRESSION: NG tube tip isin the stomach. No other interval change from prior study   Keywords: no other interval change.


SubjectID: 19631559, StudyID: 55747876, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with septic shock from likely pulmonary source, thick secretions // Assess fluid status, infiltrates, interval change Assess fluid status, infiltrates, interval change

IMPRESSION: In comparison with the study of ___, the monitoring and support devices are unchanged. Again there are low lung volumes with enlargement of the cardiac silhouette, pulmonary vascular congestion, and bilateral pleural effusions with compressive basilar atelectasis. Given these pulmonary changes, it would be extremely difficult to exclude the possibility of superimposed pneumonia, especially in the absence of a lateral view.


SubjectID: 19631559, StudyID: 59530213, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man intubated day 8 // acute process

COMPARISON: ___.

IMPRESSION: Unchanged monitoring and support devices. Minimally increased left pleural effusion. A minimal right pleural effusion is constant. Signs of mild to moderate pulmonary edema. Moderate cardiomegaly. No pneumonia, no pneumothorax.


SubjectID: 19631559, StudyID: 54918816, Comparison: same

FINAL REPORT

INDICATION: ___ male with Pseudomonas bacteremia. Assess volume status, worsening air space disease

TECHNIQUE: Portable upright chest radiograph

COMPARISON: ___

FINDINGS: The endotracheal tube and enteric tube are in standard position. Left internal jugular central line projects over the upper right atrium, and appears to have been advanced, however the apparent position could be secondary to lower inspiratory level. Lung volumes are low and there is persistent left lower lobe collapse. Mild pulmonary edema is unchanged   Keywords: unchanged. Upper lung parenchymal opacities are more readily recognized than in the lower lobes. Moderate cardiomegaly is stable.

IMPRESSION: 1. Lower lung volumes with stable mild pulmonary edema and left lower lobe collapse   Keywords: stable. 2. Stable support lines and tubes.


SubjectID: 19631559, StudyID: 52345693, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pneumonia, respiratory failure, sepsis. // NG tube replacement, interval change NG tube replacement, interval change

IMPRESSION: In comparison with the earlier study of this date, although the tip of the nasogastric tube passes below the lower margin of the image, the side port is definitely within the stomach. Little change in the appearance of the heart and lungs.


SubjectID: 19631559, StudyID: 52324310, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man intubated day 8 // acute process

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the lung bases show minimally improved ventilation. Otherwise the radiograph is unchanged. Signs of mild to moderate pulmonary edema persists   Keywords: persists. Moderate cardiomegaly. Retrocardiac atelectasis. Unchanged correct position of the monitoring and support devices.


SubjectID: 19631559, StudyID: 51152864, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with HCAP, CHF, severe sepsis, intubated // Interval change, infiltrate, volume status

IMPRESSION: As compared to ___ radiograph, lung volumes are lower, accentuating cardiomediastinal contours and bronchovascular structures. Within this context, interval worsening of bibasilar opacities is probably due to atelectasis although aspiration is an additional consideration in the appropriate clinical setting. Small bilateral pleural effusions are also demonstrated.


SubjectID: 19631559, StudyID: 58720828, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man who presented with AMS, sepstic shock, now fluid overload following volume resuscitation, undergoing diuresis // Interval change, volume status, infiltrates

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the pleural effusions have decreased in extent. Moderate cardiomegaly persists. Mild to moderate pulmonary edema. Platelike atelectasis at the right lung bases.


SubjectID: 19631559, StudyID: 52834172, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with PNA and sepsis, on vent now s/p NGT placement. // evaluate for NGT placement

TECHNIQUE: Portable semi upright chest radiograph

COMPARISON: Radiograph from earlier on the same day

FINDINGS: Nasogastric tube terminates in the left upper quadrant, beyond the diaphragm. Endotracheal tube and left internal jugular central venous line are in satisfactory position. Heart size is enlarged and the partially imaged lungs demonstrate a right pleural effusion and heterogeneous bilateral opacities.

IMPRESSION: Satisfactory position of nasogastric tube.


SubjectID: 19631559, StudyID: 50699174, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with aspiration PNA v VAP // Infiltrates, volume status, interval change

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the bilateral parenchymal opacities as well as the signs of mild to moderate pulmonary edema are constant. Unchanged appearance of a retrocardiac atelectasis. Moderate cardiomegaly persists. Unchanged monitoring and support devices.


SubjectID: 19640059, StudyID: 58087032, Comparison: worse

FINAL REPORT

EXAM: Chest AP upright portable views. CLINICAL INFORMATION: ___-year-old female with history of shortness of breath, rule out infection versus fluid.

COMPARISON: ___.

FINDINGS: AP upright portable views of the chest were obtained. Per the radiology technologist, x-ray was repeated due to patient kyphosis. The patient's chin overlies the lung apices. Again seen are increased interstitial markings, worse at the lung bases in this patient with history of known chronic interstitial pulmonary disease   Keywords: worse, increase. Opacity at the right lung base appears increased compared to the prior study and superimposed infectious process is not excluded. No large pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable.

IMPRESSION: Known chronic interstitial disease with increased interstitial markings seen at the lung bases   Keywords: increase. Interval increase in right base opacity raises concern for a superimposed infectious process.


SubjectID: 19640059, StudyID: 52350132, Comparison: None

FINAL REPORT

INDICATION: Pulmonary fibrosis and increased shortness of breath.

COMPARISON: Radiograph available from ___. FRONTAL CHEST RADIOGRAPH: The heart size is top normal. The aorta is markedly tortuous. Reticular nodular opacities scattered at the lung bases are minimally changed since ___. There is increased opacity across the left upper lung zone, which may represent new edema or consolidation. There is no pneumothorax. The right costophrenic angle is obscured either by overlying fibrosis or small amount of fluid.

IMPRESSION: New left upper zone opacity which may represent asymmetric edema or new consolidation.


SubjectID: 19640059, StudyID: 52064406, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with history of IPF and new left upper lobe infiltrate, on antibiotics. Evaluate for interval change.

COMPARISON: ___. UPRIGHT AP VIEW OF THE CHEST: Evaluation is limited by head positioning, which obscures the lung apices. Within this limitation, there is little change in left upper lung opacity. Low lung volumes and reticular opacities at the lung bases are unchanged and consistent with stated history of IPF. The cardiomediastinal silhouette is stable. There is no pneumothorax. I

IMPRESSION: No change in left upper lung opacity or findings related to IPF.


SubjectID: 19640899, StudyID: 53847198, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Diabetes, worsening shortness of breath.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Moderate cardiomegaly, moderate-to-severe pulmonary edema. The presence of small bilateral pleural effusions cannot be excluded. No new parenchymal opacities   Keywords: new. The position of the hemodialysis catheter is constant.


SubjectID: 19640899, StudyID: 52554367, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, evaluation.

COMPARISON: ___.

FINDINGS: There is status post cardiac arrest. The pleural effusions have slightly increased in extent. Otherwise, no relevant changes seen   Keywords: no relevant change. Cardiomegaly, moderate-to-severe pulmonary edema. Rather extensive atelectasis at the lung bases.


SubjectID: 19648564, StudyID: 59283559, Comparison: None

FINAL REPORT

HISTORY: ___-year-old male with aortic stenosis status post transcatheter aortic valve replacement.

COMPARISON: Multiple prior chest radiographs, most recently of ___.

FINDINGS: Frontal views of the chest were obtained. Right pleural effusion has increased, now moderate to large in volume, with bilateral lower lung opacities presumed to be atelectasis. Small left pleural effusion is unchanged. No pneumothorax. Heart size and cardiomediastinal contours are stable. Right internal jugular transvenous pacer has been removed. The replaced aortic valve is unchanged in position.

IMPRESSION: Increased right pleural effusion, now moderate to large, with presumed bibasilar atelectasis. No pneumothorax.


SubjectID: 19648564, StudyID: 55017475, Comparison: same

FINAL REPORT

TYPE OF

EXAMINATION: Chest AP portable single view.

INDICATION: ___-year-old male patient status post intubation. Evaluate.

FINDINGS: AP single view of the chest has been obtained with patient in supine position. Available for comparison is the next preceding PA and lateral chest examination of ___. During the latest examination interval, the patient has undergone an intravascular placement of a CoreValve. The patient is now intubated, the ETT terminating in the trachea 4 cm above the level of the carina. A right internal jugular approach wire has been placed, seen to terminate in the apical portion of the right ventricle, thus representing a temporary pacing wire. The grid structures of a CoreValve device are seen in expected location covering the outflow tract of the left ventricle and the root of the aorta. There is no evidence of pulmonary vascular congestion similar as such finding was absent on the preceding chest examination of ___   Keywords: similar. A now present diffuse haze over the entire right-sided hemithorax can be explained by patient's previously identified right-sided basal pleural effusion which is now layering in the posterior compartments of the pleural space as the patient is in supine position. No pneumothorax can be identified on either side.

IMPRESSION: Satisfactory findings on interventional procedure chest examination with patient in supine position. No pneumothorax.


SubjectID: 19648564, StudyID: 51043267, Comparison: same

FINAL REPORT

HISTORY: Orogastric tube placement.

FINDINGS: In comparison with the earlier study of this date, there has been placement of an orogastric tube that extends only to the lower esophagus. Otherwise, little change   Keywords: little change. This information has been telephoned to the nursing office at ___.


SubjectID: 19650945, StudyID: 51132517, Comparison: same

WET READ: ___ ___ 4:37 PM Vascular congestion, with similar radiographic appearance to the study from ___   Keywords: similar, similar radiograph. No focal consolidation. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___M with wheezing, DOE, hypoxia to ___ RA. Evaluate ? infiltrate, edema.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph from earlier on the same date and ___.

FINDINGS: Again seen is mild pulmonary vascular congestion, but no overt pulmonary edema   Keywords: again. This is similar in appearance to the radiograph from ___   Keywords: similar in appearance. Heart size is enlarged and unchanged from that time. No pneumothorax, pleural effusion, or focal consolidation.

IMPRESSION: Vascular congestion, with similar radiographic appearance to the study from ___. No focal consolidation.


SubjectID: 19650945, StudyID: 51102882, Comparison: None

FINAL REPORT

INDICATION: ___M with hypoxia to ___, DOE x several days, // eval ? pneumonia, edema

TECHNIQUE: Single portable view of the chest.

COMPARISON: ___.

FINDINGS: Low lung volumes are noted with secondary crowding of the bronchovascular markings. Exam is also limited due to overlying soft tissues and portable technique. There is no confluent consolidation or frank pulmonary edema. The cardiomediastinal silhouette is stable given differences in technique. No acute osseous abnormalities.

IMPRESSION: No acute cardiopulmonary process based on this limited exam.


SubjectID: 19655295, StudyID: 58436216, Comparison: None

FINAL REPORT

INDICATION: Lung collapse status post intubation, for bronchoscopy. Evaluate for endotracheal tube placement.

COMPARISON: ___ at 4:50 a.m.

FINDINGS: The tip of the endotracheal tube is approximately 3 cm from the carina. There is slight interval aeration of the left upper lobe with continued collapse of the left lower lobe. Atelectasis at the right lung base has increased. Evaluation of the heart is obscured.

IMPRESSION: Endotracheal tube tip is 3 cm from the carina. Improved ventilation of the left lung apex.


SubjectID: 19655295, StudyID: 50327738, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman with mucous impaction and left lower lobe collapse. Now with desaturation, on BiPAP.

FINDINGS: Comparison is made to previous study from ___. There has been removal of the nasogastric tube. There is volume loss on the left side with increased opacification in the left lung. In particular, opacification in the left upper lobe has developed. The right lung appears clear. There is persistent anterior dislocation of the right shoulder. This appears unchanged from the dedicated shoulder radiograph from ___.


SubjectID: 19655295, StudyID: 58132863, Comparison: None

FINAL REPORT

INDICATION: History: ___F with hypoxia // ? pna

TECHNIQUE: Single portable upright AP image of the chest.

COMPARISON: Comparison made with chest radiographs from ___ and ___.

FINDINGS: Increased opacification of the left lung with leftward mediastinal shift is suggestive of increased left lung collapse from prior exam. Opacity of the right lung base could represent atelectasis, however cannot exclude pneumonia or aspiration in the right clinical setting. Along the lateral border of the right lung, there is again seen a fluid collection adjacent to several rib fractures which are more displaced than on prior exam. This fluid collection is larger than on prior exam and likely reflect ongoing bleeding into the extra-pleural space. There is increased right pleural effusion from prior exam. The cardiomediastinal silhouette cannot be well evaluated due to collapse of left lung. Right anterior shoulder dislocation and multiple right-sided chronic rib fractures are again noted.

IMPRESSION: 1. Increases fluid collection along the lateral aspect of the right lung adjacent to several rib fractures which are more displaced than on prior exam, likely representing ongoing bleeding into the extrapleural space. 2. Interval increase in collapse of the left lung. 3. Opacity in the right lung base, which could represent atelectasis but cannot exclude pneumonia or aspiration in the right clinical setting.

NOTIFICATION: Findings communicated to the___ medical team at 10:50 a.m. on ___ by phone.


SubjectID: 19655295, StudyID: 56237240, Comparison: None

WET READ: ___ ___ ___ 12:07 AM Allowing for differences in positioning, there is no substantial change.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with severe COPD presenting with complete L lung collapse, s/p a fall // r/o right hemothorax (check if changed from prior CXR)

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, there is unchanged total collapse of the left lung. , with displacement of the mediastinum towards the left. Old rib fractures on the right are visible in almost unchanged manner. Unchanged moderate right pleural effusion and evidence of basal atelectasis. No evidence of pneumonia.


SubjectID: 19655295, StudyID: 57540238, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with dyspnea // acute intrathoracic process

COMPARISON: Chest x-ray from ___ at 13 39

FINDINGS: Compared with the prior film, I doubt significant interval change. Again seen is cardiomegaly with a calcified, unfolded aorta ; small left effusion with increased retrocardiac density and obscuration of the left hemidiaphragm, consistent with left lower lobe collapse and/or consolidation; patchy opacity at the right base with a small right effusio; and upper zone redistribution, without other evidence of CHF. There is background hyperinflation suggestive of COPD. There is deformity of some of the right upper ribs consistent with old rib fractures. As before, the there is anterior dislocation of the right humeral head with respect to the glenoid .

IMPRESSION: 1. Doubt significant change compared with ___. No definite acute superimposed process. 2. Upper zone redistribution, without overt CHF, similar to the prior film   Keywords: similar. 3. Small left-greater-than-right effusions, with left lower lobe collapse and/or consolidations and patchy opacity at the right base, unchanged. 4. COPD and old thoracic deformity again noted. 5. Anterior dislocation of the right shoulder again noted.


SubjectID: 19655295, StudyID: 53852871, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with severe COPD and hypercapnia // pneumonia? volume overload

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Heart size and mediastinum are unchanged. Rib fractures on the right are unchanged. Bibasal atelectasis is unchanged. No new consolidations to suggest infectious process demonstrated. Small bilateral pleural effusions are unchanged and there is no evidence of pneumothorax.


SubjectID: 19655295, StudyID: 52948264, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with concern for PNA vs COPD exacerbation // Assess for cardiopulmonary process

IMPRESSION: As compared to ___ chest radiograph, bibasilar opacities have slightly worsened, and may be due to atelectasis, with or without coexisting aspiration or infectious pneumonia. Small pleural effusions are again demonstrated, and remainder of exam is unchanged.


SubjectID: 19655295, StudyID: 55406143, Comparison: None

FINAL REPORT

STUDY: AP CHEST, ___. CLINICAL

HISTORY: ___-year-old woman with respiratory distress. Evaluate for interval change.

FINDINGS: Comparison is made to previous study from ___. There is interval increase in pleural fluid within the left lung. Virtually the entire left lung is dense and there is only a small pocket of aerated lung in the lateral mid lung field. There is also volume loss and mediastinal shifting toward the left side. The visualized right lung field is clear. No pneumothoraces are seen. There is persistent anterior dislocation of the right shoulder.


SubjectID: 19655295, StudyID: 53975510, Comparison: None

FINAL REPORT

CLINICAL

HISTORY: COPD, CHF, evaluate for aspiration pneumonia. CHEST

COMPARISON: ___. Since the previous chest x-ray, there appears to be some mediastinal shift to the left. Some of this could be technical reasons due to rotation, but there is now an almost complete whiteout of the left chest probably indicating volume loss and a left effusion. There is also an increase in the size of the right effusion and increased pulmonary plethora. Overall, the appearances suggest worsening failure and volume loss in the left lung probably due to collapse of the left lower lobe.

IMPRESSION: Worsening failure, volume loss and mediastinal shift to the left.


SubjectID: 19655295, StudyID: 52349354, Comparison: same

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Multiple prior Chest radiographs and CT scans dating between ___ and ___.

FINDINGS: The left hemithorax is completely opacified with ipsilateral shift towards the left, consistent with complete left lung collapse. This is similar in appearance to the radiograph of one day earlier but is a new finding compared to earlier studies   Keywords: similar in appearance. Abrupt cutoff of the left main bronchus suggest mucous plugging as the cause of this finding. Right lung is slightly overexpanded. Small-to-moderate right pleural effusion has slightly decreased in size and is accompanied by improving atelectasis at the right lung base. Known left effusion cannot be accurately assessed in the setting of complete left lung collapse. Minimal interstitial edema and pulmonary vascular congestion are unchanged   Keywords: unchanged. Dr. ___ was telephoned with these findings on ___ at 9:40 a.m. at the time of discovery.


SubjectID: 19655295, StudyID: 50027671, Comparison: None

FINAL REPORT

HISTORY: Hypoxemia and edema.

FINDINGS: In comparison with study of ___, there is again complete opacification of the left hemithorax with shift to the ipsilateral side, consistent with lung collapse. This most likely is related to mucus plugging. The right lung is essentially clear except for a small residual effusion with atelectatic changes at the bases.


SubjectID: 19657904, StudyID: 57914834, Comparison: None

WET READ: ___ ___ 9:03 PM Endotracheal tube in right mainstem bronchus. Right internal jugular line retracted with tip projecting over low SVC. Orogastric tube tip projecting over left upper quadrant, likely within the stomach. Low lung volumes. Discussed with ___ ___ by phone at 20:59 on ___. ______________________________________________________________________________

FINAL REPORT

PORTABLE AP SEMI-ERECT CHEST FILM ___ AT ___ CLINICAL

INDICATION: ___-year-old with asthma and respiratory failure, check for orogastric tube placement.

COMPARISON: ___ at ___. Single portable semi-erect chest film ___ at ___ is submitted.

IMPRESSION: 1. When compared with the prior study, the endotracheal tube still has its tip in the right mainstem bronchus and there is increasing retrocardiac consolidation likely representing left lower lobe collapse. Right internal jugular central line and nasogastric tube appear unchanged in position. There is persistent linear opacity in the right lung which likely reflects subsegmental atelectasis. No pneumothorax. No evidence of pulmonary edema.


SubjectID: 19657904, StudyID: 56788489, Comparison: None

FINAL REPORT

PORTABLE AP CHEST FILM ___ AT 4:21 CLINICAL

INDICATION: ___-year-old with asthma and CHF status post extubation. Assess for interval change. Comparison is made to the patient's prior study of ___ at 21:56. Single portable upright chest film, ___ at 4:21 is submitted.

IMPRESSION: 1. Right internal jugular central line has its tip in the distal SVC. Interval extubation and removal of the nasogastric tube. 2. Low lung volumes with bibasilar airspace opacities and likely layering effusions suggestive of compressive atelectasis, less likely pneumonia. No evidence of pulmonary edema. No pneumothorax. Heart remains enlarged. Overall mediastinal contours are likely unchanged, given differences in positioning and technique between studies. Degenerative changes of the acromioclavicular joint. Cystic changes within an incompletely visualized right humeral head, possibly related to degenerative change or remote trauma.


SubjectID: 19657904, StudyID: 56197730, Comparison: None

FINAL REPORT

PORTABLE AP SEMI-ERECT CHEST FILM ___ 10:05 P.M. CLINICAL

INDICATION: ___-year-old with respiratory failure. Please evaluate endotracheal tube and central venous line location. Comparison is made to the patient's previous study dated ___ at 18:10. Single portable AP semi-upright chest film dated ___ at 10:05 p.m. is submitted.

IMPRESSION: 1. Endotracheal tube now has its tip at the thoracic inlet, approximately 3 cm above the carina. The nasogastric tube continues to have its side port in the distal esophagus and advancement is continued to be recommended. Right internal jugular central line has its tip in the distal SVC. 2. Lung volumes remain low with persistent linear opacity in the right mid lung consistent with subsegmental atelectasis and persistent retrocardiac consolidation which likely represents partial lower lobe atelectasis, although a pneumonia cannot be entirely excluded. No evidence of pulmonary edema. No pneumothorax.


SubjectID: 19657904, StudyID: 51105576, Comparison: None

FINAL REPORT

INDICATION: Respiratory distress.

COMPARISONS: Chest radiograph of ___.

FINDINGS: AP portable view of the chest demonstrates low lung volumes. No large pleural effusion, pneumothorax or focal consolidation. The aorta is markedly tortuous without focal aneurysmal changes. Heart is mildly enlarged. Mild perihilar vascular congestion is noted.

IMPRESSION: Mild cardiomegaly and perihilar vascular congestion.


SubjectID: 19657904, StudyID: 50238440, Comparison: None

FINAL REPORT

PORTABLE SEMI-ERECT CHEST FILM ___ AT 10:10 P.M. CLINICAL

INDICATION: ___-year-old with respiratory distress, adjust orogastric tube. Comparison is made to the patient's previous study of ___ at 21:53. Single semi-upright portable chest film dated ___ at 10:10 p.m. is submitted.

IMPRESSION: 1. The endotracheal tube continues to have its tip approximately 2 cm above the carina. The nasogastric tube has been advanced with its tip coursing below the diaphragm and not definitively identified on this study. Right internal jugular central line has its tip in the distal SVC. 2. The heart is enlarged but stable. There is improving aeration in the retrocardiac area and a persistent linear opacity in the right mid lung which likely reflects subsegmental atelectasis. No pulmonary edema. No pneumothorax.


SubjectID: 19657904, StudyID: 50002184, Comparison: None

WET READ: ___ ___ 9:06 PM Endotracheal tube in right mainstem bronchus. Retracting approximately 3 cm is recommended. Right internal jugular line with tip projecting over low SVC. Orogastric tube tip projecting over left upper quadrant, likely within the stomach, but has been retracted with side port now above diaphragm; advancing the tube is recommended. Low lung volumes. Possible left pleural effusion. Findings and recommendations discussed with ___ ___ by phone at 20:59 on ___. ______________________________________________________________________________

FINAL REPORT

PORTABLE AP SEMI-ERECT CHEST FILM ___ AT 6:25 P.M. CLINICAL

INDICATION: ___-year-old with respiratory failure, check placement of endotracheal tube. Comparison to ___ at 18:06. Single portable semi-erect chest film ___ at 6:25 p.m. is submitted.

IMPRESSION: 1. The endotracheal tube continues to have its tip in the right main stem bronchus. A wet reading was again provided to ___ by Dr. ___ ___ on ___ at 20:59. Repositioning was advised. Right internal jugular central line has its tip in the distal SVC near the cavoatrial junction. Nasogastric tube has now been retracted and the side port is in the distal esophagus. Advancement is also advised of this tube. 2. Low lung volumes with persistent linear opacity in the right mid lung consistent with subsegmental atelectasis and retrocardiac consolidation with air bronchograms likely representing lower lobe atelectasis given the position of the endotracheal tube being in the right main stem bronchus. No evidence of pulmonary edema. No pneumothorax.


SubjectID: 19664783, StudyID: 59722980, Comparison: None

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Dyspnea.

COMPARISONS: None.

TECHNIQUE: Chest, AP upright and lateral.

FINDINGS: The heart is mild-to-moderately enlarged. There is unfolding and calcification of the thoracic aorta. A soft tissue density projecting over the medial right lung apex is uncertain in etiology but may be due to mild vascular congestion or atelectasis, but perhaps less likely pneumonia, in the right upper lobe. To some extent this may be more due to mediastinal widening on the right. Patchy opacity in the left lower lobe is likely compatible with atelectasis. Pulmonary vasculature does not appear particularly prominent. Bones appear demineralized.

IMPRESSION: Questionable medial right upper lobe opacity versus mediastinal widening. When clinically feasible, repeat radiographs are suggested with PA and lateral technique to better assess. The main concern is a possible right perihilar consolidation which might indicate pneumonia in the appropriate setting. There is no generalized convincing evidence for fluid overload although the finding may alternatively indicate mild perihilar congestion change.


SubjectID: 19664783, StudyID: 50311642, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST FILM ___ AT 921 CLINICAL

INDICATION: ___-year-old with possible infiltrate on portable chest film, recommend PA and lateral for further evaluation. Comparison to ___ at ___. PA and lateral imaging of the chest ___ at 921 is submitted.

IMPRESSION: 1. Stable cardiac enlargement and stable unfolded tortuous aorta. A faint opacity is seen in the right medial lung adjacent to the paratracheal soft tissues. This is not felt to likely correspond to vascular structures and either could represent an area of pneumonia, post-inflammatory scarring, or possibly a mass. Further imaging evaluation with CT may be helpful. No evidence of pulmonary edema. No pleural effusions. No pneumothorax. Degenerative changes in the mid to lower thoracic spine with no acute bony abnormality appreciated. Results were communicated by phone to the patient's nurse, ___, on ___ at 12:08 p.m. at the time of discovery.


SubjectID: 19664783, StudyID: 57130455, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with cholecystitis s/p open cholecystectomy // Assess ches post difficult extubation

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Severe cardiomegaly and widening mediastinum due to tortuous aorta are stable. Pacer leads are in standard position. Right lower lobe opacities have increased consistent with increasing atelectasis. Left lower lobe atelectasis is unchanged. Presumed small bilateral effusions are stable. There is no evident pneumothorax


SubjectID: 19664783, StudyID: 52123669, Comparison: None

FINAL REPORT

INDICATION: ___F with chest pain with radiation to the back, evaluate for acute process..

COMPARISON: Chest radiograph from ___.

TECHNIQUE AP and lateral view of the chest.

FINDINGS: Mediastinal contour unchanged from ___. Mild cardiomegaly is unchanged. There is no focal lung consolidation. Transvenous pacing leads and in the right atrium and right ventricle. No acute osseous abnormality.

IMPRESSION: No acute cardiopulmonary process. Mediastinal contour unchanged compared to ___


SubjectID: 19666743, StudyID: 59796261, Comparison: better

FINAL REPORT

AP CHEST, 9:13 P.M. ___

HISTORY: ___-year-old woman with COPD and CHF, recently extubated, now hypoxic.

IMPRESSION: AP chest compared to ___ through ___, 4:01 a.m.: Mild pulmonary edema has improved since earlier in the day   Keywords: improve. Lung volumes are maintained and in fact right infrahilar atelectasis or edema has improved   Keywords: improve. Severe cardiomegaly is chronic. No pneumothorax. Small pleural effusions are presumed.


SubjectID: 19666743, StudyID: 56406856, Comparison: same

WET READ: ___ ___ 8:14 PM Bibasilar opacities right greater than left combination of atelectasis and effusion. Mild pulmonary edema, stable since earlier yesterday. ______________________________________________________________________________

FINAL REPORT

CHEST 5:35 P.M. ON ___

HISTORY: ___-year-old woman with new desaturation and right middle lobe collapse.

IMPRESSION: AP chest compared to ___: New opacification in the right lower lung could be atelectasis, aspiration or early pneumonia. There has been no recurrence of previous pulmonary edema or left pleural effusion but pulmonary vasculature remains engorged   Keywords: remains. Pulmonary arteries and cardiac silhouette are large. No pneumothorax.


SubjectID: 19666743, StudyID: 54852628, Comparison: same

FINAL REPORT

HISTORY: CHF, for ET placement.

FINDINGS: In comparison with the study of ___, the patient has taken a much better inspiration. There is persistent enlargement of the cardiac silhouette with pulmonary vascular congestion   Keywords: persistent. Right pleural effusion with compressive atelectasis at the base. Left hemidiaphragm is now quite sharp. Endotracheal tube tip lies approximately 4 cm above the carina. Nasogastric tube extends well into the stomach.


SubjectID: 19666743, StudyID: 53013864, Comparison: same

WET READ: ___ ___ ___ 6:07 PM Little change from 1 day prior. Left lower lobe opacity a combination of atelectasis and effusion. Moderate pulmonary edema. Right middle lobe collapse as seen on the CT. Continued right lower lobe atelectasis. ______________________________________________________________________________

FINAL REPORT

HISTORY: RML collapse status post bronch, now with fever.

FINDINGS: In comparison with the study of ___, there are lower lung volumes. Continued enlargement of the cardiac silhouette with pulmonary vascular congestion   Keywords: continue. Opacification at the left base is consistent with atelectasis and effusion, though in the appropriate clinical setting, supervening pneumonia would have to be considered. Continued volume loss in the right middle lobe. Monitoring and support devices remain in place.

IMPRESSION: Lower lung volumes but otherwise little change   Keywords: little change.


SubjectID: 19666743, StudyID: 50692671, Comparison: None

FINAL REPORT

HISTORY: Shortness of breath.

TECHNIQUE: AP view of the chest.

COMPARISON: None.

FINDINGS: There is moderate cardiomegaly. The aorta is mildly unfolded. Mild perihilar haziness and vascular indistinctness is compatible with mild pulmonary edema. No large pleural effusion or pneumothorax is present. Vascular calcifications are noted overlying both axillary regions and lung apices. Left-sided cervical rib is incidentally detected.

IMPRESSION: Mild pulmonary edema.


SubjectID: 19666743, StudyID: 54731610, Comparison: same

FINAL REPORT

HISTORY: COPD and CHF with possible right lower lobe pneumonia.

FINDINGS: In comparison with study of ___, there is little overall change   Keywords: little overall change. Again there is a mild opacification at the right base that most likely reflects atelectasis, though supervening pneumonia would have to be considered in the appropriate clinical setting. Stable enlargement of the cardiac silhouette with evidence of pulmonary vascular congestion. Probable mild atelectatic changes and possible small effusion on the left. The central catheter remains in place.


SubjectID: 19666743, StudyID: 50321474, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Cough.

COMPARISONS: Two days earlier.

TECHNIQUE: Chest, portable AP upright.

FINDINGS: A left-sided PICC line has been retracted somewhat and terminates in the mid portion of the superior vena cava. The heart is moderately enlarged, as before. There is a suggestion of upper zone re-distribution of pulmonary vascularity, which suggests pulmonary venous hypertension, but congestive heart failure has largely resolved   Keywords: resolve. A developing opacity is suspected in the right lower lung, however, but not optimally evaluated with portable technique. Streaky left basilar opacity probably is probably compatible with minor atelectasis. There is no definite pleural effusion or pneumothorax.

IMPRESSION: Near resolution of pulmonary edema. Possible developing opacity at the right lung base. Short-term followup radiographs with standard PA and lateral technique, if possible, may be helpful to assess for whether it may represent a focus of infection rather than atelectasis.


SubjectID: 19667420, StudyID: 58673365, Comparison: None

FINAL REPORT

PORTABLE CHEST X-RAY

COMPARISON: ___ chest x-ray.

FINDINGS: Indwelling support and monitoring devices are unchanged in position, and cardiomediastinal contours are stable in appearance. Bilateral small-to-moderate layering pleural effusions are present, with adjacent basilar lung opacities, which probably reflect atelectasis. Allowing for positional differences, this is not appreciably changed. Left anterior rib fractures are again visualized, and have been more fully characterized on recent CT of ___.


SubjectID: 19667420, StudyID: 56448469, Comparison: same

FINAL REPORT

INDICATION: Intubation.

COMPARISON: ___. SEMI-ERECT PORTABLE CHEST: Endotracheal tube is in unchanged position, terminating in the mid thoracic trachea. A right subclavian catheter extends to the mid SVC. Left pectoral pacer with two trans-subclavian leads is unchanged. There are sternotomy wires and thoracolumbar fusion hardware, incompletely assessed. The upper lungs remain well aerated, with slight decrease in pulmonary edema. The opacities at the bases again reflect the presence of effusions. There is no opacity to suggest pneumonia. There is no pneumothorax. Hilar and cardiomediastinal contours are unchanged. Known left rib fractures are not well assessed.

IMPRESSION: Stable position of support and monitoring devices. Unchanged effusions. No evidence of pneumonia or new vascular congestion   Keywords: new.


SubjectID: 19667420, StudyID: 55289779, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Intubation, evaluation for interval change.

COMPARISON: ___.

FINDINGS: On the current radiograph, the endotracheal tube cannot be seen. Apparently, the patient has been extubated. As a consequence, the lung volumes have decreased. There is moderate fluid overload and the presence of small pleural effusions cannot be excluded. Moderate atelectasis and moderate cardiomegaly. Retrocardiac atelectasis but no evidence of pneumonia.


SubjectID: 19667420, StudyID: 53904566, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

TECHNIQUE: Single semi-erect portable radiograph of chest was reviewed in comparison with prior chest series through ___ to ___.

FINDINGS: Basal opacity in the right hemithorax reflects moderate right pleural effusion associated with right lung atelectasis. Mild left pleural effusion is unchanged. Bilateral pulmonary vascular engorgement suggests mild pulmonary congestion. Patient is status post median sternotomy with intact sternal sutures. Cardiomediastinal contour is unchanged. The position of left transvenous pacemaker leads is unchanged. Bibasal atelectasis, right more than left side is similar.


SubjectID: 19677105, StudyID: 51115508, Comparison: None

FINAL REPORT

INDICATION: ___F with chest pain, evaluate for pneumonia or pneumothorax.

COMPARISON: Comparison is made to chest radiograph from ___.

TECHNIQUE AP and lateral view of the chest.

FINDINGS: Lung volumes are low. Moderate cardiomegaly persists. Mediastinal contour is unchanged. Blunting of the bilateral costophrenic angles likely secondary to small effusions. There is no pneumothorax. No definite focal consolidation is seen.

IMPRESSION: 1. Moderate cardiomegaly, not significantly changed. 2. Small bilateral pleural effusions. 3. No definite evidence of pneumonia. No pneumothorax.


SubjectID: 19677105, StudyID: 50243033, Comparison: None

FINAL REPORT

EXAMINATION: PA and lateral chest radiograph

INDICATION: ___ year old woman with dyspnea, PND, h/o pericardial effusion ___ ___ virus myopericarditis s/p window x2 at___. // baseline prior to V/Q scan.

COMPARISON: Chest radiograph dated ___.

FINDINGS: The heart size may be slightly decreased compared to the prior exam but is still mildly enlarged. Bilateral small pleural effusions are overall unchanged. The lungs are clear. No focal consolidation, pulmonary edema, or pneumothorax. The thoracic aorta is calcified and ectatic. Mild dextroconvex scoliosis of the thoracic spine is unchanged.

IMPRESSION: No interval change in bilateral small pleural effusions.


SubjectID: 19683695, StudyID: 55771822, Comparison: same

FINAL REPORT

INDICATION: ___-year-old man with hypoxemia secondary to congestive heart failure.

TECHNIQUE: Single AP upright portable chest view was read in comparison with multiple prior radiographs with the most recent from ___.

FINDINGS: Mild pulmonary edema is unchanged since ___   Keywords: unchanged. Heart size is mild to moderately enlarged and similar since at least ___. Bilateral lower lung opacities and increased retrocardiac density, likely represent atelectasis and/or consolidation in combination with bilateral pleural effusions, mild-to-moderate left and minimal right, and has not really changed much since last 24 hours. Concurrently associated bilateral lower lung infection cannot be ruled out, and needs clinical correlation.

IMPRESSION: Mild-to-moderate pulmonary edema, bilateral lower lung opacities due to combination of atelectasis and/or consolidation, mild-to-moderate left and minimal right pleural effusions and mild to moderately enlarged heart size have not changed over last 24 hours. Concurrently associated infection in lower lungs cannot be ruled out, clinical correlation is required.


SubjectID: 19683695, StudyID: 53114438, Comparison: worse

FINAL REPORT

INDICATION: Hypoxia.

COMPARISON: ___. UPRIGHT AP VIEW OF THE CHEST: The heart size remains moderately enlarged. The aortic knob is calcified. There is perihilar haziness and vascular indistinctness compatible with mild pulmonary edema. Additionally, a moderate left pleural effusion has increased from the prior study, and a small right pleural effusion appears relatively unchanged. Bibasilar airspace opacities may reflect compressive atelectasis, though infection, particularly in the left lower lobe cannot be excluded. No pneumothorax is present. No acute osseous abnormalities are visualized.

IMPRESSION: Mild pulmonary edema with increased moderate-sized left pleural effusion, and similar-sized right pleural effusion   Keywords: increase. Bibasilar airspace opacities may reflect compressive atelectasis, though infection cannot be excluded.


SubjectID: 19695954, StudyID: 55187223, Comparison: None

WET READ: ___ ___ ___ 7:45 PM Moderate left pleural effusion, increased compared to the most recent radiograph from ___. Consolidative left retrocardiac opacification is likely compressive atelectasis. Heterogeneous right lower lung opacities continue to increase, possibly atelectasis or a developing infectious process. Mild interstitial pulmonary edema is not significantly changed. Moderate cardiomegaly is redemonstrated. No pneumothorax. No pneumomediastinum. Marked deformity of the left humeral head, as before. Interval removal of a large bore right internal jugular central venous catheter. Findings were discussed with Dr. ___ by Dr. ___ at 7:44 p.m. via telephone on the day of the study, immediately after discovery of the findings. ______________________________________________________________________________

FINAL REPORT

HISTORY: Shortness of breath.

FINDINGS: In comparison with the study of ___, there is some increased opacification at the left base consistent with volume loss and pleural effusion. In the appropriate clinical setting, supervening pneumonia would have to be considered. Continued enlargement of the cardiac silhouette with some elevation of pulmonary venous pressure. The large-bore central catheter from the right IJ has been removed.


SubjectID: 19696084, StudyID: 57866320, Comparison: worse

FINAL REPORT

TYPE OF

EXAMINATION: Chest, AP portable single view.

INDICATION: ___-year-old male patient with coronary artery disease, now with shortness of breath and hypoxia, evaluate for pulmonary edema.

FINDINGS: AP single view of the chest has been obtained with patient in sitting semi-upright position. Analysis is performed in direct comparison with the next preceding AP and lateral chest examination of ___. The diaphragms are now in higher position. The pulmonary vasculature shows marked perivascular haze throughout, compatible with development of CHF   Keywords: development. As there are hazy densities predominantly in the central pulmonary areas, findings match the clinical impression of beginning pulmonary edema. There is no pneumothorax detectable in the apical area on this portable chest examination. In comparison with the next preceding study obtained one day earlier, the patient has now developed severe left-sided CHF   Keywords: develop. Observed that the lateral view on the previous examination demonstrated suspicious calcifications within the aortic valve area and the aortic root. Referring physician, ___. ___, was paged at 2:___ p.m. and the case discussed.


SubjectID: 19696084, StudyID: 54904837, Comparison: None

FINAL REPORT

EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Chest pain, recent MI.

COMPARISON: ___.

FINDINGS: Frontal and lateral views of the chest were obtained. There are bibasilar opacities most consistent with atelectasis, although underlying consolidation not excluded in the appropriate clinical setting. There are trace bilateral pleural effusions. No evidence of pneumothorax is seen. The aorta is calcified and tortuous. The cardiac silhouette is top normal. There is mild pulmonary vascular congestion.


SubjectID: 19697979, StudyID: 59256372, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with history of CAD, FH and EF ___%, admitted with right sided pneumonia. // interval change in opacities, pulmonary edema

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___.

IMPRESSION: ET tube tip is 3.5 cm above the carinal. NG tube tip is in the stomach. Heart size and mediastinum are stable. Right lung consolidation and right pleural effusion as well as left pleural effusion all pleural unchanged. The slight improvement of the right upper lobe density of the opacity is noted but might is felt represent a dilatation in the position of the pleural effusion. No pneumothorax.


SubjectID: 19697979, StudyID: 58748912, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with respiratory distress, intubated, s/p NG tube placement // location of NG tube?

COMPARISON: ___, 1:53

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The patient has received a nasogastric tube. The course of the tube is unremarkable, the tip of the tube is not visualized on the image. The pre-existing parenchymal opacities are constant. Constant position of the endotracheal tube. No new parenchymal opacities   Keywords: new. Unchanged moderate cardiomegaly.


SubjectID: 19697979, StudyID: 55146372, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with heart failure, intubated for respiratory distress // assess interval change

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The nasogastric tube has been removed. The endotracheal tube is in unchanged position. Unchanged evidence of small bilateral pleural effusions. Bilateral areas of basilar atelectasis. Mild pulmonary edema persists   Keywords: persists. No convincing evidence for pneumothorax.


SubjectID: 19717260, StudyID: 57684820, Comparison: None

WET READ: ___ ___ 4:56 PM Multiple bilateral patchy opacities projecting over the lungs. Differential diagnosis includes multifocal pneumonia however, metastatic disease not excluded particularly if this patient has known history of malignancy. Given setting of trauma, a pulmonary contusion can not be excluded. Followup to resolution. Chest CT pending ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with fall // chf?

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___, today, at 12:07

FINDINGS: There are multiple bilateral patchy opacities in the lung, the largest in the lateral left mid lung zone but also seen in the right greater than left bibasilar regions and possibly in the upper lobes as well. Differential diagnosis includes multifocal pneumonia versus neoplastic process, metastatic disease, particularly if patient has a known primary. Given history of trauma, pulmonary contusion cannot be excluded. Small left pleural effusion is seen. Difficult to exclude a trace right pleural effusion. No pneumothorax is seen. The cardiac silhouette is mildly enlarged. The aorta is calcified and tortuous. This is a partially imaged the proximal left humerus fracture.

IMPRESSION: Multiple bilateral patchy opacities projecting over the lungs. Differential diagnosis includes multifocal pneumonia however, metastatic disease not excluded particularly if this patient has a known history of malignancy. Given setting of trauma, a pulmonary contusion can not be excluded


SubjectID: 19717260, StudyID: 57448967, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with s/p NGT // placement

IMPRESSION: As compared to ___ radiograph, a nasogastric tube is been placed, terminating within the stomach with distal tip beyond the field of view. Multifocal areas of consolidation demonstrate slight improvement in the left lower lung but slight worsening in the right mid and lower lung. As noted on recent CT, findings are most suggestive of multifocal pneumonia with or without aspiration. Followup radiographs are suggested to document resolution.


SubjectID: 19717260, StudyID: 57111538, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with intubation // eval tube placement

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___ at 16:10

FINDINGS: There has been interval placement of an endotracheal tube, terminating approximately 5.8 cm above the level the carina. The lungs appear somewhat better aerated as compared to the prior study but otherwise are similar in appearance with persistent multifocal opacities seen.


SubjectID: 19717260, StudyID: 55797296, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with new R IJ CVL. // eval for line placement

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___ at 17:36

FINDINGS: There has been interval placement of a right internal jugular central venous catheter terminating in the region of the proximal to mid SVC without evidence of pneumothorax. Multifocal bilateral pulmonary opacities again seen   Keywords: again. There is persistent right greater than left apical opacification as well as multifocal opacities projecting over the left greater than right lungs   Keywords: persistent.


SubjectID: 19717260, StudyID: 53184834, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p fall w cxr c/w contusions vs diffuse infiltrates // pls eval for interval changes pls eval for interval changes

IMPRESSION: In comparison with the study of ___, diffuse bilateral pulmonary opacifications are again seen bilaterally   Keywords: again. As seen on the recent CT, the findings are consistent with multifocal pneumonia. The pattern on radiographs raises the possibility of septic emboli, especially if the patient has vegetations on cardiac valve spur. The endotracheal and nasogastric tubes have been removed. Right IJ catheter the extends to the mid portion of the SVC. There is suggestion of increased opacification with possible cavitation in the right apical region, though this could be mimicked by a combination of consolidation and overlying bony structures.


SubjectID: 19723160, StudyID: 59685431, Comparison: None

WET READ: ___ ___ ___ 11:37 AM Underpenetrated study. Moderate to severe cardiomegaly with pulmonary vascular engorgement suggestive of mild CHF. Band-like opacity in RUL may represent pneumonia. PA and lateral CXR recommended.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

INDICATION: Shortness of breath and cough with a history of asthma.

COMPARISON: Chest radiograph from ___. PORTABLE UPRIGHT RADIOGRAPH OF THE CHEST: The radiograph is underpenetrated, limiting evaluation. There is moderate-to-severe cardiomegaly with slightly increased right ventricular predominance compared to the prior examination. There is more prominent pulmonary vascular engorgement compared to the prior study. A region of band-like opacity in the right upper lobe obscures the right mediastinal contour. The lung bases are difficult to evaluate due to limitations in technique, and an underlying effusion or consolidation cannot be excluded. There is no pneumothorax.

IMPRESSION: 1. Moderate-to-severe cardiomegaly, with more prominent right atrial dilation, accompanied by pulmonary vascular engorgement is concerning for congestive heart failure. 2. Possible right upper lobe pneumonia. Evaluation with PA and lateral radiographs is recommended for more optimal evaluation.


SubjectID: 19723160, StudyID: 57120919, Comparison: None

FINAL ADDENDUM Follow-up to resolution as right upper lobe neoplasm cannot be excluded. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___: Comparison with a prior study from earlier today. CLINICAL

HISTORY: Shortness of breath, cough, assess for pneumonia.

FINDINGS: AP, upright and lateral views of the chest were obtained. There is slight improvement in lung aeration and technique compared with prior. There is right upper lobe consolidation which could represent a small focus of pneumonia. The heart is mildly enlarged. There is no overt CHF. Aorta appears unfolded. No large pleural effusion. Bony structures are intact.

IMPRESSION: Focus of consolidation in the right upper lobe is concerning for pneumonia. Mild cardiomegaly is again noted.


SubjectID: 19723160, StudyID: 58568688, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with asthma, here with dyspnea, ? pneumonia // ? pneumonia ? pneumonia

IMPRESSION: In comparison with the study of ___, there is little overall change   Keywords: little overall change. Scatter radiation obscures detail. There is enlargement of the cardiac silhouette with prominence of both hila suggesting pulmonary arterial hypertension. No definite pneumonia or vascular congestion is seen

NOTIFICATION: On this somewhat limited study.


SubjectID: 19723160, StudyID: 56210574, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: History: ___F with dyspnea and hypoxia

TECHNIQUE: Portable upright AP view of the chest

COMPARISON: ___ chest CTA and chest radiograph

FINDINGS: Study is slightly limited by underpenetrated technique. Heart size remains mildly to moderately enlarged. The aorta is tortuous with mild atherosclerotic calcifications noted at the aortic arch. Enlargement of the pulmonary arteries bilaterally is similar and suggestive of underlying pulmonary arterial hypertension. Retrocardiac opacity could reflect atelectasis though infection is not completely excluded. Right lung is grossly clear. No pleural effusion or pneumothorax is identified.

IMPRESSION: Limited study due to underpenetration. Patchy retrocardiac opacity, possibly atelectasis, but infection cannot be excluded.


SubjectID: 19735078, StudyID: 59811136, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH:

INDICATION: Pleural effusion, status post thoracocentesis, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has undergone left thoracocentesis. The extent of the pre-existing pleural effusion has substantially decreased. There is no evidence of pneumothorax or other complication. The lung volumes remain low, there is mild fluid overload but no overt pulmonary edema   Keywords: remain. Atelectasis at the left lung bases. No evidence of pneumonia.


SubjectID: 19735078, StudyID: 53131872, Comparison: None

FINAL REPORT

EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Worsening substernal chest pain, previously diagnosis of left pleural effusion.

COMPARISON: ___.

FINDINGS: Frontal and lateral views of the chest were obtained. There has been interval increase in left-sided pleural effusion, with overlying atelectasis. Left basilar consolidation is difficult to exclude. There is minor blunting of the posterior right costophrenic angle and a trace right pleural effusion may be present. The cardiac silhouette is enlarged with a somewhat globular configuration and underlying pericardial effusion is not excluded. No pneumothorax is seen.

IMPRESSION: 1. Interval increase in left-sided pleural effusion with overlying atelectasis, left basilar consolidation not entirely excluded. Possible new trace right pleural effusion. 2. Enlarged cardiac silhouette in a somewhat globular configuration, underlying pericardial effusion is not excluded.


SubjectID: 19735078, StudyID: 54587532, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with recurrent pleural effusion and recent pericardial effusion of unknown etiology // r/o ptx

COMPARISON: ___, 15:27.

IMPRESSION: As compared to the previous radiograph, the extent of the known right pleural effusion and the appearance of the cardiac silhouette is unchanged. There is no evidence of pneumothorax. No new effusion. No focal parenchymal opacities suggesting pneumonia. Atelectasis adjacent to the right effusion is constant.


SubjectID: 19735078, StudyID: 50638138, Comparison: None

FINAL REPORT

INDICATION: Recurrent pleural effusion and recent pericardial effusion of unknown etiology. Please assess for pleural effusion or cardiomegaly.

COMPARISON: Comparison is made to chest radiograph performed ___.

FINDINGS: Frontal and lateral chest radiographs demonstrate interval decrease in size of cardiac silhouette; however, there is similar "water bottle" configuration to the cardiac silhouette suggesting persistent pericardial effusion. Right pleural effusion is decreased, now small to moderate in size. Faint opacification projecting over the right lower lung likely reflects residual atelectasis. No pulmonary nodules identified.

IMPRESSION: Decreased cardiac silhouette with configuration suggesting residual small pericardial effusion. Slight interval decrease in size of right pleural effusion.


SubjectID: 19735078, StudyID: 53409243, Comparison: None

FINAL REPORT

INDICATION: Chest tube followup.

COMPARISON: Chest radiograph from ___.

FINDINGS: There are small unchanged bilateral pleural effusions and associated mild-to-moderate bibasilar atelectasis, slightly improved. A left-sided pleural catheter is unchanged in position, ending along the lateral aspect of the lower pleural space. There is no definite pneumothorax. The cardiac and mediastinal contours are unchanged, allowing for differences in lung volumes.

IMPRESSION: 1. Unchanged positioning of the left-sided pleural catheter. 2. Small bilateral pleural effusions and decreased bibasilar atelectasis.


SubjectID: 19735078, StudyID: 51185128, Comparison: None

FINAL REPORT

HISTORY: Chest tube for pleural effusion.

FINDINGS: In comparison with the study of ___, the left chest tube remains in place and there is no definite pneumothorax. Persistent opacification at the right base is consistent with pleural effusion and atelectatic change. In the appropriate clinical setting, supervening pneumonia would have to be considered. Continued low lung volumes.


SubjectID: 19757915, StudyID: 54693396, Comparison: same

FINAL REPORT

HISTORY: Patient with heart failure and rhonchi, evaluate for consolidation, effusion, or pulmonary edema.

COMPARISON: ___.

FINDINGS: Frontal and lateral chest radiographs were obtained. No focal consolidation, pleural effusion, or pneumothorax is seen. The heart is moderately enlarged but stable. Hilar contours are enlarged, possibly secondary to underlying pulmonary hypertension, but there is no pulmonary edema. A left chest pacemaker has leads in the appropriate positions in the right atrium and right ventricle.

IMPRESSION: Stable moderate cardiomegaly without pulmonary edema   Keywords: stable. No focal consolidations or pleural effusions.


SubjectID: 19757915, StudyID: 52900766, Comparison: same

WET READ: ___ ___ ___ 9:12 PM No evidence of congestive heart failure. Vague focal opacity projecting over the right upper to mid lung field, which is nonspecific. This could potentially reflect an inflammatory or infectious focus, but follow up radiographs are recommended to assess for resolution of this finding. ______________________________________________________________________________

FINAL REPORT

HISTORY: Weight gain, history of congestive heart failure.

TECHNIQUE: AP upright and lateral views of the chest.

COMPARISON: ___.

FINDINGS: Left-sided pacemaker device is noted with leads terminating in the right atrium and right ventricle, unchanged. Moderate to severe cardiomegaly is re- demonstrated. The mediastinal contours are unchanged with tortuosity of the thoracic aorta again noted. Hilar contours are stable, and there is no pulmonary edema demonstrated   Keywords: stable. Vague focal opacity is seen within the right upper to mid lung field, which is nonspecific, but not clearly demonstrated on the previous exam. No focal consolidation, pleural effusion or pneumothorax is otherwise demonstrated.

IMPRESSION: No evidence of congestive heart failure. Vague focal opacity projecting over the right upper to mid lung field, which is nonspecific. This could potentially reflect an inflammatory or infectious focus, but follow up radiographs are recommended to assess for resolution of this finding.


SubjectID: 19765159, StudyID: 59277472, Comparison: None

FINAL REPORT

EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of dyspnea.

COMPARISON: ___.

FINDINGS: Frontal and lateral views of the chest were obtained. There are small bilateral pleural effusions with overlying atelectasis. No pneumothorax is seen. The aorta is calcified. The cardiac silhouette is not enlarged. Degenerative changes are seen along the spine.

IMPRESSION: Small bilateral pleural effusions.


SubjectID: 19765159, StudyID: 50913933, Comparison: same

WET READ: ___ ___ ___ 11:15 PM emphysema and small bilateral pleural effusions w/ bibasilar atelectasis; no evidence of fluid overload or lobar consolidation. ______________________________________________________________________________

FINAL REPORT

PA AND LATERAL CHEST, ___

HISTORY: ___-year-old woman with increasing dyspnea, diastolic CHF, volume overload and cough.

IMPRESSION: PA and lateral chest compared to ___ and ___: Small bilateral pleural effusions and pulmonary vascular congestion and top normal heart size overall unchanged since ___   Keywords: unchanged. Moderate-to-large hiatus hernia is chronic. There are no focal findings in the lungs to suggest pneumonia.


SubjectID: 19765159, StudyID: 58969411, Comparison: None

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: COPD, presenting with one week of shortness of breath.

COMPARISONS: Radiographs from ___ are not currently available for review and likewise for radiographs from ___. However, a chest CT from ___ is available and comparison can be made to the scout view.

TECHNIQUE: Chest, PA and lateral.

FINDINGS: The heart is at the upper limits of normal size to mildly enlarged. The aorta is partly calcified. The mediastinal and hilar contours appear unchanged. On the prior CT, there was a substantial hiatal hernia which is not well visualized on this examination. Small bilateral pleural effusions are present and better seen on the lateral view. The lungs are hyperinflated. Fissures are minimally thickened, which may suggest slight fluid overload. However, the lungs appear clear. Small anterior osteophytes are noted throughout the visualized thoracolumbar spine. Leftward convex curvature along the upper lumbar spine is probably similar and associated with compression deformity of an upper lumbar vertebral body that may be similar, although not optimally characterized.

IMPRESSION: Slightly thickened fissures and small pleural effusions, which may suggest mild congestion or fluid overload; otherwise unremarkable.


SubjectID: 19769933, StudyID: 57235634, Comparison: None

FINAL REPORT

CHEST, TWO VIEWS: ___.

FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. Again seen is cardiomegaly which is essentially stable from prior. The lungs remain clear. There is a small left pleural effusion. Pacemaker wires are in stable position. There are surgical clips in the upper abdomen, potentially from prior cholecystectomy.

IMPRESSION: Small left pleural effusion. Stable cardiomegaly.


SubjectID: 19769933, StudyID: 52504484, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Dyspnea on exertion, chronic heart failure, assessment for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has received a right internal jugular vein device, in addition to the left pacemaker. The size of the cardiac silhouette is still substantially enlarged and the presence of a small pleural effusion on the left cannot be excluded. Otherwise, there are signs of minimal fluid overload but no overt pulmonary edema with no evidence of pneumonia. Unchanged retrocardiac atelectasis.


SubjectID: 19780933, StudyID: 54877811, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cabg // r/o ptx, s/p ct d/c

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

FINDINGS: Moderate severe cardiomegaly is stable. Widened mediastinum has minimally increased. Mild pulmonary edema has minimal increased   Keywords: increase. Retrocardiac atelectasis are new. If any there is a small left effusion. ET tube is in standard position. Swan-Ganz catheter tip is in the takeoff of the main pulmonary artery. NG tube tip is out of view below the diaphragm.

IMPRESSION: Pulmonary edema. No pneumothorax


SubjectID: 19780933, StudyID: 50999758, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP) CLINICAL

HISTORY ___ year old man with CAD // eval cardiopulmonary dz Surg: ___ (CABG) eval cardiopulmonary dz

COMPARISON: ___

FINDINGS: There is again evidence of mild pulmonary venous hypertension. Small pleural effusions have resolved, however. Mediastinal structures are stable.

IMPRESSION: Resolution of small pleural effusions.


SubjectID: 19783125, StudyID: 58539774, Comparison: None

FINAL REPORT

HISTORY: Worsening edema.

FINDINGS: In comparison with the study of ___, there may be mild increased elevation of pulmonary venous pressure. Otherwise, little change with bilateral pleural effusions, worse on the right, and underlying atelectasis, which is more prominent on the left.


SubjectID: 19783125, StudyID: 56736024, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH.

INDICATION: Chronic heart failure, evaluation for pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is a minimal increase in extent of the pre-existing right pleural effusion. Moderate cardiomegaly persists. Relatively extensive bilateral areas of atelectasis. No new focal parenchymal opacity suggesting pneumonia.


SubjectID: 19783125, StudyID: 55253826, Comparison: None

FINAL REPORT

HISTORY: Chills, cough, low sats.

TECHNIQUE: Frontal and lateral views of the chest.

COMPARISON: ___.

FINDINGS: There are moderate bilateral pleural effusions with overlying atelectasis, underlying basilar consolidation is not excluded in the appropriate clinical setting. The cardiomediastinal silhouette is grossly stable. There is minimal pulmonary vascular congestion. No evidence of pneumothorax is seen.

IMPRESSION: Bilateral pleural effusions with overlying atelectasis, underlying consolidation not excluded. Possible mild vascular congestion.


SubjectID: 19783125, StudyID: 54028818, Comparison: None

WET READ: ___ ___ ___ 8:14 PM Increased opacity of the right the lower and mid lung likely represents layering pleural effusion due to positioning. Retrocardiac opacity likely represents a combination of effusion and atelectasis; although, an underlying infection is possible in the correct clinical setting. Mild pulmonary vascular congestion persists. Heart size remains severely enlarged. ______________________________________________________________________________

FINAL REPORT

HISTORY: CHF exacerbation.

FINDINGS: In comparison with study of ___, there is a hazy opacification at the right base consistent with layering pleural effusion, which may be different in appearance due to change in patient position. Retrocardiac opacification is more prominent, consistent with volume loss in the left lower lobe and pleural effusion. In the appropriate clinical setting, supervening pneumonia would have to be considered. There is continued enlargement of the cardiac silhouette with evidence of elevated pulmonary venous pressure. Engorgement of the azygos region suggests some element of right-sided cardiac failure.


SubjectID: 19783125, StudyID: 50820558, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluation for effusion and acute change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Moderate cardiomegaly with signs of mild-to-moderate pulmonary edema. Bilateral pleural effusions, left more than right, associated with atelectasis of the lung bases. No new parenchymal opacity suggesting pneumonia. No pneumothorax. The left PICC line is in unchanged position. Unchanged clips projecting over the right breast.


SubjectID: 19783125, StudyID: 55221356, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, pulmonary edema, pleural effusion.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Moderate pulmonary edema with relatively large bilateral pleural effusions and moderate-to-severe cardiomegaly. Subsequent areas of atelectasis at the lung bases. Overall, the changes are constant as compared to the previous examination.


SubjectID: 19783125, StudyID: 55677601, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Shortness of breath, persistent crackles, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the pleural effusion on the right has minimally increased in extent. This increase is more obvious on the frontal than on the lateral image. The effusion on the left is unchanged in size. Minimal increase in size of the cardiac silhouette. To rule out a potential pericardial effusion as a reason for this change, echocardiography could be performed. Minimal areas of atelectasis at both the left and the right lung bases. No evidence of pneumonia or pneumothorax.


SubjectID: 19783125, StudyID: 51063453, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Hypoxia, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, no relevant change   Keywords: no relevant change. Moderate bilateral pleural effusions with subsequent areas of atelectasis. Moderate cardiomegaly. No signs of overt pulmonary edema. Tortuosity of the thoracic aorta. No pneumothorax. No new parenchymal changes. The right PICC line is in unchanged position.


SubjectID: 19788382, StudyID: 51073383, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male patient with shortness of breath, crackles, hypotension. Study requested for evaluation of an acute process.

COMPARISON: Prior chest radiograph from ___.

TECHNIQUE: Portable chest radiograph.

FINDINGS: Moderate-to-severe cardiomegaly is stable. The mediastinal and hilar contours are unchanged. As compared to prior chest radiograph from ___, pulmonary congestion appears slightly more prominent. Left pleural effusion and compressive atelectasis are unchanged. There is no pneumothorax. Right costodiaphragmatic angle is not included in this examination.


SubjectID: 19788382, StudyID: 50093647, Comparison: same

FINAL REPORT

HISTORY: Generalized weakness.

TECHNIQUE: AP upright and lateral views of the chest.

COMPARISON: ___.

FINDINGS: Moderate to severe cardiomegaly is unchanged. The aortic knob remains calcified. Mediastinal and hilar contours are similar. Moderate size left pleural effusion appears minimally increased compared to the prior study. Opacification of the left lung base likely is due to compressive atelectasis. Mild pulmonary vascular congestion appears similar   Keywords: similar. Trace right pleural effusion is relatively unchanged. No pneumothorax is identified.

IMPRESSION: Slight interval increase in size of moderate left pleural effusion. Left basilar opacity likely reflects atelectasis. Trace right pleural effusion also noted. Mild pulmonary vascular congestion, similar compared to the prior study   Keywords: similar.


SubjectID: 19804575, StudyID: 59445096, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Pulmonary fibrosis, congestive heart failure, increasing shortness of breath, evaluation for pleural effusion.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the fibrotic changes of the lung parenchyma has moderately increased. In addition, there is a minimal prominence of the vascular structures. Given the increased size of the cardiac silhouette, a combination of progressive fibrosis and mild fluid overload is likely. However, neither the frontal nor the lateral radiographs show evidence of pleural effusion. Moderate tortuosity of the thoracic aorta.


SubjectID: 19804575, StudyID: 56385507, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female with shortness of breath.

COMPARISON: ___.

FINDINGS: PA and lateral views of the chest demonstrates stable cardiomegaly. Fibrotic changes particullary at the periphery of the lung parenchyma are stable. There is no evidence of pleural effusion. No focal consolidation is seen. There is moderate tortuosity of the thoracic aorta

IMPRESSION: Fibrotic changes of the lungs with cardiomegaly, stable from 2 days prior.


SubjectID: 19805298, StudyID: 58725948, Comparison: better

FINAL REPORT

INDICATION: Pulmonary edema, evaluation for interval change.

TECHNIQUE: Portable AP chest radiograph.

COMPARISONS: ___ and ___.

FINDINGS: The ET tube terminates in the standard position. The NG tube terminates outside the field of view in the region of the stomach. However, the side port still terminates in the region of the GE junction. Median sternotomy wires and CABG clips are again noted with a slight decrease in the heart size. Bilateral parenchymal opacities have significantly improved from ___, indicating marked improvement in pulmonary edema   Keywords: improve. Nondisplaced left seventh rib fracture is again noted. There is no pneumothorax or pleural effusion.

IMPRESSION: 1. Marked improvement in pulmonary edema   Keywords: improve. 2. NG tube sidehole still terminates in the region of the GE junction.


SubjectID: 19805298, StudyID: 51625747, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Hypoxia, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. No monitoring and support devices are constant, no newly appeared focal parenchymal opacities. Unchanged size of the cardiac silhouette. Constant pacemaker monitoring and support devices. No pneumothorax, no pleural effusions.


SubjectID: 19805298, StudyID: 51429874, Comparison: None

WET READ: ___ ___ 11:52 PM NGT with sideport at the GE junction, suggest advancement so that it is well within the stomach. distal tip of NGT likely terminates in the stomach. ETT 3 cm above carina. extensive bilateral perihilar opacities likely pulmonary edema, with possibly underlying contusions/aspiration. ? nondisplaced lateral left 7th rib fx.

WET READ VERSION #1

WET READ VERSION #2 ___ ___ ___ 11:51 PM NGT with sideport at the GE junction, suggest advancement so that it is well within the stomach. distal tip of NGT likely terminates in the stomach. ETT 3 cm above carina. extensive bilateral perihilar opacities likely pulmonary edema, with possibly underlying contusions/aspiration. ______________________________________________________________________________

FINAL REPORT

EXAM: Chest, single supine AP portable view. CLINICAL INFORMATION: ___-year-old female status post intubation.

FINDINGS: Single supine portable view of the chest was obtained. The endotracheal tube terminates approximately 3 cm above the level of the carina. Nasogastric tube is seen coursing below the level of the diaphragm, with the side port at the GE junction and distal tip likely terminating within the stomach, suggest advancement so that the side port is well within the stomach. Extensive bilateral perihilar opacities likely relate to edema, although underlying consolidation may also be present. No large pleural effusion or pneumothorax is seen. The patient is status post median sternotomy and CABG. Left-sided AICD is stable in position.


SubjectID: 19809627, StudyID: 55696312, Comparison: same

WET READ: ___ ___ ___ 8:11 PM Small to moderate left pleural effusion, which layers on decubitus view.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

EXAMINATION: DX CHEST WITH DECUB

INDICATION: ___ yo M with a history of ischemic cardiomyopathy s/p stent x 3, CKD (stage IV-V), h/o DVT on coumadin, presenting with cough and dyspnea, with course complicated by AOCRF now on HD, new atrial fibrillation, transferred to the ICU with respiratory distress. // eval pleural effusion

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. Moderate cardiomegaly, retrocardiac atelectasis, approximately 1 cm broad pleural effusion, better appreciated on the decubitus view. No pulmonary edema. No pneumonia. Right central venous access line in situ.


SubjectID: 19809627, StudyID: 54301133, Comparison: worse

FINAL REPORT

INDICATION: ___ year old man with recent nerve block on right and SOB likely secondary to phrenic nerve motor blockade. Please evaluate for right pneumothorax. // ___ year old man with recent nerve block on right and SOB likely secondary to phrenic nerve motor blockade. Please evaluate for right pneumothorax. Surg: ___ (___)

TECHNIQUE: Single portable upright AP image of the chest.

COMPARISON: Comparison is made with chest radiographs from ___ and ___.

FINDINGS: Lung volumes are decreased from prior exam. There are increased interstitial markings consistent with increased mild pulmonary edema   Keywords: increase. There is increased opacity in the left lung base, which may reflect atelectasis, pneumonia, or aspiration and possibly an element of pleural effusion. There is no pneumothorax. A right-sided central line is again seen terminating in the right atrium. The cardiomediastinal silhouette is severely enlarged, similar to prior exam.

IMPRESSION: 1. Increased mild pulmonary edema   Keywords: increase. 2. Increased left lung base consolidation, which may reflect atelectasis, pneumonia, or aspiration, with possible left pleural effusion.

NOTIFICATION: Findings were communicated to Dr. ___ at 2:15 p.m. on ___ by phone.


SubjectID: 19813794, StudyID: 54778729, Comparison: 1.0

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: COPD and chronic heart failure, new hypoxia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The severity of pulmonary edema has minimally decreased   Keywords: decrease. Unchanged massive cardiomegaly. Calcified thoracic aorta. Sternal wires in situ. Likely small right pleural effusion with right basal atelectasis. Calcified descending aorta. The left pectoral pacemaker is constant in appearance.


SubjectID: 19813794, StudyID: 50463466, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, COPD, evaluation for pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Moderate cardiomegaly. Tortuosity of the thoracic aorta. Small bilateral pleural effusions and mild-to-moderate pulmonary edema. Unchanged alignment of sternal wires and clips of the CABG. Left pectoral pacemaker is unchanged.


SubjectID: 19818127, StudyID: 57882600, Comparison: None

WET READ: ___ ___ ___ 5:30 PM There is hazy right midlung opacity, the which could represent infection in the proper clinical setting. Part of left lung base is obscured by pacemaker.

WET READ VERSION #___ ___ ___ ___ 4:13 PM Mild retrocardiac opacity may reflect atelectasis, but cannot exclude aspiration or pneumonia in the clinical setting. Part of left lung base is obscured by pacemaker. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: Chest radiographs

INDICATION: ___F with tachypnea. // PNA?

TECHNIQUE: Single portable semi upright frontal image of the chest.

COMPARISON: Comparison is made with chest radiographs from ___ and ___.

FINDINGS: A left sided pacemaker is seen with intact leads in appropriate position. A right sided central line is noted, in adequate position. Median sternotomy wires are similar to prior exam. The lungs are well expanded. Scarring is seen at the bilateral lung apices, similar to prior exam. Part of the left lung base obscured pacemaker. There is a hazy right midlung opacity. The cardiomediastinal silhouette mildly enlarged, similar prior exam.

IMPRESSION: There is hazy right midlung opacity, the which could represent infection in the proper clinical setting. Part of left lung base is obscured by pacemaker.


SubjectID: 19818127, StudyID: 52405909, Comparison: None

WET READ: ___ ___ ___ 6:30 PM Hazy right midlung opacity which could represent infection in the proper clinical setting. Severe mid thoracic compression deformity new since ___ but age indeterminate, to be correlated clinically. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___F with tachypnea and hypoxia // PNA?

TECHNIQUE: Frontal and lateral views of the chest.

COMPARISON: Film from earlier the same day at 15:32. Chest x-ray from ___.

FINDINGS: New compared to prior older exam is hazy right midlung opacity seen on the frontal view. Increased opacity projecting over the hilar region on the lateral view is also new and may correspond a finding on the frontal view. Biapical scarring is grossly unchanged. The cardiac silhouette is enlarged but similar compared to prior. Markedly tortuous thoracic aorta is noted. Left chest wall dual lead pacing device is again noted. Right-sided dual lumen central venous catheter seen with tip projecting over the proximal right atrium. There is no pleural effusion. Compression deformity in the mid thoracic spine is new since ___ but is age indeterminate.

IMPRESSION: Hazy right midlung opacity which could represent infection in the proper clinical setting. Severe mid thoracic compression deformity new since ___ but age indeterminate, to be correlated clinically.


SubjectID: 19820893, StudyID: 57908320, Comparison: same

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Shortness of breath. Question pneumonia.

COMPARISONS: ___.

TECHNIQUE: Chest, AP upright and lateral.

FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged including cardiomegaly. The lung volumes are low. The right costophrenic angle is obscured suggesting a small pleural effusion. Right lateral pleural thickening appears stable. There is probably also a small pleural effusion on the left side. Patchy opacity at the left lung base has decreased and probably is due to minor atelectasis or scarring. A mild interstitial process is similar to the prior study and could be seen with mild pulmonary edema, although chronicity is uncertain since it is not a substantial change   Keywords: similar. Carotid bulb calcifications are present bilaterally.

IMPRESSION: Similar mild interstitial abnormality suggesting mild pulmonary edema although, given the lack of change, acuity is uncertain   Keywords: similar.


SubjectID: 19820893, StudyID: 51281123, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with ESRD on HD, sCHF (EF ___%), and COPD with dyspnea and wheezing. // pulmonary edema

COMPARISON: ___.

FINDINGS: AP portable upright view of the chest. Lung volumes are low. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact.

IMPRESSION: No acute intrathoracic process


SubjectID: 19840128, StudyID: 54478624, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with cough, weakness, and rales in the right base. Evaluate for evidence of pneumonia.

COMPARISON: ___.

TECHNIQUE: Portable chest radiograph.

FINDINGS: The lungs are well expanded. There are no focal opacities. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax.

IMPRESSION: No acute intrathoracic process.


SubjectID: 19840128, StudyID: 51011747, Comparison: None

FINAL REPORT

HISTORY: Cough and weakness.

FINDINGS: In comparison with the study of ___, the cardiomediastinal silhouette remains unchanged and there is no evidence of acute pneumonia or vascular congestion. There is some blunting of the costophrenic angles that could represent small amount of pleural fluid.


SubjectID: 19844485, StudyID: 54532060, Comparison: None

FINAL REPORT

AP CHEST, 11:57 A.M. ON ___

HISTORY: ___-year-old woman with shortness of breath and diastolic heart failure, pleural effusion and possible pulmonary edema.

IMPRESSION: AP chest compared to ___: There is greater consolidation at the right lung base today, which could be atelectasis worsening in the setting of persistent moderate right pleural effusion or worsening pneumonia. Improvement in perihilar opacification in the left mid lung may be a function of difference in radiographic technique. The area is not clear, whether it is edema or a second focus of pneumonia, is radiographically indeterminate. Moderate enlargement of the cardiac silhouette is longstanding. Dr. ___ was paged.


SubjectID: 19844485, StudyID: 50762309, Comparison: None

WET READ: ___ ___ 7:32 PM Persistent moderate right pleural effusion and underlying consolidation. Possible mild interstitial edema, slightly increased compared to prior. Low lung volumes with bilateral perihilar atelectasis. Discussed with Dr. ___ ___ by phone at 7:30 p.m. on ___ at time of initial review of the study. ______________________________________________________________________________

FINAL REPORT

STUDY: Portable AP chest radiograph.

COMPARISON EXAM: Portable AP chest x-ray ___, PA and lateral chest x-ray ___.

INDICATION: ___-year-old with wheezing and pleural effusions.

FINDINGS: There is stable moderate cardiomegaly. The mediastinal contour is stable. There is a persistent right pleural effusion with associated atelectasis. There is also some mild left base atelectasis as well as mild interstitial edema.

IMPRESSION: Persistent right pleural effusion and atelectasis.


SubjectID: 19849930, StudyID: 52054554, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with shortness of breath.

TECHNIQUE: Single portable AP radiograph.

COMPARISON: Radiograph dated ___.

FINDINGS: Single AP upright radiograph demonstrates an enlarged heart. Perihilar patchy opacity, cephalization of vessels, and vascular congestion are suggestive of pulmonary edema. There is likely a small left pleural effusion. There is no pneumothorax. Patient is status post sternotomy, wires which appear intact. Numerous clips are noted along the left mediastinal border. A left clavicular deformity appears chronic. No acute osseous abnormalities detected.

IMPRESSION: Enlarged heart with evidence to suggest moderate pulmonary edema.


SubjectID: 19849930, StudyID: 51184265, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___-year-old gentleman with history of coronary artery disease, status post CABG and redo CABG with bioprosthetic MVR in ___, paroxysmal atrial fibrillation, hypertension, hyperlipidemia, conduction system disease manifesting with RBBB status post dual-chamber pacemaker presenting with acute onset shortness of breath found to have cellulitis and aoschf. // interval change

TECHNIQUE: Portable chest

COMPARISON: ___ at 02:00.

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change.


SubjectID: 19855099, StudyID: 58572689, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with dCHF with HCAP // worsening infiltrates

COMPARISON: Chest radiograph from ___.

FINDINGS: AP portable upright view of the chest. The patient is post CABG. Central vascular congestion and mild pulmonary edema have improved since the ___ examination   Keywords: improve. A small left pleural effusion remains stable. A right pleural effusion appears resolved. The heart is mildly enlarged.

IMPRESSION: 1. Improved mild central pulmonary vascular congestion and pulmonary edema   Keywords: improve. 2. Resolved right pleural effusion. 3. Unchanged small left pleural effusion.


SubjectID: 19855099, StudyID: 56733033, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with SOB and fever // ?pneumonia vs acute cardiopulmonary process?

COMPARISON: Chest radiograph from ___.

FINDINGS: AP portable upright view of the chest. The heart is mildly enlarged. The patient is post CABG. There is central pulmonary vascular congestion with mild pulmonary edema, slightly worsened since ___, with increased small bilateral pleural effusions   Keywords: worse, increase. There is no pneumothorax.

IMPRESSION: Central pulmonary vascular congestion with mild pulmonary edema and small bilateral pleural effusions have slightly worsened since ___   Keywords: worse.


SubjectID: 19855099, StudyID: 57815598, Comparison: worse

FINAL REPORT

PATIENT

HISTORY: ___ years old woman with postop MRV/CABG, please assess interval changes.

COMPARISON: The exam is compared to chest x-ray of ___.

FINDINGS: AP single view of the chest was provided. All the monitoring devices are unchanged and in standard position. Lung volume is still low, with interval increase of lower lung opacification for increased dependent lung edema   Keywords: increase. Heart size is minimally larger since prior CXR, this interval increase might be due to pericardial effusion. Minimal enlargement of the upper mediastinal border is normal postoperative appearance after cardiac surgery. There is a new, small left pleural effusion. There is no pneumothorax. Focal atelectasis in the periphery of the right upper lobe is stable. Bibasilar atelectasis is unchanged.

IMPRESSION: Increased pulmonary edema, especially in the lung bases and new left small pleural effusion   Keywords: new, increase. Interval increase of heart size might be due increased pericardial effusion. Echocardiography is recommended. Finidngs were paged at 5:56 pm to Dr ___, by Dr ___


SubjectID: 19855099, StudyID: 56943615, Comparison: None

FINAL REPORT

HISTORY: Chest tube removal, to assess for pneumothorax.

FINDINGS: In comparison with the study of ___, the left chest tube has been removed, and there is no evidence of pneumothorax. Other monitoring and support devices remain in place. There are lower lung volumes which accentuate the enlargement of the cardiac silhouette and pulmonary vascular congestion. Focal atelectasis in the periphery of the right upper lobe is again seen, in the region of previous chest tube. Atelectatic changes persist at the bases with probable small pleural effusions bilaterally.


SubjectID: 19855099, StudyID: 53932703, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Dobbhoff placement.

COMPARISON: ___, 6:45.

FINDINGS: Status post Dobbhoff placement. Series of images document device placement. Image #4, acquired 4:29, shows the device positioned in the stomach, with the tip in the middle aspect of the stomach.


SubjectID: 19855099, StudyID: 50288596, Comparison: same

FINAL REPORT

PORTABLE CHEST X-RAY, ___

COMPARISON: ___ radiograph.

FINDINGS: Interval removal of intra-aortic balloon pump and right-sided chest tube, with no visible pneumothorax. Other indwelling devices remain in standard position, and cardiomediastinal contours are stable allowing for patient rotation. Persistent pulmonary vascular congestion   Keywords: persistent. Focal atelectasis in periphery of right upper lobe at site of previous right chest tube. Additional patchy foci of atelectasis at both bases as well as a layering left pleural effusion.


SubjectID: 19855099, StudyID: 55726431, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Dobbhoff tube placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the Dobbhoff tube has been replaced. The current Dobbhoff tube is in correct position. The tip projects over the middle parts of the stomach. It is the second gastric device in this patient. The Swan-Ganz catheter has been removed. The venous introduction sheath on the right is still present. Endotracheal tube in situ. Small area of pleural thickening, previously hidden by one of the ECG leads. Increasing pleural effusions and moderate fluid overload   Keywords: increasing. Unchanged size of the cardiac silhouette.


SubjectID: 19855099, StudyID: 51221401, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post CABG, evaluation for Dobbhoff tube.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, a new Dobbhoff catheter was inserted. The second catheter projects over the stomach and shows a coil in the prepyloric region. No complications. All other monitoring and support devices are constant. Constant appearance of the heart and of the lung.


SubjectID: 19855099, StudyID: 55441013, Comparison: same

WET READ: ___ ___ ___ 1:08 AM Lines and tubes in appropriate position. No change. ___ p___

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

PORTABLE CHEST ___

COMPARISON: Radiograph of earlier the same date.

FINDINGS: Interval placement of endotracheal tube with tip terminating 3 cm above the carina. Otherwise, no relevant short interval change since the recent study of the same date   Keywords: no relevant short interval change.


SubjectID: 19855099, StudyID: 51244780, Comparison: same

FINAL REPORT

PORTABLE CHEST OF ___ WITH

COMPARISON STUDY OF ONE DAY EARLIER

FINDINGS: Tip of intra-aortic balloon pump terminates 4.5 cm below the superior aspect of the aortic knob. Other indwelling devices are in standard and unchanged position, except for removal of midline drains. Bilateral chest tubes remain in place, with no visible pneumothorax. Cardiomediastinal contours are slightly decreased in width compared to the prior study, likely due to improving volume status of the patient. There remains pulmonary vascular congestion and mild interstitial edema, however   Keywords: remains. Bibasilar retrocardiac atelectasis is again demonstrated, slightly improved on the left.


SubjectID: 19855099, StudyID: 50912117, Comparison: worse

FINAL REPORT

PORTABLE SUPINE CHEST, ___

COMPARISON: Study of earlier the same date.

FINDINGS: Tip of intra-aortic balloon pump has been advanced, but is still in a low position, now terminating 9.1 cm below the superior aspect of the aortic knob. At the time of this dictation, a subsequent radiograph has already been obtained with further advancement of this device. Other indwelling devices are unchanged in position, and cardiomediastinal contours are stable. Pulmonary vascular congestion is accompanied by worsening pulmonary edema, and note is also made of worsening atelectasis in the left lower lobe as well as increasing moderate layering bilateral pleural effusions   Keywords: worse.


SubjectID: 19855099, StudyID: 54992841, Comparison: nan

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: CABG, rising white blood cell count, evaluation for pneumonia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is increasing pulmonary edema   Keywords: increasing. In addition, the atelectatic opacities in the perihilar lung regions as well as in the retrocardiac lung regions have increased. Coexisting pneumonia cannot be excluded. The size of the cardiac silhouette continues to be enlarged. No larger pleural effusions are seen. The pleural lesion on the left is unchanged in appearance   Keywords: unchanged in appearance.


SubjectID: 19855099, StudyID: 51878086, Comparison: None

FINAL REPORT

INDICATION: ___F with hyperglycemia, weakness.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph ___, ___.

FINDINGS: The patient is status post CABG. Median sternotomy wires are unchanged. There is moderate to severe cardiomegaly. The mediastinal and hilar contours are unchanged. There is no pleural effusion or pneumothorax. The lungs are mildly hypoinflated with moderate vascular congestion. There is no focal consolidation concerning for pneumonia.

IMPRESSION: Moderate vasculature congestion. No focal consolidation concerning for pneumonia.


SubjectID: 19855099, StudyID: 50834175, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: Hyperglycemia, acute kidney injury, leukocytosis, type 1 diabetes.

TECHNIQUE: Upright AP view of the chest.

COMPARISON: ___.

FINDINGS: Patient is status post median sternotomy and CABG. Heart remains mildly enlarged. Mediastinal hilar contours are within normal limits. Pulmonary vasculature remains mildly engorged , but improved compared to the prior exam. No focal consolidation, pleural effusion or pneumothorax is seen. No acute osseous abnormality seen.

IMPRESSION: Mild pulmonary vascular congestion, improved compared to the prior exam   Keywords: improve. No focal consolidation to suggest pneumonia.


SubjectID: 19859251, StudyID: 59669393, Comparison: 0.0

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Flash pulmonary edema, evaluation for interval changes.

COMPARISON: ___, 11:56 p.m.

FINDINGS: As compared to the previous radiograph, the pre-existing pulmonary edema has slightly improved   Keywords: improve. Mild cardiomegaly persists. Moderate retrocardiac atelectasis and healed left rib fractures are constant. No newly appeared parenchymal opacities   Keywords: new. No pneumothorax.


SubjectID: 19859251, StudyID: 51121748, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Acute shortness of breath, interval worsening of pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the quality of the image is reduced due to respiratory motion artifacts. However, the size of the cardiac silhouette has mildly increased and there is increasing pulmonary edema with mild retrocardiac atelectasis   Keywords: increase. No pleural effusions. No focal parenchymal opacity suggesting pneumonia.


SubjectID: 19859251, StudyID: 57832065, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Shortness of breath and chest pain.

COMPARISONS: ___.

TECHNIQUE: Chest, portable AP upright.

FINDINGS: The heart is mild-to-moderately enlarged. The lungs appear clear aside from minimal vascular prominence and widespread peribroncial cuffing. There is no pleural effusion or pneumothorax.

IMPRESSION: Slight vascular prominence with peribronchial cuffing, but otherwise unremarkable.


SubjectID: 19859251, StudyID: 56264354, Comparison: None

FINAL REPORT

INDICATION: Shortness of breath with hypoxia, evaluate for CHF.

COMPARISON: Chest radiograph from ___.

FINDINGS: There is pulmonary vascular congestion with mild interstitial pulmonary edema. Heterogeneous opacity at the right lung base could be atelectasis or pneumonia. Moderate cardiomegaly is slightly decreased compared to ___. The mediastinal contours are normal. Aortic calcifications are noted. There are no definite pleural effusions. No pneumothorax is seen. Carotid artery calcifications are noted.

IMPRESSION: 1. Mild interstitial pulmonary edema. 2. Decreased moderate cardiomegaly. 3. Heterogeneous right basilar opacity could be atelectasis or pneumonia.


SubjectID: 19859251, StudyID: 53242144, Comparison: better

FINAL REPORT

HISTORY: ___-year-old male with leukocytosis. STUDY: PA and lateral chest radiograph.

COMPARISON: ___ at 5:03 a.m.

FINDINGS/

IMPRESSION: The heart size is at the upper limits of normal. The mediastinal and hilar contours are unremarkable. The lungs demonstrate much improved pulmonary edema and no lobar consolidation   Keywords: improve. Trace bilateral pleural effusions are seen. There is no pneumothorax.


SubjectID: 19859251, StudyID: 55954105, Comparison: worse

WET READ: ___ ___ 10:58 PM Unchanged retrocardiac opacity, marked cardiomegaly and pulmonary edema. No definite consolidation, but if concern for pna, consider lateral radiograph. ______________________________________________________________________________

FINAL REPORT

AP CHEST, 6:24 P.M. ON ___

HISTORY: ___-year-old man with new fever and shortness of breath, suspect pneumonia.

IMPRESSION: AP chest compared to ___: In the setting of severe chronic cardiomegaly and pulmonary vascular congestion, which worsened between ___ and ___, it is difficult to say whether heterogeneous opacification at the right lung base is pneumonia or more likely a combination of vascular congestion, mild dependent edema, atelectasis and overlying costal calcification   Keywords: worse. No appreciable pleural effusion is present. No pneumothorax. No mediastinal widening.


SubjectID: 19859251, StudyID: 50771019, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Desaturation, elevated venous pressures.

COMPARISON: ___.

FINDINGS: On today's radiograph, there is mild distention of the pulmonary vasculature and minimal peribronchial cuffing. In combination with the cardiomegaly that pre-existed the findings are suggestive of mild pulmonary edema. There is no evidence of pleural effusion or pneumonia, but the retrocardiac atelectasis is present. At the time of dictation, the referring physician ___. ___ was paged for notification at 8:53 a.m., ___.


SubjectID: 19859251, StudyID: 55464180, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with COPD exacerbation, chest pain // ? interval change ? interval change

IMPRESSION: Comparison to ___. No relevant change is seen   Keywords: no relevant change. Mild overinflation. Mild cardiomegaly without pulmonary edema. No pneumonia, no pleural effusions. Old healed left-sided rib fractures.


SubjectID: 19859251, StudyID: 50858280, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M with chest pain. Evaluate for pneumothorax.

TECHNIQUE: Single portable AP view of the chest.

COMPARISON: Chest radiograph of liver ___,014 and CTA chest from the same date.

FINDINGS: Compared with the prior radiograph, increased bibasilar opacities reflect atelectasis. Heart size is top normal. Mediastinal and hilar silhouettes are normal. Lungs are otherwise clear without focal consolidation, pleural effusion, or pneumothorax. Linear calcifications overlying the right lung apex are unchanged. Healed bilateral rib fractures are unchanged in appearance. A left-sided presumed pacer device is unchanged in appearance and position.

IMPRESSION: No evidence of pneumothorax.


SubjectID: 19859524, StudyID: 58010756, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with cellulitis, increasing o2 requirement // ?PNA

TECHNIQUE: PA and lateral chest radiographs

COMPARISON: Chest radiograph ___

FINDINGS: Lung volumes are unchanged compared to the prior study. The trachea is central. The cardiomediastinal contour is unchanged with mild cardiomegaly. Mild prominence of pulmonary vasculature is noted but no frank pulmonary edema. No consolidation or pneumothorax seen. The visualized bony structures are unremarkable in appearance.

IMPRESSION: Findings consistent with mild congestive heart failure, no overt pulmonary edema appreciated.


SubjectID: 19859524, StudyID: 55531849, Comparison: None

WET READ: ___ ___ ___ 6:45 PM Film limited secondary to body habitus. Mild edema and cardiomegaly. Possible left pleural effusion. Retrocardiac opacity is new from the prior exam and could reflect effusion/atelectasis/and or edema. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with O2 requirement // ? consolidation, effusion, volume overload ? consolidation, effusion, volume overload

COMPARISON: Chest radiographs since ___, most recently ___.

IMPRESSION: Imaging is subject to the technical limitations of bedside radiography with this patient's body habitus. Mild to moderate cardiomegaly is unchanged. Lungs are grossly clear but significant abnormality,particularly below the level of the hila, might not be appreciated. There is no large pleural effusion or large pneumothorax.


SubjectID: 19859524, StudyID: 54623908, Comparison: same

FINAL REPORT

INDICATION: ___-year-old female with shortness of breath and hypoxia.

COMPARISON: Radiograph dated ___ as well as CT chest dated ___.

FINDINGS: Penetration is poor secondary to body habitus. The lower lungs are particularly difficult to see and a lateral view would be very helpful in assessment. Pulmonary edema present in ___ has cleared. There may be new consolidation in the right lower lobe. Left lower lobe is obscured by soft tissue and cardiac silhouette, and the cardiac apex is obscured by the abdomen. Heart is probably not enlarged, but upper lobe vascular redistribution is an indication of borderline cardiac dysfunction. If there pleural effusions they are not large.

IMPRESSION: Possible right lower lobe pneumonia. Lateral view strongly recommended. Increased left atrial pressure, but no pulmonary edema or cardiomegaly   Keywords: increase.

NOTIFICATION: Dr. ___ reported the findings to Dr ___ by telephone on ___ at 9:18 AM, 10 minutes after discovery of the findings.


SubjectID: 19859524, StudyID: 50705187, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___F with ?RLL on pCXR, called by rads and rec'ed to do rpt PA/lat to eval

COMPARISON: Chest radiograph ___ at 01:42

FINDINGS: PA and lateral views of the chest provided. Cardiomegaly is noted. Underpenetration in the setting of large body habitus limits assessment. No convincing evidence for pneumonia. No overt CHF no large effusion or pneumothorax. Difficult to exclude mild congestion/edema. Mediastinal contour appears grossly within normal limits. Bony structures are intact.

IMPRESSION: 1. Slightly enlarged heart size with possible mild congestion. 2. No convincing signs of pneumonia.


SubjectID: 19866517, StudyID: 59828624, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old man with coronary artery disease status post CABG, congestive heart failure, ejection fraction ___%, persistently shortness of breath.

TECHNIQUE: Erect portable chest view was read in comparison with multiple prior chest radiographs, with the most recent from ___.

FINDINGS: Mild pulmonary edema has minimally worsened since ___   Keywords: worse   Keywords: worse. Left pectoral ICD device with leads in standard position. Patient is following CABG and there is evidence of median sternotomy and intact sternal sutures. Moderately enlarged heart size is stable. Mediastinal and hilar contours are unchanged. Increased retrocardiac density reflecting left lower lung atelectasis or consolidation and small to moderate left pleural effusion is new. There is no pneumothorax.

IMPRESSION: 1. Mild pulmonary edema has minimally worsened since ___. 2. Left lower lung and increased retrocardiac density reflecting atelectasis and/or consolidation and small to moderate left pleural effusion is new.


SubjectID: 19866517, StudyID: 57436393, Comparison: None

FINAL REPORT

CHEST ON ___

HISTORY: Heart failure, empiric treatment for pneumonia and PE, respiratory distress. REFERENCE EXAM: ___ at ___.

FINDINGS: Compared to the study from three hours prior, an ET tube is now present with tip 2.6 cm above the carina. The remainder of the exam is unchanged.


SubjectID: 19866517, StudyID: 56009861, Comparison: better

FINAL REPORT

CHEST ON ___

HISTORY: Heart failure, arrhythmias, hypoxia. REFERENCE EXAM: ___.

FINDINGS: Compared to the prior study, there has been some interval partial clearing of the alveolar infiltrate; however, there continues to be moderate cardiomegaly, pulmonary vascular redistribution, perihilar haze, and dense retrocardiac opacity. The ET tube, pacemaker, right IJ line, and NG tube are unchanged.

IMPRESSION: Slight improvement in pulmonary edema   Keywords: improve.


SubjectID: 19866517, StudyID: 52833381, Comparison: None

FINAL REPORT

CHEST ON ___

HISTORY: Intubation, new OG tube.

FINDINGS: The ET tube is 4 cm above the carina. OG tube tip is in the proximal stomach with the proximal port just above the GE junction. This should be advanced slightly. The appearance of the lungs is similar to that of the prior day compatible with CHF.


SubjectID: 19866517, StudyID: 53572152, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Respiratory distress, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is unchanged evidence of moderate cardiomegaly and minimal fluid overload   Keywords: unchanged. A very faint opacity in the perihilar right area is constant. The monitoring and support devices are also unchanged.


SubjectID: 19866517, StudyID: 57067930, Comparison: better

FINAL REPORT

INDICATION: ___-year-old man with new onset cough, left-sided crackles.

COMPARISONS: ___ to ___.

FINDINGS: A single portable AP chest radiograph was obtained. There is mild improvement in moderate pulmonary vascular congestion   Keywords: improve. Moderate-to-severe cardiomegaly is unchanged. There is no new consolidation, large effusion, or pneumothorax. A right internal jugular dialysis catheter terminates in the right atrium. Biventricular and atrial pacing leads terminate in appropriate positions and connect with a left chest generator. Mediastinal clips and sternal wires are intact.

IMPRESSION: Mildy improved pulmonary vascular congestion   Keywords: improve.


SubjectID: 19866517, StudyID: 54928222, Comparison: None

FINAL REPORT

AP CHEST, 8:19 A.M., ___

HISTORY: CHF. History of V tach with a pacemaker. Recent PEA arrest. Intubated.

IMPRESSION: AP chest compared to ___. ET tube has been partially withdrawn, still in standard placement. Previous mild pulmonary edema has cleared. Severe consolidation in the left lung has been present for more than a week, presumably atelectasis. Moderate-to-severe cardiomegaly has improved slightly since ___, stable since ___. Atrio-biventricular pacer defibrillator leads are in standard positions, unchanged. Nasogastric tube ends in the upper stomach and a dual-channel right supraclavicular dual central venous line ends in the low SVC and upper right atrium. Right PICC line can be traced to the junction of the brachiocephalic veins, but is obscured by other devices beyond that point. No pneumothorax.


SubjectID: 19866517, StudyID: 51246994, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Cardiac arrest, intubation, evaluation for endotracheal tube position.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has been intubated. The endotracheal tube projects 3 cm above the carina with its tip. Otherwise, there is no relevant change   Keywords: no relevant change. The other monitoring and support devices are constant, with the exception of a nasogastric tube that has been newly inserted. Course of the tube is unremarkable. No complications, notably no pneumothorax.


SubjectID: 19866517, StudyID: 57012854, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Mental status, sepsis, intubation, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. The monitoring and support devices are constant. There is moderate cardiomegaly with retrocardiac atelectasis. The mild perihilar opacity on the right is unchanged. No evidence of larger pleural effusions. The diameter of the vascular structures might indicate mild fluid overload, as observed on ___, 4:15 a.m. No newly appeared parenchymal opacities   Keywords: new.


SubjectID: 19866517, StudyID: 54385021, Comparison: same

WET READ: ___ ___ ___ 10:27 PM Entire chest not included in this view. Esophageal catheter tip projects over the left upper quadrant. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Intubation, status post nasogastric tube change.

COMPARISON: ___, 4:15 a.m.

FINDINGS: Compared to the previous radiograph, the film focuses on the upper abdomen. The tip of the esophageal tube projects over the left upper quadrant. A wet read was entered into the system. With the given technical limitations, there are no other changes   Keywords: no other change. Moderate cardiomegaly with extensive retrocardiac and mild right perihilar opacity. No larger pleural effusions.


SubjectID: 19866517, StudyID: 56415628, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Cough, evaluation for pneumonia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is unchanged evidence of a perihilar increase in density of the lung parenchyma, right more than left. The distribution of these changes, notably combine to the cardiomegaly of the patient, are more consistent with pulmonary edema than with pneumonia. There is no evidence of pleural effusions. Normal appearance of the hilar and mediastinal contours. Right central venous access line and left Port-A-Cath in situ.


SubjectID: 19866517, StudyID: 51803094, Comparison: worse

WET READ: ___ ___ ___ 7:19 PM increased diffuse hazy opacification consistent with development of mild edema. moderate cardiomegaly. dialysis catheter tip in low svc. right picc tip not clearly visualized however likely also in low svc. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, productive cough.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is slightly increased opacity bilaterally in the lung parenchyma. The changes are consistent with the development of mild pulmonary edema   Keywords: development. Unchanged moderate cardiomegaly and dialysis catheter in the low SVC. Unchanged right PICC line and left pectoral pacemaker.


SubjectID: 19866517, StudyID: 55016617, Comparison: None

FINAL REPORT

AP CHEST, 7:30 A.M. ON ___

HISTORY: ___-year-old man intubated after cardiac arrest. Check ET tube placement.

IMPRESSION: AP chest compared to ___ and ___: ET tube is in standard placement. Severe cardiomegaly is unchanged. There is no longer any pulmonary edema. There is probably small volume of pleural fluid bilaterally, particularly on the left because of the persistent left lower lobe collapse. No pneumothorax. Dual-channel right supraclavicular dialysis catheters end in the low SVC and upper right atrium respectively. Atrio-biventricular pacer defibrillator leads are also unchanged in their positions. Nasogastric tube ends in the stomach which is not distended. No pneumothorax or free air below the diaphragm.


SubjectID: 19897794, StudyID: 59341566, Comparison: better

FINAL REPORT

CLINICAL

HISTORY: End-stage renal disease, on dialysis, hypoxemia. CHEST:

COMPARISON FILM: ___. Compared to the prior chest x-ray, there has been considerable clearing of the pulmonary edema present at this time. Upper zone re-distribution persists. The heart remains enlarged.

IMPRESSION: Improving pulmonary edema   Keywords: improving.


SubjectID: 19897794, StudyID: 57199780, Comparison: None

FINAL REPORT

INDICATION: ___-year-old with CHF.

TECHNIQUE: Single frontal radiograph of the chest was obtained.

COMPARISON: Radiograph from ___. CT of the abdomen and pelvis from ___.

FINDINGS: There is moderate pulmonary edema and small bilateral pleural effusions. There is no pneumothorax. Calcifications of the aortic arch are seen.

IMPRESSION: Moderate pulmonary edema.


SubjectID: 19911133, StudyID: 55359755, Comparison: None

FINAL REPORT

PORTABLE CHEST FILM ___ AT 4:02 A.M. CLINICAL

INDICATION: ___-year-old with heart failure, hypoxia, fever, question pulmonary edema versus pneumonia. Comparison is made to the patient's previous study dated ___ at ___. A portable semi-erect chest film ___ at 4:02 a.m. is submitted.

IMPRESSION: 1. Right internal jugular central line unchanged in position. A left-sided pacemaker unchanged. The heart remains enlarged. Mediastinal contours are stable. There is persistent retrocardiac consolidation and a layering effusion. The airspace consolidation most likely represents partial lower lobe atelectasis, although pneumonia or aspiration cannot be entirely excluded. Streaky opacities at the right base likely reflect patchy atelectasis, although aspiration should also be considered. No pulmonary edema. No pneumothorax.


SubjectID: 19911133, StudyID: 54581217, Comparison: None

FINAL REPORT

HISTORY: Dyspnea, fever, cough and new oxygen requirement.

TECHNIQUE: PA and lateral views of the chest.

COMPARISON: None.

FINDINGS: Dual-chamber pacemaker device is noted in the left chest with leads terminating in the right atrium and right ventricle. The heart is mildly enlarged. Atherosclerotic calcification of the aorta is noted. Mediastinal and hilar contours are otherwise unremarkable. Lungs appear mildly hyperinflated. No pulmonary vascular engorgement is seen. Left basilar opacification is noted, with a small left pleural effusion . No pneumothorax is seen, and there is no right-sided pleural effusion. Loss of height of several thoracic vertebral bodies is age indeterminate.

IMPRESSION: 1. Left basilar opacification may reflect atelectasis or infection, with adjacent small left pleural effusion. 2. Multiple compression fractures in the thoracic spine, of indeterminate chronicity.


SubjectID: 19912537, StudyID: 59389186, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hematemesis and right mainstem bronchus intubation s/p 3cm retraction. // Please eval for ET tube placement.

COMPARISON: ___

IMPRESSION: As compared to the previous image, the endotracheal tube has been pulled back. The tip of the tube now projects approximately 2.3 cm above the carinal. The course of the nasogastric tube is unchanged. The lung volumes remain low. There is left and right basilar atelectasis but no larger pleural effusions and no evidence of pneumonia or pulmonary edema.


SubjectID: 19912537, StudyID: 53553312, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiograph.

INDICATION: Status post endotracheal intubation.

COMPARISON: Earlier on the same day.

TECHNIQUE: Chest, portable AP.

FINDINGS: The patient has been intubated. The endotracheal tube closely approaches the carinal within about 1 cm. An orogastric tube passes into the stomach on and terminates there. The cardiac, mediastinal and hilar contours appear stable. The lung volumes are decreased with patchy left basilar opacity which is probably due to atelectasis.

IMPRESSION: Status post endotracheal intubation. Low-lying endotracheal tube, although at the time of this dictation, it had already been retracted on a subsequent film. Left basilar opacity, probably due to atelectasis. Attention in follow-up is suggested.


SubjectID: 19912537, StudyID: 52286758, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hematemesis s/p intubation // eval ETT

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: ET tube tip is 4.5 cm above the carinal. Heart size and mediastinum are unchanged. Bibasal consolidations have increased in the interim.


SubjectID: 19912537, StudyID: 51170224, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiographs.

INDICATION: Hemoptysis.

COMPARISON: None.

TECHNIQUE: Chest, PA and lateral.

FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. The chest is hyperinflated. There is no pleural effusion or pneumothorax. The lungs appear clear. Mild degenerative changes are noted along the mid through lower thoracic spine.

IMPRESSION: No evidence of acute cardiopulmonary disease.


SubjectID: 19912537, StudyID: 56491082, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (AP AND LATERAL)

INDICATION: History: ___F with dyspnea

TECHNIQUE: Upright AP and lateral views of the chest

COMPARISON: Chest radiograph ___ and chest CTA ___

FINDINGS: Heart size remains moderately enlarged. The mediastinal and hilar contours are unchanged. The pulmonary vasculature is not engorged. Patchy opacities are noted within the right lung base, more pronounced when compared to the previous exam. Nodular opacity measuring 6 mm is re- demonstrated within the right mid lung field. No pleural effusion or pneumothorax is present. No overt pulmonary edema is demonstrated. Moderate multilevel degenerative changes are again seen in the thoracic spine.

IMPRESSION: Worsening patchy opacity in the right lung base, potentially worsening atelectasis though infection is not excluded.


SubjectID: 19912537, StudyID: 51099652, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CAD, CHF now with acute pleuritic L sided chest pain // ?opacity, edema ?opacity, edema

COMPARISON: Comparison to ___ at 18:18

FINDINGS: Portable AP upright chest ___ at 14:31 is submitted.

IMPRESSION: Stable cardiac enlargement. There has been interval development of mild interstitial edema   Keywords: development. Subtle patchy opacities at both bases likely reflect patchy atelectasis rather than aspiration or pneumonia. Clinical correlation is recommended. No pneumothorax. Previously reported 6 mm nodular opacity in the right mid lung is not well appreciated on the current study.


SubjectID: 19912537, StudyID: 53697349, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with recent trach placement and CHF // Assess interval change in lung fields

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Tracheostomy is in place. Cardiomediastinal silhouette is unchanged but there is interval development of severe interstitial pulmonary edema   Keywords: development. . There is asymmetry noted, right lung is more involved than the left as well as there is increased amount of right pleural effusion.


SubjectID: 19912537, StudyID: 53511926, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CAD/CHF, new dx of ? angiosarcoma at base of tongue s/p excision and tracheostomy, now has intermittent stridor w/ coughing // evaluate for ? CHF evaluate for ? CHF

COMPARISON: Chest radiographs since ___ most recently ___.

IMPRESSION: Mild to moderate pulmonary edema has improved since ___   Keywords: improve. Moderate cardiomegaly and small to moderate right pleural effusion are stable. Tracheostomy tube midline. Right PIC line ends in the upper SVC. No pneumothorax.


SubjectID: 19912537, StudyID: 52015590, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F intubated // Evaluate for interval change

IMPRESSION: Allowing for differences in technique and positioning, there has been little interval change in the appearance of the chest since the recent study of 1 day earlier, except for slight worsening of bibasilar atelectasis.


SubjectID: 19943755, StudyID: 59822348, Comparison: None

FINAL REPORT

INDICATION: ___-year-old woman with prior right pleural effusion status post thoracentesis.

COMPARISON: ___.

FINDINGS: The cardiomediastinal and hilar contours are stable, with mild cardiomegaly. A right basal pleural catheter has been removed. A small residual right pleural effusion is seen with fissural extension. No pneumothorax is seen. The left lung is well expanded and clear. Left chest wall AICD device is seen with leads in the expected position of the right atrium and right ventricle.

IMPRESSION: Small-to-moderate residual right pleural effusion. No pneumothorax.


SubjectID: 19943755, StudyID: 53006861, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female patient with significant cardiac history referred to ED by PCP for shortness of breath. Study requested for evaluation of change in pleural effusion.

COMPARISON: Prior chest radiograph from ___ and ___.

TECHNIQUE: PA and lateral chest radiographs.

FINDINGS: As compared to prior radiograph from ___, there has been slight worsening of right-sided pleural effusion, with fluid tracking within the minor fissure. No focal consolidations are identified and there is no pneumothorax. There is increased anteroposterior diameter of the thorax with hyperinflated lungs suggestive of COPD. There is moderate to severe cardiomegaly. Left-sided dual-lead pacemaker leads terminate in the expected positions of the right atrium and right ventricle. There is evidence of kyphosis.

IMPRESSION: Slight worsening of right-sided pleural effusion. Increased anteroposterior diameter of the thorax with hyperinflated lungs suggestive of COPD.


SubjectID: 19943755, StudyID: 52984714, Comparison: None

WET READ: ___ ___ ___ 6:34 PM Significant reduction in pleural effusion size after drainage. Note that the the pigtail of the drainage catheter has not properly coiled. D/W Dr ___ ___ phone at ___ ______________________________________________________________________________

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with pleural effusion, thoracocentesis, chest tube in place, rule out pneumothorax.

COMPARISON: ___.

FINDINGS: There is no pneumothorax after chest tube placement; right moderate pleural effusion has significantly improved and is now minimal. There is bronchovascular crowding at the left lung base. Moderate cardiomegaly is unchanged.

CONCLUSION: 1. There is no pneumothorax after right chest tube placement. 2. Right pleural effusion has significantly improved.


SubjectID: 19943755, StudyID: 54707024, Comparison: None

FINAL REPORT

HISTORY: Right-sided pleural effusion, status post PleurX, question reaccumulation. CHEST, SINGLE AP PORTABLE VIEW The catheter overlies the base of the right lung. No ptx detected. A small effusion is present. This appears slightly larger than on ___ at 2:49 a.m. even accounting for slight differences in positioning. There is also a stable, small left effusion and underlying collapse and/or consolidation at both bases. Suspect background COPD. Cardiomediastinal silhouette is prominent, but stable. Tapered appearance of both hila suggests pulmonary hypertension. There is upper zone redistribution. I doubt overt CHF.

IMPRESSION: 1) Small right effusion, with underlying collapse and/or consolidation, probably slightly worse compared with one day earlier. 2) Previously described right apical pneumothorax is not appreciated on the current examination.


SubjectID: 19943755, StudyID: 56554585, Comparison: None

FINAL REPORT

INDICATION: A semi-upright view of the chest was obtained portably.

COMPARISONS: Chest radiographs, ___, ___, ___.

FINDINGS: A frontal semi-upright view of the chest was obtained portably. Small bilateral pleural effusions with adjacent atelectasis are increased on the left and decreased on the right. The upper lung zones are clear and pulmonary vasculature is within normal limits. The right apical pneumothorax is not seen on this semiupright study. Mild cardiomegaly is unchanged. The left chest wall pacemaker leads are unchanged in position.

IMPRESSION: Small bilateral pleural effusions with adjacent atelectasis, larger on the left and smaller on the right. No edema.


SubjectID: 19943755, StudyID: 54004767, Comparison: None

FINAL REPORT

HISTORY: Pleurx catheter.

FINDINGS: In comparison with the earlier study of this date, there is little change in the opacification at the right base consistent with residual pleural fluid. Little change in the small right apical pneumothorax. Remainder of the study is unchanged.


SubjectID: 19943755, StudyID: 52038513, Comparison: same

FINAL REPORT

HISTORY: Right effusion with placement of Pleurx catheter.

FINDINGS: In comparison with study of ___, there has been substantial clearing of the pleural effusion with a small residual. There is a faint suggestion of a pleural line in the right apical region that could represent a small pneumothorax. Otherwise, little change   Keywords: little change.


SubjectID: 19943755, StudyID: 56283712, Comparison: worse

FINAL REPORT

PORTABLE CHEST FILM, ___ AT 8:19 CLINICAL

INDICATION: ___-year-old with CHF and bilateral effusions, now with chest heaviness, assess for interval change. Portable AP upright chest film ___ at 8:19 is submitted.

IMPRESSION: 1. There is worsening pulmonary edema with associated bilateral small-to-moderate pleural effusions, left greater than right, and associated bibasilar airspace disease, most likely representing compressive atelectasis, although pneumonia cannot be entirely excluded   Keywords: worse. The patient's mandible obscures the right apex. Heart remains enlarged. A left-sided dual-lead pacer remains in place. No pneumothorax.


SubjectID: 19943755, StudyID: 55615391, Comparison: None

FINAL REPORT

PORTABLE CHEST FILM, ___ AT 22:17 CLINICAL

INDICATION: ___-year-old with hypertension, CHF, AFib on Coumadin, with shortness of breath, question pulmonary edema. Comparison is made to the patient's previous study dated ___. A portable AP upright chest film ___ at 22:17 is submitted.

IMPRESSION: 1. A dual-lead left-sided pacer remains in place. The heart remains enlarged. There are bilateral effusions, left greater than right, with associated bibasilar airspace disease, left greater than right, which may reflect compressive atelectasis, although pneumonia or aspiration should also be considered. No evidence of pulmonary edema. No pneumothorax.


SubjectID: 19957730, StudyID: 54177917, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, shortness of breath, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there are newly appeared bilateral pleural effusions of moderate extent. In addition, the diameter of the vascular structures has increased, there are bilateral areas of atelectasis and the right aspect of the mediastinum is slightly widened. Altogether, the image is strongly suggestive of moderate cardiogenic pulmonary edema. No evidence of pneumonia. Unchanged left pectoral pacemaker. Referring physician, ___. ___ paged for notification at the time of dictation, 8:48 a.m., on ___.


SubjectID: 19957730, StudyID: 53355012, Comparison: None

FINAL REPORT

PORTABLE CHEST X-RAY ___

COMPARISON: Chest x-ray ___ and prior radiographs dating back to ___.

FINDINGS: The aortic contour and calcification pattern appears similar compared to prior studies. Descending thoracic aortic contour also appears similar to prior studies, but is obscured inferiorly by adjacent lung and pleural abnormalities. Cardiac silhouette remains enlarged, and is accompanied by upper zone vascular redistribution. Small-to-moderate bilateral pleural effusions are present as well as adjacent basilar atelectasis and/or consolidation, worse on the right than the left. ICD pacing device remains in place with leads in the right atrium and right ventricle.

IMPRESSION: No portable chest radiographic findings to suggest aortic dissection, but the sensitivity of this study is low for detecting this diagnosis. If there is clinical suspicion for acute aortic dissection, a CT angiogram would be recommended.


SubjectID: 19972786, StudyID: 55158639, Comparison: None

FINAL REPORT

INDICATION: ___ year old man s/p CABG // eval for pneumothoraces

COMPARISON: Radiographs from ___ at 13:18.

IMPRESSION: There has been removal of the chest tubes. No pneumothoraces are seen. There is unchanged cardiomegaly. There is a left retrocardiac opacity with a small left-sided pleural effusion. Low lung volumes are again seen. No overt pulmonary edema is seen.


SubjectID: 19972786, StudyID: 51226076, Comparison: None

FINAL REPORT

INDICATION: ___ year old man s/p CABG // eval for pneumothorax with chest tube clamped (airleak noted)

COMPARISON: Radiographs from ___. Mediastinal drains and bilateral chest tubes are again seen. There has been removal of the endotracheal tube and feeding tube since the previous study. No pneumothoraces are identified. There are low lung volumes due to poor inspiratory effort and some elevation of the left hemidiaphragm. Patchy opacities at the lung bases may be due to atelectasis, early infiltrate, or aspiration, but are stable.

IMPRESSION: The tip of the endotracheal tube is cm above the carina, appropriately sited. There is a sided central venous line with distal tip in the . There is an enteric tube with sideport and tip below the GE junction. Lungs are grossly clear without focal consolidation, pleural effusions, or pneumothoraces. There is no pulmonary edema. Heart size and mediastinal structures are within normal limits. Bony structures are intact.


SubjectID: 19981210, StudyID: 58268363, Comparison: None

FINAL REPORT

HISTORY: New non-ST elevation MI and bibasilar crackles on exam. Evaluation for pulmonary edema.

TECHNIQUE: Frontal view of the chest.

COMPARISON: Multiple chest radiographs the most recent on ___.

FINDINGS: The lungs are clear with no focal opacities. There is some minimal bibasilar atelectasis. The cardiomediastinal silhouette and hilar contours are normal. The pleural surfaces are clear without effusion or pneumothorax. The left chest wall pacing device and pacer leads are unchanged in appearance.

IMPRESSION: No evidence of acute cardiopulmonary process.


SubjectID: 19981210, StudyID: 56442723, Comparison: None

FINAL REPORT

CHEST, TWO VIEWS: ___

HISTORY: ___-year-old male with chest pain.

COMPARISON: ___.

FINDINGS: Frontal and lateral views of the chest. Left chest wall pacing device seen with leads in the right atrium and right ventricular apex. The lungs are clear of consolidation, effusion or pneumothorax. Linear opacities at the left costophrenic angle are suggestive of atelectasis. Cardiomediastinal silhouette is within normal limits. Median sternotomy wires and mediastinal clips again noted. No acute osseous abnormality is detected.

IMPRESSION: No acute cardiopulmonary process.


SubjectID: 19985757, StudyID: 56226939, Comparison: same

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old woman with cardiac tampenade // evaluate for pericardial fluid

TECHNIQUE: Portable chest

COMPARISON: Portable chest radiograph dated ___

FINDINGS: In comparison to the chest radiograph obtained 1 day prior, there has been interval removal of a pericardial drain. Heart size in cardia ___ mediastinal silhouettes are unchanged. Lungs are fully expanded and clear without focal consolidation. No pleural effusions or pneumothorax.

IMPRESSION: Interval removal of pericardial drain, otherwise no significant changes   Keywords: no significant change. If concerned about pericardial effusion, echocardiogram is recommended.


SubjectID: 19985757, StudyID: 55605283, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with Afib s/p PVI x2, cardioversion and multiple AADs, with symptomatic Afib/AT admitted for redo PVI/AT ablation. // AM CCU CXR AM CCU CXR

COMPARISON: ___

IMPRESSION: Heart size and mediastinum are stable. Central venous line of unclear origin, potentially pulmonary is present projecting over the heart, please correlate with patient history. Lungs are clear. There is no pleural effusion or pneumothorax.


SubjectID: 19985757, StudyID: 55790772, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with new dual chamber PPM (axillary access) // assess lead position

COMPARISON: Radiographs from ___

IMPRESSION: Left-sided pacemaker is unchanged. There is unchanged cardiomegaly. There are no focal consolidations, pleural effusion, or pulmonary edema. Lungs are hyperinflated. There are no pneumothoraces.


SubjectID: 19985757, StudyID: 54542750, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with AFib and pericardial effusion // please assess for pulmonary edema please assess for pulmonary edema

IMPRESSION: Comparison to ___. No relevant change is noted   Keywords: no relevant change. Unchanged shape and size of the cardiac silhouette. No pleural effusions. No pulmonary edema. No pneumonia. No pneumothorax.


SubjectID: 19985757, StudyID: 50121353, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman sp AV nodal ablation // pulmonary edema?

FINDINGS: No significant interval change   Keywords: no significant interval change as compared to chest radiograph from 1 day prior   Keywords: no significant interval change. No pulmonary edema, pneumonia, effusions or pneumothorax. Cardiomediastinal silhouette is unchanged. The dual lead pacer is in similar positioning.

IMPRESSION: No pulmonary edema. No significant interval change.


SubjectID: 19995127, StudyID: 50841744, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male patient with history of left lower lung mass and mediastinal lymphadenopathy now with chest pain. Evaluate for pneumothorax or other acute cardiopulmonary process.

COMPARISON: Prior chest radiograph from ___ and ___.

TECHNIQUE: PA and lateral views of the chest.

FINDINGS: The cardiac silhouette is normal. A mass in the superior segment of the left lower lobe is not significantly changed from prior. No new focal consolidations. A calcified pleural plaque in the lateral aspect of the mid right lung is also stable. There are no pleural effusions or pneumothorax. Visualized osseous structures are grossly unremarkable.

IMPRESSION: Stable left lower lobe mass. Correlate with subsequent CT chest.


SubjectID: 19995127, StudyID: 50679867, Comparison: None

FINAL REPORT

PORTABLE CHEST X-RAY OF ___

COMPARISON: ___.

FINDINGS: Large left juxtahilar mass within the superior segment of the left lower lobe extending to the left hilar structures appears similar to the recent radiograph but has been more fully characterized on CTA of the chest of one day earlier. Heart is upper limits of normal in size and the aorta is tortuous. Displacement of trachea is due to known right thyroid mass. Bilateral calcified pleural plaques are present as well as subtle basilar interstitial opacities at the lung bases, possibly due to asbestos-related interstitial changes. No focal areas of consolidation are evident to suggest the presence of an acute pneumonia.


SubjectID: 19997367, StudyID: 59832202, Comparison: None

FINAL REPORT

PORTABLE CHEST ___, ___

COMPARISON: ___ radiograph.

FINDINGS: The patient is status post recent median sternotomy and mitral valve surgery. Indwelling support and monitoring devices are similar in position. There is no visible pneumothorax. Cardiomediastinal contours are stable allowing for differences in lung volumes. Small left and moderate right pleural effusion are again demonstrated with interval improvement and adjacent bilateral lower lobe atelectasis. Asymmetrical left apical thickening with volume loss is likely a sequela of previous radiation therapy.


SubjectID: 19997367, StudyID: 58206248, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Study of earlier the same date.

FINDINGS: Following removal of a left-sided chest tube, there is no visible pneumothorax. Small left pleural effusion has increased in size. Moderate right pleural effusion is likely unchanged allowing for positional differences, and note is also made of atelectasis involving the right middle and both lower lobes.


SubjectID: 19997367, StudyID: 59310942, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with empyema // effusion f.u

TECHNIQUE: Portable chest x-ray.

COMPARISON: Multiple prior radiographs of the chest dated ___ to ___.

FINDINGS: Portable semi upright radiograph of the chest demonstrates low lung volumes with resultant bronchovascular crowding. There is a persistent moderate-sized loculated right pleural collection with adjacent atelectasis. There is stable left apical thickening with volume loss. The cardiomediastinal and hilar contours are unchanged. Mild pulmonary edema is unchanged   Keywords: unchanged. A right-sided Port-A-Cath ends at the cavoatrial junction. A dual-chamber pacemaker is again seen over the left chest, with appropriate position of the leads in the right atrium and ventricle.

IMPRESSION: Persistent moderate size loculated right pleural collection with adjacent atelectasis. CT could be considered for additional evaluation.


SubjectID: 19997367, StudyID: 53649096, Comparison: None

FINAL REPORT

AP PORTABLE CHEST ___ ___

COMPARISON: ___ radiograph.

FINDINGS: Persistent moderate-sized, partially loculated right pleural effusion with associated atelectasis in the right mid and lower lung. Chronic left upper lobe volume loss with associated left apical thickening appears similar compared to older radiographs dating back to ___. There is no evidence of pneumothorax.


SubjectID: 19997367, StudyID: 52126829, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with empyema // empyema f/u

TECHNIQUE: Portable chest x-ray.

COMPARISON: Multiple prior radiographs of the chest dated ___ and ___.

FINDINGS: Portable semi-upright radiograph of the chest demonstrates low lung volumes which results in bronchovascular crowding. There is a moderate-sized partially loculated right pleural effusion with adjacent atelectasis. A chest tube projects over the right hemi thorax. Median sternotomy wires are in place. The right-sided Port-A-Cath is in unchanged position. There is no pneumothorax .

IMPRESSION: Moderate-sized partially loculated right pleural effusion with adjacent atelectasis, not significantly changed from the prior radiograph.


SubjectID: 19997367, StudyID: 58801152, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with decompensted diastolic HF // interval change in pulmonary edema interval change in pulmonary edema

COMPARISON: Chest radiographs since ___, most recently ___.

IMPRESSION: Moderate cardiomegaly is increased since ___, perhaps a function of lower lung volumes. Mild to moderate pulmonary edema and small bilateral pleural effusions are stable   Keywords: stable. No pneumothorax. Infusion port catheter ends in the right atrium and atrioventricular pacer leads continuous from the left pectoral pacemaker are all unchanged.


SubjectID: 19997367, StudyID: 55294872, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: : ___F with SOB and hypoxia // Eval for CHF

TECHNIQUE: AP views of the chest

COMPARISON: ___

FINDINGS: A right-sided Port-A-Cath is unchanged in position as is a left chest wall pacer and leads. Sternotomy wires are stable. Mild enlargement of the cardiac silhouette is again demonstrated and stable from the prior studies. Mediastinal contours are similar. There is moderate pulmonary edema, increased from the prior examination done on ___   Keywords: increase. The focal opacity seen at the right lung base could represent an area of atelectasis and effusion however infection should be considered. There may be a small left pleural effusion. Visualized osseous structures are stable.

IMPRESSION: Moderate pulmonary edema, new from the prior exam on ___   Keywords: new. Right basal opacity is increased from the prior exam and infection should be considered in the appropriate clinical setting. Small bilateral pleural effusions, right greater than left. S


SubjectID: 19997367, StudyID: 58763598, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman with effusion.

FINDINGS: Comparison is made to previous radiographs from ___. There are two pigtail catheters within the right chest. There is again seen a small right-sided pleural effusion with some loculation along the right lateral chest wall. This appears unchanged. There are no pneumothoraces. There is a left-sided pacemaker. Slight blunting of the left CP angle is again seen and unchanged. There are no signs for overt pulmonary edema or focal consolidation.


SubjectID: 19997367, StudyID: 55842514, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with effusion // effusion f/uperform at 6am effusion f/uperform at 6am

IMPRESSION: In comparison with the study ___ ___, there is little change   Keywords: little change. Blunting of the right costophrenic angle continues with irregular opacification along the right lateral chest wall consistent with loculated effusion. The left lung is clear.


SubjectID: 19997367, StudyID: 51916468, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with effusion // effusion f/u

TECHNIQUE: Portable chest

COMPARISON: ___.

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change.


SubjectID: 19997367, StudyID: 58396642, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: Chest, AP portable single view.

INDICATION: ___-year-old female patient, status post mitral valve repair, evaluate for interval change.

FINDINGS: AP single view of the chest has been obtained with patient in semi-upright position. Analysis is performed in direct comparison with the next preceding similar study ___ ___. During the interval, the Swan-Ganz catheter has been withdrawn, but the right internal jugular approach sheath remains. The heart size has not changed significantly, and the three small metallic components of a ___ mitral valve prosthesis appear in unchanged position. There may be a slight increase of the pleural basal densities, but no new pulmonary parenchymal abnormalities identified and no pneumothorax is present.


SubjectID: 19997367, StudyID: 57313392, Comparison: None

FINAL REPORT

HISTORY: Respiratory failure after cardiac surgery, to assess for pneumothorax after thoracentesis.

FINDINGS: In comparison with the earlier study of this date, there has been a thoracentesis on the left with removal of a substantial amount of fluid. No convincing evidence of pneumothorax. Residual opacification at the right base has somewhat decreased. Monitoring and support devices remain in place.


SubjectID: 19997367, StudyID: 54987965, Comparison: None

FINAL REPORT

HISTORY: Re-intubation.

FINDINGS: In comparison with the study of ___, the tip of the endotracheal tube has been pulled back to approximately 3.5 cm above the carina. Other monitoring and support devices are essentially unchanged. The overall appearance of the heart and lungs is quite similar to the earlier study on ___ and improved since the later of the two studies on that date.


SubjectID: 19997367, StudyID: 53549055, Comparison: None

FINAL REPORT

HISTORY: Central line insertion.

FINDINGS: In comparison with study of ___, the Swan-Ganz catheter extends to the right pulmonary artery. Nasogastric tube extends well into the stomach. Endotracheal tube tip is about 1.6 cm above the carina and should be pulled back somewhat. Diffuse bilateral hazy opacification is consistent with substantial layering pleural effusions and compressive atelectasis of lung. In the appropriate clinical setting, supervening pneumonia would be difficult to exclude. This information was conveyed to Dr. ___.


SubjectID: 19997367, StudyID: 52395088, Comparison: None

FINAL REPORT

HISTORY: MVR with increased shortness of breath.

FINDINGS: In comparison with the study of ___, there again are extensive hazy opacifications at the bases, consistent with large layering effusions and underlying atelectasis. The cardiac silhouette is essentially unchanged. The pulmonary vascularity is difficult to assess, though does not appear to be appreciably elevated. The right IJ sheath has been removed. Dual-channel pacer device remains in place.


SubjectID: 19997367, StudyID: 51135348, Comparison: None

FINAL REPORT

HISTORY: Pleural effusion.

FINDINGS: In comparison with the earlier study of this date, there again is extensive bilateral opacifications consistent with some combination of effusion, atelectasis and pneumonia. Subsequent study previously dictated shows a thoracentesis with removal of the large amount of pleural fluid from the left pleural space.


SubjectID: 19997367, StudyID: 58340493, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Intubation, status post bilateral tapping of pleural effusion. Evaluation for interval change.

COMPARISON: ___, 5:55 p.m.

FINDINGS: As compared to the previous radiograph, there is a minimal hyperlucency at the level of the left lung base, potentially representing an indirect sign for minimal post-procedural pneumothorax. Otherwise, the radiograph is unchanged. No left pleural effusion, moderate right pleural effusion. Unchanged appearance of the cardiac silhouette. Unchanged monitoring and support devices.


SubjectID: 19997367, StudyID: 56794797, Comparison: None

FINAL REPORT

HISTORY: Removal of right chest tube.

FINDINGS: In comparison with the study of earlier in this date, the right chest tube has been removed. There is assortment of bony structures and tubes overlying the right apical region. It is difficult to unequivocally exclude a small pneumothorax. Remainder of the study is essentially unchanged.


SubjectID: 19997367, StudyID: 55253335, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post right chest tube placement.

FINDINGS: As compared to the previous radiograph, the patient has received a right chest tube. The course of the tube is unremarkable, the tip of the tube projects over the right apex. There is no evidence of pneumothorax. The other monitoring and support devices are constant. No other relevant changes   Keywords: no other relevant change.


SubjectID: 19997367, StudyID: 52686576, Comparison: same

FINAL REPORT

HISTORY: Concern for pneumothorax on left, to assess with lines removed.

FINDINGS: In comparison with the earlier study of this date, allowing for some difference in position of the patient, there is essentially no change in the degree of left apical pneumothorax. Bilateral lower lung opacifications are again seen   Keywords: again. No evidence of right pneumothorax.


SubjectID: 19997367, StudyID: 52358840, Comparison: None

WET READ: ___ ___ ___ 9:04 PM Fluid seems to be reaccumulating within the right-sided horizontal fissure. There is not appear to be any pneumothorax. Small amount of fluid remains in the left as well although substantially decreased from prior studies ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH.

INDICATION: Evaluation for pneumothorax. Status post bilateral thoracocentesis.

COMPARISON: ___.

FINDINGS: As compared to the previous image, there are bilateral opacities suggesting pleural effusion. There is no convincing evidence for the presence of a pneumothorax. The monitoring and support devices are constant.


SubjectID: 19997367, StudyID: 50985847, Comparison: same

FINAL REPORT

HISTORY: Possible pneumonia with chest tubes in place.

FINDINGS: In comparison with study of ___, the monitoring and support devices remain in place. However, there has been the development of a moderate left apical pneumothorax. Diffuse bilateral opacifications are again seen in the mid to lower lung zones   Keywords: again. This information has been conveyed to Dr. ___.


SubjectID: 19997367, StudyID: 55414125, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with second chest tube // r/o ptx, f/u effusion

TECHNIQUE: Portable chest x-ray.

COMPARISON: Multiple prior radiographs of the chest dated ___ through ___.

FINDINGS: Portable semi upright radiograph the chest demonstrates low lung volumes with resultant bronchovascular crowding. Two pigtail chest tubes project over the right hemi thorax with the more superior pigtail incompletely formed. Kinking cannot be excluded on the current single view. There has been interval decrease in size of the right-sided pleural effusion, however there is a new small right-sided lateral pneumothorax. The cardiomediastinal and hilar contours are unchanged. A a right-sided central venous line ends at the cavoatrial junction. Median sternotomy wires are in place.

IMPRESSION: New a small lateral right-sided pneumothorax status post new pigtail chest tube placement.

NOTIFICATION: These findings were discussed with Dr. ___ by Dr. ___ ___ telephone at 9:31 on ___, 2 minutes after discovery.


SubjectID: 19997367, StudyID: 52868225, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with effusion // effusion f/uperform at 6am please

TECHNIQUE: Portable chest x-ray.

COMPARISON: Prior chest radiographs dated ___ through ___.

FINDINGS: Portable semi-upright radiograph of the chest demonstrates low lung volumes with resultant bronchovascular crowding. Two chest tubes project over the right hemithorax. There is a small right-sided pleural effusion with adjacent atelectasis. No pneumothorax. Right-sided Port-A-Cath is in unchanged position. The cardiomediastinal and hilar contours are unchanged. The left lung is essentially clear.

IMPRESSION: Small right-sided pleural effusion with adjacent atelectasis. No pneumothorax.


SubjectID: 19997367, StudyID: 57787634, Comparison: None

FINAL REPORT

HISTORY: MVR, to assess effusion.

FINDINGS: In comparison with study of ___, there are slightly lower lung volumes. The degree of pleural effusion on the left is similar to or even larger than on the previous study with extensive atelectasis at the left base. Developing right pleural effusion with basilar atelectasis is noted. The endotracheal tube has been removed.


SubjectID: 19997367, StudyID: 52970039, Comparison: None

FINAL REPORT

DATE: ___. TYPE OF

EXAMINATION: Chest, AP portable single view.

INDICATION: ___-year-old female patient status post mitral valve replacement, assess effusion.

FINDINGS: AP single view of the chest has been obtained with patient in semi-upright position. Analysis is performed in direct comparison with the next preceding similar study of ___. Status post sternotomy, ___ mitral valve prosthesis in place, permanent left-sided pacer with dual intracavitary electrode system, all unchanged. On the right side, the evidence of pleural effusion has again decreased slightly in comparison with the next preceding study of ___ at which time a mild increase of pleural effusion was noted in comparison with an image obtained two days earlier. These variations illustrate difficulties to quantitate pleural effusions on single portable chest views. On the left side, the evidence of pleural effusion is more impressive as it obliterates totally the entire left-sided diaphragm and the density reaches up to the hilar area and beyond. Also noted is an increased amount of pleural density along the mediastinal structures reaching into the left-sided apical area. No pneumothorax is identified.

IMPRESSION: Further increasing left-sided pleural effusion likely to compromise left side lung function severely. ___ was paged to transmit findings. He had already observed the findings with massive pleural effusion and a pleural tap is planned later this afternoon.


SubjectID: 19997367, StudyID: 52125457, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: Chest AP portable single view.

INDICATION: ___-year-old female patient status post mitral valve replacement with pleural effusions, now evaluate status post left-sided thoracocentesis for possible pneumothorax.

FINDINGS: AP single view of the chest has been obtained with patient in semi-upright position. Analysis is performed in direct comparison with the next preceding portable chest examination obtained seven hours earlier during the same day. Left-sided thoracocentesis has been performed during the interval. Left-sided pleural effusion has regressed but is not completely eliminated. Some improvement of left-sided pulmonary aeration is noted. There is no evidence of any remaining pneumothorax in the apical area.


SubjectID: 19997367, StudyID: 57615707, Comparison: None

FINAL REPORT

HISTORY: Left thoracentesis.

FINDINGS: In comparison with the study of ___, there has been a thoracentesis on the left with removal of a substantial pleural fluid. No definite pneumothorax. Residual opacification at the left most likely represents a combination of pleural fluid, volume loss, and re-expansion edema. Remainder of the study is essentially unchanged.


SubjectID: 19997367, StudyID: 54627229, Comparison: None

FINAL REPORT

HISTORY: Thoracentesis, to assess for pneumothorax.

FINDINGS: In comparison with the earlier study of this date, there is no convincing evidence of pneumothorax on either side. Continued opacification involving the left mid and lower lung zones.


SubjectID: 19997367, StudyID: 57557006, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hemoptysis // Any progression of a PNA?

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, the lung volumes have minimally decreased, causing an apparent increase in radiodensity at the right lung base. However, there is no new focal parenchymal opacity and no progression of the pre-existing changes. No pulmonary edema. Borderline size of the cardiac silhouette. Unchanged alignment of the sternal wires.


SubjectID: 19997367, StudyID: 50946608, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___F with hemoptysis // acute process?

COMPARISON: ___.

IMPRESSION: As compared to the previous radiograph, there is a slight increase in extent of a pre-existing right pleural effusion. The areas of atelectasis on the right are also increasing. On the left, and new perihilar parenchymal opacity has occurred that could represent pneumonia or aspiration. Normal size of the cardiac silhouette. Unchanged left pectoral pacemaker and right Port-A-Cath.


SubjectID: 19997367, StudyID: 52125024, Comparison: None

FINAL REPORT

HISTORY: Status post CABG question right pneumothorax.

COMPARISON: ___.

FINDINGS: Again seen is a left apical pneumothorax that has not significantly changed in size. There continues to be alveolar infiltrate throughout the left lung which is slightly worse than on the prior study in particular in the left upper lung. There is opacity in the right lower lobe that could be due to volume loss or infiltrate. No right pneumothorax is seen. The ET tube, Swan-Ganz catheter, pacemaker, and right subclavian line, and NG tube are unchanged.


SubjectID: 19997367, StudyID: 55871455, Comparison: None

FINAL REPORT

HISTORY: Right pleural effusion status post thoracentesis. Evaluate for pneumothorax.

COMPARISON: Chest radiographs from approximately 4 hours prior on the same day and ___.

FINDINGS: A portable frontal chest radiograph demonstrates a decreased right pleural effusion after thoracentesis. The small left pleural effusion is unchanged. There is no pneumothorax. The remainder of the exam is unchanged.

IMPRESSION: Decreased right pleural effusion after thoracentesis. No pneumothorax.


SubjectID: 19997367, StudyID: 51372171, Comparison: None

FINAL REPORT

HISTORY: Pleural effusion.

COMPARISON: Chest radiograph from ___.

FINDINGS: Frontal and lateral chest radiographs demonstrate a dual lead pacemaker with leads overlying the right atrium and ventricle, and a right chest central catheter terminating in the low SVC. Bilateral pleural effusions are again seen, right greater than left, with the right unchanged to slightly increased and the left unchanged. There is no focal consolidation or pneumothorax. The heart is top-normal in size.

IMPRESSION: Bilateral pleural effusions, right greater than left. The right is unchanged to slightly increased in size, and the left is unchanged.


SubjectID: 19997367, StudyID: 55370105, Comparison: same

FINAL REPORT

HISTORY: Pleural effusion.

FINDINGS: In comparison with study of ___, there is little overall change   Keywords: little overall change. Again there are bilateral pleural effusions, more prominent on the right, with underlying compressive atelectasis. Pacer devices are essentially unchanged, as is the Port-A-Cath. No evidence of acute pneumonia or vascular congestion.


SubjectID: 19997367, StudyID: 54284246, Comparison: None

FINAL REPORT

HISTORY: Right pleural effusion status post thoracentesis, and left PleurX catheter removal.

TECHNIQUE: Single, AP, portable view of the chest with the patient in upright position.

COMPARISON: Comparison is made to radiographs dated ___ at 2:16 p.m.

FINDINGS: Comparison with the study dated ___ at 2:16 p.m., there has been minimal interval change. The patient is status post left PleurX catheter removal. Redemonstrated are bilateral pleural effusions, slightly more prominent on the left. The left pacemaker and right Port-A-Cath are essentially unchanged. There is no evidence of acute pneumonia or vascular congestion.


SubjectID: 19997367, StudyID: 54330649, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: History: ___F with altered mental status

TECHNIQUE: Chest PA and lateral

COMPARISON: ___

FINDINGS: Patient is status post median sternotomy and mitral valve repair. Right-sided Port-A-Cath tip terminates at the junction of the SVC and right atrium. Left-sided dual-chamber pacemaker device is re- demonstrated with leads in the right atrium and right ventricle. Heart size is normal. Aortic knob calcifications are re- demonstrated. Mediastinal and hilar contours are unchanged. Small right pleural effusion which is partially loculated laterally and medially appears relatively unchanged as is a small left pleural effusion. Lungs remain hyperinflated with streaky opacities in the lung bases, potentially atelectasis though infection cannot be excluded. No pneumothorax is identified, and no pulmonary vascular congestion is present. The patient is status post left mastectomy and breast implant. Cholecystectomy clips are noted in the right upper quadrant of the abdomen. There are no acute osseous abnormalities.

IMPRESSION: Relatively unchanged appearance of small bilateral pleural effusions, with the right pleural effusion appearing partially loculated. Patchy opacities in lung bases are nonspecific and may reflect atelectasis or infection.


SubjectID: 19997367, StudyID: 52790106, Comparison: worse

WET READ: ___ ___ ___ 7:42 AM Increasing interstitial markings from ___ are concerning for worsening edema   Keywords: increasing, worse. There are bilateral small pleural effusions. The heart is normal in size, and the patient is status post median sternotomy. A cardiac pacer has its leads in appropriate position.

WET READ VERSION #1 ___ ___ ___ 6:44 PM Increasing interstitial markings from ___ are concerning for worsening edema. There are bilateral small pleural effusions. The heart is normal in size, and the patient is status post median sternotomy. A cardiac pacer has its leads in appropriate position. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with complicated past medical history (including hemochromatosis with cirrhosis, history of AML s/p HSCT) here for confusion/HE and UTI, now with SOB. // Please evaluate for pulmonary edema or etiology for DOE.

TECHNIQUE: Chest two views

COMPARISON: ___

IMPRESSION: Increasing interstitial markings from ___ are concerning for worsening edema. There are bilateral small pleural effusions. The heart is normal in size, and the patient is status post median sternotomy. A cardiac pacer has its leads in appropriate position


SubjectID: 19998330, StudyID: 59735820, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Intubated and respiratory distress.

COMPARISONS: Earlier on the same afternoon.

TECHNIQUE: Chest, AP portable supine.

FINDINGS: An endotracheal tube has been placed since the prior examination, which terminates 3 cm above the carina. An orogastric tube courses towards the stomach. Its tip not visualized. The sidehole, however, appears to lie slightly above the left hemidiaphragm. Superimposed on background elevation of the right hemidiaphragm, there is persistent opacification at the right lung base with right infrahilar opacification and suspected pleural effusion. Aeration is much better in the left lower lung, however, which appears better expanded with reduction in opacification. There is no pneumothorax. Mild congestion appears similar to slightly decreased with enlarged indistinct vessels   Keywords: decrease.

IMPRESSION: 1. Status post endotracheal tube placement; sidehole of orogastric tube projecting above the gastroesophageal junction. The clinician was aware of the finding and the tube had apparently been replaced by the time of interpretation. 2. Findings suggesting mild vascular congestion. 3. Persistent right basilar opacification suggesting atelectasis associated with elevation of the right hemidiaphragm and suspected pleural effusion. 4. Improved aeration of the left lung base.


SubjectID: 19998330, StudyID: 54781575, Comparison: None

FINAL REPORT

AP CHEST, 5:11 A.M., ___

HISTORY: ___-year-old woman with COPD, extubated.

IMPRESSION: AP chest compared to ___: Lung volumes are unchanged following extubation. Moderate right and small left pleural effusion and severe right basal atelectasis are unchanged as is severe enlargement of the cardiac silhouette. No pneumothorax.


SubjectID: 19998330, StudyID: 54053771, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with prior study from ___. CLINICAL

HISTORY: Dyspnea, COPD, question pneumonia.

FINDINGS: Portable semiupright chest radiograph is obtained portably. Patient is rotated to her right, which limits the evaluation. There is persistent pulmonary edema with bilateral pleural effusions noted, size cannot be assessed   Keywords: persistent. No pneumothorax is seen. Degenerative changes of the left shoulder again noted.

IMPRESSION: Pulmonary edema, small bilateral effusions. If there is oncern for pneumonia, recommend repeat chest radiograph post-diuresis.


SubjectID: 19998330, StudyID: 50226892, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: COPD, chronic heart failure, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Monitoring and support devices are constant. Moderate cardiomegaly, mild fluid overload and atelectatic opacities at both lung bases. No new parenchymal opacities, notably no evidence of pneumonia.


SubjectID: 19998330, StudyID: 58626532, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___ Comparison with a prior study from approximately 30 minutes earlier. CLINICAL

HISTORY: Intubated, assess ET tube.

FINDINGS: Semi-upright portable chest radiograph was obtained. The endotracheal tube is seen with its tip located approximately 3 cm above the carina. The NG tube courses into the left upper quadrant. Pulmonary edema persists with cardiomegaly again noted   Keywords: persists, again. Elevated right hemidiaphragm, unchanged.


SubjectID: 19998330, StudyID: 52741948, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___.

COMPARISON: ___. CLINICAL

HISTORY: Short of breath.

FINDINGS: Portable AP upright chest radiograph is obtained. Cardiomegaly with moderate pulmonary edema is noted. Evaluation for effusion is limited. No pneumothorax.

IMPRESSION: Cardiomegaly with pulmonary edema.


SubjectID: 19998330, StudyID: 50007325, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, questionable pulmonary edema and pneumonia.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient is still intubated and a nasogastric tube is in place. There is unchanged obvious cardiomegaly with signs of mild pulmonary edema   Keywords: unchanged. However, pre-existing opacity in the right perihilar areas and at the right lung base have almost completely cleared. No interval appearance of new opacities   Keywords: new. No larger pleural effusions. No pneumothorax.